La experiencia de los receptores en el trasplante de órganos y tejidos

El trasplante de órganos y/o tejidos es considerado como una opción terapéutica viable para el tratamiento tanto de enfermedades crónicas o en estadios terminales, como de afectaciones no vitales, pero que generen una disminución en la calidad de vida percibida por el paciente. Este procedimiento, de carácter multidimensional, está compuesto por 3 actores principales: el donante, el órgano/tejido, y el receptor. Si bien un porcentaje significativo de investigaciones y planes de intervención han girado en torno a la dimensión biológica del trasplante, y a la promoción de la donación; el interés por la experiencia psicosocial y la calidad de vida de los receptores en este proceso ha aumentado durante la última década. En relación con esto, la presente monografía se plantea como objetivo general la exploración de la experiencia y los significados construidos por los pacientes trasplantados, a través de una revisión sistemática de la literatura sobre esta temática. Para ello, se plantearon unos objetivos específicos derivados del general, se seleccionaron términos o palabras claves por cada uno de estos, y se realizó una búsqueda en 5 bases de datos para revistas indexadas: Ebsco Host (Academic Search; y Psychology and Behavioral Sciences Collection); Proquest; Pubmed; y Science Direct. A partir de los resultados, se establece que si bien la vivencia de los receptores ha comenzado a ser investigada, aún es necesaria una mayor exploración sobre la experiencia de estos pacientes; exploración que carecería de objetivo si no se hiciera a través de las narrativas o testimonios de los mismos receptores

Epidemiología y perdurabilidad empresarial en Colombia: Grupo Éxito

La muerte empresarial es un proceso que se ha venido presentando en compañías de las diferentes industrias a nivel nacional. La causa son los diferentes factores externos que impactan directamente las operaciones y estructura de estas. Con base en lo anterior es importante resaltar que existen diferentes tipos de muerte empresarial que para efectos de este trabajo se encontraron importante referenciar, pues son el marco del análisis de caso sobre Almacenes Éxito S.A. perteneciente al sector retail, donde se buscaba determinar cuál fue el tipo de cesión que tuvo, como consecuencia de la venta de acciones a la Compañía Francesa Casino Guichard-Perrachon S.A. Además del marco teórico empleado, se encontró importante realizar una reseña histórica de las diferentes empresas que han integrado el sector con el fin de entender posibles generalidades que se han venido replicando y que han llevado a la muerte empresarial de importantes compañías. Este trabajo permite la comprensión de las diferentes transformaciones que pueden tener los entes económicos a lo largo de su vida empresarial, no solo con lo que puede entenderse como el cese de operaciones sino también como apertura a nuevas estrategias de crecimiento y expansión.

Efficiency and Equity in Learning Communities and schools

Traditionally, school efficiency has been measured as a function of educational production. In the last two decades, however, studies in the economics of education have indicated that more is required to improve school efficiency: researchers must explore how significant changes in school organization affect the performance of at-risk students. In this paper we introduce Henry Levin’s adoption of the X-efficiency approach to education and we describe the efficient and cost-effective characteristics of one Learning Communities Project School that significantly improved its student outcomes and enrollment numbers and reduced its absenteeism rate to zero. The organizational change that facilitated these improvements defined specific issues to address. Students’ school success became the focus of the school project, which also offered specific incentives, selected teachers, involved parents and community members in decisions, and used the most efficient technologies and methods. This case analysis reveals new two elements—family training and community involvement—that were not explicit parts of Levin’s adaptation. The case of the Antonio Machado Public School should attract the attention of both social scientists and policy makers

La UNASUR y su accionar frente a conflictos internacionales (Tema Central)

Este artículo se centra en el papel de UNASUR frente a las diversas crisis nacionales e internacionales que ha vivido Suramérica desde 2008. Igualmente, analiza su accionar en dos casos concretos: Ecuador en 2010 y Paraguay en 2012, que son ejemplos extremos de la vulnerabilidad institucional prevaleciente en la región. Se evidencia, además, que el proceso de resolución de conflictos es un tema frágil en la agenda política e institucional de UNASUR que se vincula, sobre todo, con la defensa de la democracia y el mantenimiento de la paz, factores importantes para los Estados.

Pullpipelining: A technique for systolic pipelined circuits

Pullpipelining, a pipeline technique where data is pulled from successor stages from predecessor stages is proposed Control circuits using a synchronous, a semi-synchronous and an asynchronous approach are given. Simulation examples for a DLX generic RISC datapath show that common control pipeline circuit overhead is avoided using the proposal. Applications to linear systolic arrays in cases when computation is finished at early stages in the array are foreseen. This would allow run-time data-driven digital frequency modulation of synchronous pipelined designs. This has applications to implement algorithms exhibiting average-case processing time using a synchronous approach.

Farmer experience of pluralistic agricultural extension, Malawi

Purpose: Malawi’s current extension policy supports pluralism and advocates responsiveness to farmer demand. We investigate whether smallholder farmers’ experience supports the assumption that access to multiple service providers leads to extension and advisory services that respond to the needs of farmers. Design/methodology/approach: Within a case study approach, two villages were purposively selected for in-depth qualitative analysis of available services and farmers’ experiences. Focus group discussions were held separately with male and female farmers in each village, followed by semi-structured interviews with 12 key informants selected through snowball sampling. Transcripts were analysed by themes and summaries of themes were made from cross case analysis. Findings: Farmers appreciate having access to a variety of sources of technical advice and enterprise specific technology. However, most service providers continue to dominate and dictate what they will offer. Market access remains a challenge, as providers still emphasize pushing a particular technology to increase farm productivity rather than addressing farmers’ expressed needs. Although farmers work in groups, providers do not seek to strengthen these to enable active interaction and to link them to input and produce markets. This limits farmers’ capacity to continue with innovations after service providers pull out. Poor coordination between providers limits exploitation of potential synergies amongst actors. Practical implications: Services providers can adapt their approach to engage farmers in discussion of their needs and work collaboratively to address them. At a system level, institutions that have a coordination function can play a more dynamic role in brokering interaction between providers and farmers to ensure coverage and responsiveness. Originality/value: The study provides a new farmer perspective on the implementation of extension reforms.

Wearable device to assist independent living

Older people increasingly want to remain living independently in their own homes. The aim of the ENABLE project is to develop a wearable device that can be used to support older people in their daily lives and which can monitor their health status, detect potential problems, provide activity reminders and offer communication and alarm services. In order to determine the specifications and functionality required for the development of the device, user surveys and focus groups were undertaken, use case analysis and scenario modeling carried out. The project has resulted in the development of a wrist-worn device and mobile phone combination that can support and assist older and vulnerable wearers with a range of activities and services both inside their home and as they move around their local environment. The device is currently undergoing pilot trials in five European countries. The aim of this paper is to describe the ENABLE device, its features and services, and the infrastructure within which it operates.

On the cause of a magnetospheric flux transfer event

We present a detailed investigation of a magnetospheric flux transfer event (FTE) seen by the Active Magnetospheric Tracer Explorer (AMPTE) UKS and IRM satellites around 1046 UT on October 28, 1984. This event has been discussed many times previously in the literature and has been cited as support for a variety of theories of FTE formation. We make use of a model developed to reproduce ion precipitations seen in the cusp ionosphere. The analysis confirms that the FTE is well explained as a brief excursion into an open low-latitude boundary layer (LLBL), as predicted by two theories of magnetospheric FTEs: namely, that they are bulges in the open LLBL due to reconnection rate enhancements or that they are indentations of the magnetopause by magnetosheath pressure increases (but in the presence of ongoing steady reconnection). The indentation of the inner edge of the open LLBL that these two models seek to explain is found to be shallow for this event. The ion model reproduces the continuous evolution of the ion distribution function between the sheath-like population at the event center and the surrounding magnetospheric populations; it also provides an explanation of the high-pressure core of the event as comprising field lines that were reconnected considerably earlier than those that are draped over it to give the event boundary layer. The magnetopause transition parameter is used to isolate a field rotation on the boundaries of the core, which is subjected to the tangential stress balance test. The test identifies this to be a convecting structure, which is neither a rotational discontinuity (RD) nor a contact discontinuity, but could possibly be a slow shock. In addition, evidence for ion reflection off a weak RD on the magnetospheric side of this structure is found. The event structure is consistent in many ways with features predicted for the open LLBL by analytic MHD theories and by MHD and hybrid simulations. The de Hoffman-Teller velocity of the structure is significantly different from that of the magnetosheath flow, indicating that it is not an indentation caused by a high-pressure pulse in the sheath but is consistent with the motion of newly opened field lines (different from the sheath flow because of the magnetic tension force) deduced from the best fit to the ion data. However, we cannot here rule out the possibility that the sheath flow pattern has changed in the long interval between the two satellites observing the FTE and subsequently emerging into the magnetosheath; thus this test is not conclusive in this particular case. Analysis of the fitted elapsed time since reconnection shows that the core of the event was reconnected in one pulse and the event boundary layer was reconnected in a subsequent pulse. Between these two pulses is a period of very low (but nonzero) reconnection rate, which lasts about 14 mins. Thus the analysis supports, but does not definitively verify, the concept that the FTE is a partial passage into an open LLBL caused by a traveling bulge in that layer produced by a pulse in reconnection rate.

Using developmental evaluation methods with communities of practice

Purpose This research explored the use of developmental evaluation methods with community of practice programmes experiencing change or transition to better understand how to target support resources. Design / methodology / approach The practical use of a number of developmental evaluation methods was explored in three organisations over a nine month period using an action research design. The research was a collaborative process involving all the company participants and the academic (the author) with the intention of developing the practices of the participants as well as contributing to scholarship. Findings The developmental evaluation activities achieved the objectives of the knowledge managers concerned: they developed a better understanding of the contribution and performance of their communities of practice, allowing support resources to be better targeted. Three methods (fundamental evaluative thinking, actual-ideal comparative method and focus on strengths and assets) were found to be useful. Cross-case analysis led to the proposition that developmental evaluation methods act as a structural mechanism that develops the discourse of the organisation in ways that enhance the climate for learning, potentially helping develop a learning organization. Practical implications Developmental evaluation methods add to the options available to evaluate community of practice programmes. These supplement the commonly used activity indicators and impact story methods. 2 Originality / value Developmental evaluation methods are often used in social change initiatives, informing public policy and funding decisions. The contribution here is to extend their use to organisational community of practice programmes.

Influence of Er:YAG laser on surface treatment of aged composite resin to repair restoration

The purpose of this study was to investigate the effect of Er:YAG laser on surface treatment to the bond strength of repaired composite resin after aged. Sixty specimens (n = 10) were made with composite resin (Z250, 3M) and thermocycled with 500 cycles, oscillating between 5 to 55A degrees C. The specimens were randomly separated in six groups which suffered the following superficial treatments: no treatment (GI, control), wearing with diamond bur (GII), sandblasted with aluminum oxide with 27.5 A mu m particles (GIII) for 10 s, 200 mJ Er:YAG laser (GIV), 300 mJ Er:YAG laser (GV), and 400 mJ Er:YAG laser (GVI), with the last 3 groups under a 10 Hz frequency for 10 s. Restoration repair was done using the same composite. The shear test was done into the Universal testing machine MTS-810. Analyzing the results through ANOVA and Tukey test, no significant differences were found (p-value is 0.5120). Average values analysis showed that superficial treatment with aluminum oxide presented the highest resistance to shear repair interface (8.91MPa) while 400 mJ Er:YAG laser presented the lowest (6.76 MPa). Fracture types analysis revealed that 90% suffered cohesive fractures to GIII. The Er:YAG laser used as superficial treatment of the aged composite resin before the repair showed similar results when used diamond bur and sandblasting with aluminum oxide particles.

Escolas de administração e comunidade: a interação necessária : uma investigação sobre a extensão universitária e sua estruturação na Faculdade de Administração da Unversidade Federal Fluminense

Esta dissertação é produto de uma investigação sobre a extensão universitária e as bases institucionais para o seu desenvolvimento. A sua construção teve como norte o objetivo de analisar a estruturação da extensão em uma instituição de educação superior em Administração, o que foi realizado através de explorações teóricas e do estudo de caso da Faculdade de Administração da Universidade Federal Fluminense. Tendo como principal referência o pensamento do Fórum Nacional de Pró-Reitores de Extensão das Universidades Públicas, as dimensões institucionais que orientaram a análise do caso foram: política de gestão, plano acadêmico e infra-estrutura. De acordo com suas caracteristicas atuais na instituição em foco, foi possível compreender que estas bases, que suportam o desenvolvimento da extensão, ainda não estão adequadamente consolidadas. A principal conseqüência deste cenário é o desequilíbrio e dissociabilidade entre ensino, pesquisa e extensão. Isto, por sua vez, gera a prevalência da reprodução de conhecimentos que muitas vezes foram gerados em ambientes com caracteristicas distintas da sociedade brasileira e da comunidade onde a Universidade está inserida. Diante um cenário onde é urgente a necessidade de conhecimentos comprometidos com a solução de problemas que impedem a sustentabilidade do desenvolvimento do Brasil, é necessário que esta instituição se renove para corresponder aos desafios da sociedade atual.

Relacionamento Interpessoal entre Compradores e Vendedores: Troca de Atendimento em Vendas e o Impacto na Continuidade das Relações Comerciais.

In a highly competitive environment, the ability to retain a substantial customer base represents a tremendous competitive advantage, therefore this transaction-based emphasis in sales is increasingly being replaced by relationally focused approach. Although existing sales literature is in agreement to the theoretical composition of buyer-seller relationships, a lack of empirical evidence exists for the interrelationships of various aspects of relational selling on individual salesperson¿s performance. This paper explores the impact of interpersonal relationships on customer satisfaction and loyalty towards the firm. Based on a review of different streams of research, the paper contributes to the existing theories using a case analysis of customer behavior when there is salesperson turnover. Much of the relationship with the company comes from trust in the salesperson, which is built up through the development of the relationship. The existence of a friendship interpersonal relationship with a salesperson also increases the customer willingness to follow him in case he leaves the company, thus possibly switching to another service provider. Utilizing a case analysis method this paper has the objective to find evidences that could prove the positive or negative impact of the salesperson¿s turnover in the organizations. Finally, the paper discusses managerial implications and directions for future research.

Governando os comuns ou para os comuns?: gestão de áreas protegidas e os arranjos institucionais da política ambiental no Estado de São Paulo

Desde o século XIX, quando foi instituído o primeiro parque nacional, a gestão de áreas protegidas foi evoluindo e se aprimorando, sendo um importante mecanismo para a conservação da biodiversidade e uma das ações de maior intervenção estatal. Neste sentido, esta dissertação apresenta uma análise dos arranjos institucionais da política ambiental que impactam o uso comum dos recursos naturais por populações residentes do Parque Estadual da Serra do Mar. Para esta discussão, são analisados: o embate teórico entre ambientalismo e socioambientalismo; a problemática do uso de acesso comum, associada a necessidade, ou não, de intervenção governamental; os programas e ações do Governo do Estado de São Paulo para a consolidação das unidades de conservação de proteção integral; e as variáveis que compõe os arranjos institucionais da política ambiental dos casos avaliados, na Cota 400 e Água Fria, no município de Cubatão. Face aos arranjos institucionais da política ambiental para gestão de áreas protegidas, esta dissertação busca compreender qual a melhor situação para a conservação dos recursos naturais, com estudos aplicados a luz do modelo proposto por Elinor Ostrom. A análise dos casos permitiu verificar uma performance institucional frágil da comunidade para o uso sustentável dos recursos de acesso comum.

A região metropolitana da Baixada Santista: uma análise a partir dos fatores que favorecem a capacidade de governança e governabilidade regional

As regiões metropolitanas são reconhecidas como locus estratégico para o desenvolvimento econômico e social das sociedades modernas, porém ainda têm dificuldades em responder às crescentes demandas e problemas complexos. São inúmeras as soluções buscadas e aplicadas para melhor responder às demandas coletivas em áreas metropolitanas, no entanto, o que se observam ainda são sucessos parciais, que evidenciam os desafios deste tema para a gestão pública. Desta forma, o presente estudo busca contribuir tanto para a discussão teórica quanto para a base empírica dos estudos de regiões metropolitanas. Por meio de levantamento bibliográfico, foram identificados oito fatores apontados como favoráveis à governança e governabilidade em regiões metropolitanas. Com a realização de entrevistas semiestruturadas e o levantamento de dados e informações, foi possível analisar esses fatores a partir do caso da Região Metropolitana da Baixada Santista e avançar no debate sobre os limites e potencialidades relativos às ações regionais.

Uma análise da atuação da auditoria operacional em empresas de transformação na cidade do Rio de Janeiro: um estudo de casos

Esta pesquisa teve como principal objetivo analisar os serviços de auditoria interna em sua modalidade operacional nas empresas industriais de transformação na cidade do Rio de Janeiro, no que concerne a estrutura organizacional e seu funcionamento, considerando-se suas características individuais em conformidade com a área ou setor de atuação de cada empresa, em relação com a literatura estudada. A revisão de literatura apresentada no capítulo II, enfoca aspectos relevantes que foram usados como fundamentos teóricos para nortear o presente estudo. No capítulo III é apresentada a metodologia utilizada, onde se chama a atenção para a utilização do método de estudo de casos, levando-se em consideracão a carência de verificações empíricas na área de auditoria, utilizadas nas empresas pesquisadas. A seguir, no capítulo IV, são descritos os casos estudados, abordando-se as características de cada Departamento de Auditoria, e as respectivas formas com que desenvolvem os seus trabalhos. No capítulo V é apresentado a análise dos casos através de comparações com os pontos vistos como importantes na literatura. Finalmente, no capitulo VI, são apresentadas as conclusões, recomendações e sugestões de novos estudos.