"Weathering a hidden storm" : an application of Andersen's behavioral model of health, and health services use for those with diagnosable anxiety disorder

"Weathering a Hidden Storm": An App~ication of Andersen's Behaviora~ Mode~ of Hea~th, and Hea~th Services Use for Those With Diagnosab~e Anxiety Disorder Research has primarily focused on depression and mood disorders, but little research has been devoted to an examination of mental health services use amongst those with diagnosable anxiety disorder (Wittchen et al., 2002; Bergeron et al., 2005). This study examined the possible predicting factors for mental health services utilization amongst those with identifiable anxiety disorder in the Canadian population. The methods used for this study was the application of Andersen's Behavioral Model of Health Services Use, where predisposing, need and enabling 111 characteristics were regressed on the dependent variable of mental health services use. This study used the Canadian Community Health Survey (cycle 1.2: Mental Health and Well- Being) in a secondary data analysis. Several multiple logistics models predicted the likelihood to seek and use mental health services. Predisposing characteristics of gender and age, Enabling characteristics of education and geographical location, and those with co-occurring mood disorders were at the greatest increased likelihood to seek and use mental health services.

Examining the roles of core and local temperature on forearm skin blood flow

The interaction between local and reflexive control of skin blood flow (SkBF) is unclear. This thesis isolated the roles of rectal (Tre) and local (Tloc) temperature on forearm SkBF regulation at normal and elevated body temperatures, and to investigate the interaction between local and reflexive SkBF control. While either normothermic (Tre ~37.0°C) or hyperthermic (∆Tre +1.1°C), SkBF was assessed on the dorsal aspect of each forearm in 10 participants while Tloc was manipulated in an A-B-A-B fashion between neutral (33.0°C) and hot (38.5°C). Finally, local heating to 44°C was performed to elicit maximal SkBF. Data are presented as a percentage of maximal cutaneous vascular conductance (CVC), calculated as laser-Doppler flux divided by mean arterial pressure. Tloc manipulations performed during normothermia had significantly greater effects on CVC than during hyperthermia. The decreased modification to SkBF from the Tloc changes during hyperthermia suggests that strong reflexive vasodilation attenuates local SkBF control mechanisms.

RAILAS Lauri, The Rise of the LEX ELECTRONICA and the International Sale of Goods Publication of the faculty of law, University of Helsinski, Helsinski, 2004 Recension effectuée par Karim SEFFAR

L’ouvrage constitue la thèse de Doctorat de Monsieur Lauri Railas soutenue le 16 Octobre 2004 à la faculté de droit de l’Université de Helsinki. Expert reconnu en droit du commerce international, son parcours professionnel explique les orientations prises dans son étude et son approche très large des transactions relatives à la vente internationale de marchandises comparativement à d’autres travaux dans le même domaine. L’auteur a été conseiller juridique à l’Institut d’arbitrage de la chambre de commerce centrale finlandaise puis secrétaire général de la section finlandaise de la chambre internationale de commerce. Il a, ensuite, occupé le poste d’administrateur principal au secrétariat général du conseil de l’Union Européenne entre 1996 et 2002. Il est, actuellement, associé senior chez Krogerus & Co, un des plus importants cabinets d’avocats de Finlande. L’originalité de la thèse réside dans le fait qu’elle aborde les transactions relatives à la vente internationale de marchandises du point de vue du commerce électronique. L’étude traite de la création d’un cadre juridique uniforme et cohérent encadrant l’utilisation des instruments du commerce élecronique pour la vente internationale de marchandises en se concentrant, uniquement, sur le commerce électronique entre professionnels (B to B) et plus précisément sur les initiatives des organisations internationales pour en diffuser et en faciliter l’usage. S’inspirant des théories de l’analyse économique du droit, le postulat de départ de Monsieur Railas est que le commerce électronique peut changer les procédures du commerce international et apporter d’importante économie de coûts. Pour ce faire, un cadre juridique pour le commerce électronique et plus généralement les affaires électroniques, est en cours d’élaboration par les organisations internationales. L’étude aborde ces développements dans différents domaines comme la formation du contrat, le crédit documentaire ou encore la résolution des conflits.L’approche est holistique et basée sur les efforts déployés pour introduire des sources uniformes de régulation pour les transactions électroniques dans le commerce international. L’auteur recense un large répertoire de règles de droit qui sont en majorité d’origine internationales avec pour objectif la détermination du rôle que peuvent jouer les communications électroniques dans la passation de contrats de vente de marchandises, leur livraison mais aussi dans le recours au service de tiers dans des fonctions comme le transport, l’assurance-transport et la sécurisation des droits des différentes parties impliquées. L’idée de base étant que la vente internationale et le transport constituent une chaine de contrats et de services interreliés. En plus des règles de droits déjà établies, l’auteur analyse différentes initiatives de régulation novatrices pour le commerce électronique initiées par la CNUDCI notamment. L’ouvrage traite, également, des problématiques générales comme la formation des contrats et la signature électronique. Par ailleurs, l’auteur procède à l’analyse des contrats de vente dans lesquels le vendeur a l’obligation de livrer en plus des marchandises, les documents relatifs aux marchandises et ceux de transfert de propriété. Les marchandises étant soumises à différents droits de propriété, les documents de vente et de transport ont un rôle important à jouer dans l’exercice de ces droits. Enfin, l’auteur considère la procédure de résolution des conflits comme une part du cycle de vie de chaque transaction. L’arbitrage en ligne et les autres méthodes de résolution en ligne des conflits contribuant à la réalisation de transactions électroniques réussies. L’ouvrage peut être particulièrement utile pour les personnes qui s’intéressent à l’harmonisation internationale des droits applicables au commerce international. L’auteur fait une analyse, particulièrement intéressante, de plusieurs instruments et projets comme les E-terms 2004 de la chambre internationale de commerce, le système Boléro, le système TEDI (Trade Electronic Data Interchange) et le système de transactions financières SWIFNet. La finalité de la démarche est de trouver une plate-forme commune qui fasse en sorte que les transactions électroniques puissent être conclues de manière sécuritaire en s’inspirant des résultats tangibles d’harmonisation atteints par la convention de Vienne sur la vente internationale de marchandises et par les principes UNIDROIT mais aussi du consensus selon lequel le commerce électronique doit être gouverné dans une large part par les instruments de « droit mou » comme les codes de conduite, et que, les règlements extrajudiciaires des conflits doivent être utilisés pour les transactions électroniques.

The effects of administration of a nuclear factor kappa-B inhibitor on pulmonary endothelial dysfunction after cardiopulmonary bypass: impact on oxygenation and hemodynamics and development of therapeutic and preventive modalities in a porcine model

Introduction: La circulation extracorporelle (CEC) peut entraîner une dysfonction endothéliale pulmonaire et l’hypertension pulmonaire. Le SN50 agit au niveau de la signalisation cellulaire pour prévenir ces réactions à la CEC et pourrait renverser la dysfonction endothéliale pulmonaire post-CEC sans effets néfastes sur l’hémodynamie. Méthodes: Quatre groups de porcs ont reçu un parmi quatre traîtements avant de subir 90 minutes de CEC et 60 minutes de reperfusion: (1) milrinone nébulisé; (2) sildenafil nébulisé; (3) placebo nébulisé; et (4) SN-50 intraveineux. Un monitoring hémodynamique invasif a été utilisé. La réactivité vasculaire des artères pulmonaires de deuxième ordre a été évaluée face à l’acétylcholine et la bradykinine. Résultats: Le sildénafil produit une augmentation significative de la pression de l’artère pulmonaire (PAP) moyenne à 60 minutes de reperfusion par rapport au début de la chirurgie. Les relaxations dépendantes de l’endothélium face à la bradykinine étaient meilleurs dans les groupes milrinone et SN-50 et surtout dans le groupe sildénafil par rapport au groupe placébo. Le SN-50 produisait de moins bonnes relaxations dépendantes de l’endothélium face à l’acétylcholine que les autres traitements incluant placébo. Conclusion: Le sildénafil prévient mieux la dysfonction endothéliale pulmonaire que les autres traitements. Les bénéfices du SN-50 sont possiblement sous-estimés vu que la dose n’a pas pu être ajustée à la durée de CEC. Le sildenafil inhalé mérite une étude plus importante chez l’humain et le SN-50 dans un model de CEC animal.

Being a bereaved parent : early bereavement experiences and perspectives on paediatric palliative care and bereavement services

La mort d'un enfant est considérée comme l'une des expériences les plus difficiles à laquelle une personne puisse faire face. Les cliniciens, les hôpitaux et plusieurs organismes ont pour objectif d’aider les parents endeuillés, mais leurs efforts sont compliqués par un manque de recherche dans le domaine du deuil parental. Cette thèse est composée de trois articles, soit deux revues de littérature et une étude empirique, qui tentent de combler cette lacune et d’informer les services en soins palliatifs pédiatriques et les services de soutien au deuil en particulier. Le premier article porte sur les besoins des patients recevant des soins palliatifs pédiatriques et de leurs familles. Par le biais d’un méta-résumé de la recherche descriptive et qualitative récente, 10 domaines de besoins ont été identifiés qui correspondent aux lignes directrices actuelles en soins palliatifs pédiatriques et de fin de vie. Ces besoins sont présentés de manière à être facilement applicables à la pratique. Cependant, les résultats mettent aussi en évidence plusieurs aspects des soins identifiés comme déficitaires ou problématiques qui mériteraient une attention particulière dans le cadre de politiques futures. Dans le deuxième article, l'objectif était de résumer une vaste littérature d'une manière utile aux cliniciens. À cette fin, une synthèse narrative a permis d’intégrer la recherche quantitative et qualitative dans le domaine du deuil parental. Les résultats mettent en évidence les éléments susceptibles de favoriser l’adaptation des parents au deuil, éléments qui suggèrent par le fait même des avenues possibles de soutien et d'intervention. Cette synthèse a cependant cerné dans la littérature certaines failles méthodologiques qui rendent l'applicabilité clinique des résultats difficile. L'objectif du troisième article était d'informer les services de suivi et de soutien au deuil auprès des parents en se renseignant directement auprès de parents endeuillés. À cette fin, 21 parents (dont 8 couples) et 7 membres du personnel impliqués dans des activités de suivi de deuil de 2 hôpitaux pédiatriques ont été interrogés dans le cadre d’une description interprétative, et l'application clinique des résultats a été vérifiée par le biais de réunions avec des collaborateurs de recherche et les décideurs des centres hospitaliers. Les résultats décrivent comment les parents ont fait face à leur détresse dans la phase précoce de leur deuil, ainsi que leurs points de vue sur la façon dont les divers services de suivi de deuil ont été aidants. Les résultats suggèrent que les parents gèrent leurs sentiments intenses de douleur par une alternance de stratégies axées soit sur leur deuil ou sur leur quotidien et que dans plusieurs cas leurs relations avec autrui les ont aidé. Cette étude a également permis d'élucider la façon dont divers services de soutien aide les parents à aborder leur deuil. Les implications cliniques de ces résultats sont discutées ainsi que des recommandations à l’intention de ceux qui sont impliqués dans la provision des services en deuil.

Return and Volatility performance comparison of Ethical and Non-ethical publicly-listed financial services companies

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STUDIES ON THE CHARACTERISTICS OF TROPOSPHERE AND LOWER STRATOSPHERE ASSOCIATED WITH THE PASSAGE OF TROPICAL CYCLONES

In the present thesis, an attempt has been made to study the characteristics of troposphere and lower stratosphere during the passage of tropical cyclones from a tropical station in India using MST radar. MST radar is an excellent tool for studying various features of the atmosphere from ground to mesospheric heights, as it can be operated continuously with good time and altitude resolution. The major objectives are to identify the multiple layers of reflectivity observed in the atmosphere during cyclones, to study the troposphere characteristics during these cyclones and its dependence on cyclone position and intensity, to detect the waves present in the atmosphere, to study the transport of momentum fluxes and to understand stratosphere. The winds in the troposphere and lower stratosphere are greatly affected by the passage of cyclones; the presence of high reflectivity layers below the tropopause suggests the passage of severe weather systems etc. are some of the major findings of the study. The study can be extended further to understand the circulation and dynamics of the atmosphere associated with the passage of tropical cyclones. The gravity wave generation and its characteristics during the passage of storms is another important aspect to be studied in detail.

Studies on rainfall variability and the influence of orography and land use on the climate of Peninsular India

The present study helped to understand the trend in rainfall patterns at smaller spatial scales and the large regional differences in the variability of rainfall. The effect of land use and orography on the diurnal variability is also understood. But a better understanding on the long term variation in rainfall is possible by using a longer dataset,which may provide insight into the rainfall variation over country during the past century. The basic mechanism behind the interannual rainfall variability would be possible with numerical studies using coupled Ocean-Atmosphere models. The regional difference in the active-break conditions points to the significance of regional studies than considering India as a single unit. The underlying dynamics of diurnal variability need to be studied by making use of a high resolution model as the present study could not simulate the local onshore circulation. Also the land use modification in this study, selected a region, which is surrounded by crop land. This implies the high possibility for the conversion of the remaining region to agricultural land. Therefore the study is useful than considering idealized conditions, but the adverse effect of irrigated crop is more than non-irrigated crop. Therefore, such studies would help to understand the climate changes occurred in the recent period. The large accumulation of rainfall between 300-600 m height of western Ghats has been found but the reason behind this need to be studied, which is possible by utilizing datasets that would better represent the orography and landuse over the region in high resolution model. Similarly a detailed analysis is needed to clearly identify the causative relations of the predictors identified with the predictant and the physical reasons behind them. New approaches that include nonlinear relationships and dynamical variables from model simulations can be included in the existing statistical models to improve the skill of the models. Also the statistical models for the forecasts of monsoon have to be continually updated.

Customer perceptions of Banking Products and Services in Kerala with reference to Specific Customer Segments in the Urban Area

As of 1999. the state of Kerala has 3210 offices of scheduled commercial banks (SCBS). In all, there are 48 commercial banks operating in Kerala, which includes PSBs, OPBs, NPBS. FBs, and Gramin Banks. The urban areas give a complete picture of the competition in the present day banking scenario with the presence of all bank groups. Semi-urban areas of Kerala have 2196 and urban areas have 593 as on March 1995.“ The study focuses on the selected segments ofthe urban customers in Kerala which is capable of giving the finer aspects of variation in customer behaviour in the purchase of banking products and services. Considering the exhaustive nature of such an exercise, all the districts in the state have not been brought under the purview of the study. Instead. three districts with largest volume of business in terms of deposits, advances, and number of offices have been short listed as representative regions for a focused study. The study focuses on the retail customer segment and their perceptions on the various products or services offered to them. Non Resident Indians (NRIs), and Traders and Small—ScaIe Industries segments have also been included in the study with a view to obtain a comparative picture with respect to perception on customer satisfaction and service quality dimensions and bank choice behaviour. The research is hence confined to customer behaviour and the implications for possible strategies for segmentation within the retail segment customers

Studies on the horizontal and vertical distribution of clouds and their impact on energetics of the Atmosphere over the Indian Region

Motivation for the present study is to improve the scienti c understanding on the prominent gap areas in the average three-dimensional distribution of clouds and their impact on the energetics of the earth-atmosphere system. This study is focused on the Indian subcontinent and the surrounding oceans bound within the latitude-longitude bands of 30 S to 30 N and 30 E to 110 E. Main objectives of this study are to : (i) estimate the monthly and seasonal mean vertical distributions of clouds and their spatial variations (which provide the monthly and seasonal mean 3-dimensional distributions of clouds) using multi-year satellite data and investigate their association with the general circulation of the atmosphere, (ii) investigate the characteristics of the `pool of inhibited cloudiness' that appear over the southwest Bay of Bengal during the Asian summer monsoon season (revealed by the 3-dimensional distribution of clouds) and identify the potential mechanisms for its genesis, (iii) investigate the role of SST and atmospheric thermo-dynamical parameters in regulating the vertical development and distribution of clouds, (iv) investigate the vertical distribution of tropical cirrus clouds and their descending nature using lidar observations at Thiruvananthapuram (8.5 N, 77 E), a tropical coastal station at the southwest Peninsular India, and (v) assessment of the impact of clouds on the energetics of the earth-atmosphere system, by estimating the regional seasonal mean cloud radiative forcing at top-of-the-atmosphere (TOA) and latent heating of the atmosphere by precipitating clouds using satellite data

A Literature Review on the Benefits of Ethnic and Minority Entrepreneurship

Ethnic/Minority entrepreneur is a business owner who does not represent the majority population of a country. Ethnic/Minority entrepreneurship can bring benefits to individual, society, region, economy, and globe too. So, understanding the importance of ethnic/minority entrepreneurship will really be useful to all the stakeholders. The unique culture and value system of ethnic minorities are the most wanted characteristics for any successful entrepreneur in general. Many industrial nations like U.S, U.K., Germany, etc. have utilised the ethnic minorities to build their economy. The future of the minority businesses looks bright as the world economy is booming, availability of experienced and already successful minority entrepreneurs as role models, and institutional support services. In this paper, literature relating to the benefits of ethnic and minority entrepreneurship is reviewed to understand its magnitude of benefits.

The effects of information and communication technologies on the banking sector and the payments system

This dissertation studies the effects of Information and Communication Technologies (ICT) on the banking sector and the payments system. It provides insight into how technology-induced changes occur, by exploring both the nature and scope of main technology innovations and evidencing their economic implications for banks and payment systems. Some parts in the dissertation are descriptive. They summarise the main technological developments in the field of finance and link them to economic policies. These parts are complemented with sections of the study that focus on assessing the extent of technology application to banking and payment activities. Finally, it includes also some work which borrows from the economic literature on banking. The need for an interdisciplinary approach arises from the complexity of the topic and the rapid path of change to which it is subject. The first chapter provides an overview of the influence of developments in ICT on the evolution of financial services and international capital flows. We include main indicators and discuss innovation in the financial sector, exchange rates and international capital flows. The chapter concludes with impact analysis and policy options regarding the international financial architecture, some monetary policy issues and the role of international institutions. The second chapter is a technology assessment study that focuses on the relationship between technology and money. The application of technology to payments systems is transforming the way we use money and, in some instances, is blurring the definition of what constitutes money. This chapter surveys the developments in electronic forms of payment and their relationship to the banking system. It also analyses the challenges posed by electronic money for regulators and policy makers, and in particular the opportunities created by two simultaneous processes: the Economic and Monetary Union and the increasing use of electronic payment instruments. The third chapter deals with the implications of developments in ICT on relationship banking. The financial intermediation literature explains relationship banking as a type of financial intermediation characterised by proprietary information and multiple interactions with customers. This form of banking is important for the financing of small and medium-sized enterprises. We discuss the effects of ICT on the banking sector as a whole and then apply these developments to the case of relationship banking. The fourth chapter is an empirical study of the effects of technology on the banking business, using a sample of data from the Spanish banking industry. The design of the study is based on some of the events described in the previous chapters, and also draws from the economic literature on banking. The study shows that developments in information management have differential effects on wholesale and retail banking activities. Finally, the last chapter is a technology assessment study on electronic payments systems in Spain and the European Union. It contains an analysis of existing payment systems and ongoing or planned initiatives in Spain. It forms part of a broader project comprising a series of country-specific analyses covering ten European countries. The main issues raised across the countries serve as the starting point to discuss implications of the development of electronic money for regulation and policies, and in particular, for monetary-policy making.

Formation and circulation of the cold intermediate layer in the Gulf of Saint Lawrence

[ 1] The local heat content and formation rate of the cold intermediate layer (CIL) in the Gulf of Saint Lawrence are examined using a combination of new in situ wintertime observations and a three-dimensional numerical model. The field observations consist of five moorings located throughout the gulf over the period of November 2002 to June 2003. The observations demonstrate a substantially deeper surface mixed layer in the central and northeast gulf than in regions downstream of the buoyant surface outflow from the Saint Lawrence Estuary. The mixed-layer depth in the estuary remains shallow (< 60 m) throughout winter, with the arrival of a layer of near-freezing waters between 40 and 100 m depth in April. An eddy-permitting ice-ocean model with realistic forcing is used to hindcast the period of observation. The model simulates well the seasonal evolution of mixed-layer depth and CIL heat content. Although the greatest heat losses occur in the northeast, the most significant change in CIL heat content over winter occurs in the Anticosti Trough. The observed renewal of CIL in the estuary in spring is captured by the model. The simulation highlights the role of the northwest gulf, and in particular, the separation of the Gaspe Current, in controlling the exchange of CIL between the estuary and the gulf. In order to isolate the effects of inflow through the Strait of Belle Isle on the CIL heat content, we examine a sensitivity experiment in which the strait is closed. This simulation shows that the inflow has a less important effect on the CIL than was suggested by previous studies.

Towards an assessment of multiple ecosystem processes and services via functional traits

Managing ecosystems to ensure the provision of multiple ecosystem services is a key challenge for applied ecology. Functional traits are receiving increasing attention as the main ecological attributes by which different organisms and biological communities influence ecosystem services through their effects on underlying ecosystem processes. Here we synthesize concepts and empirical evidence on linkages between functional traits and ecosystem services across different trophic levels. Most of the 247 studies reviewed considered plants and soil invertebrates, but quantitative trait–service associations have been documented for a range of organisms and ecosystems, illustrating the wide applicability of the trait approach. Within each trophic level, specific processes are affected by a combination of traits while particular key traits are simultaneously involved in the control of multiple processes. These multiple associations between traits and ecosystem processes can help to identify predictable trait–service clusters that depend on several trophic levels, such as clusters of traits of plants and soil organisms that underlie nutrient cycling, herbivory, and fodder and fibre production. We propose that the assessment of trait–service clusters will represent a crucial step in ecosystem service monitoring and in balancing the delivery of multiple, and sometimes conflicting, services in ecosystem management.

Effect of fluid mechanical stresses and plasma constituents on aggregation of LDL

LDL aggregates when exposed to even moderate fluid mechanical stresses in the laboratory, yet its half-life in the circulation is 2-3 days, implying that little aggregation occurs. LDL may be protected from aggregation in vivo by components of plasma, or by a qualitative difference in flows. Previous studies have shown that HDL and albumin inhibit the aggregation induced by vortexing. Using a more reproducible method of inducing aggregation and assessing aggregation both spectrophotometrically and by sedimentation techniques, we showed that at physiological concentrations, albumin is the more effective inhibitor, and that aggregation is substantially but not completely inhibited in plasma. Heat denatured and fatty-acid-stripped albumin were more effective inhibitors than normal albumin, supporting the idea that hydrophobic interactions are involved. Aggregation of LDL in a model reproducing several aspects of flow in the circulation was 200-fold slower, but was still inhibited by HDL and albumin, suggesting similar mechanisms are involved. Within the sensitivity of our technique, LDL aggregation did not occur in plasma exposed to these flows.jlr Thus, as a result of the characteristics of blood flow and the inhibitory effects of plasma components, particularly albumin, LDL aggregation is unlikely to occur within the circulation.