Thesis advisor: Robert C. Bartlett / This dissertation investigates how Socrates understands his trial. It is a well-known fact that Socrates is accused of impiety and corruption of the young and is subsequently executed. Unlike an ordinary defendant who is supposed to make every effort to be acquitted, Socrates, behaving provocatively, seems even to induce the death penalty. By reading Plato's and Xenophon's works, this dissertation clarifies his thoughts on the trial that must be the basis of his conduct and explains how he achieves his aim. To deal with Socrates' view of the trial as a whole, this study examines three questions. First, does he believe in his own innocence? I argue that before and even at the trial, Socrates does not intend to prove his innocence effectively. He does not reveal his belief clearly, but at least it is clear that to be acquitted is not his primary purpose. Second, what does Socrates want to achieve at the trial? Socrates' primary purpose is to demonstrate his virtue in public. His speech that provocatively emphasizes his excellence as a benefactor of the city enables him to be convicted as a wise and noble man rather than as an impious corrupter of the young. Third, why does he refuse to escape from jail? I argue that by introducing the speech that defends the laws of the city, Socrates makes himself appear to be a supremely law-abiding citizen who is executed even when escape is possible. This study maintains that Socrates vindicates his philosophy before the ordinary people of Athens by making a strong impression of his moral excellence and utility to others. His presentation of philosophy makes it possible that being convicted and executed are compatible with appearing virtuous and being respected. Socrates promotes his posthumous reputation as a great philosopher, and thus secures the life of philosophy after his death by mitigating the popular hostility against him and philosophy as such. Socrates' understanding of his trial leads us to his idea of the nature of philosophy and the city, and of their ideal relationship. This dissertation is therefore an introduction to Socratic political philosophy. / Thesis (PhD) — Boston College, 2011. / Submitted to: Boston College. Graduate School of Arts and Sciences. / Discipline: Political Science.

Le procès civil est un des moyens essentiels pour le bon déroulement de la justice. Il amène une difficulté de fait et de droit à l’examen d’un juge par un ensemble des formalités qui doivent être suivies pour soumettre une prétention à un juge civil, ce qu’on appelle : une instance civile. L’objectif premier de l’instance civile est de permettre l’exercice d’une justice efficace, respectueuse du droit de chaque partie afin de créer un climat de sécurité juridique. A première vue, la répartition du rôle du juge et des parties dans le fond de l’instance civil semble simple, puisque les parties sont en chargent des faits et le juge doit rendre le droit. En réalité, l’articulation des fonctions du juge et des parties est plus complexe. Concrètement, les faits et le droit n’étant que les deux versants d’une même réalité, il est délicat de définir précisément l’étendue de la place que doivent occuper respectivement le juge et les parties. Faut-il aller dans le sens d’une extension ou d’une limitation du pouvoir du juge ? Le procès civil doit-il rester la chose des parties ? Et de même la forme de l’instance nécessite la comparaison entre les deux systèmes en essayant de connaître si ils sont arrivés à aboutir à l’objective du procès civil. Bien que les systèmes juridiques français et koweitien soit de prime abord quelque différent, l’intérêt d’une telle étude comparée réside dans le fait de faire ressortir les dysfonctionnements en matière du procès civile en premier instance, et cela notamment dans le droit koweitien. L’étude de l’instance civile française va servir de référence pour apporter des améliorations dans l’instance civile du Koweït. La procédure civile française est historiquement bien plus ancienne que celle du Koweït. C’est la loi du 14 avril 1806 qui institue le premier code de procédure civile en France alors que le Koweït n’en sera doté que bien plus tard. Il ressort que la dynamique donnée au procès civil en France et au Koweït n’est pas la même, et cela en raison de la formulation des dispositions relatives à la répartition du rôle du juge et des parties. Dans l’instance civile française, ces dispositions sont plus explicites et plus précises alors que dans l’instance civile koweitienne, elles apparaissent de manière plus implicite et plus éparse. Ainsi,« le flou » qui règne dans le procès civil koweitienne, laisse plus de place à l’intervention de la jurisprudence qui plus est n’est pas toujours cohérente. Il est alors nécessaire de combler les lacunes du système koweitien, pour garantir une meilleure sécurité juridique. Le modèle français pourrait alors constituer une source d’inspiration pour apporter des améliorations au procès civil koweitienne. Ces améliorations pourraient notamment consister à réorganiser le code de procédure civile afin de rendre plus visible les dispositions concernant la répartition du rôle du juge et des parties dans les procès de première instance. Il s’agit aussi d’apporter des précisions législatives pour expliciter et faciliter le déroulement du procès civil, en déterminant les rôles respectifs du juge et des parties dans le procès civil d’instance et d’en comprendre les implications et cela sous l’angle d’une étude comparative entre le droit français et le droit koweitien. / The civil trial is an essential means for the proper conduct of justice. Hebrings a difficulty of fact and law under consideration by a judge by a set of steps that must be followed to submit a claim to a civil court, which is called: a civil proceeding. The primary objective of the civil proceeding is to permit the exercise of effective justice, respects the right of each party to create a climate of legal certainty. At first glance, the distribution of the role of the judge and the parties in the merits of the civil judge appears simple, because the parties are in charge of the facts and the judge must make the law. In fact, the articulation of the judge and the parties is more complex. Specifically, the facts and the law is that the two sides of the same coin, it is difficult to precisely define the extent of the space to be occupied respectively the judge and the parties. Should we go in the direction of extension or limitation of the judicial power ? The civil trial should he remain the party thing ? And even the shape of the proceeding requires the comparison between the two systems trying to know if they got to reach the objective of the civil trial. Although the French and Kuwaiti legal system is at first a different, the value of such a comparative study is that to highlight the dysfunction in the civil trial in the first instance, and that especially in the Kuwaiti law. The study of French civil case will serve as a reference for making improvements in the civil case of Kuwait. The French civil procedure is historically much older than that of Kuwait. This is the law of 14 April 1806 which established the first code of civil procedure in France while Kuwait will have not much later. It appears that the momentum given to the civil trial in France and Kuwait is not the same, and that because of the wording in relation to the distribution of the role of the judge and the parties. In the French civil, these provisions are more explicit and precise while in the Kuwaiti civil, they appear more and more sparse implied. Thus, "blur" that prevails in the Kuwaiti civil trial, leaves more room for the intervention of the law that is more is not always consistent. It is then necessary to fill gaps in the Kuwaiti system to ensure greater legal certainty. The French model could be a source of inspiration to make improvements to the Kuwaiti civil trial. These improvements might include reorganizing the Code of Civil Procedure in order to make more visible the provisions concerning the distribution of the role of the judge and the parties in the original trial. It is also for legislative clarification to clarify and facilitate the conduct of the civil trial, determining the roles of the judge and the parties in the civil trial of first instance and to understand its implications and that under the angle of a comparative study between the french law and the Kuwaiti law.

Background. Mindfulness-based Cognitive Therapy (MBCT) is a relapse-prevention treatment for people in remission from major depression (rMDD). The neuropsychological mechanisms of MBCT are largely unknown. The key theoretical mechanisms of MBCT include self-compassion and rumination, with other mindfulness-based studies suggesting mechanisms across domains of attention, emotional processing, and cognitive flexibility. The aims of this thesis were to investigate the neuropsychological and neuroimaging mechanisms of MBCT in rMDD and to investigate relationships with relapse six months beyond MBCT. Paper One. 40 MBCT, 33 Treatment As Usual (TAU), and 42 healthy volunteers (HVs) took part. Experimental tasks for self-compassion and rumination were completed at baseline and post-session, alongside self-report questionnaires. Results showed increases for self-compassion following MBCT, with non-specific reductions for rumination. Paper Two. 40 MBCT, 33 TAU, and 42 HV participants took part. Tasks of attention, emotional processing, and cognitive flexibility were completed at baseline and post-session. Results showed increases in positive emotions post-MBCT, with non-specific changes for face emotion recognition and affective attentional bias tasks both post-MBCT and TAU. There were no changes over time for sustained attention or cognitive flexibility. Paper Three. 16 rMDD participants completed baseline and post-MBCT fMRI tasks of sustained attention and self-blame. Results showed reduced activation over time in the bilateral dACC in self-blame contrasts but no activation changes for sustained attention. Paper Four. 69 rMDD participants (38 MBCT & 31 TAU) completed task-based and self-report assessments up to six months follow-up. Non-relapsing MBCT participants showed increased self-compassion post-session which was maintained in follow-up. MBCT non-relapsing and TAU participants showed reduced rumination post-session and in follow-up. Conclusions. MBCT encourages a move towards more self-compassionate, positive processing but does not alter more automatic, bottom-up levels of processing. MBCT initiates a process for change beyond the course, particularly for self-compassion. Findings have theoretical and clinical implications and extend our understanding of the mechanisms of MBCT in rMDD participants.

Student Number : 0115350V - MSc dissertation - School of Plant, Animal and Environmental Science - Faculty of Science / The effect of between-tree competition in separate even aged stands of a Eucalyptus grandis seedling and a single Eucalyptus grandis x Eucalyptus urophylla hybrid clone was assessed. This was done by comparing treatments within an experiment, that was designed to test the effect planting density and genotype had on timber production and stand dynamics through time. This experiment is located on an escarpment in the Summer rainfall region of South Africa, approximately 7 km North West of Albert Falls dam in the Kwa-Zulu Natal Midlands. The terrain is flat with deep apedal soils, and the site has an estimated mean annual precipitation of 1143 mm. The simplest method of evaluating competition effects in plantation stands is through the use of spacing trials. Spacing trials create stands/plots in which all silvicultural and climatic variables are constant. Differences between treatments can then be attributed to competition alone. The planting densities tested were 6667 stems.ha-1, 3333 stems.ha-1, 2222 stems.ha-1, 1587 stems.ha-1 and 1111 stems.ha-1 respectively. Competition was measured at three levels, namely; (i)individual tree, (ii)size-class and (iii)stand level. Vigour and its distribution within the population were used to explain competition processes. Basal area was chosen as the size variable for which vigour would be analysed. Relative Growth Rate (RGR) and Relative Production Rate (RPR) were chosen as the measures of vigour for analysis. Morphological changes in the trees as a result of competition were also used to understand the competitive mechanisms. It was found that resources are not shared amongst individuals in proportion to their size, but rather the larger individuals use disproportionately more of the resources than the smaller individuals, and therefore competition is asymmetrical. The dominant form of competition was found to be resource pre-emption where larger individuals passively prevent solar resources from reaching smaller competitors. Using RPR as the measure of vigour, competition was found to be one-sided, meaning that smaller individuals do not reduce the vigour of larger ones. If RGR is accepted as the measure of vigour then competition is two-sided meaning that the smaller individuals do reduce the vigour of the larger ones to a certain extent. There was no difference in the degree to which the smaller competitors in the clonal and seedling treatments reduced the growth of the larger individuals. The self-thinning rate in the seedling treatments was significantly higher than in the clonal treatments. Increases in mean tree size and production per hectare were accompanied by increases in mortality in the seedling treatments. In the clonal treatments it was found that even once the mean tree size approached the self thinning line, very few or no trees died, however there was also very little or no increase in mean tree size. When the relationship between number of live trees and production per hectare was analysed it was found that the clone could increase production per hectare without any change in survivorship, which is contrary to popular theory. As time progressed the skewness of the population progressed from negative to positive. This increase was the most pronounced in the higher planting density treatments, and the clonal treatments. The size variability in the population first decreased, then steadily increased. This increase was more pronounced in the high planting density treatments, and the clonal treatments. Clones and seedlings react in very different ways to competition. The large differences in population dynamics observed, indicate that we cannot just apply knowledge built up over the years regarding the management of Eucalyptus grandis and other plantation species to Eucalyptus hybrid clones.

As adaptive clinical trials (ACTs) receive growing attention and exhibit promising performance in practical trials during last decade, they also present challenges to drug supply chain management. As indicated by Burnham et al. (2015), the challenges include the uncertainty of maximum drug supply needed, the shifting of supply requirement, and rapid availability of new supply at decision points. To facilitate drug supply decision making and the development of mathematical analysis tools, we propose two trial supply chain optimization problems that represent different mindsets in response to trial adaptations. In the first problem, we treat the impacts of ACTs as exogenous uncertainties and study important aspects of trial supply, including drug wastage, resupply policy, trial length, and costs minimization, via a two-stage stochastic program. In the second problem, we incorporate the adaptation rules of ACTs with supply chain management and numerically study the impact of joint optimization on the trial and drug supply planning through a mixed-integer nonlinear program (MINLP). For solution approaches to the problems, we use progressive hedging algorithm (PHA) and particle swarm optimization (PSO) respectively, and take advantages of the problem structures to enhance the solution efficiency. With case studies, we see that the proposed models capture the features of ACT drug supply and the mechanisms of trial conduction well. The solutions not only reflect the impact of trial adaptations but also provide managerial suggestions, e.g. the prediction of needed production amount, storage capacity at clinical sites, and resupply schemes. The joint optimization also suggests a new angle and research extension in the field of ACT design and supply.

All pharmaceutical products are required by law to display an expiry date on the packaging. The period between the date of manufacture and expiry date is known as the label shelf-life. The label shelf-life indicates the period of time during which the consumer can expect the product to be safe and effective. Methods for determining the label shelf-life from stability data are discussed in the guidelines on the evaluation of stability data issued by the International Conference for Harmonization. These methods are limited to data that can be analysed using linear model methods. Furthermore, in the situation where a number of batches are used to determine a label shelf-life, the current regulatory method (unintentionally) penalizes good statistical design. In addition, the label shelf-life obtained this way may not be a reliable guide to the properties of future batches produced under similar conditions. In this thesis it is shown that the current definition of the label shelf-life may not provide the consumer with the desired level of confidence that the product is safe and effective. This is especially the case when the manufacturer has performed a well designed stability study with many assays. Consequently, a new definition for the label shelf-life is proposed, such that the consumer can be confident that a certain percentage of the product will meet the specification by the expiry date. Several methods for obtaining such a label shelf-life under linear model and generalized linear model assumptions are proposed and evaluated using simulation studies. The new definition of label shelf-life is extended to allow a label shelf-life to be obtained from stability studies that make use of many batches, such that a proportion of product over all batches can be assured to meet specifications by the expiry date. Several methods for estimating the label shelf-life in the multi-batch case are proposed and evaluated with the help of simulation studies. / Thesis (Ph.D.)--School of Agriculture and Wine, 2003.

Migraine affects 8 -16% of population in different countries resulting in significant economic and social impacts. Current pharmacological treatment provides symptomatic relief, but not without side effects. Hence, an increasing proportion of patients prefer complementary therapies including acupuncture for migraine relief. Randomised controlled trials (RCTs) of acupuncture treatment for migraine have produced conflicting evidence due to methodological and reporting deficiencies, including small sample sizes and inappropriate outcome measures. Furthermore, systematic reviews on acupuncture for headache failed to adequately represent non-English studies such as those conducted in China. This project aimed to: (1) systematically review studies of acupuncture for migraine; and (2) conduct a RCT addressing key deficiencies identified from the systematic reviews (SRs). Two SRs were conducted based onfollowing Cochrane review protocols. Major English, Chinese, Japanese and Korean databases were searched. The first SR included 15 English studies and the second SR had 17 Chinese studies. No Japanese or Korean RCTs were identified. Overall, those two SRs supported the value of acupuncture in the treatment and prevention of migraine when compared with western medications. However, conflicting results were found when real acupuncture treatments were compared with sham/placebo procedures. When compared with the studies published in English, Chinese studies had a higher frequency of acupuncture treatment, displayed poor methodological quality, and commonly used pharmacotherapy as a comparator. The SRs revealed that there was limited evaluation of acupuncture for frequent migraine. In the RCT, fifty participants with a minimum of eight migraine days per four weeks were randomly allocated to receive real (RA, n = 26) and sham (SA, n = 24) acupuncture for a total of 16 sessions over 20 weeks in a gradually decreasing treatment frequency. Fixed and supplementary acupoints were used. Participants were followed up for further assessment at three months and one year. Results showed that at the end of the treatment period, the mean (SD) migraine attack days per four weeks decreased from 11.81 (5.76) to 5.17 (5.02) in the RA group and from 12.41 (6.4) to 10.08 (7.11) in SA (group difference: p = .008). Intensity of migraine assessed using a Six-point Likert scale was lower in the RA (2.18 ±1.05) than that in the SA group (2.93 ± 0.61, p = 0.004). The percentile changes of pressure pain threshold (PPTs) detected at the bilateral points of TaiYang (Ex-HN5) were significantly higher in the RA group (RA 228.48% vs. SA -0.66 % on the left and 92.69% vs. -2.52% on the right). However, there was no s tatistically significant difference between the two groups with respect to Migraine Specific Quality of Life (MSQOL). At the end of the three-month follow up, medication consumption was less in the RA group, but not at the one-year follow up. In conclusion, this project demonstrates that acupuncture is a potentially effective and safe option for adult patients with frequent migraine headache with the effects lasting up to three months. Further studies are needed to confirm these therapeutic benefits with adequate sample sizes and the potential mechanism for this action.

Thesis (LL. M.)--Judge Advocate General's School, U.S. Army, 1969. / "April 1969." Typescript. Includes bibliographical references (leaf 87). Also issued in microfiche.

Background: Stories may be an effective tool to communicate with and influence patients because of their ability to engage the reader. Objectives: To develop story booklets and evaluate their effectiveness compared to standard information sheets for parents of children attending the emergency department (ED) with a child with croup. Methods: A systematic process was followed to develop and pilot-test the story booklets. Parents were randomized to receive story booklets or standard information sheets during their ED visit. The primary outcome of change in anxiety during the ED visit was assessed using the State Trait Anxiety Inventory, which was completed upon recruitment and at discharge. Follow-up telephone interviews were conducted at 1 and 3 days post-ED visit to gather information on secondary outcomes: symptoms, expected anxiety for future croup, satisfaction, regret, knowledge, return for medical care, and resource use. Telephone interviews were conducted every other day until symptoms resolved or until day 9. Outcomes were compared using independent-groups t-tests, Mann Whitney tests, or Chi-square tests. Results: There was no significant difference in the primary outcome of change in parental anxiety between recruitment and ED discharge. The story group (n=129) showed significantly greater decision regret regarding their decision to go to the ED than the comparison group (n=126) (p<0.001). The story group reported quicker resolution of symptoms: median days to no symptoms 3 versus 5; the survival distributions were significantly different (p=0.032). There were no differences for the remaining outcomes. Conclusions: This study provides preliminary evidence regarding the use of stories in the ED for an acute, self-limiting condition and contributes to a growing evidence matrix identifying when, where, and for whom storytelling may be most effective. Reasons for lack of significance for the primary and other outcomes may relate to choice of outcome, timing of outcome assessment, or disconnect between the intervention and needs of the end-user. Further research is needed to corroborate the significant findings and examine their underlying mechanism. An examination of risk of bias in a sample of pediatric trials demonstrates that there is room for improvement in the design, conduct, and reporting of research related to child health and provides direction for future research.

Background: Acupuncture involves puncturing the skin with thin sterile needles at defined acupuncture points. Previous studies are inconclusive regarding the effect of acupuncture on labour pain, but some studies have found a reduction in the use of pharmacological pain relief when acupuncture is administered. The appropriate dose of acupuncture treatment required to elicit a potential effect on labour pain has not been fully explored. The dose is determined by many different factors, including the number of needles used and the intensity of the stimulation. In Sweden, manual stimulation of the needles is common practice when acupuncture is used for labour pain, but electrical stimulation of the needles, which gives a higher dose, could possibly be more effective. The overall aim of this thesis was to evaluate the effectiveness of acupuncture with manual stimulation (MA) of the needles as well as acupuncture with a combination of manual and electrical stimulation (EA) in reducing labour pain, compared with standard care without any form of acupuncture (SC). Methods: The study was designed as a three-armed randomised controlled trial in which 303 nulliparous women with normal pregnancies were randomised to MA, EA, or SC. The primary outcome was labour pain, assessed using the Visual Analogue Scale (VAS). Secondary outcomes were relaxation during labour, use of obstetric pain relief, and associations between maternal characteristics and labour pain and use of epidural analgesia respectively. Also, labour and infant outcomes, recollection of labour pain, and maternal experiences, such as birth experience and experience of the midwife, were investigated two months after the birth. The sample size calculation was based on the potential to discover a difference of 15 mm on the VAS. Data were collected during labour before the interventions, the day after birth, and two months later. Besides using the VAS, information was collected by means of study specific protocol, questionnaires and medical records. Results: The mean VAS scores were 66.4 in the MA group, 68.5 in the EA group, and 69.0 in the SC group (mean differences: MA vs. SC 2.6 95% CI -1.7 to 6.9, and EA vs. SC 0.6 95% CI -3.6 to 4.8). Other methods of pain relief were used less frequently in the EA group, including epidural analgesia, MA 61.4%, EA 46%, and SC 69.9%. (EA vs. SC OR 0.4 95% CI 0.2 to 0.7). No statistically significant differences were found in the recollection of labour pain between the three groups two months after birth (mean VAS score: MA 69.3, EA 68.7 and SC 70.1). A few maternal characteristics were associated with labour pain (age, dysmenorrhea, and cervix dilatation), but none of the investigated characteristics predicted the outcome of the acupuncture treatment in MA or EA. Women in the EA group experienced acupuncture as being effective for labour pain to a higher extent than women who received MA, MA 44.4%, EA 67.1% (EA vs. MA OR 2.4 95% CI 1.2 to 4.8). Women in the EA group also spent less time in labour (mean 500 min) than those who received MA (mean 619 min) and SC (mean 615 min) (EA vs. MA HR 1.4 95% CI 1.0 to1.9, EA vs. SC HR 1.4, 95% CI 1.1 to 2.0), and had less blood loss than women receiving SC, (EA vs. SC OR 0.1 95% CI 0.3 to 0.7). The women’s assessment of the midwife as being supportive during labour (MA 77.2%, EA 83.5%, SC 80%), overall satisfaction with midwife care (MA 100%, EA 97.5%, SC 98.7%), and having an overall positive childbirth experience (MA 64.6%, EA 61.0%, SC 54.3%) did not differ statistically. No serious side effects of the acupuncture treatment were reported. Conclusion: Acupuncture, regardless of type of stimulation, did not differ from standard care without acupuncture in terms of reducing women’s experience of pain during labour, or their memory of pain and childbirth overall two months after the birth. However, other forms of obstetric pain relief were less frequent in women receiving a combination of manual and electrical stimulation, suggesting that this method could facilitate coping with labour pain.