The purpose of this dissertation is to examine the burden-sharing behavior of new NATO members and the impact of enlargement on NATO burden-sharing. Qualitative and quantitative methods are used to test several hypotheses. The findings suggest that large NATO members are burden-sharing at a greater rate than smaller NATO members when looking at military expenditures and air contributions to NATO missions, in accordance with the logic of collective action. Contribution of troops to NATO missions depends on the mix of private and public benefits received, in accordance to the joint product model. The findings support the hypothesis that new NATO members are burden-sharing at a greater rate than older NATO members. An analysis of the burden-sharing behavior of NATO's new members reveals that new NATO members have demonstrated the willingness to contribute to NATO missions, but are often constrained by their limited capabilities. However, new member contributions to NATO have improved and, in comparison to older NATO members, the new members are doing quite well. Finally, NATO expansion did not lead to greater free-riding behavior in NATO. / Political Science

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Bakgrund: Vårdnadsbelastning och stress är vanligt bland anhörigvårdare till personer med demens eller långvarig sjukdom. Minfulness-Based Stress Reduction (MBSR) är en tänkbar fysioterapeutisk intervention för denna grupp. Syfte: Att genomföra en systematisk litteraturstudie i syfte att kartlägga effekt, risk för snedvridning och tillförlitlighet med MBSR som behandlingsmetod för stress och vårdnadsbelastning för anhörigvårdgivare. Metod: En systematisk litteraturöversikt av randomiserade kontrollerade studier genomfördes i databaserna PubMed och PsychInfo. TestEx användes för att bedöma kvaliteten av de utvalda artiklar och tillförlitligheten granskades med granskningsmallen Bedömning av den sammanvägda tillförlitligheten i systematiska översikter. Resultat: Åtta artiklar inkluderades i denna studie och deltagarna var alla anhörigvårdgivare till vuxna personer med långvarig sjukdom. Sju undersökte vårdnadsbelastning och fem undersökte stress. Ingen signifikant skillnad observerades på vårdnadsbelastning. Stress minskades signifikant i tre av fem studier. Kvalitetsgranskning med TextEx resulterade i fyra artiklar med hög kvalitet och fyra med låg. Av de fyra med hög kvalitet gick två att sammanväga för tillförlighet, men dessa bedömdes ha mycket låg tillförlighet. Konklusion: Resultatet baseras på två studier som kunde sammanvägas med kontrollgruppen “ingen behandling”. Dessa visade mycket låg tillförlitlighet för att MBSR hade effekt på stress och vårdnadsbelastning. / Objective: Caregiver burden and stress are common challenges faced by family caregivers of individuals with dementia or chronic illness. Additionally, Mindfulness-Based Stress Reduction (MBSR) is a potential physiotherapeutic intervention for this group. Aim: To assess the effectiveness, risk of bias, and reliability of MBSR as a method of treatment for stress and caregiver burden among informal caregivers. Method: A systematic literature review of randomized controlled trials was conducted using the databases PubMed and PsychInfo. TestEx was used to assess the quality of the chosen studies, and reliability was evaluated using the template to assess the reliability of the results. Results: Eight articles were included in this study and the participants were informal caregivers to adults with chronic illness. Seven investigated caregiver burden, while five examined stress. No significant difference was observed in caregiver burden. However, stress was significantly reduced in three out of five studies. The quality assessment using TestEx resulted in four articles being classified as high quality, and four as low quality. Among the high-quality articles, two could be combined for reliability assessment, but they were deemed to have very low reliability. Conclusion: The results are based on two studies that could be combined with the control group “no treatment”. These studies showed very low reliability regarding MBSR as a treatment of stress and caregiver burden for informal caregivers.

Bakgrund Befolkningen i Sverige blir äldre och fler drabbas av kognitiv sjukdom, vilket innebär att antalet anhöriga som vårdar personer med kognitiv sjukdom i hemmet kommer att öka. SyfteVar att beskriva livskvalitet hos anhörig till person med kognitiv sjukdom.  MetodKvalitativ intervjustudie. Anhöriga som levt med personer med kognitiv sjukdom har intervjuats. Intervjuerna analyserades med kvalitativ innehållsanalys. ResultatDenna studies resultat presenteras i två huvudkategorier: “Faktorer som möjliggör upplevelse av livskvalitet” och ”Anhörigas psykosociala och fysiska utmaningar”. SlutsatsDet är viktigt för anhörigas livskvalitet att de får stöd och hjälp i sin situation, både av vården och närstående. Även sociala relationer och att få bestämma över sig själv och sin tid är viktigt för god livskvalitet. Att bli belastad både psykiskt och fysiskt samt att uppleva att relationen till personen med kognitiv sjukdom förändras, sänker livskvaliteten. / Background The population in Sweden is getting older and more people are affected by cognitive disease, which means that the number of relatives who care for people with cognitive disease at home will increase. AimThe aim of the study was to describe the quality of life of relatives of a person with cognitive disease. Method Qualitative interview study. Relatives who have lived with people with cognitive disease have been interviewed. The interviews were analyzed with qualitative content analysis.  ResultsThe results of this study are presented in two main categories: "Factors that enable the experience of quality of life" and "Relatives' psychosocial and physical challenges". ConclusionsIt is important for the quality of life of relatives that they receive support and help in their situation, both from the health care system and their relatives. Social relationships and being able to decide over oneself and one's time are also important for a good quality of life. To be burdened both mentally and physically, and to experience that the relationship with the person with cognitive disease changes, lowers the quality of life.

No / The Atlantic burden-sharing debate during the early part of the twenty-first century is shaping up to be very different from those of NATO's first fifty years. The resources needed for direct defence of western Europe have fallen sharply, and further cuts are possible. The gradual strengthening of European cooperation means that the EU is becoming an actor in its own right in many international regimes. Debates about which countries are pulling their weight internationally are also taking into account contributions to non-military international public goods¿financing EU enlargement, aiding the Third World, reducing emissions of climate-damaging pollutants. In this new multidimensional debate, it becomes more apparent that states that contribute more to one regime often do less than most in another. Germany, for example, is concerned about its excessive contribution to the costs of EU enlargement, but it spends considerably less than France and the UK on defence. European countries contribute three times as much as the United States to Third World aid, and will soon pay almost twice as much into the UN budget. Yet they were dependent on the US to provide most of the military forces in the 1999 Kosovo conflict, and would be even more dependent in the event of a future Gulf war. This widening of the burden-sharing debate contains both dangers and opportunities. It could lead to a fragmentation of the Atlantic dialogue, with each side talking past the other on an increasing number of issues, ranging from global warming to Balkan peacekeeping. In order to avoid such a dangerous situation, the US and European states should maintain the principle that all must make a contribution to efforts to tackle common problems, whether it be through troops in Kosovo or commitments to reducing greenhouse gas emissions. Yet there should also be some flexibility in defining who does how much. The preparedness of some countries to lead, by doing more, will be essential if international cooperation is to have a chance to work.

Background: The cumulative effect of taking anticholinergic medicines (anticholinergic burden) is associated with adverse outcomes for older people. Prevalence of anticholinergic prescribing is increasing, and there is a need for tools to proactively identify at-risk patients for medication reviews. Aim: To explore the need for, and feasibility of, an integrated case-finding tool that predicts risks using electronic health records (EHRs), facilitating the review of anticholinergic medicines for frail older people. Methods: Mixed methods, adopting a pragmatic approach. A systematic review, prediction modelling of cohort study data, and qualitative interviews were undertaken. Results: The systematic review found anticholinergic exposure was associated with adverse outcomes for the frail; poorer physical function, falls, and mortality, indicating a need for a risk reducing intervention. In the prediction modelling study, predicting risks using composite measures of anticholinergic burden and frailty indicated limited feasibility. Neither enhanced the performance of best subset models using cohort study data. Their predictive utility needs to be investigated using EHR data, to determine their feasibility within primary care. The qualitative study found healthcare professionals needed a proactive tool, supporting risk prediction as a feasible approach. Factors influencing future implementation were; upskilling requirements, deprescribing confidence, patient reluctance, motivation, holistic care, interoperability, trust in risk prediction, remuneration, among other barriers and facilitators. Conclusions: Through identifying a need, and potential feasibility, foundations towards the future developments of a case-finding tool have been provided, informing an early tool prototype (AC-FRAIL). Recommendations for further work suggest a roadmap ahead, to maximise the potential for integrated solutions to proactively reduce anticholinergic risks. / NIHR Yorkshire and Humber Patient Safety Translational Research Centre (NIHR YHPSTRC)

Genetic association studies usually include related individuals. Meanwhile, high-throughput sequencing technologies produce data of multiple genetic variants. Due to linkage disequilibrium (LD) and familial relatedness, the genotype data from such studies often carries complex correlations. Moreover, missing values in genotype usually lead to loss of power in genetic association tests. Also, repeated measurements of phenotype and dynamic covariates from longitudinal studies bring in more opportunities but also challenges in the discovery of disease-related genetic factors. This dissertation focuses on developing novel statistical methods to address some challenging questions remaining in genetic association studies due to the aforementioned reasons. So far, a lot of methods have been proposed to detect disease-related genetic regions (e.g., genes, pathways). However, with multiple-variant data from a sample with relatedness, it is critical to account for the complex genotypic correlations when assessing genetic contribution. Recognizing the limitations of existing methods, in the first work of this dissertation, the Adaptive-weight Burden Test (ABT) --- a score test between a quantitative trait and the genotype data with complex correlations --- is proposed. ABT achieves higher power by adopting data-driven weights, which make good use of the LD and relatedness. Because the null distribution has been successfully derived, the computational simplicity of ABT makes it a good fit for genome-wide association studies. Genotype missingness commonly arises due to limitations in genotyping technologies. Imputation of the missing values in genotype usually improves quality of the data used in the subsequent association test and thus increases power. Complex correlations, though troublesome, provide the opportunity to proper handling of genotypic missingness. In the second part of this dissertation, a genotype imputation method is developed, which can impute the missingness in multiple genetic variants via the LD and the relatedness. The popularity of longitudinal studies in genetics and genomics calls for methods deliberately designed for repeated measurements. Therefore, a multiple-variant genetic association test for a longitudinal trait on samples with relatedness is developed, which treats the longitudinal measurements as observations of functions and thus takes into account the time factor properly. / PHD / It has been widely recognized that complex diseases are results of poor habits and genetic predisposition. Though people can make their own choices about lifestyle, the mysterious genome language seems to be unchangeable and inevitable. Decoding the messages delivered by DNA can help with prevention, prediction and treatment of diseases. This work focuses on developing novel statistical methods that can make contributions to the detection of disease-related genetic factors. Specifically, given the genotype data and phenotype (e.g., fasting glucose level) data on a sample of individuals where some could be relatives and the rest may be not, three challenges are addressed in this work: (1) how to detect if a genetic region (such as a gene) is significantly associated with the phenotype, while non-genetic information (such as demographic data) is taken into account; (2) how to deal with missing values in genotype data via the relatedness among individuals as well as the similarity among genetic variants; (3) if the phenotype is measured over time for every individual, how to take advantage of the abundant information to discover genes with time-related effects on the phenotype. To address question (1), a hypothesis test is proposed, which is proved being able to successfully detect genes already discovered being associated with a specific trait in previous studies. To address question (2), an imputation method is developed and it is shown that this method can improve the power of association tests. For the third challenge, a second hypothesis test is proposed and it is verified to be able to identify genes contributing to the pattern of a longitudinal trait.

Yes / Objectives: Qualitative research has suggested that spousal experiences of discontinuity in their relationship with a person who has dementia (i.e. the relationship is experienced as radically changed) may contribute to heightened feelings of burden, entrapment, isolation, guilt and intolerance of behaviours that challenge. By contrast, continuity in the relationship may contribute to a greater sense of achievement and gratification from providing care. The present study served as a quantitative test of these suggestions. Method: A convenience sample of 71 spouses of people with dementia completed three questionnaires - the Zarit Burden Interview (ZBI), the Positive Aspects of Caregiving measure (PAC) and the Birmingham Relationship Continuity Measure (BRCM). Results: In accordance with the hypotheses, the experience of greater relationship continuity (higher BRCM scores) was correlated with fewer negative emotional reactions to caregiving (lower ZBI scores; rho = −.795) and more positive emotional reactions (higher PAC scores; rho = .764). Conclusions: The study provided some quantitative support for suggestions arising from qualitative research about how perceptions of continuity/discontinuity in the relationship may impact on the caregiving spouse's emotional well-being. Helping couples to maintain a sense of continuity and couplehood may assist their emotional adjustment to dementia.

A presente dissertação volta-se à análise da alteração superveniente das circunstâncias fáticas, especificamente, em contratos interempresariais. Tais contratos, compreendidos como aqueles em que, ao menos, uma das partes é ente empresarial e ambos os contratantes visam auferir lucro, têm características distintas de outros contratos de natureza civil (contratos existenciais), mormente no que se refere à assunção de riscos pelas partes envolvidas. Dado o caráter arriscado da atividade empresarial, a intervenção exógena nos contratos interempresariais visando à tutela dos contratantes deve ser reduzida, de forma a se privilegiar tanto quanto possível a força obrigatória dos contratos (pacta sunt servanda). Nessa medida, as nuances dos contratos interempresariais, em conjunto com a imprescindível atividade estatal de regulação do mercado (fenômeno poliédrico), demandam uma aplicação diferenciada do modelo da onerosidade excessiva previsto nos artigos 478 a 480 do Código Civil, sob pena de desvirtuamento da lógica empresarial e desestímulo ao tráfico mercantil. O primeiro capítulo deste trabalho é destinado à individualização dos principais vetores da atividade empresarial e os respectivos reflexos daqueles na formação dos contratos empresariais. Em seguida, no segundo capítulo da empreitada, são analisadas as teorias revisionistas de maior influência na construção do modelo de onerosidade excessiva brasileiro, bem como as especificidades do próprio modelo em si. Por fim, o terceiro e conclusivo capítulo visa à identificação do suporte fático da onerosidade excessiva em contratos empresariais, bem como à análise dos efeitos decorrentes da aplicação do modelo a referidas formas de contratação. / This dissertation is focused on the analysis of the change of circumstances, regarding specifically entrepreneurial contracts. These contracts, understood as those in which at least one of the parties involved is an entrepreneurial entity and both of the parties seek to obtain profits with the deal, can be defined by distinguished characteristics when compared to civil contracts in general (contratos existenciais), mainly when it comes to the risk assumption by the parties in the contract. Given the risk inherent to business activities, the exogenous intervention in entrepreneurial contracts aiming the protection of one of the parties should be reduced as much as possible, in such a way to respect the binding force of the contracts (pacta sunt servanda). Accordingly, the specificities of the entrepreneurial contracts, together with the indispensable public regulation of the market (polyhedral phenomenon), require a distinguished applicability of the rules provided by the Brazilian Civil Code under the articles 478 to 480, otherwise entrepreneurial rationality of commercial contracts may be ruined and, as a result, the commercial traffic discouraged. The first chapter of this study is dedicated to finding the main features of the business activity and their implications to the formation of entrepreneurial contracts. Subsequently, in the second chapter of the essay, the theories related to change of circumstances that most influenced the construction of a Brazilian theory are analyzed, as well as the peculiarities of the Brazilian theory itself. Finally, the third and concluding chapter seeks to identify the hypothesis provided by articles 478 to 480 for entrepreneurial contracts, as well to analyze the effects arising from the application of this set of rules to referred contracts.

Made available in DSpace on 2016-04-26T20:22:14Z (GMT). No. of bitstreams: 1 Landolfo Andrade de Souza.pdf: 1706067 bytes, checksum: c3f41df8c866866f22a3fd11abb9cfa4 (MD5) Previous issue date: 2013-10-24 / There is no doubt that the modern civil procedure must be updated to cope with the substantive law needs and the new contemporary society dynamics. Likewise, such changes dispense legislative modifications, which often take a long time to be made. Thus, it s necessary to pursue the procedure s improvement by a more appropriate managing of the procedural techniques available for the judge, in the light of the constitutional guarantees. The rule for the burden of proof is within this perspective: it s one of the matters to which the doctrine devotes its attention in order to make the indispensable transformations in the procedural system to bring it closer to substantive law s reality. To this end, this work searched to examine how the burden of proof operates in the class actions, studying the reasons that authorize its change, since such possibility beyond the realm of consumer law - may correspond to a significant condition of effective protection of collective interests. For that purpose, one has used law doctrine, case law and deductive, inductive and analogical methods. The Federal Constitution and federal rules related to the burden of proof dogma and the collective interests protection have also been examined. The research has been split in for main parts. Firstly, some relevant aspects of the collective procedure have been studied. Then, the structural elements of the burden of proof have been analysed. The third part was dedicated to the conceptual elements, as well as the fundaments of applicability, including de lege lata, of the dynamic burden of proof theory in Brazilian law were outlined. In the fourth part, it has been demonstrated that the hipotheses that allow the flexibility of the general criteria for the distribution of the proof burdens are consistent with one of the most relevant preoccupations of procedural law jurists: the search for more effectiveness in the substantive field by the procedural technique refinement / Não há dúvidas de que o processo civil moderno deve atualizar-se para fazer frente às necessidades do direito material e da nova dinâmica da sociedade contemporânea. Tampouco se duvida que esta mudança prescinde de alterações legislativas, pois estas, muitas vezes, demoram a ocorrer. Impõe-se, então, buscar aprimorar o processo com o manejo mais adequado das técnicas processuais postas à disposição do juiz, à luz das garantias constitucionais. A regra sobre o ônus da prova se insere nesta perspectiva: constitui ela um dos pontos em que se debruça a doutrina para imprimir necessárias alterações no sistema processual, tornando-o mais próximo à realidade do direito material. Nesse propósito, este trabalho buscou apreciar como se comporta a regra do ônus da prova nas ações civis públicas, avaliando as razões que autorizariam a sua modificação, já que esta possibilidade para além dos campos do direito do consumidor pode importar significativa condição para a efetiva tutela dos interesses coletivos. Para tanto, valeu-se do estudo da doutrina e da jurisprudência, bem como se utilizaram os métodos dedutivo, indutivo e analógico. Examinaram-se a Constituição Federal e as normas federais pertinentes ao dogma do ônus da prova, bem como à defesa dos interesses coletivos. A pesquisa foi dividida em quatro partes principais. Na primeira, foram examinados alguns aspectos relevantes do direito processual coletivo. Na segunda, analisaram-se os principais aspectos do instituto do ônus da prova. Na terceira, foram fixados os elementos estruturais, bem como os fundamentos de aplicabilidade, inclusive de lege lata, da teoria do ônus dinâmico da prova no direito brasileiro. Na última parte, demonstrou-se que as hipóteses de flexibilização dos critérios gerais de repartição dos encargos probatórios encontram-se afinadas com uma das principais preocupações dos cultores do direito processual: buscar maior efetividade no plano material por meio do aprimoramento da técnica processual