This paper investigates the bivariate dependence structure for three pairs of exchange rates measured against the US dollar: Euro and Japanese yen, Euro and British pound, Euro and Swiss franc, over the period January 1994 to November 2007. The Deutsche mark (DM) is used for the pre-euro period. By using non-parametric plots and copula models estimated by semi-parametric methods, we are able to detect changes in the dependence structure from the pre-euro to the post-euro period for the pairs DM (Euro)-Japanese yen, and DM (Euro)-British pound, with major changes occurring during the initial years of the launch of the new currency. For these two pairs of exchange rates we also capture asymmetric tail dependence, implying different degrees of comovements during appreciations and depreciations against the dollar. The dependence between the DM (Euro) and the Swiss franc remains unchanged, both in strength and structure, over the whole sample period, reflecting a marked tendency of the Swiss franc to follow the fluctuations of the DM and Euro against the dollar. The results may be of interest for international trade, international portfolio diversification and currency risk management.

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People with intellectual disability (ID) experience cardiometabolic related morbidity and mortality. However, it has been suggested that this population present and live with underestimated cardiovascular risk factors at a younger age, hence affecting their overall health, quality of life and contributing to early mortality. We assessed autonomic nervous system function in subjects with ID (n=39), aged 18-45 years, through measures of sudomotor function, heart rate and systolic blood pressure variability, and cardiac baroreflex function. Traditional clinical cardiovascular measurements and a biochemical analysis were also undertaken. We found that young adults with ID presented with sudomotor dysfunction, and impaired cardiac baroreflex sensitivity and systolic blood pressure variability, when compared to age-matched control subjects (n=38). Reduced hand and feet electrochemical skin conductance and asymmetry were significantly associated with having a moderate-profound ID. Autonomic dysfunction in those with ID persisted after controlling for age, sex and other metabolic parameters. Subjects in the ID group also showed significantly increased blood pressure, body mass index, waist/hip circumference ratio, and increased plasma haemoglobin A1c and high sensitivity C reactive protein. We conclude that autonomic dysfunction is present in young adults with ID and is more marked in those with more severe disability. These finding have important implications in developing preventative strategies to reduce the risk of cardiovascular disease in people with ID.

Background Young adults with intellectual disability (ID) are experiencing early mortality, and it is suggested that they are living with undiagnosed cardiovascular and metabolic risk factors (hereafter referred to as cardiometabolic). Methods We investigated the association between modifiable risk factors and cardiometabolic health profile in adults with ID aged 18–45 years through clinical evaluation of traditional cardiometabolic parameters, and assessment of physical activity levels, diet and associated health knowledge. Results We found that young adults with ID have an increased obesity (mean body mass index; ID group: 32.9 ± 8.6 vs. control group: 26.2 ± 5.5, P = 0.001), are engaging in less physical activity than the age‐matched general population (total activity minutes per week; ID group: 172.2 ± 148.9 vs. control group: 416.4 ± 277.1, P < 0.001), and overall have unhealthier diets. Additionally, knowledge about nutrition and physical activity appears to be an important predictor of cardiometabolic risk in this population. If young people with ID are to improve their cardiometabolic health to reduce morbidity and early mortality, we need to further explore how to consistently apply health messaging to get lasting behavioural change in this population.

Agitation-Sedation (A-S) cycling in critically ill intensive care unit (ICU) patients is damaging to health. Sedation quality is assessed by nurses and may suffer from subjectivity in their judgment and lead to sub-optimal sedation. Therefore, the use of quantitative modelling to enhance understanding of the A-S system is a key tool for optimising sedation management. Inadequate assessment of the agitation associated with clinical outcomes may lead to under or over-sedation and harm a patient's wellbeing.Empirical distributions of the nurses' ratings of a patient's pain and/or agitation levels and the administered dose of sedative are often positively skewed and if the joint distribution is non-elliptical, then the high nurses' ratings of a patient's agitation levels may not correspond to the occurrences of patient's A-S profile with large infusion dose. Copulas measure nonlinear dependencies capturing the dependence between skewed distributions. Therefore, the aim is to use a copula-based dependence measure between the nurses' rating of patients' agitation level, and the automated sedation dose to identify patient-specific thresholds that separate the regions of mild, moderate, and severe agitation intensities. Delineating the occurrences with different agitation intensities allows us to establish the regions where nurses' rating has stronger or weaker correlation with the automated sedation dose. This pilot study modelled agitation-sedation profiles o f t wo p atients c ollected a t C hristchurch Hospital, Christchurch School of Medicine and Health Sciences, NZ, from the pool of 37 patients. Classification of patients into poor and good trackers based on Wavelet Probability Bands (WPB). One of the patients is a poor tracker and the other patient is a good tracker. The best-fitting c opula s hows t hat t he d ependency structure between the nurses rating of a patients agitation level and the administered dose of sedative for both patients has an upper and lower tail. More specifically, a correlation between the nurses rating of a patients agitation severity and the administered dose of the sedative is the strongest when patients are expressing signs of a mild agitation, namely in the lower tail region (below the lower threshold for nurses' rating: 1.1 for poor tracker and 1.3 for good tracker) and weakest when patients are expressing signs of a severe agitation, namely in the upper tail region (above the upper threshold for nurses' rating: 2.6 for poor tracker and 6.1 for good tracker). The results show that for a good tracker, the nurses' rating of the patients' agitation levels has strong positive correlation with the administered dose of the sedative for low and mild agitation severity. For a poor tracker, the nurses' rating of the patients' agitation levels has strong positive correlation with the administered dose of the sedative only for low agitation severity. In addition, incorporating the tail dummy variables improved predictions of the nurses' rating by increasing the adjusted R 2 values by 28%. Moreov...