The present study consisted of two parts: (1) The examination of whether demographic differences in utilization of multiple forms of health services existed among Non-Hispanic Whites, Mexican-, Cuban-, and Puerto Rican-American adolescents. (2) The examination of whether the Andersen model, revised for Latino adolescents, fit equally well for Mexican-, Cuban-, and Puerto Rican-Americans. Data for this study were drawn from the first two waves of the National Longitudinal Study of Adolescent Health (Add Health), a nationally representative sample of 7th through 12th-grade students in the United States collected between 1994 and 1996.Logistic regression analyses indicated that there were significant differences in routine physical exams based on ethnicity. Mexican-American adolescents were less likely than Non-Hispanic White, Cuban-American, and Puerto Rican-American adolescents to receive routine physical exams. Finding based both on the logistic regressions and on the latent mean comparisons suggested that Cuban- and Puerto Rican-American adolescents are more likely to utilize health services than Mexican-American adolescents. Cuban-American adolescents were also less likely to indicate the need for medical services, whereas Mexican-American adolescents were more likely to state that they needed medical services but were unable to receive them.The results of multi-group confirmatory factor analyses provide mixed evidence toward the indication that the revised Andersen's conceptual model is an appropriate overall framework to utilize with Mexican-, Cuban-, and Puerto Rican-American adolescents. Based on the structural equation model findings, it appears that the major link between need and use of health care services is not supported in the three Latino subgroups. The Andersen model only partially addressed health care needs among the adolescent Latino subgroups. Although there are connections from the main predisposing predictors (including Latino adolescent-specific characteristics) to enabling resources and need, these indirect associations do not necessarily predict use of health services with Mexican-, Cuban-, and Puerto Rican-American adolescents. Clearly there is a great need for health care services among Latino adolescents, particularly given their health disparities in adolescent risk behavior; however current models need further revision, such as including key cultural factors and social context, to predict use of health care services.

No description available.

Mexican Americans, the largest Hispanic subgroup in the United States, tend to underuse mental health services. Grounded in Andersen's behavioral model of health services use, the purpose of this nonexperimental study was to examine the likelihood of birth country, education, income, and insurance predicting which respondents would report seeking mental health services to treat depression. The Mini International Neuropsychiatric Interview was used to diagnose depression in 203 Mexican Americans whose data was archived from the primary study. This archived data was analyzed within this study. The results of the 2 x 2 chi-square tests of independence indicated a significant association between a person's birth country and the likelihood that a person will seek mental health treatment, with U.S.-born participants more likely to seek mental health treatment than foreign-born participants. There were no significant bivariate associations found between education, income, or insurance and seeking mental health treatment. The full model containing the 4 independent variables was statistically significant per the results of the binary logistic regression analysis. This finding indicates that the model reliably distinguished between respondents who reported seeking and not seeking mental health treatment. The results of the binary logistic regression analysis indicated education was the only independent variable that made a uniquely significant contribution to the model, with participants with 12 years or more of education more likely to seek mental health treatment. The implications for positive social change include the potential to provide communities and health care providers knowledge of the factors that influence whether Mexican Americans with depression access mental health.

Le syndrome d’Andersen est une maladie rare et associée à la perte de fonction du canal potassique Kir2.1. Afin d’étudier sa physiopathologie, nous avons généré et caractérisé des cellules souches pluripotentes induites (iPS) contrôle et Andersen. Nous avons ensuite différencié ces cellules iPS en cellules souches mésenchymateuse (MSC). Les cellules MSC de patients présentent une capacité de différenciation en ostéoblastes et en chondrocytes diminuée par rapport aux cellules contrôle. En effet, la production de matrice extracellulaire et l'expression des master gènes des différenciations osseuses et cartilagineuses, est réduite chez les patients. Ces travaux de thèse montrent que le canal Kir2.1 est essentiel au développement osseux. Les défauts de différentiation observés pourraient expliquer les dysmorphies associées avec le syndrome d’Andersen. / Andersen's syndrome is a rare disorder associated with a Kir2.1 potassium channel loss of fuction. To study the pathophysiology, we have generated and characterized induced Pluripotent Stem cells (iPS) from control and patient cells. We have then differentiated those iPS cells into mesenchymal stem cells (MSC). Patient's MSc have a lower osteoblastic and chondrogenic differnciation ability compared to control cells. Indeed, extracellular matrix production and master gene expression of osteoblastic and chondrogenic differenciation are reduced in patient’s cells. Alltogether, these results shown that Kir2.1 channel is required for bone developement. The differenciation defects saw in patient cells could explain the Andersen's syndrome associated dysmorphies.

A program slice consists of a subset of the statements of a program that can potentially affect values computed at some point of interest. Such a point of interest along with a set of variables is called a slicing criterion. Slicing tools are useful for several applications, such as program understanding, testing, program integration, and so forth. Slicing object oriented programs has some special problems that need to be addressed due to features like inheritance, polymorphism and dynamic binding. Alias analysis is important for precision of slices. In this thesis we implement a slicing tool for sequential Java programs in the Soot framework. Soot is a front-end for Java developed at McGill University and it provides several forms of intermediate code. We have integrated the slicer into the framework. We also propose an improved technique for intraprocedural points-to analysis. We have implemented this technique and compare the results of the analysis with those for a flow-insensitive scheme in Soot. Performance results of the slicer are reported for several benchmarks.

The thesis deals with the problem of welfare state. It focuses on a comprehensive analysis of the causes of the welfare state's problems, and, furthermore it outlines the risks that these problems bring. In the analytical part, these risks are calculated in three areas, which are financing system, family policy and population aging. The Czech Republic is compared in these indicators with countries that have been selected based on Esping-Andersen typology of welfare state: the UK, Germany, Denmark and the United States of America. The results of the analysis are evaluated in conclusion of the thesis. On this basis, ther are formulated recommendations for the Czech Republic, which has the biggest deficiencies in family policy in comparison with other selected countries. Denmark, a representative of the Scandinavian welfare state model, has relatively best results; on the other hand, the United States, with its emphasis on free market, individual freedom and own responsibility principles, face the challenge. The crisis of the welfare state does not have to necessarily result into the end; however, it is inevitable to imply certain unavoidable steps. These measures do not hold for the Czech Republic.

In this study, the utilization of palliative care services, acute care services, and location of death for clients who were palliative and receiving services from Champlain Community Care Access Centre (CCAC) in Ontario during their last month of life were investigated. An adaptation of Andersen?s Behavioral Model of Health Services Utilization provided context and structure to this study. This is an historical, quantitative descriptive study using chart audits for data collection. The data on CCAC clients who were palliative and who died during the month of July 2009 were tracked during their last month of life. Collection of socio-demographic data, services provided through CCAC, emergency department visits, hospital admissions, and location of death provided the data for this study. The clients who died at home used more CCAC services than those who died at other locations and frequently community palliative care physicians provided their medical care. The findings of this study included: 1) The majority of the clients, who expressed a preference, died in their preferred location. 2) The role of community palliative care physicians was an important component of the services that supported the clients to die in their location of choice. 3) Over 25% of the study sample died in a hospital and the clients used a large number of in-patient hospital days with one quarter of the hospital deaths taking place in an emergency department or an intensive care unit. 4) During the last month of life, 25% of the clients received chemotherapy and/or radiation therapy. 5) The clients who died at home used more CCAC services than those who died in other locations and who used institutional resources. The implications for practice, policy, research, and education are discussed.

In this study, the utilization of palliative care services, acute care services, and location of death for clients who were palliative and receiving services from Champlain Community Care Access Centre (CCAC) in Ontario during their last month of life were investigated. An adaptation of Andersen?s Behavioral Model of Health Services Utilization provided context and structure to this study. This is an historical, quantitative descriptive study using chart audits for data collection. The data on CCAC clients who were palliative and who died during the month of July 2009 were tracked during their last month of life. Collection of socio-demographic data, services provided through CCAC, emergency department visits, hospital admissions, and location of death provided the data for this study. The clients who died at home used more CCAC services than those who died at other locations and frequently community palliative care physicians provided their medical care. The findings of this study included: 1) The majority of the clients, who expressed a preference, died in their preferred location. 2) The role of community palliative care physicians was an important component of the services that supported the clients to die in their location of choice. 3) Over 25% of the study sample died in a hospital and the clients used a large number of in-patient hospital days with one quarter of the hospital deaths taking place in an emergency department or an intensive care unit. 4) During the last month of life, 25% of the clients received chemotherapy and/or radiation therapy. 5) The clients who died at home used more CCAC services than those who died in other locations and who used institutional resources. The implications for practice, policy, research, and education are discussed.

In this study, the utilization of palliative care services, acute care services, and location of death for clients who were palliative and receiving services from Champlain Community Care Access Centre (CCAC) in Ontario during their last month of life were investigated. An adaptation of Andersen?s Behavioral Model of Health Services Utilization provided context and structure to this study. This is an historical, quantitative descriptive study using chart audits for data collection. The data on CCAC clients who were palliative and who died during the month of July 2009 were tracked during their last month of life. Collection of socio-demographic data, services provided through CCAC, emergency department visits, hospital admissions, and location of death provided the data for this study. The clients who died at home used more CCAC services than those who died at other locations and frequently community palliative care physicians provided their medical care. The findings of this study included: 1) The majority of the clients, who expressed a preference, died in their preferred location. 2) The role of community palliative care physicians was an important component of the services that supported the clients to die in their location of choice. 3) Over 25% of the study sample died in a hospital and the clients used a large number of in-patient hospital days with one quarter of the hospital deaths taking place in an emergency department or an intensive care unit. 4) During the last month of life, 25% of the clients received chemotherapy and/or radiation therapy. 5) The clients who died at home used more CCAC services than those who died in other locations and who used institutional resources. The implications for practice, policy, research, and education are discussed.