The subject of this study is the earls and earldom of Mar c.1281-1513. Chapter 1 provides a description and analysis of the internal structure and administration of Mar, detailing the lands contained within each of Mar’s lordships and their respective caputs. This is supplemented by a breakdown of the Mar rental yields between 1435 and 1565, sourced from various accounts contained within the Exchequer Rolls. Chapter 2 charts the political development of the early earls and earldom of Mar between c.1281 and 1388. It is argued that the earldom suffered from extended periods of absentee lordship, instigating a decline in the earldom’s fortunes and importance, only interrupted by a brief revival between 1388 and 1435. Chapter 3 is concerned with the fortunes of Mar under the control of Mar’s only female countess to rule in her own right, Isabella Douglas, sister of James Douglas, 2nd earl of Douglas and Mar. The chapter draws particular attention to her attempts to consolidate her authority in the wake of debates surrounding the Douglas inheritance after 1388, and her response to Albany Stewart interference in her earldom between 1402 and 1404. In doing so, it presents an alternative interpretation of Countess Isabella’s role in the coup of 1404 led by Alexander Stewart, son of Alexander Stewart lord of Badenoch. This chapter also explores the issue of female authority, and argues that the proactive policies of Countess Isabella have been largely ignored in the historiography of the period. Chapter 4 provides an assessment of the earls and earldom of Mar from 1435-1513. Building on the examination of the career of Alexander Stewart, earl of Mar contained in chapter 3, this chapter explores the political ramifications of his death and the attempts by both the Erskines and the Lyles to secure their Mar inheritance. Their decision to court the Forbes family in a bid to secure local support for their claims highlights the hitherto underemphasized importance of this family as the font of local authority, and draws attention to the effect of Stewart’s death on the exercise of local lordship in Mar. Taken together, these four chapters will challenge current perceptions of Mar’s geographical development and political decline between c.1281 and 1513.

Les divisions de la créance ne renvoient qu’aux hypothèses de l’article 1309 du code civil : la division de la créance constituée au profit de plusieurs créanciers et la division de la créance dévolue à une pluralité d’héritiers. Pourtant, le procédé ne doit pas être réduit à ces deux occurrences. Peuvent être identifiées non seulement d’autres divisions de l’objet de la créance, mais également des divisions d’une autre forme, qui consisteraient en une répartition des prérogatives du droit de créance. Suivant un classement des divisions de la créance – division de l’objet de la créance, division des prérogatives du droit de créance –, il faut identifier les mécanismes qui y correspondent et, le cas échéant, établir des rapprochements susceptibles de compléter leur régime. S’agissant des divisions de l’objet de la créance, le modèle de l’article 1309 du Code civil consiste dans l’attribution, par un effet légal, à chacun des créanciers ou des héritiers du créancier d’un droit complet sur une fraction de l’objet de la créance. Au-delà, le modèle peut être reproduit par l’effet de la volonté grâce à des mécanismes – comme la cession partielle de créance – qui permettent de transmettre, par l’effet de la volonté, un droit sur une fraction de l’objet de la créance. S’agissant des divisions des prérogatives de la créance, le modèle réside dans le démembrement du droit de propriété. D’abord, ce modèle s’applique à la créance pour en diviser les prérogatives – avec l’usufruit de la créance ou un droit réel sui generis. Ensuite, se pose la question de l’imitation du modèle, c’est-à-dire de la possibilité de diviser directement les prérogatives du droit de créance. / The divisions of the credit-claim refer only to the hypotheses of article 1309 of the French Civil Code : the division of the credit-claim to the benefit of multiple creditors and the division of the credit-claim transferred to multiple heirs. However this process must not be limited to these two occurrences. Firstly, it is possible to identify other ways to divide the credit-claim’s subject matter. Secondly, the division of a credit-claim may consist in distributing the prerogatives resulting from the credit-claim. Following a typology of the divisions of the credit-claim – divisions of the subject matter of the credit-claim, division of the prerogatives resulting from the credit-claim -, it is necessary to identify the corresponding notions and, where appropriate, to suggest how their regimes can be perfected accordingly.As far as the divisions of the credit-claim’s subject matter are concerned, the way they are modelled on article 1309 of the Civil Code consists in conferring, through an effect of the legislation, to each creditor or to each creditor’s heir a full right on a fraction of the credit-claim’s subject matter. This initial model can be expanded, as it can be replicate through the effects of will, thanks to notions such as the partial assignment of the credit-claim which enable the transfer, through the effects of individual will, of right on a fraction of the credit-claim’s subject matter.As for the divisions of the prerogatives attached to the credit-claim, the archetypal reference is the dismemberment of ownership. Firstly, this archetype applies to the credit-claim in order to divide its prerogatives – with the usufruct of the credit-claim or a sui generis real right. Secondly, the question is whether it is possible to replicate the model, ie whether it is possible to divide directly the prerogatives of the credit-claim.

En France, l'usage des bases de données médico-administratives dans le cadre épidémiologique est récent comparativement à d'autres pays d'Europe, du fait notamment de leur complexité, liée à leur développement initial mené dans une optique comptable. Les travaux menés ont porté sur l'apport de ces bases de données à l'étude de la prise en charge et de la morbidité évitable dans l'asthme et dans l'ostéoporose. Dans un premier temps, nous avons montré que ces bases de données permettaient au travers d'algorithmes d'identifier des nourrissons asthmatiques et leurs exacerbations, et que la prise en charge de ces nourrissons n'était pas optimale en France, avec une forte consommation d'antibiotiques et de corticoïdes oraux. Nous avons prolongé ces recherches par la description de la prise en charge des asthmatiques enfants/adolescents et adultes, et les constats ont été les mêmes. Une surconsommation des traitements de crise a pu être mise en évidence, ainsi que des sous-groupes de patients à risque d'exacerbation sévère. Ces résultats nous ont amené à nous intéresser tout particulièrement à l'adhésion aux traitements de fond. Dans une étude menée sur 5 000 patients asthmatiques, le taux de couverture par un traitement de fond était en moyenne de 51%, et seuls 24% des patients avaient un taux de couverture supérieur ou égal au taux minimal recommandé (80%). Enfin, concernant l'ostéoporose, nous nous sommes attachés à décrire la prise en charge des patients ostéoporotiques sur une période de 6 ans, en nous concentrant particulièrement sur les changements de stratégies thérapeutiques / Anglais In France, the use of claims data in the epidemiological context is recent compared to other European countries, in particular because of their complexity, linked to their initial development for accounting purposes. This work was focused on the contribution of these databases to study disease management and unmet needs in asthma and osteoporosis. First, we showed that it was feasible, through algorithms, to identify in these data infants with asthma and their exacerbations, and we noted that management of these infants was not optimal, with high use of antibiotics and oral corticosteroids. We extended this research by describing the treatment of asthmatic children/adolescents and adults, with similar findings. Overuse of reliever therapy was observed, beyond the identification of subgroups at risk of serious exacerbation. These results led us to focus on adherence to controller therapy. In a study including 5,000 asthma patients, the coverage by controller therapy was 51%, and only 24% of patients had a higher coverage than the recommended minimum (80%). Finally, regarding osteoporosis, we described the treatment of osteoporotic patients over 6 years, with a particular focus on treatment switches

Employers want to reduce or eliminate claims of employee retaliation whenever possible because of associated negative organizational consequences such as legal liability, various financial costs for the organization, and negative effect on employee morale. As such, it is important to identify the factors that impact the court’s decision to rule in favor of the plaintiff or the defendant. The purpose of the present study is to identify factors driving the court’s decision, as well as to review the implications of recent Supreme Court holdings for retaliation issues. Supreme Court cases involving a claim of employee retaliation from BNSF v. White (2006) to the present were reviewed and coded on factors likely to influence the court’s decision. Implications associated with these factors and the implications of relevant Supreme Court holdings are discussed. The ability of the plaintiff to establish all three prongs of a retaliation claim was found to be important for the court to rule in his/her favor. If the retaliatory act meets or exceeds the EEOC deterrence standard, the court tended to favor the plaintiff. Finally, the results suggest that the plaintiff should use the organization’s grievance policy, if there is one, as the court tended to rule favorably for the plaintiff when he/she used the available grievance policy. Additional implications are explored and limitations are discussed.

Healthcare big data are a growing source of real-world data with which to identify and validate medications with repurposing potential. Previously, we developed a claims-based workflow to evaluate medications with potential to treat stimulant use disorders. In order to test the workflow, the framework was applied in the context of opioid use disorders (OUDs), for which there are medications with known efficacy. Using the Truven Marketscan Commercial Claims Database, a nested case-control analysis was conducted to determine the association between OUD medications (buprenorphine, naltrexone) and remission. Cases were defined as enrollees with a remission diagnosis and matched (1:4) to controls (individuals without remission) using incidence density sampling, with age group, sex, region, and index year as additional matching variables. After adjusting for behavioral health visits, polysubstance use disorders, and psychiatric disorders using conditional logistic regression, the odds of OUD medication exposure were 3.8 (99% confidence interval: 3.0 – 4.9) times higher in cases than controls. Evaluation of angiotensin converting enzyme inhibitors (e.g. lisinopril) as a negative control revealed no significant association between the medication and remission. This work demonstrates the feasibility of using administrative health claims data to evaluate the effectiveness of medications to treat substance use disorders.

Diversity structures (e.g. diversity trainings) have been implemented in companies to bring awareness to discrimination and promote equality (Shen, Chanda, D’Netto, & Monga, 2009). However, previous research has shown that diversity structures can act as legitimizing cues and can threaten the authenticity of claims of discrimination made by low-status groups (Dover, Major, & Kaiser, 2012). Ironically, high-status group are typically threatened by pro-diversity organizational messages (Dover, Major & Kaiser, 2015). Could diversity structures meant to help minorities make it more likely that high-status groups are more likely to believe bias claims from an in-group member? In Study 1, White participants were randomly assigned to read a description of a company that had a diversity training versus regular employee training, then read a claim of discrimination made by a White employee. They also completed a measure of White group identification. There was a significant interaction (Condition X GID), which suggested that when participants in the control condition identified more with their in-group, the more believable they found the claim of discrimination to be. The unexpected but interesting result could be due to the fact participants in the diversity condition withdrew their support of the White claimant because they did not want to appear racist or felt that the White claimant was acting as a bad in-group member. A replication of the Study 1 with the additional measures, group level social cost and individual level social cost was conducted, and the results did not replicate. However, exploratory mediation analyses revealed group level social cost served as a significant mediator for the relationship between GID and claim believability, perceptions of diversity structures and perceptions of policy changes while individual social cost did not. Implications for diversity structures, GID and future research directions are discussed.

Thesis (M.DEV.) --University of Limpopo, 2012. / This research presents a study to investigate impact of support services rendered to land restitution claim settlement, with a focus on Masakona community in Makhado municipality in Limpopo Province There is encouraging evidence from a number of studies, however that the period after land settlement or restitution is the most critical because the success of land reform is not only measured by the number of hectors restitution, but by the support services rendered to those restituted projects. However, in this study, indicators were developed with overall purpose of determining or assessing whether specific improvement is been realized after implementation of agricultural support services. The indicators include improved access to financial,( implements , mechanization and job creation), access to extension support (improved crop production owing to provided advisory services); access to market information; and capacity building (change in farmer’s skills and knowledge). The study includes a review of international and local literature on land reform (especially land restitution). It is based on repeated field visits to Masakona land restitution projects, interview with employed beneficiaries of Masakona restituted project, CPA management committee members and extension officers from Limpopo Department of Agriculture who are servicing the restituted projects. The findings of this study point to the need for the state to rethink its strategy on post- settlement support and the involvement of a range of institutions, especially local government, for the sustainability and productivity of these projects.

Continuity of patient care is an essential element of primary care because it should result in better quality care and disease management, especially for older adults who often have multiple chronic illnesses. Even though continuity of care has been studied for decades, it remains difficult to define and quantify and, there is no consensus about best practices for assessing whether or not a patient experiences it or a practitioner provides it. Moreover, no theoretically-driven measures for the assessment of continuity of care exist, and there have been few rigorous evaluations of its association with subsequent health and health service utilization outcomes. The principal purpose of this dissertation research was to better understand continuity of care for older adults by identifying the components of the patient-provider relationship that are important from the patient perspective, understanding how commonly used provider-proxy continuity measures relate to the patient experience, and evaluating whether the patient experience or provider-proxy assessments are associated with improved health and health services utilization. I used survey data from the 2,997 Medicare beneficiaries who participated in the 2004 National Health and Health Services Use Questionnaire (NHHSUQ) linked to their Medicare claims for 2002-2009. The NHHSUQ contained patient-reported data on usual primary provider, usual place of care, and the quality and duration of the relationship with their provider. By linking this information to their Medicare claims, I was able to evaluate both patient-reported and provider-proxy (claims-based) measures of continuity of care from two years prior to the survey, and evaluate the impact of continuity on health and health service utilization for five years after the survey. Study results indicate that the older adult patient experience of continuity is reflective of both relationship duration and patient-provider interaction during the care visit, and that most provider-proxy continuity assessments did not relate to patient perceptions. And, the patient and provider-proxy experiences of continuity had different relationships with important health outcomes. These results enhance our understanding of continuity of care for older adults and inform policymakers and researchers about aspects of continuity that are important for the health of older adults and the appropriate use of health care resources.

This is a study of "workplace diversity" from a social constructionist perspective. The perspective holds that while human meaning is socially created, it is the social order which gives us resources for making this meaning. There is much literature about workplace diversity from objectivist standpoints that takes for granted the term "diversity." What is missing is a comprehensive understanding of diversity: what does this term mean? What does it conceal? I attempt to contribute to a better understanding of diversity by interrogating its construction in popular culture. I analyze the content of an advertising supplement called "Diversity Works," published in the New York Times Sunday Magazine, with a literal read to learn how diversity is manifestly constructed on the surface as well as how it is typified through formula stories. Diversity is ideally defined as programs for creating a "culture of inclusion," but practical efforts imply normative attempts to assimilate persons designated as diverse to the standards imposed by the dominant group. I argue that claims about diversity act to construct collective identity for certain types of people thereby reinforcing their subordinate positions among the social hierarchy. As constructed, the social goodness of diversity is taken for granted, yet by its narrow typification reproduces race and gender divisions and accompanying inequalities. In practice, diversity is an alternate term for the other, the type of person who is not a member of the highly valued and socially privileged dominant group of white (Anglo) men. I suggest that diversity is linked to larger structures of domination evidenced by its construction as agents of social engineering existing to help certain types of people -- women and minorities. My analysis offers potential contributions to diversity scholarship by attending to issues of power and dominance as they are constructed and interpreted in popular culture. Further, I contribute to a dialogue about power and dominance relations between identity groups. Finally, this study contributes to empirical work on the issues of socialization in the workplace. As constructed, diversity programs invoke the ideal of respecting difference in persons while coordinating sameness in behavior for the benefit of capitalist expansion.

The main objectives of this dissertation were to examine the effects of bariatric surgery on medication and health services utilization among a cohort of Commercial and Medicare insured members from a large health benefits organization in the U.S.. A total of 1,492 members with morbid obesity underwent gastric bypass (n=785) or gastric banding (n=707) procedure between January 2005 and June 2008. Administrative claims databases were accessed and three data files including a member file, a medical file and a pharmacy file were merged at the member level. Non-parametric Wilcoxon signed rank tests revealed that the average number of all prescription claims were significantly lower during the 12 months post-surgery, compared to the 12 months pre surgery (p<0.0001). Moreover, McNemar’s Chi Square analyses showed that after the surgery, there was a statistically significant (p=<0001) decline in the proportion of members utilizing antihypertensives, antidiabetics and antihyperlipidemics. Our results also showed that the average number of prescription claims for each of these medication groups significantly declined during the 12-month post-surgery period, among members who had at least one prescription for these medications before the surgery (p<0.0001). Logistic regression modeling revealed that members who underwent bypass procedures were more likely to discontinue antihypertensives (OR=2.04; 95% CI= 1.30-3.23) , antihyperlipidemics (OR=3.25; 95% CI 1.96-5.40) and antidiabetics (OR=1.89; 95% CI 1.13–3.08) post-surgery than members who underwent banding procedures. In terms of medical services utilization, our results showed a significant decline in the average number of medical claims for all outpatient services overall from the 12 months pre to the 12 months post-surgery (p<0.0001). In contrast, the average number of medical claims for emergency room and inpatient hospitalizations were significantly increased from the pre to the post-surgery period (p<0.01). Logistic regression modeling revealed that the type of bariatric surgery was a significant positive predictor for inpatient hospitalizations post-surgery (OR =2.33; 95% CI= 1.76-3.08; p<0.0001) but not for emergency room visits (OR=1.23; 95% CI 0.97–1.56). The implications of the findings from a managed care perspective are discussed, along with limitation and future directions.