Corticosteroids in acute respiratory distress syndrome

Improving the course and outcome of patients with acute respiratory distress syndrome presents a challenge. By understanding the immune status of a patient, physicians can consider manipulating proinflammatory systems more rationally. In this context, corticosteroids could be a therapeutic tool in the armamentarium against acute respiratory distress syndrome. Corticosteroid therapy has been studied in three situations: prevention in high-risk patients, early treatment with high-dose, short-course therapy, and prolonged therapy in unresolving cases. There are differences between the corticosteroid trials of the past and recent trials: today, treatment starts 2-10 days after disease onset in patients that failed to improve; in the past, the corticosteroid doses employed were 5-140 times higher than those used now. Additionally, in the past treatment consisted of administering one to four doses every 6 h (methylprednisolone, 30 mg/kg) versus prolonging treatment as long as necessary in the new trials (2 mg kg-1 day-1 every 6 h). The variable response to corticosteroid treatment could be attributed to the heterogeneous biochemical and molecular mechanisms activated in response to different initial insults. Numerous factors need to be taken into account when corticosteroids are used to treat acute respiratory distress syndrome: the specificity of inhibition, the duration and degree of inhibition, and the timing of inhibition. The major continuing problem is when to administer corticosteroids and how to monitor their use. The inflammatory mechanisms are continuous and cyclic, sometimes causing deterioration or improvement of lung function. This article reviews the mechanisms of action of corticosteroids and the results of experimental and clinical studies regarding the use of corticosteroids in acute respiratory distress syndrome.

Assessment of the cardiovascular effects of electroconvulsive therapy in individuals older than 50 years

To evaluate the impact of electroconvulsive therapy on arterial blood pressure, heart rate, heart rate variability, and the occurrence of ischemia or arrhythmias, 38 (18 men) depressive patients free from systemic diseases, 50 to 83 years old (mean: 64.7 ± 8.6) underwent electroconvulsive therapy. All patients were studied with simultaneous 24-h ambulatory blood pressure and Holter monitoring, starting 18 h before and continuing for 3 h after electroconvulsive therapy. Blood pressure, heart rate, heart rate variability, arrhythmias, and ischemic episodes were recorded. Before each session of electroconvulsive therapy, blood pressure and heart rate were in the normal range; supraventricular ectopic beats occurred in all patients and ventricular ectopic beats in 27/38; 2 patients had non-sustained ventricular tachycardia. After shock, systolic, mean and diastolic blood pressure increased 29, 25, and 24% (P < 0.001), respectively, and returned to baseline values within 1 h. Maximum, mean and minimum heart rate increased 56, 52, and 49% (P < 0.001), respectively, followed by a significant decrease within 5 min; heart rate gradually increased again thereafter and remained elevated for 1 h. Analysis of heart rate variability showed increased sympathetic activity during shock with a decrease in both sympathetic and parasympathetic drive afterwards. No serious adverse effects occurred; electroconvulsive therapy did not trigger any malignant arrhythmias or ischemia. In middle-aged and elderly people free from systemic diseases, electroconvulsive therapy caused transitory increases in blood pressure and heart rate and a decrease in heart rate variability but these changes were not associated with serious adverse clinical events.

Clinical trial of gabexate in the prophylaxis of post-endoscopic retrograde cholangiopancreatography pancreatitis

The objective of the present study was to determine the efficacy of prophylactic administration of gabexate for the prevention of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis, hyperamylasemia and pancreatic pain. Patients scheduled for ERCP were randomized into two groups in a double-blind manner: the patients in the gabexate group were treated with continuous intravenous infusion of 300 mg gabexate dissolved in 500 mL Ringer's solution at 111 mL/h, starting 30 min before the endoscopic maneuvers and continuing up to 4 h after them; placebo group patients were treated only with Ringer's solution also starting 30 min before the endoscopic maneuvers and continuing up to 4 h. Data for 193 patients were analyzed. The incidence of post-ERCP pancreatitis was 3 patients (3.1%) in the gabexate group and 10 (10.5%) in the placebo group (P = 0.040). The incidence of hyperamylasemia was 33 patients (33.7%) in the gabexate group and 42 (43.7%) in the placebo group (P = 0.133). The incidence of pancreatic pain was 15 patients (15.3%) in the gabexate group and 28 (29.5%) in the placebo group (P = 0.018). The results suggest that a 4.5-h infusion of gabexate (for a total of 300 mg) could prevent post-ERCP pancreatitis and pancreatic pain.

Management of Cross Border Mergers and Acquisitions

This research thesis analyses the motivation behind the cross-border mergers and acquisitions deals. How mergers and acquisitions of new knowledge and assets, enhance business with expansion into new streams and international markets. Also, how mega deals help them to gain a power in the international markets. The research focuses on understanding the interrelation between motivations which are contributing to M&A activities and how issues like cultural differences and different management styles are overcome by these firms in cross-border settings. Chapter 1, gives a background knowledge on cross-border M&A as popular internationalization strategy choice, continuing with describing the process in Finnish and Japanese cultural context, and how these deals are proceeding in particular cases. Chapter 2, reviews the important findings and touches the common gaps or aspects those are not studied extensively, does play a key role in the success and failure of M&A deals. A methodology is presented in chapter 3, presenting the hurdles faced by many in this research field. Chapter 4, present the case study is presented to show how M&A can play an important role in structuring the entire economy of Japan. At last chapter 5, presents the evidence, if cultural, HRM and geographical aspects really contribute to the success of M&A, based on which managerial implications are suggested and propositions are built for future research references.

Neutrophil function and metabolism in individuals with diabetes mellitus

Neutrophils act as first-line-of-defense cells and the reduction of their functional activity contributes to the high susceptibilityto and severity of infections in diabetes mellitus. Clinical investigations in diabetic patients and experimental studies in diabetic rats and mice clearly demonstrated consistent defects of neutrophil chemotactic, phagocytic and microbicidal activities. Other alterations that have been reported to occur during inflammation in diabetes mellitus include: decreased microvascular responses to inflammatory mediators such as histamine and bradykinin, reduced protein leakage and edema formation, reduced mast cell degranulation, impairment of neutrophil adhesionto the endothelium and migration to the site of inflammation, production of reactive oxygen species and reduced release of cytokines and prostaglandin by neutrophils, increased leukocyte apoptosis, and reduction in lymph node retention capacity. Since neutrophil function requires energy, metabolic changes (i.e., glycolytic and glutaminolytic pathways) may be involved in the reduction of neutrophil function observed in diabetic states. Metabolic routes by which hyperglycemia is linked to neutrophil dysfunction include the advanced protein glycosylation reaction, the polyol pathway, oxygen-free radical formation, the nitric oxide-cyclic guanosine-3'-5'monophosphate pathway, and the glycolytic and glutaminolytic pathways. Lowering of blood glucose levels by insulin treatment of diabetic patients or experimental animals has been reported to have significant correlation with improvement of neutrophil functional activity. Therefore, changes might be primarily linked to a continuing insulin deficiency or to secondary hyperglycemia occurring in the diabetic individual. Accordingly, effective control with insulin treatment is likely to be relevant during infection in diabetic patients.

Cytogenetic studies of Brazilian pediatric myelodysplastic syndrome cases: challenges and difficulties in a large and emerging country

Myelodysplastic syndromes (MDS) and juvenile myelomonocytic leukemia (JMML) are rare hematopoietic stem cell diseases affecting children. Cytogenetics plays an important role in the diagnosis of these diseases. We report here the experience of the Cytogenetic Subcommittee of the Brazilian Cooperative Group on Pediatric Myelodysplastic Syndromes (BCG-MDS-PED). We analyzed 168 cytogenetic studies performed in 23 different cytogenetic centers; 84 of these studies were performed in patients with confirmed MDS (primary MDS, secondary MDS, JMML, and acute myeloid leukemia/MDS+Down syndrome). Clonal abnormalities were found in 36.9% of the MDS cases and cytogenetic studies were important for the detection of constitutional diseases and for differential diagnosis with other myeloid neoplasms. These data show the importance of the Cooperative Group for continuing education in order to avoid a late or wrong diagnosis.

The way to organizational longevity - Balancing stability and change in Shinise firms

THE WAY TO ORGANIZATIONAL LONGEVITY – Balancing stability and change in Shinise firms The overall purpose of this dissertation is to investigate the secret of longevity in Shinise firms. On the basic assumption that organizational longevity is about balancing stability and change, the theoretical perspectives incorporate routine practice, organizational culture, and organizational identity. These theories explain stability and change in an organization separately and in combination. Qualitative inductive theory building was used in the study. Overall, the empirical data comprised 75 in-depth and semi-structured interviews, 137 archival materials, and observations made over 17 weeks. According to the empirical findings, longevity in Shinise firms is attributable to the internal mechanisms (Shinise tenacity, stability in motion, and emergent change) to secure a balance between stability and change, the continuing stability of the socio-cultural environment in the local community, and active interaction between organizational and local cultures. The contribution of the study to the literature on organizational longevity and the alternative theoretical approaches is first, in theorizing the mechanisms of Shinise tenacity and cross-level cultural dynamism, and second, in pointing out the critical role of: the way firms set their ultimate goal, the dynamism in culture, and the effect of history of the firm to the current business in securing longevity. KEY WORDS Change; Culture; Organizational identity; Organizational longevity; Routines; Shinise firms; Stability; Qualitative research

Prevention of contrast induced nephropathy with sodium bicarbonate (the PROMEC study)

Introduction: Contrast-induced nephropathy is a common complication of radiographic procedures. Different measures have been used to avoid this damage, but the evidence is controversial. New investigations are required to clarify it. We investigated the efficacy and safety of sodium bicarbonate solution compared with sodium chloride solution to prevent contrast induced nephropathy in patients with or at risk of renal dysfunction. Methods: A prospective, single-center, randomized clinical trial conducted from May 1, 2007 to February 8, 2008. Inpatients in a tertiary center, scheduled to undergo a procedure with the nonionic radiographic contrast agent iohexol. There were 220 patients with serum creatinine levels of at least 1.2 mg/dL (106.1 µmol/L) and/or type 2 diabetics, who were randomized to receive an infusion of sodium chloride (n = 113) or sodium bicarbonate (n = 107) before and after contrast dye administration. The intervention were "A" group received 1 ml/kg/hour of normal saline solution, starting 12 hours before and continuing 12 hours after iohexol contrast. "B" group received 3 ml/kg of sodium bicarbonate solution (150 mEq/L) one hour prior to procedure and then drip rate was decreased to 1 ml/kg/hour until 6 hours post procedure. Our main outcome measure was change in serum creatinine. Results: The mean creatinine value after the procedure was 1.26 mg/dL in the saline group and 1.22 mg/dL in the bicarbonate group (mean difference: 0.036; CI 95%: -0.16 to 0.23, p = 0.865). The diagnosis of contrast-induced nephropathy, defined by increase in serum creatinine on 25% or more within 2 days after administration of radiographic contrast, was done in twelve patients (12%) in the bicarbonate group and eighth patients (7.1%) in the saline group (RR: 1.68, CI 95%: 0.72 to 3.94). Conclusion: Our investigation showed that there were no differences between normal saline solution (extended infusion) vs. bicarbonate solution for nephroprotection.

Tulevaisuuden lähtökohdista kansanvallan kolmiliittoon. Kansallinen Edistyspuolue ja kansallisen eheytymisen politiikka 1919–1939.

Kansallista Edistyspuoluetta ja sen toimijoita maailmansotien välisen Suomen sisäpolitiikassa tarkasteleva väitöstutkimus paneutuu puolueen kansallista eheytymistä ajaneen poliittisen linjan taustoihin, muodostumiseen ja toteutumiseen maailmansotien välisenä aikana vuosina 1919-1939. Vahvasti aineistopohjainen ja lähdekriittinen poliittisen historian tutkimus keskittyy parlamentaarisiin toimijoihin, poliittiseen kenttään ja näiden tuottamiin aineistoihin, kuten edistyspuolueen ja sen toimijoiden arkistoihin, lehdistöön ja valtiopäiväpöytäkirjoihin. Tutkimus selvittää, millainen oli edistyspuolueen kansallisen eheytymisen linja, mihin sillä pyrittiin, miten sitä toteutettiin ja miten se toteutui. Kansainvälisen vertailun kautta tutkimuksessa luodaan myös kuva suomalaisesta liberalismista ja liberalistista. Joulukuussa 1918 perustettu Kansallinen Edistyspuolue oli liberaali puolue, jonka politiikassa korostui erityisesti liberalismin sosiaalinen tulkinta. Puolueen sisäpoliittiseksi linjaksi vastaitsenäistyneessä ja sisällissodan runtelemassa valtiossa muodostui kansallisen eheytymisen edistäminen. Ajatuksen taustalla olivat K. J. Ståhlbergin tulevaisuuden lähtökohtia hahmotelleet artikkelit, jotka julkaistiin Helsingin Sanomissa huhtikuussa 1918 sisällissodan vielä riehuessa. Ståhlbergin mukaan kansalliseen eheytymiseen ei tullut pyrkiä sodan vuoksi vaan siitä huolimatta. Nuorsuomalaiselta puolueelta perityt liberaalit periaatteet täydentyivätkin edistyspuoluelaisessa ajattelussa sisällissodan ja tasavallan puolesta käydyn valtiomuototaistelun avainkokemuksilla. Itsenäisen Suomen ensimmäisiä vuosia hallinneissa keskustahallituksissa kansallista eheytymistä edistettiin sosiaalipoliittisin uudistuksin mm. oppivelvollisuus- ja asutuslakien muodossa. Myös sisällissodan vankien armahdukset olivat osa tätä ohjelmaa. Tutkimus osoittaa, että edistyspuolueen kansallisen eheytymisen politiikan keskeisenä tavoitteena oli poliittisen sovittelun kautta integroida vasemmisto osaksi parlamentaaris-demokraattista järjestelmää. Eheytyspolitiikan todellinen käyttöarvo ja edistyspuolueen poliittiset toimintamahdollisuudet alkoivat kuitenkin heiketä vuoden 1922 eduskuntavaalien jälkeen.Tutkimuksesta käy ilmi, että toteutettu eheytyspolitiikka ja sen osittainen epäonnistuminen näkyivät sekä kommunistien jatkuvana kannatuksena että sisäpoliittisen ilmapiirin oikeistolaistumisena. Tämä kehitys nosti myös edistyspuolueessa esille voimat, jotka suosivat porvariyhteistyötä ohi keskustavasemmistolaisen eheytyspoliittisen linjan. Alkuvuosien jälkeen valtiomuototaistelun koossapitävä voima heikkeni edistyspuolueen sisällä ja 1920-luvun puolivälissä käydyt linjakiistat osoittivat, että osalle puolueen jäsenistä vuoden 1918 puoluevalinnassa keskeisemmässä roolissa oli ollut tasavaltalaisuus kuin vasemmiston integrointi ja kansallinen eheytyminen. Edistyspuolueen johto ei kuitenkaan ollut valmis luopumaan eheytyspoliittisesta linjasta ja sen ympärille luodusta puolueidentiteetistä, joten porvariyhteistyötä kannattanut oikeisto-oppositio päätyi suurelta osin eroamaan puolueesta vuonna 1927. Tutkimus osoittaa, että parlamentarismin rapautuminen ja pienelle yleispuolueelle elintärkeiden yhteistyömahdollisuuksien heikkeneminen luokkapuolueiden puristuksessa johtivat edistyspuolueen kannatuksen alamäkeen sotien välisenä aikana. Se kutistui 26 kansanedustajan keskisuuresta puolueesta vain kuuden edustajan pienpuolueeksi. Puolueidentiteetin vahvuus ja keskeisten toimijoiden puolueen kokoa suurempi poliittinen painoarvo pitivät sen lakkauttamispohdinnoista huolimatta kuitenkin koossa ja kiinni politiikan ytimessä. Oikeistoradikalismin vuodet 1920–1930-lukujen taitteessa olivat edistyspuolueellesekä uhka että mahdollisuus. Tutkimuksessa käy ilmi, että vaikka kommunisminvastaisen kansanliikkeen vaatimukset olivat edistyspuoluelaisten mielestä oikeutettuja, oli kansanliikkeen niiden ajamiseksi omaksumia laittomia ja ulkoparlamentaarisia keinoja vaikea hyväksyä. Eheytyspolitiikan kannalta katsottuna melkotoivottamalta näyttänyt tilanne kääntyi kuitenkin lopulta voitoksi: äärivasemmisto eliminoitiin, äärioikeisto ajautui paitsioon ja tie maltillisen vasemmiston ja keskustan yhteistyölle aukesi jälleen. Tämä johti lopulta vuonna 1937 punamultahallitukseen ja kansanvallan kolmiliittoon Kansallisen Edistyspuolueen, SDP:n ja Maalaisliiton kesken. Kokemus siitä, että itsenäisyys oli alati uhattuna, toi suomalaiseen liberalismiin varsin nationalistisia piirteitä, joita eurooppalaisten veljespuolueiden ohjelmista ei löydy. Liberalismiin usein liitetty mielleyhtymä sen kosmopoliittisesta, kansallisvaltioita ylittävästä luonteesta jäi Suomessa sotien välisenä aikana nationalismin ja itäisen naapurin luoman uhan varjoon. Suomen sisäpoliittinen tilanne ja geopoliittinen asema loivat vaatimuksen vahvasta kansallisesta yhtenäisyydestä. Suomalainen liberalismi määrittyikin eurooppalaisia vastineitaan voimakkaammin nuorta valtiota hallinneen kansallisuusajattelun, itsesäilytysvaiston ja kansallisen eheyden vaatimusten kautta. Tutkimuksessa todetaan, että edistyspuolueen eheytyspoliittisen linjan muotoutumista ja toteutumista vuosien 1919‒1939 aikana voi pitää idealismin voittona realismista. Lukuun ottamatta reformipolitiikan vuosia edistyspuolueen pitäytyminen valitulla linjalla näyttäytyi poliittisten toimintamahdollisuuksien kannalta katsottuna ajoittain jopa epärealistiselta. Koko sotien välistä aikaa tarkastellessa voikin todeta, että se, minkä edistyspuolue poliittisten päämäärien saavuttamisen valossa voitti, sen se menetti kannatusluvuissa.

Economic capital allocation

For my Licentiate thesis, I conducted research on risk measures. Continuing with this research, I now focus on capital allocation. In the proportional capital allocation principle, the choice of risk measure plays a very important part. In the chapters Introduction and Basic concepts, we introduce three definitions of economic capital, discuss the purpose of capital allocation, give different viewpoints of capital allocation and present an overview of relevant literature. Risk measures are defined and the concept of coherent risk measure is introduced. Examples of important risk measures are given, e. g., Value at Risk (VaR), Tail Value at Risk (TVaR). We also discuss the implications of dependence and review some important distributions. In the following chapter on Capital allocation we introduce different principles for allocating capital. We prefer to work with the proportional allocation method. In the following chapter, Capital allocation based on tails, we focus on insurance business lines with heavy-tailed loss distribution. To emphasize capital allocation based on tails, we define the following risk measures: Conditional Expectation, Upper Tail Covariance and Tail Covariance Premium Adjusted (TCPA). In the final chapter, called Illustrative case study, we simulate two sets of data with five insurance business lines using Normal copulas and Cauchy copulas. The proportional capital allocation is calculated using TCPA as risk measure. It is compared with the result when VaR is used as risk measure and with covariance capital allocation. In this thesis, it is emphasized that no single allocation principle is perfect for all purposes. When focusing on the tail of losses, the allocation based on TCPA is a good one, since TCPA in a sense includes features of TVaR and Tail covariance.

On the creative economy chain in Brazil: potential and challenges

ABSTRACT The article presents an analysis of the Creative Economy in Brazil, showing its development potential for the generation of income and employment, in order to the country's development resumption. They are initially presented concepts and features of the Creative Economy for, in sequence, to analyze the economic development profile and potential of this industry in Brazil. The empirical part introduces some methodological aspects, in continuing with the analysis of the creative chain contribution to the generation of Value Added and employment in the country, and a vision of their foreign trade.potential. Finally, the challenges to the implementation of public policies are investigated.

Yhteistyön ongelmat kahden oppilaitoksen välillä – Case: Kotka Maritime Centre

Tämän tutkimuksen tarkoituksena oli selvittää kahden oppilaitoksen, Kymenlaakson ammattikorkeakoulun ja Etelä-Kymenlaakson ammattiopiston merenkulkualan koulutusten, välisiä yhteistyöongelmia. Tutkimus rajattiin koskemaan täydennyskoulutus- ja simulaattorikeskusyhteistyön ongelmia. Yhteistyössä oli todettu olevan ongelmia, ja tutkimuksella selvitettiin ongelmat ja luotiin toimenpide-ehdotuksia ongelmien ratkaisemiseksi. Tutkimus toteutettiin puolistrukturoiduin haastatteluin, johon haastateltiin yhteensä 22 henkilöä molemmista oppilaitoksista. Tutkimuksen runko luotiin teoreettisen viitekehyksen mukaisesti organisaatioiden välisen yhteistyön elementeistä. Haastattelujen analysoinnissa käytettiin sisällönanalyysiä. Tutkimuksen perusteella löydettiin useita ongelmia yhteistyössä. Kolme keskeisintä ongelmaa olivat henkilösuhteissa esiintynyt luottamuspula ja henkilökemiat, johtamisen puute sekä roolien ja työtehtävien epäselvyys. Työtä ongelmien korjaamiseksi tulee olemaan, mutta ne ovat ratkaistavissa luomalla tarkemmat suuntaviivat yhteistyölle ja lisäämällä vuorovaikutusta kokoontumisten avulla. Molemmilla oppilaitoksilla oli tulevaisuuteen tähtäävä näkemys yhteistyön lisäämisestä ja kehittämisestä.

Decew Residence Construction

Construction work continuing on the Decew Residence.

Organizational commitment and perceived relatedness as correlates of the intention to continue officiating in track and field

The objectives of the present study were to explore three components of organizational commitment (affective [AC], normative [NC] and continuance [CC] commitment; Allen & Meyer, 1991), perceived relatedness (Oeci & Ryan, 1985; 2002), and behavioural intention (Ajzen, 2002) within the context of volunteer track and field officiating. The objectives were examined in a 2-phase study. Ouring phase 1, experts (N = 10) with domain familiarity assessed the item content relevance and representation of modified organizational commitment (OC; Meyer, Allen & Smith, 1993) and perceived relatedness (La Guardia, Oeci, Ryan & Couchman, 2000) items. Fourteen of 26 (p < .05) items were relevant (Aiken's coefficient V) and NC (M = 3.88, SO = .64), CC (M = 3.63, SD = .52), and relatedness (M = 4.00, SD = .93) items had mean item content-representation ratings of either "good" or "very good" while AC (M = 2.50, SD = 0.58) was rated "fair". Participants in phase 2 (N = 80) responded to items measuring demographic variables, perceptions of OC to Athletics Canada, perceived relatedness to other track and field officials, and a measure of intention (yiu, Au & Tang, 2001) to continue officiating. Internal consistency reliability estimates (Cronbach's (1951) coefficient alpha) were as follows: (a) AC = .78, (b) CC = .85, (c) NC = .80 (d) perceived relatedness = .70 and, (e) intention = .92 in the present sample. Results suggest that the track and field officials felt only minimally committed to Athletics Canada (AC M = 3.90, SD = 1.23; NC M = 2.47, SD = 1.25; CC M = 3.32; SD = 1.34) and that their relationships with other track and field officials were strongly endorsed (M = 5.86, SD = 0.74). Bivariate correlations (Pearson r) indicated that perceived relatedness to other track and field officials demonstrated the strongest relationship with intention to continue officiating (r = .346, p < .05), while dimensions of OC were not significantly related to intention (all p's > .05). Together perceived relatedness (j3 = .339, p = .004), affective commitment (j3 = -.1 53, p = .308), normative commitment (j3 = -.024, p = .864) and continuance commitment (j3 = .186, P = .287) contribute to the prediction of intention to continued officiating (K = .139). These relationships remained unaffected by the inclusion of demographic (j3age = -.02; P years with Athletics Canada = -.13; bothp's > .05) or alternative commitment (j3sport = -.19; P role = .15; Pathletes = .20; all p' s > .05) considerations. Three open-ended questions elicited qualitative responses regarding participants' reasons for officiating. Responses reflecting initial reasons for officiating formed these higher order themes: convenience, helping reasons, extension of role, and intrinsic reasons. Responses reflecting reasons for continuing to officiate formed these higher order themes: track and field, to help, and personal benefits. Responses reflecting changes that would influence continued involvement were: political, organizational/structural, and personal. These results corroborate the findings of previous investigations which state that the reasons underpinning volunteer motivations change over time (Cuskelly et al., 2002). Overall, the results of this study suggest that track and field officials feel minimal commitment to the organization of Athletics Canada but a stronger bond with their fellow officials. Moreover, the degree to which track and field officials feel meaningfully connected to one another appears to exert a positive influence on their intentions to continue officiating. As such, it is suggested that in order to promote continued involvement, Athletics Canada increases its focus on fostering environments promoting positive interactions among officials.

Legitimacy in question : elite-mass relations, constitutional reform and Canadian democracy /

During the 1980s and 1990s, Canadian political authority orientations underwent a significant transformation. Canadians are no longer deferential towards their political elites. Instead, they are autonomous, challenging, and increasingly participatory, and this continuing trend has brought the procedural legitimacy of the Canadian political process into question. The following study of elite-mass relations within Canadian democracy attempts to provide insight into the meaning of this change and how it should be addressed. An attitudinalbehavioural analysis ofthe electorate presents evidence that popular cynicism and alienation is rooted more deeply in a dissatisfaction with political institutions and traditions than with politicians. A structural analysis of the elected political elite reveals the failure of consociational traditions to provide effective representation as well as the minimal impact which the aforementioned orientation shift has had upon this elite. An event-decisional analysis, or case study, ofelite-mass relations in the arena of constitutional politics augments these complementary profiles and illustrates how the transformed electorate has significantly restricted the elected political elite's role in constitutional reform. The study concludes that the lack ofresponsiveness, representativeness, and inclusiveness ofCanada's elected political elite, political institutions, and political traditions has substantially eroded the procedural legitimacy of Canadian democracy during the 1980s and 1990s. Remedying these three deficiencies in the political system, which are the objects of increasing public demand, may restore legitimacy, but the likelihood that such reforms will be adopted is presently uncertain in the face of formidable difficulties and obstacles.