This research project is a report of cost findings and rearrest rates from a program evaluation of a pre-trial diversion program. In 1978 Cascade Research Center (CRC) contracted with Clark County, Washington, to determine the cost-effectiveness and cost-efficiency of the Pre-Habilitation agency, which implements the Prosecuting Attorney's Pre-Trial Diversion Program.

SMART designs tailor individual treatment by re-randomizing patients to subsequent therapies based on their response to initial treatment. However, the classification of patients being responders/non-responders could be inaccurate and thus lead to inappropriate treatment assignment. In a two-step SMART design, by assuming equal randomization, and equal variances of misclassified patients and correctly classified patients, we evaluated misclassification effects on mean, variance, and type I error/ power of single sequential treatment outcome (SST), dynamic treatment outcome (DTRs), and overall outcome. The results showed that misclassification could introduce bias to estimates of treatment effect in all types of outcome. Though the magnitude of bias could vary according to different templates, there were a few constant conclusions: 1) for any fixed sensitivity the bias of mean of SSTs responders always approached to 0 as specificity increased to 1, and for any fixed specificity the bias of mean of SSTs non-responders always approached to 0 as sensitivity increased to 1; 2) for any fixed specificity there was monotonic nonlinear relationship between the bias of mean of SSTs responders and sensitivity, and for any fixed sensitivity there was also monotonic nonlinear relationship between the bias of mean of SSTs non-responders and specificity; 3) the bias of variance of SSTs was always non-monotone nonlinear equation; 4) the variance of SSTs under misclassification was always over-estimated; 5) the maximized absolute relative bias of variance of SSTs was always ¼ of the squared mean difference between misclassified patients and correctly classified patients divided by true variance, but it might not be observed in the range of sensitivity and specificity (0,1); 6) regarding to sensitivity and specificity, the bias of mean of DTRs or overall outcomes was always linear equation and their bias of variance was always non-monotone nonlinear equation; 7) the relative bias of mean/ variance of DTRs or overall outcomes could approach to 0 where sensitivity or specificity wasn’t necessarily to be 1. Furthermore, the results showed that the misclassification could affect statistical inference. Power could be less or bigger than planned 80% under misclassification and showed either monotonic or non-monotonic pattern as sensitivity or specificity decreased. To mitigate these adverse effects, patient observations could be weighted by the likelihood that their response was correctly classified. We investigated both normal-mixture-model (NM) and k-nearest-neighbor (KNN) strategies to attempt to reduce bias of mean and variance and improve inference at final stage outcome. The NM estimated the early stage probabilities of being a responder for each patient through optimizing the likelihood function by EM algorithm, while KNN estimated these probabilities based upon classifications for the k nearest observations. Simulations were used to compare the performance of these approaches. The results showed that 1) KNN and NM produced modest reductions of bias of point estimates of SSTs; 2) both strategies reduced bias on point estimates of DTRs when the misclassified patients and correctly classified patients from same initial treatment had unequal means; 3) NM reduced the bias of point estimates of overall outcome more than KNN; 4) in general, there were little effect on power adjustment; 5) type I error should always be preserved at 0.05 regardless of misclassification when same response rate and same treatment effects among responders or among non-responders were assumed, but the observed type I error tended to be less than 0.05; 6) KNN preserved type I error at 0.05, but NM might increase type I error rate. Even though most of time both KNN and NM strategies improved point estimates in SMART designs while we knew misclassification might be involved, the tradeoff were increased type I error rate and little effect on power. Our work showed that misclassification should be considered in SMART design because it introduced bias, but KNN or NM strategies at the final stage couldn’t completely reduce bias of point estimates or improve power. However, in future by adjusting with covariates, these two strategies might be used to improve the classification accuracy in the early stage outcomes.

François-Denis Tronchet, jurisconsulte, participa, aux premières places, à l'application du droit, mais aussi à son écriture, à un moment de l'histoire de France où les juristes refusèrent d'être les interprètes du passé pour devenir les agents du devenir historique. Il prit part à tous les grands événements de la Révolution : les Etats généraux, le Serment du Jeu de Paume, la nuit du 4-août, l'élaboration de la Constitution de 1791, la fuite du roi arrêtée à Varennes, le procès du roi ; il siégea, sous le Directoire, au Conseil des Anciens ; enfin, il fut le premier président du Tribunal de cassation sous le Consulat, avant de présider la commission chargée de l'élaboration du Code civil. La pensée de cet avocat au Parlement de Paris fut décisive dans le passage de l'ancien droit au nouveau. Elle s'y exprime dans ses consultations, qui constituent la principale source de cette étude. Conservées aujourd'hui à la bibliothèque de la Cour de cassation, elles constituent une source exceptionnelle, rarement exploitée. Pourtant, des documents furent une source d'inspiration méconnue du Code civil. Il s'agit donc d'une configuration tout-à-fait remarquable, où l'historien dispose tout à la fois d'un travail juridique, les consultations, et du résultat qu'elles ont contribué à inspirer, le Code civil, qui régit toujours notre présent. En outre, on trouve, entre la source (les consultations) et sa résultante (le Code), des témoignages précis de l'action politique de Tronchet, notamment dans les archives parlementaires. Comment un juriste aussi érudit, aussi imprégné de tradition que François-Denis Tronchet a-t-il pu participer de façon aussi décisive à la Révolution, devenant, au moment de la rédaction du Code civil, l'artisan d'un droit absolument nouveau ? L'art de la consultation, par la liberté que donne l'interprétation, lui avait donné la capacité d'envelopper son avis personnel, parfois très créatif, des formes apparemment objectives de l'autorité de l'avocat consultant. Il s'était ainsi préparé à la grande réorganisation des normes de 1789. En outre, la participation à des réseaux d'opposition proches du jansénisme ; l'influence, dans les milieux parlementaires, du culte de la république romaine et d'une philosophie stoïcienne, transmise par l'intermédiaire de Cicéron, qui soulignait la centralité politique de la justice et de la loi naturelle ; tous ces facteurs expliquent ses prises de position favorables à la Révolution, mais aussi le rôle qu'il joua dans la défense du roi. Pour conclure, il voyait la Révolution comme une régénération, une transformation du présent par un retour authentique aux principes passés. Tronchet, comme les antiques jurisconsultes, a cherché à fixer la Révolution à des principes déterminés de toute éternité. / François-Denis Tronchet, a Jurisconsult, played a crucial role in the interpretation of Law, but also in its writing, during the French Revolution. During this period of French history, some jurists refused to be only interpreters of the Past, and began to be true actors of History. François-Denis Tronchet took part in nearly all important events of the French Revolution : the Estates-General, the Tennis Court Oath, the Fourth of August and the abolition of feudal privileges, the writing of the Constitution of 1791, the flight of Louis XVI stopped at Varennes, the King's trial. He was a Member of Parliament (of the Conseil des Anciens) during the Directoire ; lastly, he was the president of the Tribunal de cassation during the Consulate and he presided the commission in charge of the redaction of the civil code. His thought was decisive in the transformation of French Law during the French Revolution. It is conveyed in its consultations, which are the main historical source of this dissertation. Today stored at the library of the Cour de cassation, they constitute an extraordinarysource, rarely used. However, these documents inspired the French civil code. Here, historians have a hand, at the same time, a lawyer's work, the consultations, and the result they partly inspired, the civil Code, that still inspires our present. Besides, between the source (the consultations) and its result (the Code) we have some documents about the political life of Tronchet (mainly parliamentary records). How is it so, that such a learned jurist, so influenced by ancient juridical traditions, played such a crucial role in the French revolution, becoming, during the redaction process of the Civil code, the architect of an absolutely new Law ? During the Ancien regime, the art of consultation gave him, by way of the intellectual freedom of interpretation, the ability of giving his own opinion, sometimes very creative, under the guise of apparently objective, and authoritative, form of the consultation. Therefore, he was intellectually prepared to the reorganization of Law brought about by the French Revolution. Besides, other factors explain his participation in the French Revolution. His belonging to opposition networks, close to Jansenism, during the Ancien Regime accounts for his itinerary. The influence, in parliamentary circles, of the celebration of the Roman Republic as well as the influence of stoic philosophy, conveyed through Cicero's writingd, which underlined the major importance of justice and natural Law, also partly account for his adhesion to the Revolution. These intellectual influences also explain his defence of Louis XVI during his trial. To conclude, he viewed the Revolution as a process of regeneration, a transformation of time present by a resurrection of the true principles of ancient Law.

acase@tulane.edu

The emergence of nanotechnology has increased the concern of exposure to nanoparticles through inhalation. Studies have examined the performance of filtering facepiece respirators against engineered nanoparticles. This has been done by the generation and dispersal of certain particles in a given size distribution, which have then been run through experimental set-ups involving Condensation Particle Counters, Scanning Mobility Particle Sizers, and high efficiency performance filters for a set flow. Published studies have shown that the respirators used do provide expected levels of filtration protection against nanometer-sized particles. However, studies have not examined or applied different types of nanoparticle samples - different particle types have differing morphologies and physical characteristics that could affect filter performance. This study has exposed NIOSH-approved N95 facepiece respirators to six different types of engineered nanoparticles: aluminum oxide, iron oxide, single-walled carbon nanotubes, synthesized diamond, silicon dioxide, and titanium dioxide. In addition, N95 respirators have not been commonly exposed to differing concentrations of an aerosol in order to observe a shift in the primary penetrating particle size and a shift in the overall size distribution. This study challenged N95 respirators to four different concentrations of sodium chloride: 0.1, 1, 10, and 50 mg/ml. Another concern is whether or not a prolonged exposure of a single respirator affects the overall performance and protection from an aerosol, especially engineered nanoparticles, since very few studies have been done regarding this matter. N95 respirators were exposed to several types of engineered nanoparticles in a respirator testing apparatus at a set flow rate, examined for penetration with an SMPS, CPC, and DMA given these conditions: differing concentrations of sodium chloride, different engineered particles, and an extended duration of exposure to both sodium chloride and 15-nm titanium dioxide. This study showed that the primary penetrating particle size through an N95 facepiece respirator does increase and shift with increasing concentrations of an aerosol; however, the overall size distribution did not seem to shift much. Penetration decreased as sodium chloride concentration increased. Different nanoparticles had differing primary penetrating particle sizes through the respirator; however, penetration of these particles was similar to one another with the exception of iron oxide which had quite a high penetration percentage. A decrease in N95 respirator performance was observed when exposed to a 1 mg/ml solution of sodium chloride, as penetration increased with prolonged exposure. However, this did not seem to be the case when the respirator was exposed to a 6.67 mg/ml suspension of 15-nm titanium dioxide, as the penetration over the extended period of time was similar to one another.

>Magister Scientiae - MSc / This study investigated the current knowledge, perceptions, and practices of Risk-Based Monitoring (RBM) using written and verbal responses to an ethics review board approved questionnaire. Responses were collected from individuals involved in the practice, oversight, and implementation of clinical trial monitoring in the USA. RBM was viewed as a positive force with a bright future. However the results suggested that a renewed focus on change management strategies is needed to ensure RBM practices penetrate all levels of clinical trial management. The site sponsor/site operational relationship was identified as a key RBM component. Shortcomings in this relationship were identified as significant operational barriers to effective RBM practice. Respondents indicated that current RBM training efforts were lacking. Because RBM is new and its practices deviate significantly from the past total monitoring efforts, both industry and the clinic need to work harder to ensure that everyone involved in clinical trial monitoring understands these differences. Fortunately, overcoming the identified barriers will not require massive changes to current RBM practice. By refocusing efforts on the sponsor/CRO and investigative sites to attain RBM governance, develop quality control plans, institute an optimal RBM platform, and improve training, the true promise of RBM is within reach. Each of these are critical pieces to an effective RBM implementation methodology and correcting initial stumbles in their implementation can assure the RBM future is as promised.

In 1997, Congress established the Individuals with Disabilities Education Act (IDEA, 1997), which required that schools conduct functional behavior assessments when a student engages in problem behavior that may lead to suspension or expulsion (Ervin et al., 2001; Yell & Katsiyanis, 2010). As a result, research has expanded to include ways to adapt the functional assessment process in school settings. The purpose of this study was to compare the correspondence between functional analysis procedures for students in a private school and validate the assessment outcomes with interventions conducted in the classroom settings. The results indicate that both assessments corresponded in 87% of all functions identified in the study. Furthermore, the interventions yielded reductions in problem behaviors for all participants.

La phase préparatoire du procès pénal est une étape décisive, c’est dans ce laps de temps, plus ou moins long, que l’affaire va être mise en état d’être jugée. Regroupant les phases d’enquête, de poursuite et d’instruction, cette phase en amont du procès pénal est par définition complexe et attentatoire aux droits et libertés fondamentaux de l’individu. Dès lors, toute la difficulté de cette période va être de concilier deux intérêts antagonistes : la protection de la société d’une part, par la recherche de la vérité et de l’auteur de l’infraction, et la protection de l’individu suspecté, d’autre part. A l’aune du développement constant du droit européen des droits de l’Homme et du renouvellement des sources de la procédure pénale, force est de s’interroger aujourd’hui sur la vision qu’adopte le droit français quant aux règles applicables à cette étape fondamentale du procès pénal. Soucieux d’atteindre un objectif de perfection, le législateur français n’a cessé, au fil des vingt dernières années, de réformer la phase préparatoire du procès pénal, allant même parfois jusqu’à bouleverser l’équilibre de la matière pénale en général. Ainsi, les rôles des acteurs institutionnels du procès pénal ainsi que les droits accordés à chacune des parties au stade de la phase préparatoire se sont trouvés considérablement modifiés. Animé par l’idée de créer un modèle universel de procès emprunt d’équité et d’un respect accru des droits de la défense, le législateur semble être en quête constante d’un procès pénal idéal. Pour autant, est-il possible de concilier l’inconciliable ? La matière pénale a-t-elle vocation à respecter un équilibre parfait entre la sécurité de la société et la protection de l’individu ? Une telle idée n’est-elle pas utopique ? / The preparatory phase of a penal trial is a decisive stage. It is a variable period of time during which a case is prepared for judgement. The phase includes investigation, prosecution plus preliminary investigation & hearing stages. It takes place ahead of the penal trial. By definition it is complex and detrimental to the fundamental freedoms of the individual. Consequently, it is a period involving a tricky balancing act to reconcile two antagonistic interests: on the one hand, protecting society, by searching for the truth and the author of a crime, and, on the other hand, protecting the suspect. On-going developments in European law on Human rights and renewed criminal procedure sources raise issues in terms of the stance that French law will adopt on rules applicable to this fundamental stage in a penal trial. Anxious to achieve perfection, over the past twenty years the French legislator has persistently reformed the preparatory phase of the penal trial, on occasions even going as far as to overturn the balance of criminal matters in general. Thus, the roles of the institutional players in the penal trial and the rights granted to each of the parties during the preparatory phase stage have been considerably amended. Motivated by the ideal of creating a universal trial model based on a notion of fairness and an increased respect for defence rights, the legislator appears to be on a constant quest for the ideal criminal trial. However, is it really possible to reconcile the irreconcilable? Is the actual purpose of a criminal case to achieve a perfect balance between the safety of society and the protection of the individual? Isn’t such an idea utopian?

Orientador: Eduardo Bresciani / Banca: Rebeca Di Nicoló / Banca: Taciana Marco Ferraz Caneppele / Banca: Luciana Fávaro Francisconi dos Rios / Banca: Flávio Henrique Baggio Aguiar / Resumo: Este estudo foi composto por um estudo in vitro, um estudo clínico randomizado, controlado e duplo cego e uma revisão sistemática, com objetivo de compreender e avaliar a aplicabilidade da técnica da dentina úmida por etanol (EWBT) em procedimentos restauradores. Estudo laboratorial: 48 incisivos bovinos foram divididos em 2 grupos, com a utilização ou não de etanol anterior ao sistema adesivo universal (Single Bond Universal) no modo autocondicionante. Em seguida blocos de resina composta (Filtek Z350 xt) foram confeccionados. A interface adesiva foi analisada, antes e após envelhecimento por 6 meses em água, com relação à nanodureza e módulo de elasticidade e em microscopia eletrônica de varredura (MEV) após a realização de nanoinfiltração com nitrato de prata. Os dados de nanodureza e módulo de elasticidade foram analisados estatisticamente com ANOVA e teste de Tukey (α=5%). Houve diferença estatística para as áreas avaliadas (p<0.001) e também para a aplicação do etanol (p<0.001). A dentina apresentou valores maiores de nanodureza quando comparado com a camada híbrida. EWBT foi capaz de manter as propriedades da interface adesiva mesmo após envelhecimento. Estudo clínico randomizado: Os voluntários receberam restaurações em cavidades do tipo classe V, provenientes de lesões cervicais não cariosas, com extensão e profundidade de no mínimo 1 mm. As restaurações foram realizadas aleatoriamente, de acordo com a divisão dos grupos, sendo o grupo controle sem pré-tratamento den... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: This study was composed by an in vitro study, a randomized, controlled and double blind clinical trial, and a systematic review, aiming to understand and evaluate the applicability of ethanol-wet-bonding technique (EWBT) in restorative procedures. Laboratory study: 48 bovine incisors were divided into 2 groups, according to EWBT use prior to the universal adhesive system (Single Bond Universal) in the self-etch mode. Blocks of composite resin (Filtek Z350 xt) were made. The adhesive interface was analyzed, on baseline and 6 months of water aging, by scanning electron microscopy (SEM) after nanoleakage with silver nitrate, besides the nanohardness and elastic modulus. The data of nanohardness and elastic modulus were statistically analyzed with ANOVA and Tukey test (α=5%). There was a statistically significant difference for the areas evaluated, in which dentin presented higher values, for nanohardness, than the hybrid layer (p<0.001) and for the use of ethanol (p<0.001). The use of ethanol was able to maintain the properties of the adhesive layer even after aging. Randomized clinical trial: The volunteers received restorations in class V cavities from non-carious cervical lesions (NCCL), with cavity extension and depth of at least 1 mm. The restorations were randomly performed according to group division: no ethanol dentin pretreatment (SE), with ethanol dentin pretreatment in association with 3-step (E) or 2-step (EU) or adhesive, or hydrophobic adhesive (EB). The restoratio... (Complete abstract click electronic access below) / Doutor

Master of Science / Haematopoietic stem cell transplantation (HSCT) is a complicated and high-risk procedure used to cure disease or stop the spread of disease in a range of cancers. HSCT carries a high incidence of mortality and is associated with distressing short and long-term side effects. In addition, patients remain at risk of recurrence or mortality years after transplantation. Therefore, patients undergoing HSCT have been found to experience significant emotional and psychosocial distress because of the trauma associated with treatment. The literature suggests that about 50% of HSCT patients will experience clinical levels of distress. Carers and family members play an important role in caring for these ill patients in the short and long-term. Major role changes and financial stressors are experienced in many families, adding to the burden of care. However, very little is known about the rates of psychopathology in carers of HSCT patients. Due to the arduous nature of HSCT, psycho-educational programmes have been developed by major transplant centres and hospitals in order to provide HSCT patients and their families with information on the treatment process, side effects, risks, and long-term outcomes. Research on patient education in oncology has shown that providing patients and carers with information about their illness and treatment reduces anxiety and distress. To date, there have been no empirical evaluations to support the use of education programmes for HSCT patients. While it could be assumed that information would be helpful in reducing anxiety and depression in HSCT as it is in oncology generally, the information provided to these patients is usually more confronting and therefore, may be less reassuring. Thus, it is not known whether providing patients with education about HSCT reduces patient and carer distress or whether it might actually increase adverse outcomes. The aim of the present study was to evaluate the rates and correlates of distress in carers and patients and examine the effect of a psychoeducation programme for patients undergoing HSCT and their carers on knowledge, distress, information satisfaction, social support and caregiver burden. A randomised control trial was conducted to provide empirical data in relation to the latter aim. The following hypotheses were proposed. Firstly, it was hypothesised that patients and carers who received the education programme would have higher levels of knowledge, not evidenced in a group waiting to receive the programme. Secondly, it was hypothesised that the education program would not lead to increased anxiety and depressive symptoms. Thirdly, patients who know more about their condition would be the least distressed. As predicted, this study found high levels of distress, particularly in carers. Higher patient distress was related to having more concern about one’s illness and experiencing more symptoms. Education was effective in increasing patient and carer knowledge. Importantly there were no adverse effects of knowledge and greater patient knowledge following the education program was associated with less distress, although there was no direct effect of education on distress. Future research should aim to identify what aspects of the education program are helpful to patients. Finally, support interventions such as CBT are needed to help patients and carers, in particular, cope with the high levels of distress inherent in the HSCT experience.