Abstract. A summary of principal findings regarding the export behavior of 423 small-and medium-sized Wisconsin manufacturing firms. Data were classified according to stages in the export development process and analyzed by multiple regression. * Export development is perhaps the most widely studied and least understood aspect of INTRODUCTION international business-as attested by the large body of literatureon internationaltrade and by the extremely empirical approach usually taken by analysts whose unit of study is the firm.1The latter typically use only very simple implicit models for data gathering, and then let the data speak for themselves. This approach has yielded an array of noncomparable information. A commonly acceptable export model is needed. The analysis summarized here explores the meaningfulness of a "stages" model for examining export behavior, particularly of small-and medium-sized firms. Such a model could be integrated into broader "stages" concepts of the firm.Italso leads to policy implications that differfromthat of non-stage concepts. The model used is-that the export development process of firms tends to occur in the following

Depression and heart disease have an intricate association and perhaps a causal relationship. We review the current status of depression and heart disease and provide an algorithm for diagnosing and treating depression in cardiac patients that internists and cardiologists can use in their daily patient encounters.

Although there are several case reports on VHE, this review is a comprehensive evaluation of its causes and potential mechanisms. Rapid diagnosis and management will help in reducing VHE-related morbidity.

Objective Assess accuracy and operating characteristics of the Patient Health Questionnaire-9 (PHQ-9) for depression-screening in adults with epilepsy. Methods Tertiary epilepsy center patients served as the study population with 237 agreeing to structured interview using the Mini-International Neuropsychiatric Interview (MINI), a “gold standard” instrument developed for rapid diagnosis of neuropsychiatric disorders, including major depressive disorder (MDD); 172 also completed the PHQ-9, and 127 completed both the PHQ-9 and the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) within two days of the MINI. Sensitivity, specificity, positive & negative predictive values & areas under the ROC curves for each instrument were determined. Cut-points of 10 for the PHQ-9 and 15 for the NDDI-E were used and ratings at or above the cut-points were considered screen-positive. The PHQ-9 was divided into cognitive/affective (PHQ-9/CA) and somatic (PHQ-9/S) subscales to determine comparative depression-screening accuracy. Results The calculated areas under the ROC curves for the PHQ-9 (n=172) and the PHQ-9/CA and PHQ-9/S sub-scales were 0.914, 0.924, and 0.846, respectively, with the PHQ-9 more accurate than the PHQ-9/S (p=0.002) but no different than the PHQ-9/CA (p=0.378). At cut-points of 10 and 15, respectively, the PHQ-9 had higher sensitivity (0.92 vs 0.87), but lower specificity (0.74 vs 0.89) than the NDDI-E. The areas under the ROC curves of the PHQ-9 and the NDDI-E showed similar accuracy (n=127; 0.930 vs 0.934; p=0.864). Significance The PHQ-9 is an efficient & non-proprietary depression screening instrument with excellent accuracy validated for use in adult epilepsy patients as well as multiple other medical populations.