Excerpt: There has been a recent push for more electronic sound amplifiers to provide affordable and accessible options that meet the needs of a large swath of people with hearing loss, particularly aging adults.

This thesis examines three main themes; depression, suicidality, and non-fatal overdose involving pharmaceutical and over-the-counter (OTC) medications. At any given time depression affects approximately one in every twenty adults in Australia. People with depression are at elevated risk of attempted and completed suicide compared to those without. Medication overdose is a frequently chosen method of suicidal behaviour, and accounts for one in ten suicide deaths and close to nine out of ten non-fatal episodes of suicidal behaviour for which hospital treatment is sought. The study reported here had six primary aims; (i) to quantify medication overdose presentations over a 12-month period to the Emergency Department (ED) of a major metropolitan public hospital in Melbourne, Australia, (ii) to describe the medication overdose patient group, including comparison with two other relevant types of presentation, illicit drug overdose, and actual or potential self-harm by means other than overdose, (iii) to explore the relationship between depression, suicidal ideation and medication overdose, (iv) to identify the medications typically used in overdose and their means of acquisition, (v) to explore patient experiences of emergency care following a medication overdose, and (vi) to comment on the feasibility of introducing a brief intervention within the ED with the intention of addressing the issue of medication overdose. Three data sources were employed: computerised ED records, interviews with a sub-sample of patients attending the ED following a medication overdose, and observation of ED processes in relation to these cases. / One of the most important findings of the study was the large contribution made by benzodiazepine medications to the overall medication overdose statistics. When considered in conjunction with the patient interview data, it appeared that many patients included in the study were prescribed benzodiazepines in a manner that contradicts current national prescribing guidelines. The problem of medication overdose could be partially addressed by working with doctors to ensure the appropriateness of their prescribing practices, to encourage them to more closely monitor the treatment progress of at-risk patients, and to increase awareness of other evidence-based forms of treatment for depression and anxiety.

Loss of physiological function, uncomfortable symptoms and various disease processes are thought to be directly related to the formation of scar tissue following tissue damage. Between ten and thirty percent of patients requiring spinal surgery suffer from failed back surgery syndrome. The pain and instability resulting from failed back syndrome often requires medical treatment and may even require additional surgeries to alleviate its associated symptoms. Following surgery, scar tissue forms that often becomes adherent to the dura and entangled in the ganglia and nerve fibers of the spinal nerves. This scar tissue is considered to play a major role in the development of failed back syndrome. Following tissue injury, excessive oxidative stress and inflammation are considered to be the primary stimulators behind increased fibroblast proliferation and activation, resulting in abundant extracellular matrix deposition. The excessive laying down of extracellular matrix ultimately leads to abundant scar tissue formation. I hypothesized that reducing oxidative stress and inflammation will mitigate scar tissue formation and produce a better outcome after spinal surgeries. Quercetin is a dietary flavonoid with anti-oxidant and anti-inflammatory properties that has been shown to improve the outcome following injury to the spinal cord and reduce the proliferation of fibroblasts. L-2-Oxothiazolidine-4-carboxylate (OTC) also minimizes inflammation and protects against oxidative stress by promoting the synthesis of the potent antioxidant and anti-inflammatory agent glutathione. OTC reduces airway inflammation in asthma models and is potentially capable of modulating extracellular matrix production. <p>Treatment with these two agents was hypothesized to decrease oxidative stress and inflammation, thereby causing an amelioration of scar tissue formation following spinal surgery and improve the outcome. Morphological changes observed initially indicated that improvements in wound healing were occurring in the experimentally treated tissues. In addition, the scar tissue area and the lateral widths of the peridural scar forming between the muscular tissue areas suggested a reduction in the scar size. Although inflammatory cell numbers increased slightly in the experimental treatment groups, particularly during the initial three day post laminectomy time point, this increase was not statistically significant. <p>While quercetin and OTC did not appear to inhibit the influx of inflammatory cells following laminectomy, they did appear to induce a more beneficial wound healing environment. It is possible that these agents are affecting parameters of wound healing not considered by these studies. For instance the myriad of processes mediated by growth factors and cytokines involved in wound healing process may play a much greater role than the inflammatory cells themselves. In conclusion, reducing oxidative stress and inflammation by these agents to ameliorate scar tissue formation following spinal laminectomy was supported by the observed morphology, but not supported by the quantification of inflammatory cells. Additional studies investigating the efficacy of quercetin and OTC on the wound healing process are needed to further understand the role they play in repair and scar tissue formation.

Loss of physiological function, uncomfortable symptoms and various disease processes are thought to be directly related to the formation of scar tissue following tissue damage. Between ten and thirty percent of patients requiring spinal surgery suffer from failed back surgery syndrome. The pain and instability resulting from failed back syndrome often requires medical treatment and may even require additional surgeries to alleviate its associated symptoms. Following surgery, scar tissue forms that often becomes adherent to the dura and entangled in the ganglia and nerve fibers of the spinal nerves. This scar tissue is considered to play a major role in the development of failed back syndrome. Following tissue injury, excessive oxidative stress and inflammation are considered to be the primary stimulators behind increased fibroblast proliferation and activation, resulting in abundant extracellular matrix deposition. The excessive laying down of extracellular matrix ultimately leads to abundant scar tissue formation. I hypothesized that reducing oxidative stress and inflammation will mitigate scar tissue formation and produce a better outcome after spinal surgeries. Quercetin is a dietary flavonoid with anti-oxidant and anti-inflammatory properties that has been shown to improve the outcome following injury to the spinal cord and reduce the proliferation of fibroblasts. L-2-Oxothiazolidine-4-carboxylate (OTC) also minimizes inflammation and protects against oxidative stress by promoting the synthesis of the potent antioxidant and anti-inflammatory agent glutathione. OTC reduces airway inflammation in asthma models and is potentially capable of modulating extracellular matrix production. <p>Treatment with these two agents was hypothesized to decrease oxidative stress and inflammation, thereby causing an amelioration of scar tissue formation following spinal surgery and improve the outcome. Morphological changes observed initially indicated that improvements in wound healing were occurring in the experimentally treated tissues. In addition, the scar tissue area and the lateral widths of the peridural scar forming between the muscular tissue areas suggested a reduction in the scar size. Although inflammatory cell numbers increased slightly in the experimental treatment groups, particularly during the initial three day post laminectomy time point, this increase was not statistically significant. <p>While quercetin and OTC did not appear to inhibit the influx of inflammatory cells following laminectomy, they did appear to induce a more beneficial wound healing environment. It is possible that these agents are affecting parameters of wound healing not considered by these studies. For instance the myriad of processes mediated by growth factors and cytokines involved in wound healing process may play a much greater role than the inflammatory cells themselves. In conclusion, reducing oxidative stress and inflammation by these agents to ameliorate scar tissue formation following spinal laminectomy was supported by the observed morphology, but not supported by the quantification of inflammatory cells. Additional studies investigating the efficacy of quercetin and OTC on the wound healing process are needed to further understand the role they play in repair and scar tissue formation.

Background: The financial crisis of 2007-2010 had a massive impact on the financial markets worldwide. The crisis was partly blamed on the credit derivatives collateralized debt obligations and credit default swaps. These instruments were used to create leverage and speculation, which led to uncertainty in the financial system worldwide. There has been no recent documentation of how credit derivatives are used in Swedish banks, and what risks and opportunities they bring along. Purpose: The purpose of this thesis is to describe the use of credit derivatives in Swedish banks, what benefits and risks they may generate and how the recent financial crisis has affected their use. Research Method: This is a qualitative multiple case study which uses an inductive approach. The study covers four cases, three of the largest Swedish commercial banks, and a bank that specializes on international financing. Seven people working in different fields in these banks have been interviewed. Conclusions: Credit derivatives are mostly used for hedging in Swedish banks, which mainly involves the use of credit default swaps, and sometimes iTraxx. Purely speculative trades are rare. The risks that arise are mainly due to lack of transparency in OTC trading, and abusive use of these instruments. Credit derivatives greatly facilitate risk management in banks. Regulations have increased since the financial crisis and the demand for more complex products greatly decreased.

Το direct marketing αποτελεί μια ιδιαίτερη μορφή marketing, όπου κάθε ενέργεια που περιλαμβάνει δημιουργεί ένα είδος διαπροσωπικής σχέσης μεταξύ επιχείρησης και πελάτη. Αποτελεί αναπόσπαστο κομμάτι της Ολοκληρωμένης Επικοινωνίας Marketing. Είναι ένας προσωπικός τρόπος προσέγγισης δυνητικών πελατών. Σύμφωνα με τον ορισμό της Direct Marketing Association , direct marketing είναι ένα αμφίδρομο σύστημα marketing (interactive system marketing) που χρησιμοποιεί ένα ή περισσότερα διαφημιστικά μέσα, προκειμένου να πραγματοποιήσει μια μετρούμενη ανταπόκριση (response) ή συναλλαγή (transaction) σε οποιοδήποτε σημείο. Γίνεται αντιληπτό, λοιπό, ότι περιγράφεται ένα αμφίδρομο σύστημα μεταξύ marketer και καταναλωτή. Τα βασικά εργαλεία του direct marketing αφενός δίνουν την ευκαιρία στους καταναλωτές να αποκριθούν θετικά ή μη στα μηνύματα που φέρουν προς αυτούς και αφετέρου δίνουν τη δυνατότητα στους marketers καταγράφοντας και μετρώντας τις αντιδράσεις των καταναλωτών να οδηγηθούν σε σημαντικά συμπεράσματα που θα τους βοηθήσουν σε μελλοντικό σχεδιασμό marketing. Τα βασικά χαρακτηριστικά του direct marketing συνοψίζονται στο ότι βρίσκεται δίπλα στον καταναλωτή, κατανοεί τις ανάγκες του, ανταποκρίνεται σε προσωπικό επίπεδο με τον καταναλωτή και διατηρεί σχέση μαζί του και μετά την συναλλαγή. Η φιλοσοφία του direct marketing είναι ότι κάθε πελάτης είναι μοναδικός. Βασικός σκοπός της έρευνας είναι πως επηρεάζει την καταναλωτική συμπεριφορά η εφαρμογή του direct marketing στο χώρο του φαρμακείου και συγκεκριμένα η εφαρμογή βασικών εργαλείων του direct marketing εντός του φαρμακείου όπως αυτή αποφασίζεται και σχεδιάζεται τόσο από τις εταιρίες όσο και από τον φαρμακοποιό. Η ερευνητική βάση της παρούσας εργασίας ήταν πως το direct marketing σε μη συνταγογραφούμενα φάρμακα- OTC δύναται να επηρεάσει την αγοραστική απόφαση του ασθενή ή δυνητικού πελάτη στο χώρο του φαρμακείου. Αποδεικνύεται, λοιπόν, ότι τo direct marketing εφαρμόζεται επιτυχώς στο σύγχρονο ελληνικό φαρμακείο. Σκοπός μιας θεματικής προβολής ενός φαρμάκου ή άλλου φαρμακευτικού ενδιαφέροντος προϊόντος είναι να λειτουργήσει σαν έναυσμα για τη συμβουλευτική προσέγγιση και πώληση. Η οργάνωση της θεματικής προβολής ξεκινά με στόχο να δοθεί ένα ξεκάθαρο μήνυμα στον επισκέπτη. Όπως προκύπτει από την ανάλυση των δεδομένων, ιδανικό είναι να γίνεται παρουσίαση σε τουλάχιστον 3 βασικά σημεία όπως είναι η βιτρίνα του φαρμακείου (την πρώτη εικόνα που έχει ο πελάτης που έρχεται στο φαρμακείο), γόνδολες ή σταντ στο χώρο προς το σημείο εξυπηρέτησης και ο πάγκο εξυπηρέτησης. Η έρευνα έγινε σε φαρμακεία δυο πόλεων της Ελλάδας( Πάτρα και Αθήνα) και απευθυνόταν σε ασθενείς και πελάτες των φαρμακείων, η επιλογή των οποίων ήταν τυχαία. Δημιουργήσαμε ένα ερωτηματολόγιο με 9 ερωτήματα και αντίστοιχα υπο-ερωτήματα. Αρχικά μοιράστηκαν 150 ερωτηματολόγια από τα οποία απαντημένα επεστράφησαν 102. Η συλλογή των απαντήσεων έγινε με την μέθοδο των προσωπικών συνεντεύξεων. Μετά τη συλλογή των ερωτηματολογίων και την καταγραφή των δεδομένων, έγινε η επεξεργασία τους με το στατιστικό πρόγραμμα spss.17 για τη εξαγωγή συμπερασμάτων. Το 44,1% των συμμετεχόντων στην έρευνα ήταν άνδρες και το 55,9 % γυναίκες. Η κατηγορία φαρμάκων που κερδίζει την προτίμηση των καταναλωτών και την οποία αγοράζουν σε τακτική βάση είναι τα αναλγητικά- αντιπυρετικά σε ποσοστό 39,2% και ακολουθούν τα αντιφλεγμονώδη –αναλγητικά σε ποσοστό 14,7%. Από την πρώτη σε προτίμηση κατηγορία φαρμάκων, το depon είναι εκείνο που αγοράζουν τακτικά οι καταναλωτές, ενώ από τα αντιφλεγμονώδη- αναλγητικά προτιμούν το ponstan. Οι συμμετέχοντες στην έρευνα συνηθίζουν να αγοράζουν τα φάρμακα βασιζόμενοι στην εμπειρία τους, στην διαφήμιση αυτών και στην ελκυστική συσκευασία τους, φροντίζουν να ενημερώνονται για τα κυκλοφορούντα OTC φάρμακα στην αγορά, η αγοραστική τους απόφαση επηρεάζεται από τις προωθητικές δραστηριότητες και ενδιαφέρονται για την ανάπτυξη ουσιαστικής επικοινωνίας με τον φαρμακοποιό. / Direct marketing is a special form of marketing, where every action creates a unique relationship between the venture and the customer. It is considered as an integral piece of Integrated Communication Marketing. Rather it can be characterized as a personal way to approach potential customers. According to the definition of the Direct Marketing Association, Direct Marketing is an interactive marketing system that uses one or more advertising means, so that it realises a measuring response or transaction at any point. As it is obvious, we have described an interactive system between the marketer and the consumer. The main philosophy of the direct marketing lies in the fact that every consumer is unique. We can summarize the basic characteristics of direct marketing in the following: • it tries to be near the customer, • understand his needs, • respond to them in a personal level • and to maintain a good relationship with him, even after the transaction. The basic tools of direct marketing enable on the one hand the consumers to respond directly in their own way (positively or negatively) to the messages of the marketers, and on the other hand enable the marketers to record and measure the counteractions of the consumers, so that they can actually conclude in significant results for their future marketing plans. The purpose of this study is to examine how the patient/consumer behavior is affected by the implementation of direct marketing in the actual area of a pharmacy, as this is applied either by companies or by the pharmacist himself. We restricted our research concern only to OTC medicines; therefore we could have a sample, where the final decision about drug consuming would be on the patient alone. We have seen that the direct marketing is successfully applied in today’s Greek pharmacy. The research took place in the pharmacies of two major cities of Greece, Athens and Patras, and was addressed to patients, who were randomly chosen. We handed out 150 questionnaires but finally gathered 102. We used SPSS 17 to process the data. 44,1% of the respondents were men and 55,9 % women. The first category of medicine that the patients buy is analgetics-antipyretics followed by anti-inflamatory drugs. As we have seen the major reasons that make patients decide what medicine to consume are experience, advertisements, and package.

Η παρούσα διπλωματική εργασία έχει ως σκοπό να μελετήσει αν η διαφήμιση των OTC παυσίπονων φαρμάκων επηρεάζει τη συμπεριφορά των καταναλωτών-ασθενών. Πιο συγκεκριμένα, μελετούνται διάφοροι παράγοντες που βρέθηκαν από τη βιβλιογραφική ανασκόπηση ότι επηρεάζουν τις επιλογές των καταναλωτών. Επίσης, διερευνήσαμε τη γνώμη των καταναλωτών για τα OTC παυσίπονα φάρμακα και πόσο σημαντικός είναι ο ρόλος του φαρμακοποιού για τις αποφάσεις που λαμβάνουν οι καταναλωτές. / The aim of this thesis is the impact of advertising OTC painkilling drugs on consumer behavior.

El presente trabajo determina, con diversas especificaciones y métodos de estimación, el impacto de las barreras comerciales (arancelarias, no arancelarias y los obstáculos técnicos) impuestas por los principales países de destino de las exportaciones peruanas sobre el valor de estas para el periodo 1992-2002. Los resultados del análisis de la información y estimaciones realizadas indican, por un lado, que los aranceles Nación Más Favorecida (NMF) y Sistema Generalizado de Preferencias (SGP) de los principales socios comerciales son relativamente bajos y cercanos a cero. Contrariamente, el número total y el promedio por partida arancelaria de exportación de las Barreras Comerciales No Arancelarias (BNA), con predominancia de los Obstáculos Técnicos al Comercio (OTC), son relativamente altos. De otro lado, a pesar de las debilidades y limitaciones de la información y sesgos de los estimadores originados por errores de omisión de variables, los impactos negativos estimados de las BNA y los OTC sobre las exportaciones parecen ser «fuertes» (robust) ante las diversas especificaciones usadas. Estos resultados sugieren que las negociaciones y acuerdos comerciales en los que el Perú participa pueden no tener los impactos positivos significativos que de ellos se esperan a menos que se reduzcan o eliminen las BNA.

Made available in DSpace on 2014-06-12T23:15:16Z (GMT). No. of bitstreams: 2 arquivo920_1.pdf: 2966352 bytes, checksum: 64f5f0a198024542cf5cad637bd100b8 (MD5) license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5) Previous issue date: 2011 / Conselho Nacional de Desenvolvimento Científico e Tecnológico / Substâncias farmacêuticas têm sido recentemente reconhecidas como contaminantes emergentes quando presentes em concentrações mesmo a nível de ng ou &#956;g nos rios e em espécies aquáticas, quer sejam zooplancton ou fitoplancton. Estas espécies devido às suas propriedades físico-químicas são persistentes e bioacumulativas no ambiente provocando efeitos negativos nos ecossistemas aquáticos ou terrestres. Dentre os grupos de fármacos, a oxitetraciclina (OTC), um antibiótico se mostra eficaz contra diversos microorganismos, com aplicação na medicina humana e veterinária. O objetivo deste trabalho foi desenvolver um eletrodo íon-seletivo para detecção de oxitetraciclina através de sistema de análise por injeção seqüencial, avaliar sua degradação aplicando processos oxidativos avançados, e avaliar o uso de rede de coordenação 3D para adsorver OTC de uma solução aquosa. Através de testes de seletividade foi possível desenvolver uma metodologia potenciométrica, utilizando na preparação da membrana sensora, dibutil ftalato (68%), PVC-COOH (31%), e &#946;-ciclodextrina (1%). A incorporação desta membrana em sistemas de análise por injeção seqüencial conduziu a uma automatização dos procedimentos analíticos envolvidos na determinação de OTC.HCl em produtos farmacêuticos, proporcionando uma freqüência analítica de aproximadamente 51 amostras h-1 sendo possivel utilizar este sistema em análise de rotina. A degradação da oxitetraciclina em solução aquosa foi avaliada utilizando Processos Oxidativos Avançados. Obteve-se através da fotólise uma degradação de 54,7% utilizando lâmpada com 250W de potência após 60 minutos. Aplicando o processo H2O2/UV a degradação foi de 92,6% com uma lâmpada de 250W de potência e [H2O2] = 6 mmol, em 15 minutos. Na aplicação do Processo Fenton, obteve-se 69,0% na degradação, utilizando [Fe2+] = 0,05 mmol e [H2O2] = 6 mmol, em 6 minutos. O uso do Processo foto-Fenton, utilizando lâmpada de 250W de potência, [Fe2+] = 0,05 mmol e [H2O2] = 6 mmol, em 6 minutos, obteve-se uma degradação de 85,0%. Através do processo por fotocatálise (TiO2) a degradação do antibiótico foi de 98,3% com injeção de ar, utilizando luz negra (400-320nm), pH = 7 e [TiO2] = 1 g L-1, em 60 minutos de processo. No processo de remoção (%) da oxitetraciclina empregando Metal Organic Frameworks (MOF) houve remoção de 4,3 a 99,7%. O comportamento das MOFs ativadas apresentou uma menor eficiência em relação aos in natura . Analisando a MOF A100, a remoção e o equilíbrio da oxitetraciclina ocorreram de forma rápida (±20 min), tanto para a MOF in natura, quanto para a ativada. Já o comportamento de saturação da coluna utilizando a MOF C300 (C18H6Cu3O12) ocorreu de maneira acentuada para os dois tipos de adsorvente, ou seja, indicando o completo esgotamento da coluna (C/C0=1). A curva de saturação da MOF Z1200 (C8H12N4Zn) ocorreu de maneira mais suave, principalmente para o adsorvente in natura . Através da caracterização das MOFs por Infravermelho, observou-se que apenas a faixa no comprimento de onda correspondente a água (3000 a 3650 nm) para a MOF Z1200 é quase nula, como também, na análise por BET obteve-se uma maior área superficial e volume poroso, isso pode ter levado a uma melhor interação junto a OTC. Aplicando o planejamento fatorial com a Basolite Z1200 foi possível verificar que quanto maior for a massa e menor o tempo significa um aumento médio 16,8 e 13,3% na quantidade de remoção da oxitetraciclina, respectivamente

Memoria (magíster en derecho económico, inversiones, comercio y arbitraje internacional) / On June 26 2008, the Delegation of Argentina issued a statement to the Technical Barriers to Trade (TBT) Committee of the World Trade Organization (WTO) which questioned the utilization of traditional expressions or additional quality terms with respect to wines that the Commission Regulations (EC) No 753/2002 and No 316/2004 of the European Union (EU) foresee. In this statement, Argentina claimed the rejection of its wines in Europe because the label contained certain terms that were protected by the cited EU regulations as exclusive rights to be used in Spanish by the Kingdom of Spain. The Republic of Argentina argued that, as terms referring to a certain product or quality features, they do not fall under the scope of Trade-Related aspects of Intellectual Property Rights (TRIPS). Such regulations constitute a virtual “expropriation” of a generic term in the Spanish language. Likewise, they are not a measure that is consistent with the Technical Barriers to Trade (TBT) Agreement as they create an unnecessary and unjustified barrier to international trade and therefore, Argentina requested the revision of the mentioned European regulations.