Close association of occupational intervention with clinical care is of primary importance in impeding progression toward chronicity of low back pain.

Abstract. Due to the major role of the sun in heating the earth's surface, the atmospheric planetary boundary layer over land is inherently marked by a diurnal cycle. The afternoon transition, the period of the day that connects the daytime dry convective boundary layer to the night-time stable boundary layer, still has a number of unanswered scientific questions. This phase of the diurnal cycle is challenging from both modelling and observational perspectives: it is transitory, most of the forcings are small or null and the turbulence regime changes from fully convective, close to homogeneous and isotropic, toward a more heterogeneous and intermittent state.These issues motivated the BLLAST (Boundary-Layer Late Afternoon and Sunset Turbulence) field campaign that was conducted from 14 June to 8 July 2011 in southern France, in an area of complex and heterogeneous terrain. A wide range of instrumented platforms including full-size aircraft, remotely piloted aircraft systems, remote-sensing instruments, radiosoundings, tethered balloons, surface flux stations and various meteorological towers were deployed over different surface types. The boundary layer, from the earth's surface to the free troposphere, was probed during the entire day, with a focus and intense observation periods that were conducted from midday until sunset. The BLLAST field campaign also provided an opportunity to test innovative measurement systems, such as new miniaturized sensors, and a new technique for frequent radiosoundings of the low troposphere.Twelve fair weather days displaying various meteorological conditions were extensively documented during the field experiment. The boundary-layer growth varied from one day to another depending on many contributions including stability, advection, subsidence, the state of the previous day's residual layer, as well as local, meso-or synoptic scale conditions.Ground-based measurements combined with tetheredballoon and airborne observations captured the turbulence decay from the surface throughout the whole boundary layer and documented the evolution of the turbulence characteristic length scales during the transition period.Closely integrated with the field experiment, numerical studies are now underway with a complete hierarchy of models to support the data interpretation and improve the model representations.

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This study analyses the relationship between occupation, work conditions and the experience of psychological distress within a model encompassing the stress promoted by constraints-resources embedded in macrosocial structures (occupational structure), structures of daily life (workplace, family, social networks outside the workplace) and agent personality (demography, physical health, psychological traits, life habits, stressful childhood events). Longitudinal data were derived from Statistics Canada's National Population Health Survey and comprised 6,359 workers nested in 471 occupations, followed four times between 1994-1995 and 2000-2001. Discrete time survival multilevel regressions were conducted on first and repeated episodes of psychological distress. Results showed that 42.9 per cent of workers had reported one episode of psychological distress and 18.7 per cent had done so more than once. Data supported the model and challenged the results of previous studies. The individual's position in the occupational structure plays a limited role when the structures of daily life and agent personality are accounted for. In the workplace, job insecurity and social support are important determinants, but greater decision authority increases the risk of psychological distress. Workplace constraints-resources are not moderated either by the other structures of daily life or by agent personality.

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In this paper, the ''Expérience sur Site pour COntraindre les Modèles de Pollution atmosphérique et de Transport d'Emissions'' (ESCOMPTE) program is presented. The ESCOMPTE program is used to produce a relevant set of data for testing and evaluating regional pollution models. It includes high-resolution (in space and time) atmospheric emission inventories and field experiments, and covers an area of 120 Â 120 km, centered over the Marseilles-Berre area in the southeast of France during Summer 2001. This region presents a high occurrence of photochemical pollution events, which result from numerous industrial and urban sources of primary pollutants. From the dynamical characteristics of the area, sea-breeze circulation and channeling effects due to terrain features highly influence the location of the pollutant plumes. ESCOMPTE will provide a highly documented framework for dynamics and chemisty studies.Campaign strategies and experimental set up are described. During the planning phase, existing modeling results helped defining the experimental design. The campaign involved surface measurement networks, remote sensing, ship-borne, balloon-borne, and airplane measurements. Mean standard meteorological parameters and turbulent fluxes, ozone, ozone precursors, photochemically active trace gases, and aerosols were measured. Five intensive observation periods (IOPs) were documented using a wide spectrum of instruments, involving aircraft (7)

Need is usually the primary determinant of ED visits in older people. Controlling for need, predisposing and enabling factors that promote access to primary medical care are associated with reduced ED utilization.

Purpose: PRISMA is an innovative co-ordination-type Integrated Service Delivery System developed to improve continuity and increase the efficacy and efficiency of services, especially for older and disabled populations. Description:The mechanisms and tools developed and implemented by PRISMA include: (1) co-ordination between decision-makers and managers, (2) a single entry point, (3) a case management process, (4) individualised service plans, (5) a single assessment instrument based on the clients' functional autonomy, and (6) a computerised clinical chart for communicating between institutions for client monitoring purposes. Preliminary results:The efficacy of this model has been tested in a pilot project that showed a decreased incidence of functional decline, a decreased burden for caregivers and a smaller proportion of older people wishing to be institutionalised. Conclusion:The on-going implementation and effectiveness study will show evidence of its real value and its impact on clienteles and cost. Keywords health services for the aged, integrated service delivery systems, frail elderly, programme evaluationAlthough the problem of continuity applies to and is significant for all health care and services, it is particularly acute at the present time in regard to the frail elderly. Many factors-demographic (accelerated ageing of the population), social (break-up of families, children moving away to find work), economic (low income women living alone), health (increased life expectancy, high incidence of disabilities) and financial (reduced health care budgets)-are putting strong pressure on both the demand for and the supply of services for this clientele. Functional decline generates an increased need, for both the dependent individuals and their families, for evaluation, treatment, rehabilitation, psychological and social support, help to remain at home, and temporary or permanent longterm care facilities w1x. These multiple needs can also change quickly over time due to the biological, psychological and social vulnerability of this frail clientele. In terms of supply, a wide range of resources and services involving numerous practitioners and partners have been developed over the past twenty years to try to meet these needs. However, continuity-related problems compromise both service accessibility and the efficiency of health care services. For example: multiple entry points, service delivery which is influenced by the resource contacted rather than the user's need, numerous redundant evaluations of clienteles not using standardised tools, inappropriate use of costly resources (e.g. hospitals, emergency services), waiting time for services, inadequate transmission of information, and the piecemeal response to needs w2-4x. In a situation where resources are scarce and the demand for services is increasing, it is essential to ensure that the services meet the users' needs, without duplication and as efficiently as possible. Therefore, there is an urgent need to provide managers and decision-maker...