Team GB is an international powerhouse in Olympic sports and has become 'much admired around the world for sporting success and the system that exists beneath it' (Grey-Thompson, 2017, p. 4). However, big budgets are levelling the playing field in the Global Sporting Arms Race (cf. De Bosscher, Bingham, Shibli, Van Bottenburg, & Knop, 2008). Instead, De Bosscher et al. (2015) explain that nations should focus on talent development and identification to stay competitive. In contrast, recent inquiries into elite sports in the United Kingdom has unearthed examples of destructive cultures (Grey-Thompson, 2017; Phelps, Kelly, Lancaster, Mehrzad, & Panter, 2017). Rees et al. (2016) indicate that a significant re-think of some of the components of current support programmes and environments is a priority to address cultural issues and improve on talent development. A critical area could be the importance of the environment, including cultural features (e.g. Henriksen, 2010; Martindale, Collins, & Abraham, 2007). Rees et at. (2016) argue that it is vital to provide an evidence-based understanding of identification and development to maintain the success of the prolific sports system. The purpose of this thesis was to examine and develop a talent development programme in the United Kingdom. This thesis followed a qualitative research design integrating Grounded Theory and Action Research into a novel method of doing change processes. The main study in this thesis was a 16-month longitudinal study. The research included one reconnaissance phase (e.g. to understand the context and identify change strategies). It also included four double-cycles of implementing change and reviewing the strategies. The primary data collection strategies were ethnography and ten focus groups. The focus groups were carried out with athletes, coaches, parents, and the national governing body (NGB). Analysis of documents and twenty-six individual interviews with stakeholders supplemented these. Eighteen of these individual interviews were with participants from other governing sports organisations (n=6; GSOs) and NGBs (n=3). The findings in the reconnaissance phase suggested that NGB-1 had a history of conflict. The conflict had alienated the community in the sport from the NGB. The influence of this was that many stakeholders disengaged from NGB-1 and set up volunteer-based talent and elite initiatives. NGB-1 explained that most important aim for change was a change of the prevailing culture. NGB-1 formulated five strategies to do so: (1) internal team development, (2) a talent development programme, (3) coach development, (4) selection policies, and (5) GBR development centres. The following four double-cycles aimed to conceptualise how the change of culture happened and what regulated this process. Three features regulated the process: (i) power relations, (ii) structural conditions, and (iii) coupling. First, power relations were divided into two sub-processes of systemic (e.g. hierarchy, official titles, policies, regulation) and informational (e.g. reward, coercive, referent) power. The influence of the power relations was that a destructive culture emerged when NGB-1 tried to implement the change strategies. Coaches and athletes engaged in antagonistic behaviours (e.g. manipulation, coercion, open critique) towards the NGB. Denial of responsibility and social weighting neutralised the stigma of perpetuating antagonism. These findings suggested ignoring and denying antagonism could lead to a destructive culture. Yet, the support towards NGB-1 increased during double-cycles three and four because NGB-1 managed to mobilise stakeholders within the sport through reward and coercive power. Second, structural conditions included how conditions outside the organisation and inside the organisation influenced the change of culture. The findings suggested that political will had isolated Olympic sports from societal changes prior to the study. However, macrocultural changes to social standards and the power of athletes suggested that the organisational culture was increasingly deficient and required radical changes. This influenced NGB-1 through systemic power. GSO used targets and coercive offers (i.e. an offer the recipient is compelled to follow) to direct the direction of change in the NGB. The data suggested that NGB-1 experienced being torn between efforts to comply with targets and antagonistic behaviours within the sports community. Third, coupling denotes how changes in one organisation call for changes in another. GSOs used their systemic power to dictate appropriate avenues for change. Athletes used their reinforced position by speaking out about aspects that challenged the welfare of athletes and others working in Olympic sports. Last, the process in this thesis produced two working models for doing a change of culture in Olympic sports in the United Kingdom. These are grounded in the findings that suggested that the change of culture was fundamental change to the processes of negotiating the change. The findings also suggested the three features above (i.e. power relations, structural conditions, and coupling) influenced changing the process. The findings might have implications for NGBs and GSOs in the United Kingdom because they provided empirical evidence for the relationship between cultural factors and developing talent development programmes. NGBs could use the working models to guide a change of culture and consider how cultural factors might influence the development of talent programmes. Using these working models could help plan and prepare NGBs for the influence of power relations within their sports community. In addition, organisational practitioners in GSOs can use the findings in this thesis to inform how they interact with other GSOs and NGBs. GSO might consider how their systemic power could influence severe conflict with-in an NGB's sports community if they seek to direct changes.


Background: Adults with congenital heart disease are hospitalized at increasing rates in the Western world. Identification of rates of and risk factors for hospitalization is essential for research and improving patient outcomes. Methods: We conducted a single-center retrospective analysis of patients with a primary diagnosis of tetralogy of Fallot (TOF), transposition of the great arteries (both d- and l-transposition of the great arteries [TGAs]), or single ventricle (SV). We investigated the rates of mortality, annual hospitalization, and patient-specific risk factors for unplanned cardiac hospitalization. Results: Adult patients with complex congenital heart disease are hospitalized at a rate four to eight times greater than the general US population (P < .001). In addition, there are significant differences between the rates of hospitalization in TOF and TGA (0.39 and 0.41 hospitalizations per patient-year, respectively) and SV (0.72 hospitalizations per patient-year). The majority of excess hospitalizations in the study group were due to cardiac disease (P < .001 for all three groups). Risk factors for unplanned cardiac hospitalization in TOF included pulmonary atresia, depressed left ventricular and right ventricular ejection fraction, and smoking; in TGA, they included Ebstein malformation, surgeries other than primary repair, noncardiac diagnoses, atrial arrhythmias, atrioventricular nodal block, left ventricular ejection fraction, and smoking; and in SV, they included atrial arrhythmias and cyanosis. Conclusions: Patients born with complex congenital heart disease are hospitalized far more frequently than the general US population, primarily for cardiac-related illness. Future research should focus on confirming the present findings and on identification of strategies to improve outcomes in this growing group of patients.


We consider the issue of illegal migration from Mexico to the US, and examine whether the lack of legal status causally impacts on outcomes, specifically wages and remitting behavior. These outcomes are of particular interest given the extent of legal and illegal migration, and the resulting financial flows. We formalize this question and highlight the principal empirical problem using a potential outcome framework with endogenous selection. The selection bias is captured by a control function, which is estimated non-parametrically. The framework for remitting is extended to allow for endogenous regressors (e.g. wages). We propose a new re-parametrisation of the control function, which is linear in case of a normal error structure, and test linearity. Using Mexican Migration project data, we find considerable and robust illegality effects on wages, the penalty being about 12% in the 1980s and 22% in the 1990s. For the latter period, the selection bias is not created by a normal error structure; wrongly imposing normality overestimates the illegality effect on wages by 50%, while wrongly ignoring selection leads to a 50% underestimate. In contrast to these wage penalties, legal status appears to have mixed effects on remitting behavior.


In Kierkegaard's treatment of the concept of reality, possibility, freedom (the not-necessity of the history) both in the Concept of Anxiety and in Philosophical Fragments is possible to make out Schelling's meontology, that is the philosophical discourse concerning the negation of the actual being of something, but not its possibility. The article makes first a survey of the latest philosophy of Schelling, the so-called "positive philosophy" and explain its methodological meaning for the development of philosophy of Mythology and philosophy of Revelation. Its shows why Kierkegaard's thought could have been attracted by Schelling's Spatphilosophie and its way of treating the concepts of possibility and reality in opposition to Hegel's "negative philosophy", but in the end it shows why Kierkegaard could not accept even Schelling's speculation.


Dynamism of development and competiveness of regions, as spatially and administratively defined units, depend not only on their natural, economic, social, and territorial potential but also on quality of regional development governance. At the time of creation of the regional level of territorial management in Slovakia there was expected that by introducing this new governance level the regional governments would become strong players in the field of regional development policy and provide supra-local and sub-national public services more effectively and with better quality. The paper, in its first part, concentrates on critical assessment of the current position and performance of entrusted tasks of the regional self-governments after 12 years of their existence, particularly in terms of their real opportunities to influence integrated development of territories pursuing principles of "good governance". Emphasis is put on analysis of key determinants conditioning legitimacy and power of regional self-governments in the area of ensuring and coordinating regional development. Findings suggest that territorial and administrative definition of the Slovak regions for fulfilling their core mission is not optimal. Furthermore there are gaps in their competencies, financial strength, fiscal autonomy and quality of development processes. We can state that despite regional governments are responsible, pursuant to law, for the comprehensive integrative development of the region, their direct impact on economic, social and environmental development of their territories is relatively small. The current status is confronted with the focus of the European policy for the period 2014-2020 and the need to react also on this level on global challenges such as climate change, ageing, lack of renewable resources, opening disparity scissors between regions etc. The paper, in its second part, in order to achieve higher quality of governing regional development within existing legal, economic and institutional framework in Slovakia, presents the innovative model of good governance in conjunction with planning and implementation of development processes. Through the analysis of individual components of the model the set of recommendations has been elaborated with the aim of optimizing position of the regional self-government as the key actor in development of its territory having not only responsibility but also adequate conditions and tools. The paper is based on results of the three years research within the project Governance financed by the Norwegian financial mechanism.


The authors present an overview of a hierarchical framework for coordinating task- and motion-level operations in multirobot systems. Their framework is based on the idea of using simple temporal networks to simultaneously reason about precedence/causal constraints required for task-level coordination and simple temporal constraints required to take some kinematic constraints of robots into account. In the plan-generation phase, the framework provides a computationally scalable method for generating plans that achieve high-level tasks for groups of robots and take some of their kinematic constraints into account. In the plan-execution phase, the framework provides a method for absorbing an imperfect plan execution to avoid time-consuming re-planning in many cases. The authors use the multirobot path-planning problem as a case study to present the key ideas behind their framework for the long-term autonomy of multirobot systems.


Increasing population is leading to water shortfalls in urban areas across the world. Shortfalls are intensified in arid and semi-arid regions under climate change through reduced and highly variable rainfall and greater frequency of droughts. Water planners are increasingly considering investments in capital infrastructure to enhance water security. Augmentation involves high capital sunk costs, and a typical challenge that arises is the need to determine whether or not, and at what scale, to invest in augmentation. Water planners face a risk of over- and under-investing in augmentation, but assessments that represent the tradeoffs involved in making augmentation decisions accurately and comprehensively are scarce. The analytical framework presented in this paper, looks retrospectively at what the insurance value of a seawater desalination plant in Adelaide would have been, had the investment been a decade earlier than it was, to illustrate assessing the risk of over- or under-investing in augmentation. The framework draws from three concepts: benefit cost analysis (BCA), probability theory, and conditional value at risk (CVaR). Results show that, at best, had the desalinisation plant been operational during the recent millennium drought, from 1998 to 2010, potential net annual cost of up to a maximum of A$170.6 m in extreme shortfall years, would have been avoided, but this would have involved incurring annual cost of up to A$149.0 m in years of no shortfalls.


Successful purification of multiple viruses from mixed infections remains a challenge. In this study, we investigated peste des petits ruminants virus (PPRV) and foot-and-mouth disease virus (FMDV) mixed infection in goats. Rather than in a single cell type, cytopathic effect (CPE) of the virus was observed in cocultured Vero/BHK-21 cells at 6th blind passage (BP). PPRV, but not FMDV could be purified from the virus mixture by plaque assay. Viral RNA (mixture) transfection in BHK-21 cells produced FMDV but not PPRV virions, a strategy which we have successfully employed for the first time to eliminate the negative-stranded RNA virus from the virus mixture. FMDV phenotypes, such as replication competent but noncytolytic, cytolytic but defective in plaque formation and, cytolytic but defective in both plaque formation and standard FMDV genome were observed respectively, at passage level BP8, BP15 and BP19 and hence complicated virus isolation in the cell culture system. Mixed infection was not found to induce any significant antigenic and genetic diversity in both PPRV and FMDV. Further, we for the first time demonstrated the viral interference between PPRV and FMDV. Prior transfection of PPRV RNA, but not Newcastle disease virus (NDV) and rotavirus RNA resulted in reduced FMDV replication in BHK-21 cells suggesting that the PPRV RNA-induced interference was specifically directed against FMDV. On long-term coinfection of some acute pathogenic viruses (all possible combinations of PPRV, FMDV, NDV and buffalopox virus) in Vero cells, in most cases, one of the coinfecting viruses was excluded at passage level 5 suggesting that the long-term coinfection may modify viral persistence. To the best of our knowledge, this is the first documented evidence describing a natural mixed infection of FMDV and PPRV. The study not only provides simple and reliable methodologies for isolation and purification of two epidemiologically and economically important groups of viruses, but could also help in establishing better guidelines for trading animals that could transmit further infections and epidemics in disease free nations.


Abstract In the present paper we use nanoindentation to investigate two shape memory alloys, austenitic Ti50Ni48Fe2 and martensitic Ti50Ni40Cu10 which both show two step martensitic transformations on cooling from the high temperature regime. No such two step features were observed during nanoindentation. Load controlled nanoindentation experiments were performed using a Berkovich indenter using maximum loads ranging from 0.5 to 85 mN resulting in maximum indentation depths between 30 and 1350 nm. For small maximum indentation loads below 5 mN, longer indentation times result in larger indentation depths (austenitic Ti50Ni48Fe2). At loads of about 1 mN the indentation curves show an abrupt change in slope which we suggest to be related to an interaction of the deformation and failure of a thin oxide layer and the formation of stress induced martensite (austenitic Ti50Ni48Fe2) or the de-twinning of martensite (martensitic Ti50Ni40Cu10). Nanohardnesses and shape recovery ratios strongly increase with decreasing indentation depths below 400 nm. For larger indentation depths, constant values are observed (austenitic Ti50Ni48Fe2: nanohardness 2.45 GPa/recovery ratio 0.25, martensitic Ti50Ni40Cu10: nanohardness 1.6 GPa/recovery ratio 0.4).


ITSBLUE A DISTRIBUTED BLUETOOTH-BASED FRAMEWORK FOR INTELLIGENT TRANSPORTATION SYSTEMS AHMED AWAD ALGHAMDI Old Dominion University, 2017 Director: Dr. Tamer Nadeem Inefficiency in transportation networks is having an expanding impact, at a variety of levels. Transportation authorities expect increases in delay hours and in fuel consumption and, consequently, the total cost of congestion. Nowadays, Intelligent Transportation Systems (ITS) have become a necessity in order to alleviate the expensive consequences of the rapid demand on transportation networks. Since the middle of last century, ITS have played a significant role in road safety and comfort enhancements. However, the majority of state of the art ITS are suffering from several drawbacks, among them high deployment costs and complexity of maintenance. Over the last decade, wireless technologies have reached a wide range of daily users. Today's Mobile devices and vehicles are now heavily equipped with wireless communication technologies. Bluetooth is one of the most widely spread wireless technologies in current use. Bluetooth technology has been well studied and is broadly employed to address a variety of challenges due to its cost-effectiveness, data richness, and privacy perverseness, yet Bluetooth utilization in ITS is limited to certain applications. However, Bluetooth technology has a potential far beyond today's ITS applications. In this dissertation, we introduce itsBlue, a novel Bluetooth-based framework that can be used to provide ITS researchers and engineers with desired information. In the itsBlue framework, we utilize Bluetooth technology advantages to collect road user data from unmodified Bluetooth devices, and we extract a variety of traffic statistics and information to satisfy ITS application requirements in an efficient and cost-effective way. The itsBlue framework consists of data collection units and a central computing unit. The itsBlue data collection unit features a compact design that allows for stationary or mobile deployment in order to extend the data collection area. Central computing units aggregate obtained road user data and extract a number of Bluetooth spatial and temporal features. Road users' Bluetooth features are utilized in a novel way to determine traffic-related information, such as road user context, appearance time, vehicle location and direction, etc. Extracted information is provided to ITS applications to generate the desired transportation services. Applying such a passive approach involves addressing several challenges, like discovering on-board devices, filtering out data received from vehicles out of the target location, or revealing vehicle status and direction. Traffic information provided by the itsBlue framework opens a wide to the development of a wide range of ITS applications. Hence, on top of the itsBlue framework, we develop a pack of intersection management applications that includes pedestrians' volume and waiting times, as well as vehicle queue lengths and waiting times. Also, we develop a vehicle trajectory reconstruction application. The itsBlue framework and applications are thoroughly evaluated by experiments and simulations. In order to evaluate our work, we develop an enhanced version of the UCBT Network Simulator 2 (NS-2). According to evaluation outcomes, itsBlue framework and applications evaluations show promising results. For instance, the evaluation results show that the itsBlue framework has the ability to reveal road user context with accuracy exceeding 95% in 25s.


The changes observed in resourcing international organisations over the last decades may have dramatic consequences for their ability to fulfil their mandates. This paper investigates into how far reaching the expected changes really are, and whether the new types and sources of financial and human resources can really be considered as causal for these developments. It appears that resourcing may not be the initial cause, but contributes to the centrifugal dynamics currently observed in the multilateral system. Administrative cost related to the new and complex funding structures are considerable, and ensuring transparency over resource flows represents a major challenge. Official decision-making bodies lose power to sub-groups of members or external actors that fund parts of the organisations' activities through separate channels. Given the large volume of non-core funding and the lack of transparency, they cannot easily adjust their own priorities. It can thus not be expected that the funding of certain activities through external channels will simply be compensated by a corresponding reduction of core funding in this area. Whether this negatively affects the ability of the organisations to fulfil their mandates – and hence, eventually their legitimacy – depends on the motivations of those actors empowered in this process.


The present study investigated the synergic effects and potential mechanisms of action of Astragalus polysaccharides (APS) combined with Crataegus flavonoids (CF) in the treatment of type 1 diabetes. Diabetes was induced by intraperitoneal injection of 100 mg/kg streptozotocin in mice. Normal and untreated diabetic control mice were used, and CF‑treated (200 mg/kg/day), APS‑treated (200 mg/kg/day), APS + CF (AC)‑treated (200 mg/kg/day of each) and metformin‑treated (200 mg/kg/day) diabetic mice were orally administrated the appropriate therapeutic agent for 4 weeks. The results demonstrated that AC treatment significantly reduced the fasting blood glucose, food and water intake in the diabetic mice. The AC group demonstrated increased serum insulin levels and islet cell function was restored. Furthermore, the AC‑treated mice demonstrated significant increases in the protein expression levels of pancreatic and duodenal homeobox‑1 and phosphorylated adenosine 5'‑monophosphate‑activated protein kinase in the pancreatic and liver tissue samples, respectively. In addition, AC significantly increased the mRNA expression levels of neurogenin 3, v‑maf musculoaponeurotic fibrosarcoma oncogene family, protein A and insulin, and simultaneously decreased the expressions of interleukin 6, tumor necrosis factor‑α and chemokine (C‑C motif) ligand 2 in the pancreatic islet cells of diabetic mice. The anti‑inflammatory activity of APS and the islet‑restoring effect of CF may contribute to the improvement of islet function. AC exerted greater antidiabetic effects compared with APS or CF treatments alone. These results indicated that AC treatment had a synergic antidiabetic effect, which may involve improvements in islet function and liver metabolism. These effects of AC may facilitate the treatment of type 1 or 2 diabetes, as these patients frequently experience impaired islet function and disordered extrapancreatic metabolism.


Compelled by converging research in the natural sciences suggesting the stratigraphic nature of time, I argue for a temporal approach to the venerable problem of synthesis in evolutionary theory. Geneticist and pioneer of the Modern Synthesis (MS), Theodosius Dobzhansky (1900-1975), constructed one of the most powerful synthesis arguments in the history of evolutionary biology in the classic "Nothing in Biology Makes Sense Except in the Light of Evolution" (1973). I argue that nothing in evolution makes sense except in the light of time, such that the problem of evolutionary time plays a powerful role in making sense of the conceptual architecture of the Extended Evolutionary Synthesis (EES). The EES offers a strong alternative to the temporal and causal idealizations operating at the hardened core of the MS. I create the philosophical concept of stratigraphic time to strengthen connections between the four problem agendas or "causal catchalls" structuring the new synthesis: (1) developmental plasticity, (2) developmental bias, (3) inclusive inheritance, and (4) niche construction (Laland 2015 et al.). The dissertation is driven by two critical arguments (Chapters 1-3) concerning the subordination of time to process, and two constructive arguments (Chapters 4 and 5) concerning the nature of evolutionary time, which together attest to the conceptual strength of a temporal approach to the multiplicity of evolutionary problems pursued by the EES, and especially the connections between them. Chapter 1, "Embracing the Problematic Structure of the Extended Evolutionary Synthesis," explicates and evaluates the core assumptions of the EES in contrast with those of the MS, which has served as the dominant conceptual framework for evolutionary science and theory since the early twentieth century. Chapter 2, "Deep Time: The Forgotten Frontier," critically argues that evolutionary time has been subordinated to evolutionary process, that the problem of evolutionary time must be revived after its eclipse at the origin of evolutionary theory, especially due to Darwin's unnecessarily strict commitments to gradualism, adaptationism, and to the preeminence of natural selection. Chapter 3, "The Chronometric Subordination of Time to Movement in Philosophy, Science, and Society," critically argues that the subordination of evolutionary time to process is primed by the chronometrically facilitated subordination of time to movement, what mathematician, physicist, and philosopher of science Henri Poincare (1854-1912) called an unconscious opportunism in philosophical and scientific thought. The constructive arguments unfolded in Chapter 4, "The Continuous Variation of Evolutionary Contingency," and Chapter 5, "Stratigraphic Time: The Synthesis of Deep and Developmental Rhythms," attempt to respect causal thinking while conceptualizing evolutionary processes not according to causal laws but rather according to passive and active temporal syntheses (or modes of repetition), effectively delimiting causal thinking to a provisional conceptualization. Stratigraphic time enables conceptualization of the multiplicity of evolutionary process, driven by a new concept of evolutionary contingency. I argue that the roles of chance and causation in the EES are strengthened by concepts of difference and repetition, akin to the conceptual roles played by arrows and cycles of time in the formation of geological and evolutionary thought. These critical and constructive arguments are guided by Gilles Deleuze's philosophy of time, which he conceptualizes under the rubric of repetition. The three passive and active temporal syntheses, or modes of repetition, Deleuze creates to think the nature of repetition provide conceptual tools for evolutionary synthesis through stratigraphic time.


Since the early 1990s several empirical studies have been undertaken linking quality efforts such as total quality management (TQM) and Six Sigma to organizational performance. In the majority of these studies the organizational performance indicators typically include sales growth, operating income, profits, employee turnover, employee satisfaction, and customer satisfaction. Direct costs and savings of implementing quality management programs have seldom been studied, and many of these studies lack statistical rigor and objectivity. For example, sales growth could be affected by a number of other business environmental factors, so how can one isolate the effect of quality improvement programs on sales growth? Due to these limitations, the results of these studies are mixed, with some showing significant relationships between quality constructs and organizational performance measures and others not. This study also attempts to quantify the financial impact of Six Sigma programs. It differs, however, from previous studies in two ways. First, it evaluates the direct costs and direct operational savings of implementing Six Sigma programs, which, to the author's knowledge, was never done before. Second, it differs in terms of the research methodology used. The author undertook an extensive search of organizational annual reports and other published materials on Six Sigma organizations that provided the actual costs and savings related to implementing Six Sigma in 28 organizations. The main finding of this research is that effective implementation of Six Sigma led to an average savings of 1.7 percent of revenues over the period of implementation and an average return of more than $2 in direct savings for every dollar invested on Six Sigma. The findings of this research are useful for organizations implementing Six Sigma to have realistic expectations of the program and to monitor and benchmark the progress of their programs.


Sickle cell anemia is the most common heritable hematological disease, yet no curative treatment exists for this disorder. Moreover, the intricacies of globin gene expression have made the development of treatments for hemoglobinopathies based on gene therapy difficult. An alternative genetic approach to sickle cell therapy is based on RNA repair. A trans-splicing group I ribozyme was used to alter mutant β-globin transcripts in erythrocyte precursors derived from peripheral blood from individuals with sickle cell disease. Sickle β-globin transcripts were converted into messenger RNAs encoding the anti-sickling protein γ-globin. These results suggest that RNA repair may become a useful approach in the treatment of genetic disorders.


The present study is a qualitative exploration of the conceptualizations of substance use, abuse, dependence, and treatment from the perspectives of Italian and American counselors-in-training. The researcher conducted semistructured interviews with two Italian and two American graduate-level counseling students. Thematic elements identified based upon collected data include differential attitudes toward alcohol and marijuana compared to illicit drug use in both Italy and the United States, consequences experienced as a result of problematic substance use, and the impact of stigma on opportunities following treatment. Differences in treatment practices and standards and differences in vocational opportunities following treatment in Italy and the United States were reported by participants. Implications for practice and recommendations for future research are provided based upon findings.


A hyperbranched derivative of triazine group (EA) was synthesized by elimination reaction between ethylenediamine and cyanuric chloride. The different-mass-ratio EA and ammonium polyphosphate (APP) were mixed and blended with polypropylene (PP) in a constant amount (25%) to prepare a series of EA/APP/PP composites. The component ratio effect of EA/APP on the flame-retardant property of the EA/APP/PP composites was investigated using the limiting oxygen index (LOI), vertical burning (UL-94), and cone calorimetry tests. Results indicated that the EA/APP/PP (7.50/17.50/75.00) composite with the appropriate EA/APP mass ratio had the highest LOI, UL94 V-0 rating, lowest heat release rate, and highest residue yield. These results implied that the appropriate EA/APP mass ratio formed a better intumescent flame-retardant system and adequately exerted their synergistic effects. Furthermore, average effective combustion heat values revealed that EA/APP flame retardant possessed the gaseous-phase flame-retardant effect on PP. Residues of the EA/APP/PP composites were also investigated by scanning electron microscopy, Fourier-transform infrared, and X-ray photoelectron spectroscopy. Results demonstrated that the appropriate EA/APP mass ratio can fully interact and lock more chemical constituents containing carbon and nitrogen in the residue, thereby resulting in the formation of a dense, compact, and intumescent char layer. This char layer exerted a condensed-phase flame-retardant effect on EA/APP/PP composites. © 2014 Wiley Periodicals, Inc. J. Appl. Polym. Sci. 2014, 131, 41006.


The growth rate of adults older than 65 in Canada is increasing more rapidly than the population as a whole. This increase is reflective of the aging baby boomer population. That population is known to have a strong attachment to automobiles, which might be reflected in their travel behavior as they move toward different stages in their older life. The purpose of this paper is to contribute to the understanding of the travel behavior, mainly public transit usage, of Canada's older population relative to younger cohorts. A pseudocohort analysis was conducted in Montreal, Quebec, Canada, of residents who were 50 or older to follow changes in public transit use of similarly aged respondents from 1998 to 2013. The results revealed that older generations used public transit more than younger generations did at the same age. In addition, the most recent survey year showed a stagnation of transit use across all age groups. Differences in transit use between males and females were more pronounced in earlier cohorts, but the difference was decreasing in more recent years. These findings add to the growing body of work suggesting that the nature of transportation behavior in seniors is changing, and accordingly planners and engineers cannot expect the baby boomer generation to behave the same way as previous generations. Addressing the transportation needs of seniors around the world will be an important challenge for planners and engineers, as the population of seniors is growing more rapidly than the population as a whole in the majority of developed countries. This growth imposes new challenges on the transportation system because of differences in the travel behavior of today's older adults compared with that of previous cohorts of seniors.


In many contracting settings, actions costly to one party but with no direct benefits to the other (money-burning) may be part of the explicit or implicit contract. A leading example is bureaucratic procedures in an employer-employee relationship. We study a model of delegation with an informed agent, where the principal may impose money-burning on the agent as a function of the agent's choice of action, and show that money-burning may be part of the optimal contract. This result holds even if action-contingent monetary transfers are possible, as long as transfers from the principal to the agent are bounded from below (as in limited liability or minimal wage requirements). In fact, the optimal contract can involve a combination of both efficient monetary incentives and inefficient nonmonetary incentives through money burning. Our model delivers some results novel to the delegation literature. First, money-burning is more likely if the principal is more sensitive to the choice of action than the agent. This is consistent with the perception that there is more bureaucratization in large organizations. Second, money-burning is more likely if the agent's limited liability constraint is tighter relative to his participation constraint. This implies that a higher minimum wage distorts employment contracts towards using socially wasteful nonmonetary incentives, leading to a Pareto inferior outcome as the agent is still held down to his reservation value through increased money burning.The appendices for this paper are available at the following URL: http://ssrn.com/abstract=2700851


Despite uncertainty about the exact levels of mortality, it is clear that the health of the South African population has worsened in the last decade. South Africa can be considered to have a quadruple burden of disease, including diseases and conditions related to poverty and under-development, chronic diseases, injuries and HIV and AIDS. The spread of HIV has been extremely rapid with an extensive impact, particularly among young adults and children. Differentials in health status have been observed between population groups, wealth groups, urban-rural and education levels. Globally, there has been a renewed interest in the determinants of health, including social determinants. A review of South African trends shows that economic and social policies have resulted in economic growth and some improvements in access to basic services such as water, sanitation and electricity. Increased provision of social grants, extreme wealth inequalities and high unemployment likely play an important role in poor health outcomes. Cultural and macro-social trends are difficult to capture, but of obvious concern to health are the culture of violence and the lower social status afforded to women. The theoretical understanding of health and its determinants is not completely formed. Nonetheless, the World Health Organization Commission on Social Determinants of Health argues that there is enough evidence for governments to take action following three principles: improving the daily living conditions of people; reducing health inequalities; and strengthening the ability to monitor population health. A revitalised Alma Ata provides an aspirational charter to build primary curative and preventive care accompanied by intersectoral action linking health and action.


BACKGROUND
Calcineurin inhibitor (cyclosporine, CsA) and mTOR inhibitors (sirolimus, SRL) - immunosuppressants used to prevent allograft rejection after renal transplantation - have a narrow therapeutic index and show considerable inter-individual pharmacokinetic differences. Differences in expression and activity of cytochrome P450 (CYP) 3A4 and 3A5 affect these pharmacokinetics; cytochrome activity differences are associated with CYP genetic polymorphisms.

MATERIAL/METHODS
This study evaluated the effects of polymorphisms in CYP3A4 and CYP3A5 on immunosuppressive drug-dose adjusted trough blood concentrations. One hundred renal transplant recipients were genotyped for CYP3A4*1B and CYP3A5*3 using PCR-RFLP. Blood concentrations of CsA and SRL were determined by EMIT and HPLC/UV, respectively.

RESULTS
The allelic frequencies of CYP3A4*1B and CYP3A5*3 in the study group were 2.5% and 96.5%, respectively. The mean cyclosporine dose in CYP3A4*1/*1B subjects was 455.04±128.68 mg/day vs. 261.68±64.72 mg/day in CYP3A4*1/*1 subjects (p<0.001). The mean cyclosporine dose-adjusted trough blood concentrations (ng/ml per mg/kg body weight) in CYP3A4*1/*1B subjects were lower than in the CYP3A4*1/*1 group (37.06±10.38 vs. 44.63±13.99; p<0.218). The mean cyclosporine dose in CYP3A5*1/*3 subjects was 400.65±164.97 mg/day vs. 263.52±64.39 mg/day in CYP3A5*3/*3 subjects (p<0.022). No association was detected between sirolimus trough blood concentration (C0) or dose requirement, and CYP3A4 or CYP3A5 genotype.

CONCLUSIONS
Genetic polymorphisms in CYP3A4 and CYP3A5 may underlie inter-individual differences in cyclosporine pharmacokinetics after renal transplantation. Patients with at least 1 functional CYP3A5*1 or CYP3A4*1B allele require significantly higher doses of cyclosporine to reach target drug levels compared to patients with the CYP3A4*1 or CYP3A5*3 alleles.


This thesis presents research that extends current knowledge in the area of business process re-design, with a specific focus on the 'Make Product' process within manufacturing organisations. Current business process re-design approaches offer only limited guidance on the specific changes that can be made to a process when re-designing it to achieve the desired performance improvements and often overlook any strategically derived performance requirements when re-designing the process. Case experience suggests that practitioners do not consider the performance requirements of their business processes when re-designing them and that the actions they take to achieve performance improvements are not selected with regard to any strategically derived performance requirements. This exploratory research investigates whether relationships can be established between the changes that can be made to a process when re-designing it and the performance improvements gained by implementing those changes. It then questions whether those relationships can be used to help companies to select the appropriate process changes to implement in order to meet their specific performance requirements. Performance Requirements and process changes (Process Improvement Actions) were derived from the relevant literature and included in a* questionnaire designed to ascertain the strength of relationships between them. The questionnaire was subject to preliminary and pilot testing to improve validation and reliability prior to being administered to international business process re-design 'experts. Statistical analysis of the questionnaire data resulted in a ranked list of Process improvement Actions for each of the Performance Requirements. These were presented in a format for inclusion in a process-based change handbook and enable the practitioner to set the agenda for the intervention and select the Process Improvement Actions on the basis of the Performance Requirements. The Performance Requirements should be derived from the strategy of the company or change programme so a strategic focus is maintained throughout re-design. It was also found that of the thirteen Process Improvement Actions included in the questionnaire just five are needed to achieve improvements in a majority (80%) of the performance requirements. This research showed that it is possible to establish links between Performance Requirements and Process Improvement Actions and according to successful validation by practitioners, against an accepted model, that these can be used for business process re-design, laying foundations for future research in the area.


In this important, entertaining book, one of the world's most celebrated psychologists, Martin Seligman, asserts that happiness can be learned and cultivated, and that everyone has the power to inject real joy into their lives. In "Authentic Happiness", he describes the 24 strengths and virtues unique to the human psyche. Each of us, it seems, has at least five of these attributes, and can build on them to identify and develop to our maximum potential. By incorporating these strengths - which include kindness, originality, humour, optimism, curiosity, enthusiasm and generosity - into our everyday lives, he tells us, we can reach new levels of optimism, happiness and productivity. "Authentic Happiness" provides a variety of tests and unique assessment tools to enable readers to discover and deploy those strengths at work, in love and in raising children. By accessing the very best in ourselves, we can improve the world around us and achieve new and lasting levels of authentic contentment and joy.


This paper examines the evolution of intra-financial sector lending in the United States, 1950- 2012, presenting estimates constructed from the Federal Reserve's Flow of Funds Accounts. We establish a number of stylized facts concerning the growth and composition of claims between financial institutions. We find that intra-financial sector lending as a share of total financial sector lending appears to have grown nearly five-fold since the 1950s. After comprising a tenth of all lending throughout 1950-1980, by 2011 lending between financial institutions accounted for nearly half of all financial sector lending. The stock of intra-financial assets has followed a similar trend. These grew rapidly during the 1980s and 1990s and presently account for nearly 30 percent of all financial sector assets. Although the growth of intra-financial assets accelerated after 1980, the fastest increase took place between 1991 and the bursting of the dotcom bubble in 2001, increasing from 15 to 25 percent of total financial sector assets. In the run up to the financial crisis of 2007-2008, the growth of intra-financial lending was concentrated in assets highly implicated in the genesis of the crisis, suggesting that this growth may have contributed to the crisis. This growth in intra-financial lending also raises questions about the contribution of the financial sector to the real economy: in the years before the financial crisis only 40 percent of financial lending was to the real economy. In recent years, we are witnessing similarly large shares of intra-financial lending.


Introduction: Grief is considered to be negative manifestations of affect, cognition, and behavior. However, persons who experience grief have also reported enduring positive outcomes in such domains as interpersonal relationships, personal strengths, and life perspectives. This review evaluated current measures of grief to determine if such positive outcomes can be adequately assessed. Methods: The Texas Revised Inventory of Grief, Grief Experience Inventory, Bereavement Phenomenology Questionnaire, Core Bereavement Items, Continuing Bonds Scale, and Hogan Grief Reaction Checklist (currently the most common measures of grief) are reviewed. Results: Only one of the reviewed measures assessed posttraumatic growth as a component of grief (i.e., Hogan Grief Reaction Checklist). Conclusion: Since posttraumatic growth and negative psychological adjustment after traumatic events can coexist, it is important that measures of grief used in both clinical and research domains allow an assessment of positive response.


Medicines play a key role in the treatment of most mental illnesses. The management of those medicines is of great importance to most mental health service users and also impacts on the daily professional life of many of those involved in caring, be they psychiatrists, nurses, pharmacists or others.
The New Ways of Working (NWW) project began with a study of the potential to devolve many of the aspects of the dispensing of medicines within pharmacy departments from pharmacists to pharmacy technicians and then to pharmacy assistants. As this project evolved it became clear that perhaps the greatest impact of pharmacy staff and potential for NWW of medicines management was not just in the dispensary but within teams and wards. As further projects began to identify the potential for pharmacy staff to improve the way medicines are used across the whole spectrum of clinical care, it also became clear that medicines management and pharmacy had for many years been an area of neglect by Mental Health Trusts (MHTs) and for many to achieve safe and effective medicines use, would require significant investment. By the end of the programme a wide range of products associated with medicines management, involving pharmacy, service users, carers and others, had been developed (www.newwaysofworking.org.uk).


The venous bubble load in the body after diving may be used to infer risk of decompression sickness (DCS). Retrospective analysis of post-dive bubbling and DCS was made on seven studies. Each of these investigated interventions, using an 18 meters of sea water (msw) air dive profile from Royal Navy Table 11 (Mod Air Table), equivalent to the Norwegian Air tables. A recent neurological DCS case suggested this table was not safe as thought. Two-hundred and twenty (220) man-dives were completed on this profile. Bubble measurements were made following 219 man-dives, using Doppler or 2D ultrasound measurements made on the Kisman-Masurel and Eftedal-Brubakk scales, respectively. The overall median grade was KM/EB 0.5 and the overall median maximum grade was KM/EB 2. Two cases of transient shoulder discomfort ("niggles") were observed (0.9% (95% CL 0.1% - 3.3%)) and were treated with surface oxygen. One dive, for which no bubble measurements were made, resulted in a neurological DCS treated with hyperbaric oxygen. The DCS risk of this profile is below that predicted by models, and comparison of the cumulative incidence of DCS of these data to the large dataset compiled by DCIEM [1, 2] show that the incidence is lower than might be expected.


Background Health literacy (the capacity to process and understand basic health information) is essential to health management, although health literacy skills decline with age. Whether cognitively stimulating behavioural practices can help older adults maintain health literacy skills is unknown. We investigated whether reading a daily newspaper, using the internet, and maintaining social attachments protect against decline in health literacy skills during ageing, independent of cognitive ageing. Methods We used data from 4439 participants aged ≥52 years in the English Longitudinal Study of Ageing (ELSA) from 2004–11. The ELSA is based on random stratified sampling of private English households and data are collected biennially through in-person interviews, nurse visits, and self-completion questionnaires. Health literacy was measured at baseline (2004–5) and follow-up (2010–11) in the study interview using a reading comprehension test of a fictitious medicine label. Newspaper reading, internet use, and social attachment were assessed in the self-completion questionnaire every two years from baseline to follow-up. The influence of consistently reading a daily newspaper (vs. never reading), consistently using the internet (vs. never using), and of consistent social attachment (vs. consistent detachment) in civic participation, leisure activities, cultural engagement, and social networks over the six-year follow-up on health literacy decline were estimated using multivariable-adjusted logistic regression (StataSE 13.0). Baseline age, ethnicity, education, cognitive function, cognitive decline, and all main effects were included in the fully-adjusted model. Results In the fully-adjusted model, consistent internet use (1427/4439; 32%) was protective against health literacy decline (OR=0.75, 95% CI 0.59–0.95). Consistent cultural engagement (1766/4439; 40%) was also protective against health literacy decline (OR=0.70, 95% CI 0.55–0.89). Consistently reading a daily newspaper (1963/4439; 44%) was not associated with health literacy decline (fully-adjusted OR=1.04, 95% CI 0.84–1.29). Consistent attachment in civic participation (1576/4439; 36%), leisure activities (1401/4439; 32%), and social networks (3341/4439; 75%) were not associated with health literacy decline in the fully-adjusted model. Conclusion Internet use and cultural engagement, including attending the cinema, art galleries, museums, or the theatre, appear to help older adults to maintain health literacy skills during ageing regardless of cognitive functioning. Reading a daily newspaper had no association with health literacy decline; future research should consider reading frequency and other types of media and literature. Importantly, older adults frequently did not use the internet. Support for older adults to maintain active social lives and access the internet should help improve health and well-being through promotion of health literacy skills.


Four-dimensional/RCS is the reference model architecture currently being developed for the Demo III Experimental Unmanned Vehicle program. Four-dimensional/RCS integrates the NIST (National Institute of Standards and Technology) RCS (Real-time Control System) with the German (Universitat der Bundeswehr Munchen) VaMoRs 4-D approach to dynamic machine vision. The four-dimensional/RCS architecture consists of a hierarchy of computational nodes each of which contains behavior generation (BG), world modeling (WM), sensory processing (SP), and value judgement (VJ) processes. Each node also contains a knowledge database (KD) and an operator interface. These computational nodes are arranged such that the BG processes represent organizational units within a command and control hierarchy.


We propose a novel hybrid nanostructure which comprises both uniaxial and coaxial multi-quantum wells (MQWs) on nanowires topped with an InGaN nano-cap. The growth process included both top-down and bottom-up approaches followed by the intentional growth of an InGaN nano-cap to offer larger active area. The In composition was optimized to absorb light at green and blue wavelengths by the uniaxial and coaxial quantum wells respectively. Extensive structural and optical characterizations were carried out. Field emission scanning electron microscopy (FE-SEM) revealed a high density of nanowires. High resolution transmission electron microscopy (HR-TEM) images displayed 5 pairs of uniaxial multi-quantum wells, 6 pairs of coaxial multi-quantum wells and the existence of the intended nano-caps. A photoluminescence (PL) spectrum was recorded for the grown structure at room temperature. The resultant emission spectrum comprised two distinct peaks resulting from each of the multi-quantum well assemblies and emission from the nano-cap. Cathodoluminescence (CL) mapping data revealed discrete bright field images of the InGaN nano-caps and uniaxial multi-quantum well structures. Emission peaks for the nano-caps and both of the multi-quantum well structures were observed in the CL point spectrum which in turn corroborated the PL measurement. During an energy-dispersive X-ray (EDX) study, a high composition of In was found in the nano-cap area along with the distinct presence of both types of multi-quantum wells. In addition, to investigate the opto-electronic device applicability of the grown MQW structure, the photocurrent was measured at various light intensities. The photocurrent density was observed to increase linearly with the increasing light power density. Also the photocurrent density was found to be higher for the hybrid structure than a single uniaxial or coaxial assembly.


The Analytic Hierarchy Process (AHP) is one of the most widely used quantitative tools in multi-criteria decision-making problems. Despite its popularity and use due to its simple but systematic procedure, AHP has limitations especially in terms of the numerical comparison scale used in one of its core steps: pairwise comparisons. AHP is based on verbal comparisons of alternatives/criteria, which are, then, converted into quantitative scores with a one-to-one mapping between the verbal comparisons and a predetermined numerical scale. The choice of the numerical scale affects an essential characteristic of pairwise comparisons: consistency. In order to understand the intrinsic consistency propinquities, this study evaluates the most widely used numerical pairwise comparison scale (Fundamental Scale) and other numerical scales that have been proposed since the initial formulation of AHP. After identifying the limitations of known scales, a new scale based on Fibonacci series is developed considering these limitations, and further analysis is conducted through extensive simulations. The results show that the proposed scale performs well when compared to the other scales.


A number of Fmoc amino acids can be effective low molecular weight hydrogelators. The type of gel formed depends on the amino acid used and, in the case of FmocF, the final pH of the system. The single crystal structure of two of the gelators (FmocF and FmocY) have been determined and the data compared to the fibre X-ray diffraction data. FmocF, which forms metastable gels, crystallises easily and the data for the fibre phase and crystal phase are relatively similar. For FmocF, the fibre axis in b is consistent with the hydrogen bonding repeat distances and the diffraction pattern calculated from the single crystal structure is a good match with the experimental fibre X-ray diffraction data. On the other hand, there are significant differences between the crystalline phase determined and the fibre phase for FmocY. The packing of FmocY within the crystal structure is created by interactions between the planar Fmoc groups, whilst it is clear that hydrogen bonding drives the self-assembly into fibrillar structures within the gels. This shows that understanding the packing in gel phase by analogy to isolated crystal structures has the potential to lead to erroneous conclusions.


BACKGROUND: The utilization of prescription opioids has increased over the last 2 decades. Associated with this is the misuse of prescription opioids for nonmedical purposes. Medicaid programs have struggled with developing strategies that balance best practice models, appropriate utilization, and reduction in costs associated with the opioid medication class. OBJECTIVES: To examine the impact of a 2-year stepwise initiative to reduce utilization and therapy costs of long-acting opioid analgesics (LAOA) by addressing issues of high dose, daily dose, and preferred therapeutic alternatives. METHODS: Utilization data from the Massachusetts Medicaid pharmacy program for LAOAs were reviewed and compared for 2 time periods. The calendar year prior to the initiative, 2002, was used as a base year and represents a time period when there were no restrictions in place for members to obtain long-acting opioids. The calendar year 2005 was the comparison year representing a time period after the multiple steps of the initiative had been implemented. A retrospective claims-based analysis was performed to determine the impact of restrictions on LAOAs, defined as brand and generic versions of oxycodone ER, morphine ER, methadone, and fentanyl transdermal system. The primary measure was the percentage of change of unique utilizers, paid claims, and average daily dose for each LAOA following the implementation of the opioid management initiative. Secondary measures included a cost analysis. RESULTS: Compared with 2002, the overall number of LAOA unique utilizers declined 17.8% (P  less than  0.0001), and the overall number of claims declined by 4.1% (P  less than  0.0001), while Medicaid pharmacy benefit member enrollment remained relatively stable. Average daily dose declined in methadone and morphine ER and increased in oxycodone ER and fentanyl transdermal system. The 2005 overall cost of LAOAs decreased 8.0% compared with the overall cost in 2002. The per-member-per-month (PMPM) cost for opioid users in 2002 was $110.57 ($120.04 when adjusted to 2005 dollars) compared with $123.75 in 2005. In comparison, the overall PMPM for all members in 2002 was $3.52 ($3.82 when adjusted to 2005 dollars) compared with $3.59 in 2005. CONCLUSIONS: Our study successfully demonstrated that a state Medicaid program initiative can result in a significant overall decrease in opioid class utilization specifically for the targeted, more costly agents. This was achieved via the implementation of a Therapeutic Class Management multidisciplinary workgroup that established a prior authorization process implementing limits on dose, as well as identified preferred less costly agents. It further facilitated the direct opportunity for pharmacy-prescriber collaboration for LAOA medication management.


PURPOSE
To use individual-level data provided from the single-arm study of helical computed tomographic (CT) screening at the Mayo Clinic (Rochester, Minn) to estimate the long-term effectiveness of screening in Mayo study participants and to compare estimates from an existing lung cancer simulation model with estimates from a different modeling approach that used the same data.

MATERIALS AND METHODS
The study was approved by institutional review boards and was HIPAA compliant. Deidentified individual-level data from participants (1520 current or former smokers aged 50-85 years) in the Mayo Clinic helical CT screening study were used to populate the Lung Cancer Policy Model, a comprehensive microsimulation model of lung cancer development, screening findings, treatment results, and long-term outcomes. The model predicted diagnosed cases of lung cancer and deaths per simulated study arm (five annual screening examinations vs no screening). Main outcome measures were predicted changes in lung cancer-specific and all-cause mortality as functions of follow-up time after simulated enrollment and randomization.

RESULTS
At 6-year follow-up, the screening arm had an estimated 37% relative increase in lung cancer detection, compared with the control arm. At 15-year follow-up, five annual screening examinations yielded a 9% relative increase in lung cancer detection. The relative reduction in cumulative lung cancer-specific mortality from five annual screening examinations was 28% at 6-year follow-up (15% at 15 years). The relative reduction in cumulative all-cause mortality from five annual screening examinations was 4% at 6-year follow-up (2% at 15 years).

CONCLUSION
Screening may reduce lung cancer-specific mortality but may offer a smaller reduction in overall mortality because of increased competing mortality risks associated with smoking.


In the classical David-and-Goliath lawsuit brought by an individual person against an institutional defendant, the pending amendments to the Federal Rules of Civil Procedure hurt David and help Goliath more than any previous round of amendments. The amendments represent corporate defendants' victory in the thirty-year war to limit the scope of discovery by enshrining "proportionality" as part of the definition of, rather than a limitation on, the scope of discovery. The amendments will also make it more difficult for plaintiffs to obtain an adverse inference jury instruction or other sanctions for a defendant's intentional loss of electronic evidence. For no good reason, the amendments will reduce the length of time within which plaintiffs must effectuate service of process, thereby gifting defendants with a corresponding reduction in the statute of limitations. In addition, the amendments wipe out thirty-six official forms, on the thin excuse that the Advisory Committee wants to "get out of the forms business"; in fact, many interpret the move as a tacit agreement with the heightened pleading standard imposed on plaintiffs by the Supreme Court in Twombly and Iqbal. The amendments' mostly anti-plaintiff effect is evidenced by a stark split in the public reaction, with plaintiffs' lawyers almost unanimously against most of the amendments and defendants' lawyers almost unanimously in favor. But the Advisory Committee was astoundingly indifferent to the polarized public reaction to the proposed amendments. One Advisory Committee member dismissed the stories told at the public hearings by plaintiffs' lawyers about their need for discovery as "Queen-For-A-Day issues," a reference to a 50-year-old daytime television show in which women tearfully told their real-life sob stories to vie for prizes.Remarkably, in evaluating the need for these amendments, the Committee did not rely on very much case law, any government caseload statistics, or any of the ninety-four district court reports on "cost and delay" mandated by the Civil Justice Reform Act of 1990. Instead, the Committee commissioned a mound of so-called "empirical studies" which consisted mostly of flawed opinion surveys of self-selected attorneys. The one methodologically sound study, conducted by the Federal Judicial Center, found that discovery worked well and at modest cost in most federal cases. The Committee either ignored or mischaracterized the FJC's study. Given the makeup of the Advisory Committee and the Standing Committee, none of this is surprising. The members of both committees are all appointed by Chief Justice John Roberts, and except for a few tokens, they are ideologically predisposed to think like Federalist Society members, demographically predisposed to think like elite white males, and/or experientially predisposed to think like corporate defense lawyers. There is no explicit constitutional, statutory, or rules authority for the Chief Justice's unbridled appointment power. The Article concludes by forecasting the passage of a default "requester pays discovery costs" rule that is sought by defense interests, unless the mechanism for appointment of federal rules committee members is changed.


The collective Mexico: Future City proposes an understanding of the city as great work of thought in which the system land formed by biological and human components, auto-regula and the complex interactions between these components have a variability of multiple scales between territorial and anthropomorphic. This global and contemporary attitude links the efforts of engineers, biologists, town planners, students and especially, citizens, to recover the lacustrine condition of the metropolis, across four strategies: water, territory, energy and public spaces. This global project tries to generate a new system of lakes fed by the waste water that take place in the capital and seeks to give solution to the problem. If the man is the causer of that of the degradation of the natural ecosystem of the Mexico City, also the man can revert this situation and initiate a new age that it takes as a flag: the art, the city, the life and the nature. The present text proposes a critical exploration on the transcendence of this project - in articulating - to deduce that the reversibility of the urban facts is the sustainable strategy of the city of the third millennium.


Peanut plays an important role in the livelihoods of poor farmers and in the rural economy of many developing countries. Aflatoxin contamination in peanut seeds, caused by Aspergillus flavus, hampers international trade and adversely affects health of consumers of peanut and its products. It can occur in the field when the crop is growing, during harvesting and curing, and in storage and transportation. Aflatoxin research on peanut at ICRISAT focuses on identification and utilization of genetic resistance to preharvest seed infection and aflatoxin production by A. flavus and pre and post harvest management practices to minimize contamination. Breeding for aflatoxin resistance has been a contentious issue in peanut for nearly four decades since the first report of host resistance to aflatoxin production by A. flavus. Despite global efforts, progress in aflatoxin resistance breeding has been limited due to the low level of resistance to different components of resistance (preharvest seed infection and aflatoxin production, and in vitro seed colonization by A. flavus), their variable performance due to high G 3 E interaction, lack of reliable screening protocols, and limited understanding of genetics of resistance. Efforts to combine the three independently inherited components of resistance did not produce expected results towards improving the host plant resistance to aflatoxin contamination. Although breeding lines have shown better performance for resistance to aflatoxin contamination at ICRISAT, they need wider evaluation under diverse growing conditions. The search for better sources of resistance in the cultivated and wild Arachis germplasm continues, and recent developments in the area of transgenic research through modification of aflatoxin biosynthesis pathway or use of genes with antifungal and anti-aflatoxin properties appear encouraging. Meanwhile, the available improved breeding lines coupled with pre and post harvest aflatoxin management practices can help to significantly reduce aflatoxin contamination in farmers' fields. It is expected that transgenic resistance against fungal infection and aflatoxin production in combination with conventional breeding efforts may lead to the development of agronomically superior peanuts that are free of aflatoxin contamination.


Executive Summary
> The Paris climate summit in December 2015
resulted in an Agreement that pragmatically
combines the science-driven demand for
ambitious global emissions reduction objectives
with key Parties' continued desire to protect
their sovereignty. Its implementation will
depend on a quasi-constant negotiation process
over the coming years.
> The constructive role played by the European
Union during the negotiations of this Agreement
allowed it to recover from the reputational
damage suffered at the 2009 Copenhagen
summit.
> Over the coming years, the EU will need to
sustain and reinforce this role to contribute to
ensuring the environmentally effective
implementation of the Agreement.
> To this end, both EU internal and external
climate policies and related policies need to be
strategically geared toward a high level of
ambition, based on solid support and ownership
from its member states.


We used satellite telemetry to document spring migration phenology, routes, stopover regions, and nesting sites of mallards Anas platyrhynchos marked in Arkansas during the winters of 2004–2007. Of the 143 marked mallards that migrated from Arkansas, they did so, on average, by mid-March. Mallards flew over the Missouri Ozarks and 42% made an initial stopover in Missouri, where they used areas that had larger rivers (Mississippi River, Missouri River) embedded in an agricultural landscape. From this stopover region they either migrated directly to the Prairie Pothole Region (PPR) or they migrated north to Minnesota where they either moved next to the PPR or to the north and east of the PPR. For those mallards (83%) that stopped for .1 d before entering the PPR, the average length at each stop was 12 d (SE = 0.90 d, range = 2–54 d). Mallards made more stopovers, made shorter migration movements, and took longer to move to the PPR in wetter than drier years. Mallards arrived in the PPR earlier in 2006 (x = 30 March, SE = 2.18 d) than in 2005 (x =7 April, SE = 2.30 d). Females nested across nine Bird Conservation Regions. Nesting occurred most frequently in South Dakota (n = 9). The average date when females nested was 19 April (SE = 2.44 d, range = 12 March–26 May). Because many mallards headed for the large river corridors in Missouri for their first stopover, this region is an important spring migration stopover of continental importance to mallards and might be considered a focal area for conservation.


This article focuses on an evaluation of the pilot implementation of the UK 'Early Excellence' programme, designed to improve Early Years services and achieve national impact. As with other 'New Labour' programmes, the evaluation approach was based on addressing the relationship between 'context, process and outcome'; to facilitate this, nationally defined indicators were adopted through collaboration between a national evaluation team, local evaluators and local practitioners. This approach left considerable scope for interpretation and participation by local evaluators and practitioners, as they engaged in data collection and analysis. However, two major shifts later undermined the original scope: first, a shift from evaluation to performance management, and second, a shift from central practitioner participation to marginal practitioner involvement. In conclusion, we note the parallels and contrasts between this experience and others in UK public services, and propose some general learning points for similar evaluation initiatives.


Automated Web service discovery requires Web service capability specifications of a high precision. Semantic-based approaches are inherently more precise than conventional keyword-based approaches. This paper proposes to build capability specifications of Web services based on an environment ontology, the main concepts of which are the environment entities in a particular application domain and their interactions. For each environment entity, there is a tree-like hierarchical state machine modeling the effects that are to be achieved by the Web services on this environment entity. The proposed approach is based on the assumption that the Web service capability specifications, built on the effects of the Web services on the environment entities, are more accessible and observable. Algorithms for constructing the domain environment ontology and the matchmaking between the Web service capability specifications are presented to show how Web service discovery is supported. An example on travel service is given to illustrate this proposed approach.


ASTM F543-07 is used to evaluate insertion load (Annex A4), driving torque (A2), and axial pullout (A3) characteristics of self-tapping metallic medical bone screws. F543-07 was designed to evaluate screws that utilize a pre-drilled pilot hole and was not intended for self-drilling screws. The objectives of this study were to (1) adapt the F543-07 test methods to allow evaluation of both self-drilling and self-tapping screws and (2) quantify differences in performance between the two screw types. For all three tests (A4, A2, A3) appropriately sized pilot holes were pre-drilled into the surrogate test medium for all the self-tapping screw designs per ASTM F543-07. No pilot holes were created for the self-drilling screws. During the insertion load tests (A4), a constant rotation was applied to the screws under an initial, near-zero axial force state. While monitoring axial load, torque, and displacement, the axial load was gradually increased. The maximum load at which there was a marked increase in torque and displacement on the graph was indicative of the force required to engage the self-drilling or the self-tapping feature. To measure driving torque (A2), a constant rotation was applied. To maintain screw driver–screw contact, a constant-force axial pre-load was required. The axial insertion load, determined during the insertion load testing (A4), was used as the preload for the driving torque testing. Axial pullout testing (A3) measured the axial tensile force required to remove a screw from the test medium. Quantifiable differences in mean insertion load, driving torque, and pullout load were found, demonstrating that these methods are able to discern differences in performance between different screw designs. Finally, this study demonstrated it is possible to adapt the test methods outlined in ASTM F543-07 to evaluate the insertion load, driving torque, and axial pullout performance of self-drilling screws in addition to self-tapping screws.


We adopt a multi-theoretic approach to investigate a previously unexplored phenomenon in extant literature, namely the differential impact of ownership identity and director dominate shareholding on the performance of emerging market firms. The main research question addressed is, whether the impact of this relationship is conditional on the identity of the block investor. First, the relationship between overall block ownership and firm performance is tested by employing multiple regressions on 500 firm-year observations for the period from 2007 to 2011. Then, the block ownership is classified as the state, individuals, insiders, financial institutions, corporate and foreign investors and the influence of these identities on firm performance is examined. It was found that only the ownership categories such as the government, institutions and foreign ownership have positive influence on the firm performance. The results also indicate that high level of insider ownership also negatively associated with the firm performance. The main contribution of this paper is the examination of the relationship between block ownership and firm performance from the perspective of the identity of investors.


Successive Australian Defence Ministers have been frustrated and occasionally embarrassed by the quality of advice and information provided to them by the Defence organisation. Decades of reviews and reorganisations have failed to find solutions to the special difficulties that Defence faces in providing accurate, timely information and advice to ministers across the broad spectrum of their responsibilities. This article argues that there are multiple explanations for the concerns that are frequently expressed about its policy advisory capacity - most of which are inherent to Defence organisations around the world. While the Defence culture of secrecy is partly responsible, other factors such as the scale of Defence's operations, the multiple cultures that exist within it (military, civilian, and intelligence) that make coherence harder than in more homogenous departments, the long-time horizons of defence planning as well as the high costs of procurement, must also be considered. The erosion of trust between the organisation and minister has been exacerbated by the intense scrutiny of the media that overburdens ministers and adds another layer of complexity to their role. As history shows, there are push and pull factors that continue to embroil ministers in the minutiae of defence difficulties, while the complexity and scale of operations will undoubtedly continue to impact on the timeliness of advice.


OBJECTIVE
To characterize the nature and degree of hospitals' efforts to collaborate with skilled nursing facilities (SNFs) and associated patient outcomes.

DATA SOURCES/STUDY SETTING
Qualitative data were collected through 138 interviews with staff in 16 hospitals and 25 SNFs in eight markets across the United States in 2015. Quantitative data include Medicare claims data for the 290,603 patients discharged from those 16 hospitals between 2008 and 2015.

STUDY DESIGN/DATA COLLECTION
Semi-structured interviews with hospital and SNF staff were coded and used to classify hospitals' collaboration efforts with SNFs into high versus low collaboration hospitals, and risk-adjusted, claims-based hospital readmission rates from SNF were compared.

PRINCIPAL FINDINGS
Hospital collaboration efforts were defined as establishing SNF partners, transition management initiatives, and hospital staff visits to SNFs. High collaboration hospitals were more likely to send patients to SNFs (as opposed to home, home with home health, or other PAC settings), sent a higher share of patients to high quality SNFs, and had fewer hospital readmissions from SNF sooner than did low collaboration hospitals.

CONCLUSIONS
Although collaboration with SNF requires significant administrative and clinical time investment, it is associated with positive patient outcomes.


In 2003 an agreement was finalized to instigate arguably the most significant reform of the European Union's (EU) Common Agricultural Policy (CAP) since its inception. In the Luxembourg Agreement many of the direct payments that have been linked to production are decoupled and instead provided in the form of a land-based payment. The reforms did not include any significant changes to either EU border support or the ability of the EU to utilize export subsidies that have been widely criticized by other nations. Even though the reforms do not directly address trade in agricultural products it is argued that World Trade Organization (WTO) concerns played a significant role in the designs of the reforms. In this paper an analysis of the Luxembourg reforms and the European proposal for agriculture under the WTO is presented. The results are used as the basis for a discussion of the interaction of the WTO and CAP reform and the implications for the agricultural sector in the EU.


Network based congestion avoidance which involves managing the queues in the network devices is an integral part of any network. Most of the mobile networks today use Droptail queue management where packets are dropped on queue overflow. Droptail, however, is known to suffer from the well known global synchronisation problem which is characterised by the phenomenon of alternating periods of empty and full queues and hence bursty losses. Especially in resource constrained networks such as MANETs, packet loss results in increased overhead in terms of energy wasted to forward a packet which was eventually dropped, additional energy required to retransmit this packet and the degraded service quality as experienced by the end user application. Active queue management (AQM) has been successfully demonstrated as a solution to the global synchronisation problem in the context of wired networks. However, if AQM is to be deployed in MANETs, it should be lightweight, proactive and easy to implement as mobile networks are resource constrained in terms of memory, processing power and battery life. To the best of our knowledge a study addressing the implications of AQM in mobile networks (MANETs in particular) does not exist. This paper presents a predictive queue management strategy named PAQMAN that proactively manages the queue, is simple to implement and requires negligible computational overhead (and hence uses the limited resources efficiently). The performance of PAQMAN (coupled with explicit congestion notification - ECN) has been compared with Droptail through ns2 simulations. Results from this study show that PAQMAN reduces packet loss ratio (and hence the fraction of retransmissions) while at the same time increasing transmission efficiency. Moreover, as its computational overhead is negligible, it is ideally suited for deployment in MANETs


This Article addresses the question whether there is or should be a church autonomy doctrine, which protects religious institutions from the force of the law. Anglo-American history, philosophy, theology, republican theory, and Supreme Court doctrine answer the question in the negative. The article traces the history of special privileges for religious entities to avoid the law since the twelfth century in Britain, and shows the decline in such privileges and a corresponding rise in the common law and the rule of law. Under republican principles, legislatures are charged with enacting laws that serve the public good, and a core principle is that individuals have a freedom of conscience, but may not act to harm others. This no-harm principle runs through the common law, the rule of law, republicanism, and important thinkers for United States history including John Locke, Thomas Jefferson, James Madison, John Witherspoon, and especially John Stuart Mill, whose ideas were furthered by H.L.A. Hart and Joel Feinberg. Thus, the arguments raised by religious entities today for autonomy from the law are anachronistic, a throwback to principles that have lost their legitimacy. Religious entities may be exempted from the laws that protect others from harm - which include at the least criminal law, tort law, and regulatory law - only when the legislature has crafted an explicit exemption and granted that exemption in light of the public good.


Extracted from text ... The overarching theme of this issue of the
African Security Review is 'Criminal business
on the African continent' with particular focus
on organised crime, money laundering and
corruption. Though highly pertinent, this is a
controversial topic. Critics argue that juxtaposing
'criminal business' and Africa contributes to
the negative image already imprinted amongst
many international financiers, donor countries
and agencies, the press and other stakeholders.
Yet, a 2005 United Nations Office on Drugs
and Crime (UNODC) report on "Crime and
development in Africa" contends that high levels
of crime may be delaying Africa's development.
The report refers to crime as "these ..


Long‐term issues following diagnosis and treatment of a childhood brain tumour often become apparent as the survivor enters adolescence and young adulthood. Their caregivers may additionally face long‐term impacts on their emotional and psychological functioning. This review synthesised evidence on the issues and supportive care needs of adolescent and young adult (AYA) survivors of a brain tumour diagnosed in childhood and their caregivers.


For more than two thousand years a familiarity with mathematics has been regarded as an indispensable part of the intellectual equipment of every cultured person. Today, unfortunately, the traditional place of mathematics in education is in grave danger. The teaching and learning of mathematics has degenerated into the realm of rote memorization, the outcome of which leads to satisfactory formal ability but does not lead to real understanding or to greater intellectual independence. This new edition of Richard Courant's and Herbert Robbins's classic work seeks to address this problem. Its goal is to put the meaning back into mathematics. Written for beginners and scholars, for students and teachers, for philosophers and engineers, What is Mathematics?, Second Edition is a sparkling collection of mathematical gems that offers an entertaining and accessible portrait of the mathematical world. Covering everything from natural numbers and the number system to geometrical constructions and projective geometry, from topology and calculus to matters of principle and the Continuum Hypothesis, this fascinating survey allows readers to delve into mathematics as an organic whole rather than an empty drill in problem solving. With chapters largely independent of one another and sections that lead upward from basic to more advanced discussions, readers can easily pick and choose areas of particular interest without impairing their understanding of subsequent parts. Brought up to date with a new chapter by Ian Stewart, What is Mathematics?, Second Edition offers new insights into recent mathematical developments and describes proofs of the Four-Color Theorem and Fermat's Last Theorem, problems that were still open when Courant and Robbins wrote this masterpiece, but ones that have since been solved. Formal mathematics is like spelling and grammar-a matter of the correct application of local rules. Meaningful mathematics is like journalism-it tells an interesting story. But unlike some journalism, the story has to be true. The best mathematics is like literature-it brings a story to life before your eyes and involves you in it, intellectually and emotionally. What is Mathematics is like a fine piece of literature-it opens a window onto the world of mathematics for anyone interested to view.


The majority of the American public would be astonished by the frequency with which counterfeit prescription drugs appear on reputable drug store shelves. In 2004, the Food and Drug Administration (FDA) noted that those who counterfeit prescription drugs "deny ill patients the therapies that can alleviate suffering and save lives." In 2006, the World Health Organization (WHO) estimated that there exists a $30 billion market in fake drugs. Although the FDA has tried to characterize the incidence of counterfeit medications in the United States prescription drug marketplace as "rare," numerous instances of counterfeit drugs reaching consumers from the shelves of large, retail pharmacy chains have been well-documented. As a result, the FDA has lifted the stay on a nearly fifteen-year-old regulation that requires distributors of prescription drugs to document the sources of the drugs they peddle. In fact, the high risk of receiving fake or diverted drugs in the United States has been referred to as "pharmaceutical roulette" for millions of American patients.


Abstract Some believe that the planet Mars holds promise as a new home for humankind and that it could become the focus of a large scale colonisation effort at some undefined point in the future. In this paper I support the assertion that Mars holds promise as a site for human scientific, and possibly commercial, exploration, but I question the idea that Mars will be colonised in a manner akin to the New World. The surface of Mars is physically extreme. Mean annual temperature is—60°C, the ultraviolet radiation flux is a thousand times more damaging to DNA than that found on the surface of the earth, and there is little or no liquid surface water. The atmosphere is unbreathable and the soil may be toxic. Although Mars is less awful than the most awful places in the solar system (such as the radiation bombarded surfaces of the Jovian moons), it is considerably more awful than the most extreme places on earth, such as the continental interior of Antarctica and the High Arctic. I suggest that the polar model of human settlement is the most accurate from which to extrapolate the future of human Mars exploration, but even this model is optimistic. Using the most hopeful assessments of colonisation prospects, the human population of Mars would be a maximum of about three million people, and would most probably be substantially less. Understanding the most likely social trajectory of human Mars exploration is not only sociologically interesting, but it is practically important for determining how Mars exploration programmes should be presented to the public.


The aim of the project is to design a curriculum thread that delivers appropriate bioscience to pre-registration nurses throughout their three year programme and to explore new and innovative methods of delivery that can be used to stimulate interest and learning, equipping student nurses with the skills to continue learning beyond their three years of study and with the skill to deliver high quality patient care. The proposal is to change the first year bioscience module so that it is closely linked with the delivery of the first year skills module - so if the students are learning about blood pressure and pulse - that same week they would have a session on the cardiovascular system. If they are having a skills session on fluid balance, they would have a bioscience session on renal physiology and so on. The bioscience module would have to be delivered as small group sessions in line with the skills module. The current large lecture format is not the favoured method of delivery of the current students. Student feedback also suggests that students enjoy the positive reinforcement of learning that occurs from the lab session within the current curriculum. However, as lab availability is limited, investigation is ongoing to find resources that will allow the creation of a lab type experience within a classroom setting. The impact the proposed changes will have on the student experience will be evaluated through student feedback ensuring the curriculum and delivery of bioscience continues to develop into the second and third year of the programme of study.


The merit of attempting to treat burn wounds has long been appreciated
since the last century, at least in the sense of providing a clean wound,
avoiding formation of purulent and exudation as well as to enhance a
granulation and reepithelization. It has been a special consideration in
medical practice as bum denatures cellular protein, inhibits cellular
metabolism hence secondary interference of local vascular supply.
Therefore, the present study was designed to investigate the effect of a crude
methanolic extract of Eupatoriurn odoraturn, Channa striatus and Centella
asiatica on burn wound healing as these natural resources have been
traditionally used in burn treatment. A standard reproducible of second degree burn wounds was inflicted using a cylindrical stainless steel template
(2.5 an diameter) on 225 adult male Sprague Dawley weighing between 250 -
350g. The animals were divided into five groups with nine animals in each
group, representing a control and experimental groups. Extracts of
Eupatoriurn odoraturn, Channa striatus and Centella asiatica with silver
sulphadiazine, as a standard treatment were applied twice daily, except in
the control group where wounds were left without any topical treatment.
The rats were closely monitored to assess any changes. The rats were
euthanized at 3, 7, 14, 21 and 28 days post burned. The macroscopic
appearance of burn wounds was evaluated and recorded. The percentage of
wound contractions was measured. The burn sites were excised and
subjected to water content assessment and biomechanical study. Apart from
that, histological study was also performed qualitatively and quantitatively
using a hematoxylin and eosin and Masson's trichrome staining.
Results obtained from this study revealed that from macroscopic study,
Eupatoriurn odoraturn showed advanced effect to minimize the progression of
zone of stasis as compared to other groups. Quantitative evaluation of the
number of inflammatory cells (polymorphonuclear leucocytes, and
macrophages) from day 3 to day 28 in wounds treated with Eupatoriurn
odorafurn demonstrated sigruficant fall in number of inflammatory cells
(polymorphonuclear leucocytes, and macrophages) from day 3 to day 28,
whereas the number of proliferative cells (fibroblasts and endothelial cells) increased from day 7 to day 28. The Eupatorium odoratum also showed
potential to preserve viable dermal tissue and induce a well-formed of
angiogenesis with better organization as compared to other treatments. A
semi quantitative wound scoring system used to evaluate the collagen
bundles indicated that the Eupatorium odoratum treated burns demonstrated a
better orientation of collagen as compared to other experimental groups as
characterized by more densely packed fibres with thick bundles of wellaligned
collagen and showed a basket-weave-like pattern with a more
random structure. Eupatorium odoratum also promoted remodeling of
collagen by synthesis of inter and intra-molecular protein crosslinking and
thus produced a marked increased @<0.05) in tensile strength as compared
to other experimental groups. Eupatorium odoratum also consistently
prevented burn edema as shown by reduction in wet to dry weight ratio of
- -
the burn site tissues. On the other hand, burn wounds treated with Channa
striatus showed earlier re-epithelialization as early as 3 days post burned
while Eupatotium odoratum treated burn wounds at day 7. The results also
demonstrated that burn wounds treated with Channa striahrs showed rapid
cleansing of the wound with minimal scarring at day 28.In conclusion, the present study showed that the Eupatoriurn odoraturn was
the most superior treatment agent for burn wounds followed by Channa
striahcs and then Centella asiatica in relation to macroscopic evaluation,
histological findings, edema measurement and biomechanical property.


To optimally allocate its marketing mix across customers, a firm needs to consider the evolution of its customers over time. Changes in the marketing environment, as well as intrinsic changes in preferences or needs, may discretely shift customers into different buying-behavior states. The ability to identify the dynamics in customer behavior and its drivers presents an opportunity for the firm to influence the movement of customers to more favorable states of buying behavior. Accordingly, we address the following managerial questions in this research: (1) how can the firm dynamically segment its customer base? (2) what are the short- and long-term effects of marketing activities? and (3) how should the firm allocate and target its marketing resources to maximize long-term profitability? To address these questions we propose a non-homogeneous hidden Markov model that accounts for dynamics in customer behavior, the long-term impact of marketing actions, and customer heterogeneity. We capture dynamics in customer behavior by allowing customers to transition over time among a set of latent states of buying behavior. We develop a unique and flexible approach to capture the enduring effect of marketing actions by incorporating a non-stationary transition matrix that is dynamically affected by these actions. To optimally allocate marketing activities, we formulate a dynamic programming approach which takes into account the evolution of customers' behavior. We apply the model in the context of direct-to-physicians marketing in a major pharmaceutical company. The results suggest that physicians transition among three behavioral states over time, showing a high degree of dynamics. Furthermore, the direct-to-physician marketing activities have varying degrees of short- and long-term effects that depend on the physician's prescription-behavior state. Specifically, we find that (i) both detailing and sampling have mostly long-term effects; (ii) detailing and sampling have a total duration impact of approximately 10 and 5 months, respectively; (iii) detailing is most effective as an acquisition marketing tool, whereas sampling is most effective as a retention tool. Using a counterfactual analysis, the optimization results show that by applying our dynamic marketing allocation approach, the firm could increase the number of prescriptions and its profits by as much as 51% and 80%, respectively. Moreover, our analysis suggests that the pharmaceutical firm should decrease its current detailing and sampling efforts by 30% and 20%, respectively. The integrative framework we propose provides important marketing implications for managing customers and maximizing long-run profitability.


The present study aims to define the basic parameters of rheumatic diseases. It focuses mainly to social parameters because of the emphasis given lately to the social character of health and illness. For this purpose greek and other literature were reviewed as well as sources from the internet. The results of this review are the following: ι) family's role is fundamental for the protection of psychological, mental and bodily health of persons suffering from rheumatic diseases, ii) the educational status of patients suffering from rheumatic diseases is also important because it affects their health attitudes and behavior, ιιι) the social and financial status of patients suffering from rheumatic diseases reflects on their health, iv) healthy social relationships are supportive and affect positively the health of patients suffering from rheumatic diseases, v) the working status and environment affect directly and indirectly the health of patients suffering from rheumatic diseases, vi) social distress affects negatively the rheumatic diseases, vii) environmental factors affect significantly the rheumatic diseases, viii) the way of life and human behavior concerning health are considered to be basic parameters in defining rheumatic diseases.