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  • image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/

    Abstract Aim-The most common vulvar squamous cell carcinoma (conventional SCC) occurs in elderly women and develops following a HPV-negative pathway. Since the highest incidence of conventional SCC is observed in patients with low oestrogen levels (postmenopausal women), we sought to investigate whether hormonal factors could play a role in the development of cancer. Methods and Results-The expression profile of oestrogen receptor ? (ER?), ER? and PR, in a section containing both normal and tumour tissue, as well as the SCC-associated vulvar lesion, was evaluated in thirty-four elderly patients. Besides, since recent studies have identified E-cadherin as a novel transcriptional target of oestrogen signalling, the modulation of this Epithelial-Mesenchimal-Transition (EMT) marker was studied. Finally, the expression of the proliferation marker Ki67 and of the apoptotic marker p53 was assessed. Results showed that changes in both ER? and ER? expression characterize the transition from normal epithelium to cancer in patients with vulvar SCC: ER? was lost in cancer, while ER? decreased, mainly showing cytoplasmic localization. A reduction in the expression of E-cadherin was also observed in tumours, compared with normal epithelium. Conclusion-Data from the present pilot study puts the ER signalling pathway into the spotlight as a potentially important player in vulvar carcinogenesis. gfzannoni@rm.unicatt.it (Zannoni, Gian Franco) mariagrazia.prisco@rm.unicatt.it (Prisco, Maria Grazia) vgvellone@hotmail.com (Vellone, Valerio Gaetano) ilaria.destefano@rm.unicatt.it (De Stefano, Ilaria) giovanni.scambia@rm.unicatt.it (Scambia, Giovanni) d.gallo@rm.unicatt.it (Gallo, Daniela) Catholic University of the Sacred Heart, Histopathology - Rome - ITALY (Zannoni, Gian Franco) Catholic University of the Sacred Heart, Obstetrics and Gynecology - Rome - ITALY (Prisco, Maria Grazia) Catholic University of the Sacred Heart, Histopathology - Rome - ITALY (Vellone, Valerio Gaetano) Catholic University of the Sacred Heart, Obstetrics and Gynecology - Rome - ITALY (Vellone, Valerio Gaetano) Catholic University of the Sacred Heart, Obstetrics and Gynecology - Rome - ITALY (De Stefano, Ilaria) Catholic University of the Sacred Heart, Obstetrics and Gynecology - Rome - ITALY (Scambia, Giovanni) Catholic University of the Sacred Heart, Obstetrics and Gynecology - Largo A. Gemelli, 8--> - 00168 - Rome - ITALY (Gallo, Daniela) ITALY

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  • image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/
    Authors: Baker, Gemma;

    The present study employed a correlational design to test the relationship between the measured variables of: reverse culture shock, social support availability, social support satisfaction among a convenience of returned volunteers (n=8 males, n=35 females), who participated voluntarily. The results indicated statistically significant correlations between reverse culture shock and social support satisfaction (tau_b =-.469, p<0.01, 1 tailed), reverse culture shock and social support availability (tau_b =-.289, p<0.01,1 tailed), reverse culture shock and agreeableness (tau_b =-.307, p<0.01,1 tailed), and reverse culture shock and neuroticism (tau_b =.572, p<0.01,1 tailed). Additionally an independent samples design was employed to test the differences in the independent variables of active church membership, and the measured variable of age and gender. The results indicated statistically significant results between reverse culture shock and gender. No statistically significant results were found to exist between reverse culture shock and active church membership or the variable of age. Author keywords: Reverse culture shock, personality traits, social support, returned volunteers

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    DBS Esource
    2012
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      DBS Esource
      2012
      Data sources: DBS Esource
  • image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/

    Abstract We develop power series approximations for a discrete-time queueing system with two parallel queues and one processor. If both queues are nonempty, a customer of queue 1 is served with probability ?, and a customer of queue 2 is served with probability 1??. If one of the queues is empty, a customer of the other queue is served with probability 1. We first describe the generating function U(z1,z2) of the stationary queue lengths in terms of a functional equation, and show how to solve this using the theory of boundary value problems. Then, we propose to use the same functional equation to obtain a power series for U(z1,z2) in ?. The first coefficient of this power series corresponds to the priority case ?=0, which allows for an explicit solution. All higher coefficients are expressed in terms of the priority case. Accurate approximations for the mean stationary queue lengths are obtained from combining truncated power series and Pade approximation. jw@telin.UGent.be (Walraevens, Joris) j.s.h.v.leeuwaarden@tue.nl (Leeuwaarden, J. S. H.) o.j.boxma@tue.nl (Boxma, Onno J.) Department of Telecommunications and Information Processing, Ghent University ? UGent - Sint-Pietersnieuwstraat 41 - 9000 - Gent - BELGIUM (Walraevens, Joris) Eindhoven University of Technology and EURANDOM - P.O. Box 513 - 5600 MB - Eindhoven - NETHERLANDS (Leeuwaarden, J. S. H.) Eindhoven University of Technology and EURANDOM - P.O. Box 513 - 5600 MB - Eindhoven - NETHERLANDS (Boxma, Onno J.) BELGIUM NETHERLANDS Registration: 2010-07-12 Received: 2008-05-16 Revised: 2010-07-09 ePublished: 2010-08-25

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  • image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/
    Authors: Denman, Peter;

    Anyone who enjoyed Patrick Deeley's assured first collection, Intimate Strangers, will find here more of the same, continuing particularly some of the concerns in the first part of that book. The Stylized City offers selections from four earlier collections by John F. Deane, with revisions, and twenty nine new poems. The flowering Tree is a good selection of twentieth-century poems in Irish with translations into English, given a generous introduction by declan Kiberd. The Irish poems "of Faith and Doubt" gathered in The Cold Heaven are drawn from the last 170 years or so, but the nineteenth century is thinly represented - too much faith and not enough doubt, in public utterance at least.

    image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/ Maynooth University ...arrow_drop_down
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      image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/ Maynooth University ...arrow_drop_down
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  • image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/

    Abstract Introduction Various forms of the managed-care concept have been conceived to reconcile the medical professionalism with necessary cost-cutting measures in health-care provision. A plethora of bureaucratic regulations and required paperwork result in increasing resignation among physicians and withdrawal from patient care. Options An appropriate option would be to focus not on structures and processes, but primarily on patient-related outcomes. We describe suitable options, their possible consequences, possible developments, and conclusions that can be derived. Prognoses Neglecting a trustful doctor-patient relationship risks forfeiting fundamental parts of essential health-care provision. Patients? preferences have to be respected, while unnecessary risks and expenses have to be avoided. Further development At least 12 dimensions influence the balance between medical professionalism and economics. The success of our health-care systems will depend on the best possible mix. Conclusion An optimal health-care system is characterized neither by the structures nor processes of health-care delivery, but by the quality of patient outcomes. Our patients must be involved in the description of the goals they want to achieve so that physicians can select the best possible ways to attain these goals. phone: +49-731-50069250 (Porzsolt, Franz) franz.porzsolt@uniklinik-ulm.de (Porzsolt, Franz) Clinical Economics, Ulm University - Frauensteige 6 - D-89073 - Ulm - GERMANY (Porzsolt, Franz) GERMANY Registration: 2009-03-20 Received: 2008-12-18 Accepted: 2009-03-17 ePublished: 2009-04-07

    image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/ Trinity's Access to ...arrow_drop_down
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  • image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/

    Our economy is in a strong position having recovered impressively from the financial crisis and the subsequent recession. At its nadir in early 2012, the unemployment rate was 16% and almost 50,000 Irish people emigrated that year. Eight years on, Ireland can be proud of the progress made. The seasonally adjusted unemployment rate is down to 5.7% at the end of 2018, almost 2.28 million people are at work and forced emigration has ended. However, there is no room for complacency. Significant vulnerabilities are evident in the domestic economy such as declining productivity levels in small-to medium-sized enterprises (SMEs). Infrastructural constraints, skills deficits and labour availability, as well as concentrations in some sectors and markets could, unless ameliorated, impede further progress. Internationally, Brexit, growing trade protectionism and the undermining of the rules-based international trading system could threaten our future economic welfare. The Government is ambitious to build upon the gains we have made in recent years and to ensure our people enjoy higher standards of living and quality of life now, and into the future. Several interconnected Government initiatives are underway to reinforce this. Project Ireland 2040 provides the framework for making Ireland a great place to live - and do business - through integrated spatial and investment strategies. Global Ireland will boost our international relations so that we can better influence our place in the world and targets an ambitious doubling of our overseas impact. Complementing these initiatives, Future Jobs Ireland will ensure our enterprises and workers are well placed to prosper in the rapidly changing global economy.

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    Resume Depuis ces dernieres annees, l?utilisation des jeux video apparait comme l?un des loisirs preferes des enfants et des adolescents. Cependant, les etudes portant sur l?addiction aux jeux video sont encore peu nombreuses. Afin d?evaluer les difficultes induites par une excessive des jeux video, l?equipe du Dr Tejeiro a developpe un autoquestionnaire : le questionnaire des problemes associes aux jeux video (Problem Video Game Playing Scale, Tejeiro, 2002). Nous avons traduit ce questionnaire avec l?accord de l?auteur et effectue, ensuite, une . Population Cinquante enfants (21 enfants temoins et 29 enfants presentant un trouble deficit de l?attention avec hyperactivite [TDA/H]) ont participe a cette etude. Ils ont tous ete evalues sur leur consommation de jeux video (Echelle PVP), ainsi que sur leurs niveaux de symptomatologie externalisee (Echelle de Conners et Child Behavior Checklist). Resultats Aucun des enfants temoins n?a repondu affirmativement a plus de quatre questions, tandis que dix enfants hyperactifs parmi les 29 ont repondu de facon affirmative (p=0.02). Au vu des resultats obtenus au questionnaire PVP, nous avons distingue deux sous-groupes parmi la population d?enfants hyperactifs : les enfants ayant un score superieur ou egal a cinq (N=10, groupe 1), et ceux ayant un score inferieur a cinq. Les sujets du groupe 1 presentaient un index d?hyperactivite a l?echelle de Conners superieur (p=0.02), et obtenaient a la Child Behavior Checklist des scores superieurs sur les dimensions comportements delinquants (p=0.03), comportements agressifs (p=0.02), et troubles externalises (p=0.01). Conclusion Les enfants hyperactifs presentent davantage de problemes associes aux jeux video. Les enfants obtenant un score eleve a l?echelle PVP apparaissent avec un profil clinique comportemental particulier. Cet outil apparait utile, pour le clinicien, dans la description des comportements des enfants et des adolescents face aux jeux video. Aussi, il est necessaire d?utiliser ce questionnaire, dans sa version francaise, sur des populations plus importantes. Abstract During recent decades, videogame playing has become one of the main leisure activities in children and adolescents. However, studies on video game addiction are still very few. In order to evaluate the difficulties induced by an excessive ?consumption? of video games, the team of Dr. Tejeiro developed a self-rating questionnaire: the Problem Videogame Playing questionnaire (PVP, Tejeiro, 2002). We translated this questionnaire with the agreement of the author and carried out, then, a ?back-translation?. Population The sample consisted of 50 children (29 children with an Attention Deficit Hyperactivity Disorder [ADHD] and 21 controls). All subjects were evaluated on their consumption of video games (PVP scale) and on their levels of externalized symptomatology by the Conners Parent rating scale and the Child Behavior Checklist (CBCL). Results None the controls scored above four on the PVP scale whereas 10 hyperactive children among the 29 answered affirmatively to five or more questions (p=0.02). We focused on PVP scores, and we distinguished two sub-groups among the hyperactive population: children having a score equal to or higher than 5 (N=10, group 1) and those having a score lower than 5 (group 2). The subjects of group 1 presented a higher index of hyperactivity on the Conners Parents rating scale than group 2 (p=0.02); and obtained higher scores on the Child Behavior Checklist, on the delinquent subscale (p=0.03), the aggressive subscale (p=0.02) and on externalizing problems (p=0.01). Conclusion The hyperactive children present more problems associated with video games. Children with high PVP scores appear with a particular behavioral clinical profile. This tool appears useful, for the clinician, in the description of the behaviours of children and teenagers towards video games. Also, it is necessary to use this questionnaire, in its French version, on larger populations. correspondence: Corresponding author. Pole Universitaire de Psychiatrie de l?Enfant et l?Adolescent (Pr Bouvard), Hopital Charles Perrens, 121, rue de la Bechade, 33076 Bordeaux cedex, France. Tel.: +05 56 56 17 19. (Bioulac, S.) stephaniebioulac@hotmail.com (Bioulac, S.) Pole Universitaire de Psychiatrie de l?Enfant et l?Adolescent (Pr Bouvard), Hopital Charles Perrens - 121--> , rue de la Bechade--> , 33076 Bordeaux cedex--> - FRANCE (Bioulac, S.) Centre Jean Abadie - SUHEA--> , 89--> , rue des Sablieres--> , 33077 Bordeaux cedex--> - FRANCE (Bioulac, S.) FRANCE (Bioulac, S.) Pole Universitaire de Psychiatrie de l?Enfant et l?Adolescent (Pr Bouvard), Hopital Charles Perrens - 121--> , rue de la Bechade--> , 33076 Bordeaux cedex--> - FRANCE (Arfi, L.) Centre Jean Abadie - SUHEA--> , 89--> , rue des Sablieres--> , 33077 Bordeaux cedex--> - FRANCE (Arfi, L.) Pole Universitaire de Psychiatrie de l?Enfant et l?Adolescent (Pr Bouvard), Hopital Charles Perrens - 121--> , rue de la Bechade--> , 33076 Bordeaux cedex--> - FRANCE (Michel, G.) Centre Jean Abadie - SUHEA--> , 89--> , rue des Sablieres--> , 33077 Bordeaux cedex--> - FRANCE (Michel, G.) Pole Universitaire de Psychiatrie de l?Enfant et l?Adolescent (Pr Bouvard), Hopital Charles Perrens - 121--> , rue de la Bechade--> , 33076 Bordeaux cedex--> - FRANCE (Bouvard, M.-P.) Centre Jean Abadie - SUHEA--> , 89--> , rue des Sablieres--> , 33077 Bordeaux cedex--> - FRANCE (Bouvard, M.-P.) FRANCE

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    Abstract The loss calculation in soft magnetic materials, used in the manufacturing industry, is still ruled by Steinmetz's simple law. It has remained unchallenged for more than a century, unproven but successfully used by designers of magnetic components. Based on experiments carried out on soft NO Fe?Si and Mn?Zn ferrite samples, in this paper we present a model of Steinmetz's approximation, based on the hyperbolic model. We also make suggestions for the formula's possible extension to a wider range of coercivity, possibly covering not only soft iron but also other groups of magnetic materials as well, used in industry. jenotakacs@aol.com (Takacs, J.) Department of Engineering Science,--> - Oxford - UNITED KINGDOM (Takacs, J.) Physics of Eotvos Lorant Univ. 1518 - Budapest - HUNGARY (Kovacs, Gy.) 1525 - Budapest - HUNGARY (Varga, L. K.) HUNGARY UNITED KINGDOM Received: 2010-02-08 Revised: 2010-06-03 Accepted: 2010-06-04

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    Authors: McCormick, Jerome;

    This is part of a series of letters between Jerome McCormick and his mother between the years 1967 and 1971. During this period Jerome originally from Cork was studying to be a chef and travelling through Ireland and Europe. These letters describe the many places he worked in and the type of training he received there.

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    Other ORP type . 1967
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    Abstract Aim-The most common vulvar squamous cell carcinoma (conventional SCC) occurs in elderly women and develops following a HPV-negative pathway. Since the highest incidence of conventional SCC is observed in patients with low oestrogen levels (postmenopausal women), we sought to investigate whether hormonal factors could play a role in the development of cancer. Methods and Results-The expression profile of oestrogen receptor ? (ER?), ER? and PR, in a section containing both normal and tumour tissue, as well as the SCC-associated vulvar lesion, was evaluated in thirty-four elderly patients. Besides, since recent studies have identified E-cadherin as a novel transcriptional target of oestrogen signalling, the modulation of this Epithelial-Mesenchimal-Transition (EMT) marker was studied. Finally, the expression of the proliferation marker Ki67 and of the apoptotic marker p53 was assessed. Results showed that changes in both ER? and ER? expression characterize the transition from normal epithelium to cancer in patients with vulvar SCC: ER? was lost in cancer, while ER? decreased, mainly showing cytoplasmic localization. A reduction in the expression of E-cadherin was also observed in tumours, compared with normal epithelium. Conclusion-Data from the present pilot study puts the ER signalling pathway into the spotlight as a potentially important player in vulvar carcinogenesis. gfzannoni@rm.unicatt.it (Zannoni, Gian Franco) mariagrazia.prisco@rm.unicatt.it (Prisco, Maria Grazia) vgvellone@hotmail.com (Vellone, Valerio Gaetano) ilaria.destefano@rm.unicatt.it (De Stefano, Ilaria) giovanni.scambia@rm.unicatt.it (Scambia, Giovanni) d.gallo@rm.unicatt.it (Gallo, Daniela) Catholic University of the Sacred Heart, Histopathology - Rome - ITALY (Zannoni, Gian Franco) Catholic University of the Sacred Heart, Obstetrics and Gynecology - Rome - ITALY (Prisco, Maria Grazia) Catholic University of the Sacred Heart, Histopathology - Rome - ITALY (Vellone, Valerio Gaetano) Catholic University of the Sacred Heart, Obstetrics and Gynecology - Rome - ITALY (Vellone, Valerio Gaetano) Catholic University of the Sacred Heart, Obstetrics and Gynecology - Rome - ITALY (De Stefano, Ilaria) Catholic University of the Sacred Heart, Obstetrics and Gynecology - Rome - ITALY (Scambia, Giovanni) Catholic University of the Sacred Heart, Obstetrics and Gynecology - Largo A. Gemelli, 8--> - 00168 - Rome - ITALY (Gallo, Daniela) ITALY

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    Authors: Baker, Gemma;

    The present study employed a correlational design to test the relationship between the measured variables of: reverse culture shock, social support availability, social support satisfaction among a convenience of returned volunteers (n=8 males, n=35 females), who participated voluntarily. The results indicated statistically significant correlations between reverse culture shock and social support satisfaction (tau_b =-.469, p<0.01, 1 tailed), reverse culture shock and social support availability (tau_b =-.289, p<0.01,1 tailed), reverse culture shock and agreeableness (tau_b =-.307, p<0.01,1 tailed), and reverse culture shock and neuroticism (tau_b =.572, p<0.01,1 tailed). Additionally an independent samples design was employed to test the differences in the independent variables of active church membership, and the measured variable of age and gender. The results indicated statistically significant results between reverse culture shock and gender. No statistically significant results were found to exist between reverse culture shock and active church membership or the variable of age. Author keywords: Reverse culture shock, personality traits, social support, returned volunteers

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    2012
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      2012
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    Abstract We develop power series approximations for a discrete-time queueing system with two parallel queues and one processor. If both queues are nonempty, a customer of queue 1 is served with probability ?, and a customer of queue 2 is served with probability 1??. If one of the queues is empty, a customer of the other queue is served with probability 1. We first describe the generating function U(z1,z2) of the stationary queue lengths in terms of a functional equation, and show how to solve this using the theory of boundary value problems. Then, we propose to use the same functional equation to obtain a power series for U(z1,z2) in ?. The first coefficient of this power series corresponds to the priority case ?=0, which allows for an explicit solution. All higher coefficients are expressed in terms of the priority case. Accurate approximations for the mean stationary queue lengths are obtained from combining truncated power series and Pade approximation. jw@telin.UGent.be (Walraevens, Joris) j.s.h.v.leeuwaarden@tue.nl (Leeuwaarden, J. S. H.) o.j.boxma@tue.nl (Boxma, Onno J.) Department of Telecommunications and Information Processing, Ghent University ? UGent - Sint-Pietersnieuwstraat 41 - 9000 - Gent - BELGIUM (Walraevens, Joris) Eindhoven University of Technology and EURANDOM - P.O. Box 513 - 5600 MB - Eindhoven - NETHERLANDS (Leeuwaarden, J. S. H.) Eindhoven University of Technology and EURANDOM - P.O. Box 513 - 5600 MB - Eindhoven - NETHERLANDS (Boxma, Onno J.) BELGIUM NETHERLANDS Registration: 2010-07-12 Received: 2008-05-16 Revised: 2010-07-09 ePublished: 2010-08-25

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    Authors: Denman, Peter;

    Anyone who enjoyed Patrick Deeley's assured first collection, Intimate Strangers, will find here more of the same, continuing particularly some of the concerns in the first part of that book. The Stylized City offers selections from four earlier collections by John F. Deane, with revisions, and twenty nine new poems. The flowering Tree is a good selection of twentieth-century poems in Irish with translations into English, given a generous introduction by declan Kiberd. The Irish poems "of Faith and Doubt" gathered in The Cold Heaven are drawn from the last 170 years or so, but the nineteenth century is thinly represented - too much faith and not enough doubt, in public utterance at least.

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    Abstract Introduction Various forms of the managed-care concept have been conceived to reconcile the medical professionalism with necessary cost-cutting measures in health-care provision. A plethora of bureaucratic regulations and required paperwork result in increasing resignation among physicians and withdrawal from patient care. Options An appropriate option would be to focus not on structures and processes, but primarily on patient-related outcomes. We describe suitable options, their possible consequences, possible developments, and conclusions that can be derived. Prognoses Neglecting a trustful doctor-patient relationship risks forfeiting fundamental parts of essential health-care provision. Patients? preferences have to be respected, while unnecessary risks and expenses have to be avoided. Further development At least 12 dimensions influence the balance between medical professionalism and economics. The success of our health-care systems will depend on the best possible mix. Conclusion An optimal health-care system is characterized neither by the structures nor processes of health-care delivery, but by the quality of patient outcomes. Our patients must be involved in the description of the goals they want to achieve so that physicians can select the best possible ways to attain these goals. phone: +49-731-50069250 (Porzsolt, Franz) franz.porzsolt@uniklinik-ulm.de (Porzsolt, Franz) Clinical Economics, Ulm University - Frauensteige 6 - D-89073 - Ulm - GERMANY (Porzsolt, Franz) GERMANY Registration: 2009-03-20 Received: 2008-12-18 Accepted: 2009-03-17 ePublished: 2009-04-07

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    Our economy is in a strong position having recovered impressively from the financial crisis and the subsequent recession. At its nadir in early 2012, the unemployment rate was 16% and almost 50,000 Irish people emigrated that year. Eight years on, Ireland can be proud of the progress made. The seasonally adjusted unemployment rate is down to 5.7% at the end of 2018, almost 2.28 million people are at work and forced emigration has ended. However, there is no room for complacency. Significant vulnerabilities are evident in the domestic economy such as declining productivity levels in small-to medium-sized enterprises (SMEs). Infrastructural constraints, skills deficits and labour availability, as well as concentrations in some sectors and markets could, unless ameliorated, impede further progress. Internationally, Brexit, growing trade protectionism and the undermining of the rules-based international trading system could threaten our future economic welfare. The Government is ambitious to build upon the gains we have made in recent years and to ensure our people enjoy higher standards of living and quality of life now, and into the future. Several interconnected Government initiatives are underway to reinforce this. Project Ireland 2040 provides the framework for making Ireland a great place to live - and do business - through integrated spatial and investment strategies. Global Ireland will boost our international relations so that we can better influence our place in the world and targets an ambitious doubling of our overseas impact. Complementing these initiatives, Future Jobs Ireland will ensure our enterprises and workers are well placed to prosper in the rapidly changing global economy.

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    Resume Depuis ces dernieres annees, l?utilisation des jeux video apparait comme l?un des loisirs preferes des enfants et des adolescents. Cependant, les etudes portant sur l?addiction aux jeux video sont encore peu nombreuses. Afin d?evaluer les difficultes induites par une excessive des jeux video, l?equipe du Dr Tejeiro a developpe un autoquestionnaire : le questionnaire des problemes associes aux jeux video (Problem Video Game Playing Scale, Tejeiro, 2002). Nous avons traduit ce questionnaire avec l?accord de l?auteur et effectue, ensuite, une . Population Cinquante enfants (21 enfants temoins et 29 enfants presentant un trouble deficit de l?attention avec hyperactivite [TDA/H]) ont participe a cette etude. Ils ont tous ete evalues sur leur consommation de jeux video (Echelle PVP), ainsi que sur leurs niveaux de symptomatologie externalisee (Echelle de Conners et Child Behavior Checklist). Resultats Aucun des enfants temoins n?a repondu affirmativement a plus de quatre questions, tandis que dix enfants hyperactifs parmi les 29 ont repondu de facon affirmative (p=0.02). Au vu des resultats obtenus au questionnaire PVP, nous avons distingue deux sous-groupes parmi la population d?enfants hyperactifs : les enfants ayant un score superieur ou egal a cinq (N=10, groupe 1), et ceux ayant un score inferieur a cinq. Les sujets du groupe 1 presentaient un index d?hyperactivite a l?echelle de Conners superieur (p=0.02), et obtenaient a la Child Behavior Checklist des scores superieurs sur les dimensions comportements delinquants (p=0.03), comportements agressifs (p=0.02), et troubles externalises (p=0.01). Conclusion Les enfants hyperactifs presentent davantage de problemes associes aux jeux video. Les enfants obtenant un score eleve a l?echelle PVP apparaissent avec un profil clinique comportemental particulier. Cet outil apparait utile, pour le clinicien, dans la description des comportements des enfants et des adolescents face aux jeux video. Aussi, il est necessaire d?utiliser ce questionnaire, dans sa version francaise, sur des populations plus importantes. Abstract During recent decades, videogame playing has become one of the main leisure activities in children and adolescents. However, studies on video game addiction are still very few. In order to evaluate the difficulties induced by an excessive ?consumption? of video games, the team of Dr. Tejeiro developed a self-rating questionnaire: the Problem Videogame Playing questionnaire (PVP, Tejeiro, 2002). We translated this questionnaire with the agreement of the author and carried out, then, a ?back-translation?. Population The sample consisted of 50 children (29 children with an Attention Deficit Hyperactivity Disorder [ADHD] and 21 controls). All subjects were evaluated on their consumption of video games (PVP scale) and on their levels of externalized symptomatology by the Conners Parent rating scale and the Child Behavior Checklist (CBCL). Results None the controls scored above four on the PVP scale whereas 10 hyperactive children among the 29 answered affirmatively to five or more questions (p=0.02). We focused on PVP scores, and we distinguished two sub-groups among the hyperactive population: children having a score equal to or higher than 5 (N=10, group 1) and those having a score lower than 5 (group 2). The subjects of group 1 presented a higher index of hyperactivity on the Conners Parents rating scale than group 2 (p=0.02); and obtained higher scores on the Child Behavior Checklist, on the delinquent subscale (p=0.03), the aggressive subscale (p=0.02) and on externalizing problems (p=0.01). Conclusion The hyperactive children present more problems associated with video games. Children with high PVP scores appear with a particular behavioral clinical profile. This tool appears useful, for the clinician, in the description of the behaviours of children and teenagers towards video games. Also, it is necessary to use this questionnaire, in its French version, on larger populations. correspondence: Corresponding author. Pole Universitaire de Psychiatrie de l?Enfant et l?Adolescent (Pr Bouvard), Hopital Charles Perrens, 121, rue de la Bechade, 33076 Bordeaux cedex, France. Tel.: +05 56 56 17 19. (Bioulac, S.) stephaniebioulac@hotmail.com (Bioulac, S.) Pole Universitaire de Psychiatrie de l?Enfant et l?Adolescent (Pr Bouvard), Hopital Charles Perrens - 121--> , rue de la Bechade--> , 33076 Bordeaux cedex--> - FRANCE (Bioulac, S.) Centre Jean Abadie - SUHEA--> , 89--> , rue des Sablieres--> , 33077 Bordeaux cedex--> - FRANCE (Bioulac, S.) FRANCE (Bioulac, S.) Pole Universitaire de Psychiatrie de l?Enfant et l?Adolescent (Pr Bouvard), Hopital Charles Perrens - 121--> , rue de la Bechade--> , 33076 Bordeaux cedex--> - FRANCE (Arfi, L.) Centre Jean Abadie - SUHEA--> , 89--> , rue des Sablieres--> , 33077 Bordeaux cedex--> - FRANCE (Arfi, L.) Pole Universitaire de Psychiatrie de l?Enfant et l?Adolescent (Pr Bouvard), Hopital Charles Perrens - 121--> , rue de la Bechade--> , 33076 Bordeaux cedex--> - FRANCE (Michel, G.) Centre Jean Abadie - SUHEA--> , 89--> , rue des Sablieres--> , 33077 Bordeaux cedex--> - FRANCE (Michel, G.) Pole Universitaire de Psychiatrie de l?Enfant et l?Adolescent (Pr Bouvard), Hopital Charles Perrens - 121--> , rue de la Bechade--> , 33076 Bordeaux cedex--> - FRANCE (Bouvard, M.-P.) Centre Jean Abadie - SUHEA--> , 89--> , rue des Sablieres--> , 33077 Bordeaux cedex--> - FRANCE (Bouvard, M.-P.) FRANCE

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