Accumulating research: a systematic account of how cumulative meta-analyses would have provided knowledge, improved health, reduced harm and saved resources

BACKGROUND: "Cumulative meta-analysis" describes a statistical procedure to calculate, retrospectively, summary estimates from the results of similar trials every time the results of a further trial in the series had become available. In the early 1990 s, comparisons of cumulative meta-analyses of treatments for myocardial infarction with advice promulgated through medical textbooks showed that research had continued long after robust estimates of treatment effects had accumulated, and that medical textbooks had overlooked strong, existing evidence from trials. Cumulative meta-analyses have subsequently been used to assess what could have been known had new studies been informed by systematic reviews of relevant existing evidence and how waste might have been reduced.

METHODS AND FINDINGS: We used a systematic approach to identify and summarise the findings of cumulative meta-analyses of studies of the effects of clinical interventions, published from 1992 to 2012. Searches were done of PubMed, MEDLINE, EMBASE, the Cochrane Methodology Register and Science Citation Index. A total of 50 eligible reports were identified, including more than 1,500 cumulative meta-analyses. A variety of themes are illustrated with specific examples. The studies showed that initially positive results became null or negative in meta-analyses as more trials were done; that early null or negative results were over-turned; that stable results (beneficial, harmful and neutral) would have been seen had a meta-analysis been done before the new trial; and that additional trials had been much too small to resolve the remaining uncertainties.

CONCLUSIONS: This large, unique collection of cumulative meta-analyses highlights how a review of the existing evidence might have helped researchers, practitioners, patients and funders make more informed decisions and choices about new trials over decades of research. This would have led to earlier uptake of effective interventions in practice, less exposure of trial participants to less effective treatments, and reduced waste resulting from unjustified research.

Movement of Capital and Trade in Services:Distinguishing Myth from Reality Regarding the GATS and the Liberalization of the Capital Account

This article will analyze the interplay between capital movements and trade
in services as structured in World Trade Organization (WTO) law, and it will
assess the implications of the capital account liberalization for the freedom of
WTO Members to pursue their economic policies. Although the movement
of capital is largely confined to the domain of international financial or monetary
policy, it is regulated by WTO law due to its role in the process of
financial services liberalization, which generally requires liberalized capital
flows. From a legal perspective, the interplay between capital movements
and trade in services requires striking a delicate balance between the right
of market access and the parallel right of economic stability. Indeed, a liberalized
regime for capital movements could pose serious stability problems
during times of crisis. For this reason, it is necessary that Members are able
to derogate from their obligations and adopt emergency measures.
Regulating the movement of capital in the General Agreement on Trade in
Services (GATS) requires stretching the regulatory oversight of WTO law
over different aspects of international economic policy. Indeed, capital movements are a fundamental component of the balance of payments and have a
major role in shaping monetary, fiscal, and financial policies. This article will
analyze how the discipline provided by the GATS on capital movements will
affect not only trade in services, but also the Members’ policy space on
monetary and fiscal policy. The article will conclude that while the GATS offers enough policy space for the maintenance of financial stability, it does
not fully take into consideration the need of Members to control capital
movements in order to conduct monetary policies.

Consolidation. An account of parties in the United States, from the convention of 1787, to the present period

This document is an account of a convention of South Carolina state representatives following the drafting of the Declaration of Independence. There were three parties involved in the convention and the account is based on the notes of Mr. Luther Martin who attended as well Mr. Justice Yates’ account. The first party wished to abolish all state governments and have one uniform monarchical government for the continent that would be restricted and limited. The second party did not wish to abolish state governments to give their own state some importance. The third party was advocating for a federal government in conjunction with state government. This document is an account of the convention.

At the end of the day: Macmillan's account of the Cuban missile crisis

Pre-publicity for the final volume of Harold Macmillan’s memoirs, At the End of the Day, stressed that it would provide the British side of the Cuban missile crisis for the first time. The Churchillian model chosen, changes required by the Cabinet Office and Macmillan’s desire to rebuke those political opponents who claimed that the crisis demonstrated a lack of British influence in Washington, however ensured a focus on his personal relationship with President Kennedy. His larding the text with contemporary observations from his diaries also skewed Macmillan’s account and, in particular, underplayed the significance of British moves at the United Nations in New York to secure a credible United Nations inspection regime and a US guarantee of the inviolability of Cuba. Careful reconstruction of Macmillan’s real-time experience of the Cuban missile crisis demonstrates the limitations of his own account of this event

Derivation and consistency checking of models in early software product line engineering

Dissertação para obtenção do Grau de Doutor em Engenharia Informática

Information provision improvement with a geofencing event-bases system

Nowadays there is a big percentage of the population, specially young users, which are smartphone users and there is a lot of information to be provided within the applications, information provision should be done carefully and should be accurate, otherwise an overload of information will be produced, and the user will discard the app which is providing the information. Mobile devices are becoming smarter and provide many ways to filter information. However, there are alternatives to improve information provision from the side of the application. Some examples are, taking into account the local time, considering the battery level before doing an action and checking the user location to send personalized information attached to that location. SmartCampus and SmartCities are becoming a reality and they have more and more data integrated every day. With all this amount of data it is crucial to decide when and where is the user going to receive a notification with new information. Geofencing is a technique which allows applications to deliver information in a more useful way, in the right time and in the right place. It consists of geofences, physical regions delimited by boundaries, and devices that are eligible to receive the information assigned to the geofence. When devices cross one of these geofences an alert is pushed to the mobile device with the information.

Strategic account management: the path to gain customer loyalty

The account management field works closely with the sales team, serving as the customer’s primary point of contact. This project’s purpose was to understand if shifting the account management from brand centric to customer centric, would be the best fit for a Portuguese Pharmaceutical company. This customer centric approach - Strategic Account Management (SAM) - was studied, understanding the implicated trade-offs to the company. The workforce was probed about the project and their comments were analyzed. The conclusion points to an implementation of SAM and proposes the adaptations to follow in order to smooth the change.

Key Account Management in Paper and Board Industry- Identification of Key Accounts for Stora Enso Graphical Boards

Tutkimuksen tarkoituksena oli tunnistaa nykyiset sekä potentiaaliset avainasiakkaat case yritykselle. Avainasiakkaat tunnistettiin Chevertonin tunnistamis- ja valintamatriisin avulla, jossa asiakkaan sijoittumista matriisiin arvioidaan asiakkaan houkuttelevuuden sekä toimittajan suhteellisten vahvuuksien avulla. Kriteereiksi avainasiakkaiden tunnistamiseen valittiin asiakkaan vuotuinen ostovolyymi, asiakkaan business-potentiaali sekä case-yrityksen toimittajaosuus. Asiakkaat luokiteltiin avainasiakkaisiin, kehitettäviin avainasiakkaisiin, ylläpidettäviin asiakkaisiin sekä satunnaisiin asiakkaisiin. Tutkimus tarjosi lähtökohdan case-yrityksen uusille avainasiakaspäälliköille sekä osoitti suunnan tulevaisuuden tutkimustarpeille. Aktiivisen tiedonvaihdannan kautta eri myyntikonttoreiden johtohenkilöstön sekä myös yrityksen eri funktionaalisten divisioonien välillä voidaan saavuttaa kilpailuetua kun lähestytään asiakasta toimintojaan järkiperäisesti koordinoineena toimittajana samalla kun asiakkaat keskittävät ostojaan. Jotta yrityksen tavoitteet, markkinamahdollisuudet sekä resurssit olisivat hyvin tasapainossa, tulisi myös asiakaskannattavuutta sekä asiakkaiden strategista merkittävyyttä arvioida ja mitata säännöllisesti tässä tutkimuksessa käytettyjen tunnistuskriteereiden lisäksi.

Checking the Boat

Before a race the crew and the coach must check the boat to make sure all the nuts are fastened and all the seats and foots stops are in the right place. Here is Tony Biernacki watching over as Brock's first female crew doing just that in 1967.

A phenomenological account of Merleau-Ponty's notion of style : from embodiment to flesh

Abstract This thesis is an investigation of Maurice Merleau-Ponty's notion of style via the individual, artwork, and the world. It aims to show that subject-object, self-other, and perceiver-perceived are not contrary, but are reverses of one another each requiring the other for meaningful experience. In experience, these cognitive contraries are engaged in relationships of communication and communion that render styles of interaction by which we have/are a world. A phenomenological investigation of Merleau-Ponty's notion of style via existential meaningfulness, corporeal and worldly understanding, stylistic nuances (with respect to the individual, the artwork, and the world), and the existential temporal dynamic provide the foundation for understanding our primordial connection with the world. This phenomenological unpacking follows Merleau-Ponty's thought from Phenomenology of Perception to "Cezanne's Doubt" and "Eye and Mind" through The Visible and the Invisible.