41 resultados para managing


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Management of the World Heritage Site Swiss Alps Jungfrau-Aletsch is challenged by the interplay of conservation and economic development. This is a situation where a knowledge-based solution is sought for a complex societal problem. This sets the frame for transdisciplinary research where the problem is defined and solved cooperatively by actors from science and the life-world. In this paper we re-examine studies carried out in the region of the WHS Jungfrau-Aletsch and reveal the issue of integration into participation, the issue of perceptions and positions as well as the issue of negotiability and implementation as key issues prevalent in transdisciplinary settings. The transdisciplinary setting in the case of the WHS Jungfrau-Aletsch constructs a situation of mutual learning among stakeholders from different levels and backgrounds. However, the positive effects of mutual learning are continuously challenged by the power play inherent in participatory approaches.

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Balancing the frequently conflicting priorities of conservation and economic development poses a challenge to management of the Swiss Alps Jungfrau-Aletsch World Heritage Site (WHS). This is a complex societal problem that calls for a knowledge-based solution. This in turn requires a transdisciplinary research framework in which problems are defined and solved cooperatively by actors from the scientific community and the life-world. In this article we re-examine studies carried out in the region of the Swiss Alps Jungfrau-Aletsch WHS, covering three key issues prevalent in transdisciplinary settings: integration of stakeholders into participatory processes; perceptions and positions; and negotiability and implementation. In the case of the Swiss Alps Jungfrau-Aletsch WHS the transdisciplinary setting created a situation of mutual learning among stakeholders from different levels and backgrounds. However, the studies showed that the benefits of such processes of mutual learning are continuously at risk of being diminished by the power play inherent in participatory approaches.

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Objectives: To update the 2006 systematic review of the comparative benefits and harms of erythropoiesis-stimulating agent (ESA) strategies and non-ESA strategies to manage anemia in patients undergoing chemotherapy and/or radiation for malignancy (excluding myelodysplastic syndrome and acute leukemia), including the impact of alternative thresholds for initiating treatment and optimal duration of therapy. Data sources: Literature searches were updated in electronic databases (n=3), conference proceedings (n=3), and Food and Drug Administration transcripts. Multiple sources (n=13) were searched for potential gray literature. A primary source for current survival evidence was a recently published individual patient data meta-analysis. In that meta-analysis, patient data were obtained from investigators for studies enrolling more than 50 patients per arm. Because those data constitute the most currently available data for this update, as well as the source for on-study (active treatment) mortality data, we limited inclusion in the current report to studies enrolling more than 50 patients per arm to avoid potential differential endpoint ascertainment in smaller studies. Review methods: Title and abstract screening was performed by one or two (to resolve uncertainty) reviewers; potentially included publications were reviewed in full text. Two or three (to resolve disagreements) reviewers assessed trial quality. Results were independently verified and pooled for outcomes of interest. The balance of benefits and harms was examined in a decision model. Results: We evaluated evidence from 5 trials directly comparing darbepoetin with epoetin, 41 trials comparing epoetin with control, and 8 trials comparing darbepoetin with control; 5 trials evaluated early versus late (delay until Hb ≤9 to 11 g/dL) treatment. Trials varied according to duration, tumor types, cancer therapy, trial quality, iron supplementation, baseline hemoglobin, ESA dosing frequency (and therefore amount per dose), and dose escalation. ESAs decreased the risk of transfusion (pooled relative risk [RR], 0.58; 95% confidence interval [CI], 0.53 to 0.64; I2 = 51%; 38 trials) without evidence of meaningful difference between epoetin and darbepoetin. Thromboembolic event rates were higher in ESA-treated patients (pooled RR, 1.51; 95% CI, 1.30 to 1.74; I2 = 0%; 37 trials) without difference between epoetin and darbepoetin. In 14 trials reporting the Functional Assessment of Cancer Therapy (FACT)-Fatigue subscale, the most common patient-reported outcome, scores decreased by −0.6 in control arms (95% CI, −6.4 to 5.2; I2 = 0%) and increased by 2.1 in ESA arms (95% CI, −3.9 to 8.1; I2 = 0%). There were fewer thromboembolic and on-study mortality adverse events when ESA treatment was delayed until baseline Hb was less than 10 g/dL, in keeping with current treatment practice, but the difference in effect from early treatment was not significant, and the evidence was limited and insufficient for conclusions. No evidence informed optimal duration of therapy. Mortality was increased during the on-study period (pooled hazard ratio [HR], 1.17; 95% CI, 1.04 to 1.31; I2 = 0%; 37 trials). There was one additional death for every 59 treated patients when the control arm on-study mortality was 10 percent and one additional death for every 588 treated patients when the control-arm on-study mortality was 1 percent. A cohort decision model yielded a consistent result—greater loss of life-years when control arm on-study mortality was higher. There was no discernible increase in mortality with ESA use over the longest available followup (pooled HR, 1.04; 95% CI, 0.99 to 1.10; I2 = 38%; 44 trials), but many trials did not include an overall survival endpoint and potential time-dependent confounding was not considered. Conclusions: Results of this update were consistent with the 2006 review. ESAs reduced the need for transfusions and increased the risk of thromboembolism. FACT-Fatigue scores were better with ESA use but the magnitude was less than the minimal clinically important difference. An increase in mortality accompanied the use of ESAs. An important unanswered question is whether dosing practices and overall ESA exposure might influence harms.

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When it comes to platform sustainability, mitigating user privacy concerns and enhancing trust represent two major tasks providers of Social Networking Sites (SNSs) are facing today. State-of-the-art research advocates reliance on the justice-based measures as possible means to address these challenges. However, as providers are increasingly expanding into foreign markets, the effectiveness of these measures in a cross-cultural setting is questioned. In an attempt to address this set of issues, in this study we build on the existing model to examine the impact of culture on the robustness of four justice-based means in mitigating privacy concerns and ensuring trust. Survey responses from German and Russian SNS members are used to evaluate the two structural equation models, which are then compared. We find that perceptions regarding Procedural and Informational Justice are universally important and hence should be addressed as part of the basic strategy by the SNS provider. When expanding to collectivistic countries like Russia, measures enhancing perceptions of Distributive and Interpersonal Justice can be additionally applied. Beyond practical implications, our study makes a significant contribution to the theoretical discourse on the role of culture in determining individual perceptions and behavior.

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This paper presents a survey on the usage, opportunities and pitfalls of semantic technologies in the Internet of Things. The survey was conducted in the context of a semantic enterprise integration platform. In total we surveyed sixty-one individuals from industry and academia on their views and current usage of IoT technologies in general, and semantic technologies in particular. Our semantic enterprise integration platform aims for interoperability at a service level, as well as at a protocol level. Therefore, also questions regarding the use of application layer protocols, network layer protocols and management protocols were integrated into the survey. The survey suggests that there is still a lot of heterogeneity in IoT technologies, but first indications of the use of standardized protocols exist. Semantic technologies are being recognized as of potential use, mainly in the management of things and services. Nonetheless, the participants still see many obstacles which hinder the widespread use of semantic technologies: Firstly, a lack of training as traditional embedded programmers are not well aware of semantic technologies. Secondly, a lack of standardization in ontologies, which would enable interoperability and thirdly, a lack of good tooling support.

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The existing literature suggests that transitions in software-maintenance offshore outsourcing projects are prone to knowledge transfer blockades, i.e. situations in which the activities that would yield effective knowledge transfer do not occur, and that client management involvement is central to overcome them. However, the theoretical understanding of the knowledge transfer blockade is limited, and the reactive management behavior reported in case studies suggests that practitioners may frequently be astonished by the dynamics that may give rise to the blockade. Drawing on recent research from offshore sourcing and reference theories, this study proposes a system dynamics framework that may explain why knowledge transfer blockades emerge and how and why client management can overcome the blockade. The results suggest that blockades may emerge from a vicious circle of weak learning due to cognitive overload of vendor staff and resulting negative ability attributions that result in reduced helping behavior and thus aggravate cognitive load. Client management may avoid these vicious circles by selecting vendor staff with strong prior related experience. Longer phases of coexistence of vendor staff and subject matter experts and high formal and clan controls may also mitigate vicious circles.

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BACKGROUND Psoriatic arthritis (PsA) substantially impacts the management of psoriatic disease. OBJECTIVE This study aimed to generate an interdisciplinary national consensus on recommendations of how PsA should be managed. METHODS Based on a systematic literature search, an interdisciplinary expert group identified important domains and went through 3 rounds of a Delphi exercise, followed by a nominal group discussion to generate specific recommendations. RESULTS A strong consensus was reached on numerous central messages regarding the impact of PsA, screening procedures, organization of the interaction between dermatologists and rheumatologists, and treatment goals. CONCLUSION These recommendations can serve as a template for similar initiatives in other countries. At the same time, they highlight the need to take into account the impact of the respective national health care system. © 2015 S. Karger AG, Basel.

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The unprecedented success of social networking sites (SNSs) has been recently overshadowed by concerns about privacy risks. As SNS users grow weary of privacy breaches and thus develop distrust, they may restrict or even terminate their platform activities. In the long run, these developments endanger SNS platforms’ financial viability and undermine their ability to create individual and social value. By applying a justice perspective, this study aims to understand the means at the disposal of SNS providers to leverage the privacy concerns and trusting beliefs of their users—two important determinants of user participation on SNSs. Considering that SNSs have a global appeal, empirical tests assess the effectiveness of justice measures for three culturally distinct countries: Germany, Russia and Morocco. The results indicate that these measures are particularly suited to address trusting beliefs of SNS audience. Specifically, in all examined countries, procedural justice and the awareness dimension of informational justice improve perceptions of trust in the SNS provider. Privacy concerns, however, are not as easy to manage, because the impact of justice-based measures on privacy concerns is not universal. Beyond theoretical value, this research offers valuable practical insights into the use of justice-based measures to promote trust and mitigate privacy concerns in a cross-cultural setting.