902 resultados para returning veterans
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Il presente studio si colloca nell’ambito di una ricerca il cui obiettivo è la formulazione di criteri progettuali finalizzati alla ottimizzazione delle prestazioni energetiche delle cantine di aziende vitivinicole con dimensioni produttive medio-piccole. Nello specifico la ricerca si pone l’obiettivo di individuare degli indicatori che possano valutare l’influenza che le principali variabili progettuali hanno sul fabbisogno energetico dell’edificio e sull’andamento delle temperature all’interno dei locali di conservazione ed invecchiamento del vino. Tali indicatori forniscono informazioni sulla prestazione energetica dell’edificio e sull’idoneità dei locali non climatizzati finalizzata alla conservazione del vino Essendo la progettazione una complessa attività multidisciplinare, la ricerca ha previsto l’ideazione di un programma di calcolo in grado di gestire ed elaborare dati provenienti da diversi ambiti (ingegneristici, architettonici, delle produzioni agroindustriali, ecc.), e di restituire risultati sintetici attraverso indicatori allo scopo individuati. Il programma è stato applicato su un caso-studio aziendale rappresentativo del settore produttivo. Sono stati vagliati gli effetti di due modalità di vendemmia e di quattro soluzioni architettoniche differenti. Le soluzioni edilizie derivano dalla combinazione di diversi isolamenti termici e dalla presenza o meno di locali interrati. Per le analisi sul caso-studio ci si è avvalsi di simulazioni energetiche in regime dinamico, supportate e validate da campagne di monitoraggio termico e meteorologico all’interno dell’azienda oggetto di studio. I risultati ottenuti hanno evidenziato come il programma di calcolo concepito nell’ambito di questo studio individui le criticità dell’edificio in termini energetici e di “benessere termico” del vino e consenta una iterativa revisione delle variabili progettuale indagate. Esso quindi risulta essere uno strumento informatizzato di valutazione a supporto della progettazione, finalizzato ad una ottimizzazione del processo progettuale in grado di coniugare, in maniera integrata, gli obiettivi della qualità del prodotto, della efficienza produttiva e della sostenibilità economica ed ambientale.
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This research was designed to answer the question of which direction the restructuring of financial regulators should take – consolidation or fragmentation. This research began by examining the need for financial regulation and its related costs. It then continued to describe what types of regulatory structures exist in the world; surveying the regulatory structures in 15 jurisdictions, comparing them and discussing their strengths and weaknesses. This research analyzed the possible regulatory structures using three methodological tools: Game-Theory, Institutional-Design, and Network-Effects. The incentives for regulatory action were examined in Chapter Four using game theory concepts. This chapter predicted how two regulators with overlapping supervisory mandates will behave in two different states of the world (where they can stand to benefit from regulating and where they stand to lose). The insights derived from the games described in this chapter were then used to analyze the different supervisory models that exist in the world. The problem of information-flow was discussed in Chapter Five using tools from institutional design. The idea is based on the need for the right kind of information to reach the hands of the decision maker in the shortest time possible in order to predict, mitigate or stop a financial crisis from occurring. Network effects and congestion in the context of financial regulation were discussed in Chapter Six which applied the literature referring to network effects in general in an attempt to conclude whether consolidating financial regulatory standards on a global level might also yield other positive network effects. Returning to the main research question, this research concluded that in general the fragmented model should be preferable to the consolidated model in most cases as it allows for greater diversity and information-flow. However, in cases in which close cooperation between two authorities is essential, the consolidated model should be used.
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Chlamydia trachomatis infection, the most common reportable disease in the United States, can lead to pelvic inflammatory disease (PID), infertility, ectopic pregnancy, and chronic pelvic pain. Although C. trachomatis is identified among many women who receive a diagnosis of PID, the incidence and timing of PID and long-term sequelae from an untreated chlamydial infection have not been fully determined. This article examines evidence reviewed as part of the Centers for Disease Control and Prevention Chlamydia Immunology and Control Expert Advisory Meeting; 24 reports were included. We found no prospective studies directly assessing risk of long-term reproductive sequelae, such as infertility, after untreated C. trachomatis infection. Several studies assessed PID diagnosis after untreated chlamydial infection, but rates varied widely, making it difficult to determine an overall estimate. In high-risk settings, 2%-5% of untreated women developed PID within the approximately 2-week period between testing positive for C. trachomatis and returning for treatment. However, the rate of PID progression in the general, asymptomatic population followed up for longer periods appeared to be low. According to the largest studies, after symptomatic PID of any cause has occurred, up to 18% of women may develop infertility. In several studies, repeated chlamydial infection was associated with PID and other reproductive sequelae, although it was difficult to determine whether the risk per infection increased with each recurrent episode. The present review critically evaluates this body of literature and suggests future research directions. Specifically, prospective studies assessing rates of symptomatic PID, subclinical tubal damage, and long-term reproductive sequelae after C. trachomatis infection; better tools to measure PID and tubal damage; and studies on the natural history of repeated chlamydial infections are needed.
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We have developed a haptic-based approach for retraining of interjoint coordination following stroke called time-independent functional training (TIFT) and implemented this mode in the ARMin III robotic exoskeleton. The ARMin III robot was developed by Drs. Robert Riener and Tobias Nef at the Swiss Federal Institute of Technology Zurich (Eidgenossische Technische Hochschule Zurich, or ETH Zurich), in Zurich, Switzerland. In the TIFT mode, the robot maintains arm movements within the proper kinematic trajectory via haptic walls at each joint. These arm movements focus training of interjoint coordination with highly intuitive real-time feedback of performance; arm movements advance within the trajectory only if their movement coordination is correct. In initial testing, 37 nondisabled subjects received a single session of learning of a complex pattern. Subjects were randomized to TIFT or visual demonstration or moved along with the robot as it moved though the pattern (time-dependent [TD] training). We examined visual demonstration to separate the effects of action observation on motor learning from the effects of the two haptic guidance methods. During these training trials, TIFT subjects reduced error and interaction forces between the robot and arm, while TD subject performance did not change. All groups showed significant learning of the trajectory during unassisted recall trials, but we observed no difference in learning between groups, possibly because this learning task is dominated by vision. Further testing in stroke populations is warranted.
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A new overground body-weight support system called ZeroG has been developed that allows patients with severe gait impairments to practice gait and balance activities in a safe, controlled manner. The unloading system is capable of providing up to 300 lb of static support and 150 lb of dynamic (or constant force) support using a custom-series elastic actuator. The unloading system is mounted to a driven trolley, which rides along an overhead rail. We evaluated the performance of ZeroG's unloading system, as well as the trolley tracking system, using benchtop and human-subject testing. Average root-mean-square and peak errors in unloading were 2.2 and 7.2 percent, respectively, over the range of forces tested while trolley tracking errors were less than 3 degrees, indicating the system was able to maintain its position above the subject. We believe training with ZeroG will allow patients to practice activities that are critical to achieving functional independence at home and in the community.
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This is the second part of a study investigating a model-based transient calibration process for diesel engines. The first part addressed the data requirements and data processing required for empirical transient emission and torque models. The current work focuses on modelling and optimization. The unexpected result of this investigation is that when trained on transient data, simple regression models perform better than more powerful methods such as neural networks or localized regression. This result has been attributed to extrapolation over data that have estimated rather than measured transient air-handling parameters. The challenges of detecting and preventing extrapolation using statistical methods that work well with steady-state data have been explained. The concept of constraining the distribution of statistical leverage relative to the distribution of the starting solution to prevent extrapolation during the optimization process has been proposed and demonstrated. Separate from the issue of extrapolation is preventing the search from being quasi-static. Second-order linear dynamic constraint models have been proposed to prevent the search from returning solutions that are feasible if each point were run at steady state, but which are unrealistic in a transient sense. Dynamic constraint models translate commanded parameters to actually achieved parameters that then feed into the transient emission and torque models. Combined model inaccuracies have been used to adjust the optimized solutions. To frame the optimization problem within reasonable dimensionality, the coefficients of commanded surfaces that approximate engine tables are adjusted during search iterations, each of which involves simulating the entire transient cycle. The resulting strategy, different from the corresponding manual calibration strategy and resulting in lower emissions and efficiency, is intended to improve rather than replace the manual calibration process.
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The American Geographical Society (AGS) serves as a case study for considering the nature of “gendered geography” in the nineteenth-century United States. This article links the ideals and programmatic interests of the society—which were fundamentally commercial in nature—with the personal subjectivity of its chief protagonist, Charles P. Daly, AGS president from 1864 until his death in 1899. Daly is presented as an “armchair explorer” who shifted the focus of the society away from statistical representations of the world toward the action packed narrative descriptions of the world supplied by embodied explorers in the field. The gender dynamics associated with the center versus the field provide a useful way to contrast both sides of Daly’s persona—as a scholar performing detached, careful study yet someone who also derived a great deal of personal authority by staging popular and dramatic spectacles in New York City, speechifying and presenting himself on stage at geographical society meetings with returning heroic explorers. Daly not only served as New York’ smost influential access point to the Arctic at the time, he also served as an important node in the reproduction of masculine culture in promotion of a particularly masculinist commercial geography. Key Words: American Geographical Society, Charles Patrick Daly, gender and geography, history of geography, masculinity.
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This study will explore familial and friend support networks and living arrangements among elderly individuals in Latin America and the impact that this type of support has on the health of the elderly individuals in the countries of interest. Using data from the Survey on Health and Well-Being of Elders (SABE) from 1999-2000, I will explore which type of support has a larger impact on overall health. I will also measure differences in unmet needs for certain health services. This topic is particularly interesting because it will help to uncover what policies are best for aiding in the healthcare of the elderly in aging population. Lastly, the investigation of this topic will allow me to draw conclusions about the most effective means of social and public policy for the elderly community and provide me with information about the role of both informal provisions of support from family and friends, and formal provisions of support from the government. My primary focus will be on Argentina, using Buenos Aires as the sample city, and Cuba, using Havana as the sample city. These two countries have increasingly aging populations, poorer resources and vast inequalities, but, extremely different political, economic and cultural situations. Comparing the two countries will further allow me to determine correlations between health and the existence of support networks, as well as provide me with information to make more general claims that may be of use in the United States. Argentina is particularly interesting to me because of my abroad experience and homestay experience with an older Argentine woman who lived alone but depended upon her family for many healthcare needs, doctors’ visits and general well-being. In Argentina, I experienced a different form of living than I am used to in the United States, where many older individuals or couples live in nursing homes or assisted living facilities rather than alone or with family. The changing economic climate of the two countries coupled with labor patterns of women returning to work at rapid rates indicates that policies cannot just rely on either the formal or informal sector but require a combination of the two sectors working together.This paper will first give background on the difference in the economies and the health care systems in Argentina and Cuba and will show why it interesting to study and compare these two countries. I will then discuss the health status of the elderly in each population as well as discuss the informal care networks and the role of family in each country. This section will then be followed by a description of the data and methods used. I will end by drawing conclusions about the study and the outcomes, and then I will attempt to make suggestions about effective health care policies for the elderly.
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In writing “Not in the Legends”, one of the images and concepts which constantly returned was that of pilgrimage. I began to write these poems while studying abroad in London, after having passed the previous semester in France and travelling around Europe. There was something in the repetition of sightseeing— walking six miles in Luxembourg to see the grave of General Patton, taking photographs of the apartment where Sylvia Plath ended her life, bowing before the bones of saints, searching through Père Lachaise for the grave of Théodore Gericault— which struck me as numinous and morbid. At the same time, I came to love living abroad and I grew discontent with both remaining and returning. I wanted the opportunity to live everywhere all the time and not have to choose between home and away. Returning from abroad, I turned my attention to the landscape of my native country. I found in the New England pilgrims a narrative of people who had left their home in search of growth and freedom. In these journeys I began to appreciate the significance of place and tried to understand what it meant to move from one place to another, how one chose a home, and why people searched for meaning in specific locations. The processes of moving from student to worker and from childhood to adulthood have weighed on me. I began to see these transitions towards maturity as travels to a different land. Memory and nostalgia are their own types of pilgrimage in their attempts to return to lost places, as is the reading of literature. These pilgrimages, real and metaphorical, form the thematic core of the collection. I read the work of many poets who came before me, returning to the places where the Canon was forged. Those poets have a large presence in the work I produced. I wondered how I, as a young poet, could earn my own place in the tradition and sought models in much the same way a painter studies the brushstrokes of a master. In the process, I have tried to uncover what it means to be a poet. Is it something like being a saint? Is it something like being a colonist? Or is to be the one who goes in search of saints and colonists? In trying to measure my own life and work based on the precedent, I have questioned what role era and generation have on the formation of identity. I focused my reading heavily on the early years of English poetry, trying to find the essence of the time when the language first achieved the transcendence of verse. In following the development of English poetry through Coleridge, John Berryman, and Allison Titus, I have explored the progression of those basic virtues in changing contexts. Those bearings, applied to my modern context, helped to shape the poetry I produced. Many of the poems in “Not in the Legends” are based on my own personal experience. In my recollections I have tried to interrogate nostalgia rather than falling into mere reminiscence. Rather than allowing myself poems of love and longing, I have tried to find the meaning of those emotions. A dominant conflict exists between adventure and comfort which mirrors the central engagement with the nature of being “here” or “there”. It is found in scenes of domesticity and wilderness as I attempt to understand my own simultaneous desire for both. For example, in “Canned Mangoes…” the intrusion of nature, even in a context as innocuous as a poem by Sir Walter Raleigh, unravels ordinary comforts of the domestic sphere. The character of “The Boy” from Samuel Beckett’s Waiting for Godot proved such an interesting subject for me because he is one who can transcend the normal boundaries of time and place. The title suggests connections to both place and time. “Legends” features the dual meaning of both myths and the keys to maps. To propose something “Not in the Legends” is to find something which has no precedent in our histories and our geographies, something beyond our field of knowledge and wholly new. One possible interpretation I devised was that each new generation lives a novel existence, the future being the true locus of that which is beyond our understanding. The title comes from Keats’ “Hyperion, a Fragment”, and details the aftermath of the Titanomachy. The Titans, having fallen to the Olympians, are a representation of the passing of one generation for the next. Their dejection is expressed by Saturn, who laments: Not in my own sad breast, Which is its own great judge and searcher out, Can I find reason why ye should be thus: Not in the legends of the first of days… (129-132) The emotions of the conquered Titans are unique and without antecedent. They are experiencing feelings which surpass all others in history. In this, they are the equivalent of the poet who feels that his or her own sufferings are special. In contrast are Whitman’s lines from “Song of Myself” which serve as an epigraph to this collection. He contends for a sense of continuity across time, a realization that youth, age, pleasure, and suffering have always existed and will always exist. Whitman finds consolation in this unity, accepting that kinship with past generations is more important that his own individuality. These opposing views offer two methods of presenting the self in history. The instinct of poetry suggests election. The poet writes because he feels his experiences are special, or because he believes he can serve as a synecdoche for everyone. I have fought this instinct by trying to contextualize myself in history. These poems serve as an attempt at prosopography with my own narrative a piece of the whole. Because the earth abides forever, our new stories get printed over the locations of the old and every place becomes a palimpsest of lives and acts. In this collection I have tried to untangle some of those layers, especially my own, to better understand the sprawling legend of history.
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In my thesis, I incorporate both psychological research and personal narratives in order to explain why, in the aftermath of the Vietnam War, the United States officially recognized Post-Traumatic Stress Disorder while the Vietnamese government did not. The absence of Vietnamese studies on the impact of PTSD on veterans, in comparison to the abundance of research collected on American soldiers, is reflective not of a disparity in the actual prevalence of the disorder, but of the influence of political policy on the scope of Vietnamese psychology. Personal narratives from Vietnamese civilians and soldiers thus reveal accounts of trauma otherwise hidden due to the absence of Vietnamese psychological research. Although these two nations conspicuously differed in their respective responses to the prevalence of psychological trauma in war veterans, these responses demonstrated that both the recognition and rejection of PTSD was a result of sociopolitical factors: political ideologies, rather than scientific reasons, dictated whether the postwar trajectory of psychological research focused on fully exploring the impact of PTSD on veteran populations. The association of military defeat with psychological trauma thus fixed attention on certain groups of veterans, including former American and South Vietnamese soldiers, while ignoring the impact of trauma on veterans of the Viet Cong and North Vietnamese Army. The correlation of a soldier¿s ideological background with psychological trauma, rather than exposure to actual traumatic experiences, demonstrates that cultural and sociopolitical factors are far more influential in the construction of PTSD than objective indicators of the disorder¿s prevalence. Culturally-constructed responses to disorders such as PTSD therefore account for the subjective treatment of mental illness. The American and Vietnamese responses to veterans suffering from PTSD both demonstrated that the evidence of mental health problems in an individual does not guarantee an immediate or appropriate diagnosis and treatment regimen. External authorities whose primary aims are not necessarily concerned with the objective treatment of all victims of mental illness subjectively dictate mental health care policy, and therefore risk ignoring or marginalizing the needs of individuals in need of proper treatment.
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The development of the Marcellus Shale gas play in Pennsylvania and the northeastern United States has resulted in significant amounts of water and wastes transported by truck over roadways. This study used geographic information systems (GIS) to quantify truck travel distances via both the preferred routes (minimum distance while also favoring higher-order roads) as well as, where available, the likely actual distances for freshwater and waste transport between pertinent locations (e. g., gas wells, treatment facilities, freshwater sources). Results show that truck travel distances in the Susquehanna River Basin are greater than those used in prior life-cycle assessments of tight shale gas. When compared to likely actual transport distances, if policies were instituted to constrain truck travel to the closest destination and higher-order roads, transport mileage reductions of 40-80% could be realized. Using reasonable assumptions of current practices, greenhouse gas (GHG) emissions associated with water and waste hauling were calculated to be 70-157 MT CO2 eq per gas well. Furthermore, empty so-called backhaul trips, such as to freshwater withdrawal sites or returning from deep well injection sites, were found to increase emissions by an additional 30%, underscoring the importance of including return trips in the analysis. The results should inform future life-cycle assessments of tight shale gases in managed watersheds and help local and regional governments plan for impacts of transportation on local infrastructure. (C) 2013 American Society of Civil Engineers.
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The transformation of the 1990s has had a bearing on the academic and scientific world, as is becoming increasingly obvious with the changing numbers of foreign students wishing to study in the Czech Republic and of Czech students wishing to study abroad, the virtual collapse of doctoral studies, and the rapidly increasing age of Czech academics (placed at 48 by official sources and at rather more by this research). At the same time there is an apparent lack of interest in analysing and understanding these trends, which Mr. Cermak terms an ostrich policy, although his research showed that academics are in fact both aware and concerned about them. The mid-1990s migration of talent to and from R+D in the Czech Republic is also reflected in the number of talented Czech students studying abroad, who represent the largest and most interesting group of actual and potential migrants. Mr. Cermak's study took the form of a Delphi enquiry participated in by 44 specialists, including experts in the problems of higher education and science policy from the Presidium of the Higher Education Council (n = 23), members of the Council's Science and Research Commission (n = 14), former and current managers of higher education authorities (n = 4) and selected participants of the longitudinal talent research (n = 3). Questions considered included the influence of continuing talent migration from domestic R+D on the efficiency of domestic higher education, the diversification of forms of the brain drain and their impact on other processes in society, the possibility of positive influence on the brain drain processes to minimise the risks it presents, and the use of the knowledge obtained about the brain drain. The study revealed a clear drop of interest in brain drain problems in higher education in the mid-1990s, which is probably related to the collapsed of Czech R+D in the field of talent education. The effects on this segment of the labour market appeared earlier, with a major migration wave in 1991-1993 which significantly "cleared" the area of scientific talent. In addition, prospective talents from the ranks of younger students have not been integrated into domestic R+D, leading to the increasing average age of those working in this field. "Talent scouting" tended to be oriented towards much younger individuals, even in some cases towards undergraduate students. The R+D institutions deprived of human resources considered as basic in a functional R+D system have lost much of their dynamism and so no longer attract not only domestic talent but also talent from other regions. As a result the public, including the mass media and political structures, have stopped regarding the support of domestic science as a priority. This is clear both among the young people who are important for the future development of R+D (support for the education of talented children has dropped), from the drop in the prestige of this area as a profession among university students, and from the lack of explicit support for R+D by any of the political parties. On the basis of his findings Mr. Cermak concludes that there is no basis for the belief that the brain drain will represent a positive force in stimulating the development of the open society. Migration data shows that the outflow of talent from the Czech Republic far exceeds the inflow, and that the latter is largely short-term. Not only has the number of returning Czech professors dropped to half of its level at the beginning of the 1990s, but they also tend to take up only short-term contracts and retain their foreign positions. Recruitment of scientific talent from other countries, including the Slovak Republic, is limited. Furthermore internal contacts between those already involved in R+D have been badly hit by economic pressures and institutional co-operation has dropped to a minimum. There have been few moves to counteract this situation, the only notable one being the Program 250, launched in 1996 with government support to try and attract younger (i.e. under 40) talent into R+D. Its resources are however limited and its effects have not so far been evaluated. The deficit of academic and scientific talent in the Czech Republic is increasing and two major directions of academic work are emerging. Classic higher education science based on the teaching process is declining, largely due to economic factors, while there is an increasing emphasis on special; ad hoc projects which cannot be related directly to teaching but are often interesting to specialists outside the Czech Republic. This is shown clearly by the increase in publishing and in participation in domestic and foreign grant projects, which often serve to supplement the otherwise low salaries in the higher education sector. This tend was also accelerated by the collapse of applied R+D in individual sectors of the national economy and by substantial cutbacks in the Czech Academy of Sciences, which formerly fostered such research. Some part of the output of this research can be used in the education system and its financial contribution does significantly affect the stability of the present staff, but Mr. Cermak sees it as generally unfavourable for the development of talent education. In addition, it has led to a certain resignation on the question of integration into international structures, due to the emphasis on short-term targets, commercial advantages and individualism rather than team work. At the same time, he admits that these developments reflect those in other areas of the transformation in the Czech Republic.
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Since the late eighties, economists have been regarding the transition from command to market economies in Central and Eastern Europe with intense interest. In addition to studying the transition per se, they have begun using the region as a testing ground on which to investigate the validity of certain classic economic propositions. In his research, comprising three articles written in English and totalling 40 pages, Mr. Hanousek uses the so-called "Czech national experiment" (voucher privatisation scheme) to test the permanent income hypothesis (PIH). He took as his inspiration Kreinin's recommendation: "Since data concerning the behaviour of windfall income recipients is relatively scanty, and since such data can constitute an important test of the permanent income hypothesis, it is of interest to bring to bear on the hypothesis whatever information is available". Mr. Hanousek argues that, since the transfer of property to Czech citizens from 1992 to 1994 through the voucher scheme was not anticipated, it can be regarded as windfall income. The average size of the windfall was more than three month's salary and over 60 percent of the Czech population received this unexpected income. Furthermore, there are other reasons for conducting such an analysis in the Czech Republic. Firstly, the privatisation process took place quickly. Secondly, both the economy and consumer behaviour have been very stable. Thirdly, out of a total population of 10 million Czech citizens, an astonishing 6 million, that is, virtually every household, participated in the scheme. Thus Czech voucher privatisation provides a sample for testing the PIH almost equivalent to a full population, thus avoiding problems with the distribution of windfalls. Compare this, for instance with the fact that only 4% of the Israeli urban population received personal restitution from Germany, while the number of veterans who received the National Service Life Insurance Dividends amounted to less than 9% of the US population and were concentrated in certain age groups. But to begin with, Mr. Hanousek considers the question of whether the public percieves the transfer from the state to individual as an increase in net wealth. It can be argued that the state is only divesting itself of assets that would otherwise provide a future source of transfers. According to this argument, assigning these assets to individuals creates an offsetting change in the present value of potential future transfers so that individuals are no better off after the transfer. Mr. Hanousek disagrees with this approach. He points out that a change in the ownership of inefficient state-owned enterprises should lead to higher efficiency, which alone increases the value of enterprises and creates a windfall increase in citizens' portfolios. More importantly, the state and individuals had very different preferences during the transition. Despite government propaganda, it is doubtful that citizens of former communist countries viewed government-owned enterprises as being operated in the citizens' best interest. Moreover, it is unlikely that the public fully comprehended the sophisticated links between the state budget, state-owned enterprises, and transfers to individuals. Finally, the transfers were not equal across the population. Mr. Hanousek conducted a survey on 1263 individuals, dividing them into four monthly earnings categories. After determining whether the respondent had participated in the voucher process, he asked those who had how much of what they received from voucher privatisation had been (a) spent on goods and services, (b) invested elsewhere, (c) transferred to newly emerging pension funds, (d) given to a family member, and (e) retained in their original form as an investment. Both the mean and the variance of the windfall rise with income. He obtained similar results with respect to education, where the mean (median) windfall for those with a basic school education was 13,600 Czech Crowns (CZK), a figure that increased to 15,000 CZK for those with a high school education without exams, 19,900 CZK for high school graduates with exams, and 24,600 CZK for university graduates. Mr. Hanousek concludes that it can be argued that higher income (and better educated) groups allocated their vouchers or timed the disposition of their shares better. He turns next to an analysis of how respondents reported using their windfalls. The key result is that only a relatively small number of individuals reported spending on goods. Overall, the results provide strong support for the permanent income hypothesis, the only apparent deviation being the fact that both men and women aged 26 to 35 apparently consume more than they should if the windfall were annuitised. This finding is still fully consistent with the PIH, however, if this group is at a stage in their life-cycle where, without the windfall, they would be borrowing to finance consumption associated with family formation etc. Indeed, the PIH predicts that individuals who would otherwise borrow to finance consumption would consume the windfall up to the level equal to the annuitised fraction of the increase in lifetime income plus the full amount of the previously planned borrowing for consumption. Greater consumption would then be financed, not from investing the windfall, but from avoidance of future repayment obligations for debts that would have been incurred without the windfall.
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Background Low back pain (LBP) is one of the major concerns in health care. In Switzerland, musculoskeletal problems represent the third largest illness group with 9.4 million consultations per year. The return to work rate is increased by an active treatment program and saves societal costs. However, results after rehabilitation are generally poorer in patients with a Southeast European cultural background than in other patients. This qualitative research about the rehabilitation of patients with LBP and a Southeast European cultural background, therefore, explores possible barriers to successful rehabilitation. Methods We used a triangulation of methods combining three qualitative methods of data collection: 13 semi-structured in-depth interviews with patients who have a Southeast European cultural background and live in Switzerland, five semi-structured in-depth interviews and two focus groups with health professionals, and a literature review. Between June and December 2008, we recruited participants at a Rehabilitation Centre in the German-speaking part of Switzerland. Results To cope with pain, patients prefer passive strategies, which are not in line with recommended coping strategies. Moreover, the families of patients tend to support passive behaviour and reduce the autonomy of patients. Health professionals and researchers propagate active strategies including activity in the presence of pain, yet patients do not consider psychological factors contributing to LBP. The views of physicians and health professionals are in line with research evidence demonstrating the importance of psychosocial factors for LBP. Treatment goals focusing on increasing daily activities and return to work are not well understood by patients partly due to communication problems, which is something that patients and health professionals are aware of. Additional barriers to returning to work are caused by poor job satisfaction and other work-related factors. Conclusions LBP rehabilitation can be improved by addressing the following points. Early management of LBP should be activity-centred instead of pain-centred. It is mandatory to implement return to work management early, including return to adapted work, to improve rehabilitation for patients. Rehabilitation has to start when patients have been off work for three months. Using interpreters more frequently would improve communication between health professionals and patients, and reduce misunderstandings about treatment procedures. Special emphasis must be put on the process of goal-formulation by spending more time with patients in order to identify barriers to goal attainment. Information on the return to work process should also include the financial aspects of unemployment and disability.
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Mansonella perstans is rarely pathogenic. The rare reports of symptomatic cases, however, include severe complications. Three cases of symptomatic hypereosinophilia with multi-organ involvement are described in a missionary family returning from tropical Africa. Pathogenicity may be related to the induction of hypereosinophilia rather than direct host-parasite interactions.