Can Lutjanus purpureus (South red snapper) be "legally" considered a red snapper (Lutjanus campechanus)?

Red snappers (Lutjanus purpureus in Brazil and Lutjanus campechanus in USA and Gulf of Mexico) are both under clear effect of overfishing. Because of their high morphological similarity it has already been suggested that they could possibly be considered as a single species. To investigate the degree of similarity and the genetic structure of red snapper populations we constructed a common dataset of partial D-loop mtDNA sequences of L. purpureus from Brazil (Amapá, Pará and Maranhão) and L. campechanus from the Atlantic coast of the USA (Florida, Louisiana and Mississippi). Phylogenetic and population genetic analyses surprisingly depicted high similarity between L. campechanus and L. purpureus, compatible with the hypothesis of a single species of red snapper for the Western Atlantic Ocean. These preliminary but very curious findings open an important discussion regarding the legislation involved on the capture of this overexploited fish resources as well as regarding their taxonomy.

BTLA mediates inhibition of human tumor-specific CD8+ T cells that can be partially reversed by vaccination

The function of antigen-specific CD8+ T cells, which may protect against both infectious and malignant diseases, can be impaired by ligation of their inhibitory receptors, which include CTL-associated protein 4 (CTLA-4) and programmed cell death 1 (PD-1). Recently, B and T lymphocyte attenuator (BTLA) was identified as a novel inhibitory receptor with structural and functional similarities to CTLA-4 and PD-1. BTLA triggering leads to decreased antimicrobial and autoimmune T cell responses in mice, but its functions in humans are largely unknown. Here we have demonstrated that as human viral antigen-specific CD8+ T cells differentiated from naive to effector cells, their surface expression of BTLA was gradually downregulated. In marked contrast, human melanoma tumor antigen-specific effector CD8+ T cells persistently expressed high levels of BTLA in vivo and remained susceptible to functional inhibition by its ligand herpes virus entry mediator (HVEM). Such persistence of BTLA expression was also found in tumor antigen-specific CD8+ T cells from melanoma patients with spontaneous antitumor immune responses and after conventional peptide vaccination. Remarkably, addition of CpG oligodeoxynucleotides to the vaccine formulation led to progressive downregulation of BTLA in vivo and consequent resistance to BTLA-HVEM-mediated inhibition. Thus, BTLA activation inhibits the function of human CD8+ cancer-specific T cells, and appropriate immunotherapy may partially overcome this inhibition.

Quality Control in the Healthcare Industry: An Analysis of Surgery Turnover Times

For virtually all hospitals, utilization rates are a critical managerial indicator of efficiency and are determined in part by turnover time. Turnover time is defined as the time elapsed between surgeries, during which the operating room is cleaned and preparedfor the next surgery. Lengthier turnover times result in lower utilization rates, thereby hindering hospitals’ ability to maximize the numbers of patients that can be attended to. In this thesis, we analyze operating room data from a two year period provided byEvangelical Community Hospital in Lewisburg, Pennsylvania, to understand the variability of the turnover process. From the recorded data provided, we derive our best estimation of turnover time. Recognizing the importance of being able to properly modelturnover times in order to improve the accuracy of scheduling, we seek to fit distributions to the set of turnover times. We find that log-normal and log-logistic distributions are well-suited to turnover times, although further research must validate this finding. Wepropose that the choice of distribution depends on the hospital and, as a result, a hospital must choose whether to use the log-normal or the log-logistic distribution. Next, we use statistical tests to identify variables that may potentially influence turnover time. We find that there does not appear to be a correlation between surgerytime and turnover time across doctors. However, there are statistically significant differences between the mean turnover times across doctors. The final component of our research entails analyzing and explaining the benefits of introducing control charts as a quality control mechanism for monitoring turnover times in hospitals. Although widely instituted in other industries, control charts are notwidely adopted in healthcare environments, despite their potential benefits. A major component of our work is the development of control charts to monitor the stability of turnover times. These charts can be easily instituted in hospitals to reduce the variabilityof turnover times. Overall, our analysis uses operations research techniques to analyze turnover times and identify manners for improvement in lowering the mean turnover time and thevariability in turnover times. We provide valuable insight into a component of the surgery process that has received little attention, but can significantly affect utilization rates in hospitals. Most critically, an ability to more accurately predict turnover timesand a better understanding of the sources of variability can result in improved scheduling and heightened hospital staff and patient satisfaction. We hope that our findings can apply to many other hospital settings.

El centro comercial : una teoría tipológica : claves para el reconocimiento de una arquitectura ignorada

Existe en el panorama edificado un patrimonio construido que se reconoce como Centro Comercial. Un conjunto entendido, en sentido genérico, como familia arquitectónica que tiene características propias y específicas que la identifican. El objeto de la presente tesis doctoral consiste en argumentar que este conjunto constituye un nuevo tipo en el panorama de las tipologías arquitectónicas. Un tipo con entidad propia, que se conecta a una forma diferente de entender la idea de modelo. Un concepto que va más allá de la consideración tradicional del término. Modelo virtual. Este tipo, que surge de una estructura teórica que hemos denominado teoría tipológica, se constituye en una herramienta más para el estudio y el desarrollo proyectual de los espacios arquitectónicos, tanto del propio Centro Comercial como del conjunto de la disciplina arquitectónica, como referencia legítima. El presente trabajo de tesis se inicia con un bloque introductorio denominado Método. Definimos en él una metodología que hemos llamado emocional. Trata de la oportunidad de la tesis. Del porqué de un título que recoge la palabra ignorada. Del interés que suscita el asunto en el contexto del momento presente. Oportunidad e interés en base a una vida profesional dedicada al mundo del Centro Comercial y a la importancia del patrimonio elegido como objeto de estudio. También ha sido un aliciente detectar como las planificaciones del territorio y de los ámbitos de las relaciones colectivas no han sido capaces de integrar un resultado satisfactorio. Quizás por no considerar la complejidad de sus muchas facetas. En consecuencia, el texto busca la esencia del Centro Comercial como soporte para la crítica de su impacto en los nuevos escenarios de relación que la sociedad y el entorno físico imponen. Ámbitos donde los mecanismos históricos del asociacionismo tradicional han dado paso a otros, como el Centro Comercial, de exaltación del individualismo, pero demandados por una sociedad que se identifica con ellos. Espacios que, con Galbraith, existen por de la perversidad intrínseca del binomio consumo-producción que inducen la perplejidad. Ésta pasa a formar parte de la esencia del nuevo espacio comercial, como quedó de manifiesto en el Congreso de Minnesota de 1997, sobre el Centro Comercial. Una sociedad que ha girado hacia el logro material en términos de culto, ocasionando creciente valor significante del consumo. Razón última de la humanidad al decir de Rem Koolhaas. Culto que desemboca en la urgencia de alcanzar niveles de estatus y de identificación con el grupo. Dos parámetros que marcan la relación con el otro. Relación de comparación que excita la necesidad de posesión de objetos que llevaban a recrear en el consumidor la ilusión de ser especiales, de no pasar desapercibidos. El producto de consumo, el objeto, se eleva a la consideración de valor social. En el Centro Comercial se venden valores. Marketing de valores. El deseo del individuo, no la necesidad, queda involucrado en el proceso. La oportunidad y el interés de este estudio surgen además para aclarar el significado de un espacio que sirve al consumidor y a su entorno. Un significado que alcanza sentido, entre otros, por la aparición de un nuevo contexto tras la Segunda Guerra Mundial. Suburbanización, automóvil, nivel de vida, un nuevo papel de la mujer. La Era del Consumo. Una era que genera la paradoja de un individuo con autodeterminación y autosuficiencia crecientes, en un mundo cada vez más condicionado y controlado por dinámicas de ofertas mediatizadas e ilimitadas. La arquitectura en este contexto ha de juzgarse por su relación con un hombre contemporáneo que camina hacia una progresiva excepcionalidad. Cerramos la presentación justificando el término ignorada que aparece en el Título de la Tesis. Subrayamos la escasa existencia de estudios estructurados que relacionen Centro Comercial y arquitectura. Realidad que se constata partiendo del libro de Pevsner, Historia de las Tipologías Arquitectónicas, de 1976. Analizamos también la aceptación que el Centro Comercial, valorado en algunos ámbitos como arquitectura populista. Primer Capítulo, los antecedentes. Se propone un recorrido histórico por la arquitectura comercial de todos los tiempos. El Documento busca concretar las características de la arquitectura comercial a lo largo de la historia para determinar relaciones entre ella y el Centro Comercial. Estas correspondencias van a permitir contestar la pregunta retórica que nos hacemos al inicio del Capítulo: ¿Es la arquitectura del Centro Comercial una arquitectura subsidiaria, o tiene personalidad propia independiente de la del mundo comercial? Con Zevi40, queremos dejar constancia que la relación arquitectura-historia es imprescindible en la tarea proyectual. Un análisis novedoso solo es posible desde la búsqueda de unas raíces auténticas. Así mismo, con Guy de Maupassant, estamos convencidos que “La arquitectura, a través de los siglos, ha tenido el privilegio de dar un símbolo a cada una de las épocas, de resumir con un pequeñísimo número de monumentos típicos, el modo de pensar, de soñar de una raza y de una civilización”. Este recorrido se inicia interpretando la arquitectura comercial minoica. Llegaremos, paso a paso, hasta el siglo XX, los grandes itinerarios comerciales y el Centro Comercial. Se descubren una serie de invariantes que permiten comparar y extraer conclusiones. Resulta novedoso constatar que el Centro Comercial nace para dar respuesta al hombre contemporáneo en su afán consumista. También lo es la rápida implantación y evolución del Centro Comercial en un corto periodo de sesenta años frente al ritmo sosegado de otras soluciones comerciales. Novedad es ver como el comercio y sus arquitecturas nacen abiertos, bajo tenderetes y el Centro Comercial se presenta cerrado. Así mismo, las referencias sacras constituyen un elemento de novedad para la reflexión, en un contexto materialista. Y tantas otras. En Minos, la óptica comercial ofrece otra visión de su legendaria cultura. ¿Palacio o plataforma logística?, gestión centralizada del intercambio, ¿vida pública y vida privada? Así, hasta llegar al siglo XIX. Sus las galerías y sus pasajes acristalados concebidos en primera instancia como medida de recomposición urbana. Espacio entendido desde lo público-privado, desde lo interior-exterior, desde el dentro-afuera, desde lo cerrado-abierto. Con los nuevos mercados de abastos, representan una revolución en el ámbito de la funcionalidad, de la máquina, de la gestión moderna y de las relaciones del ciudadano con la ciudad apoyado en base al intercambio de bienes de consumo. El Centro Comercial es heredero de esta transformación. El Gran Almacén, por otra parte, es el reflejo de otra gran revolución. La que va ligada a la producción y comercialización en masa, las comunicaciones, el precio fijo y el aumento del nivel de vida. El Centro Comercial reinterpreta estas situaciones insertándolas en un nuevo modelo de gestión. En el siglo XX, maestro en técnicas de venta, aparece el hipermercado. El Híper, con su carga de pedagogía, se incorpora al esquema orgánico del Centro Comercial. La tienda en si misma constituye la pieza base de dicho puzle orgánico. Es en esta época cuando la tienda empieza su despegue autónomo como arquitectura, aportando su experiencia. Tras ello, llegamos a las grandes rutas comerciales, que proponemos como metáfora del shopping. Cerramos el capítulo concluyendo con Eugenio Ferrer que “si establecemos una relación entre el espacio y el capitalismo, entonces podemos inferir que los espacios del consumo de masas (ECM) son configuraciones nuevas respecto al pasado (...), pero el sistema que lo introduce no lo es del todo”. Segundo Capítulo. Búsqueda de claves que permitan el reconocimiento del Centro Comercial. Llegados a este punto y con la perspectiva del tiempo cabe preguntarnos, ¿qué entendemos pues por Centro Comercial? ¿Cómo lo percibimos? Abordamos ahora el problema de la percepción del Centro Comercial y su significado. Además de constituirse en símbolo, referencia siempre presente, la eficacia del Shopping es una de las principales causas de su poder de atracción. El Centro Comercial resulta de la síntesis de la revolución del consumo y de la revolución de la gestión. Espacio eficaz del entretenimiento como destino. El usuario resuelve su vida cotidiana dentro de un hábitat que considera propio y que se entiende como el lugar hiperbólico de la transacción comercial. Espacio de la abundancia para el disfrute. Una arquitectura involucrada en esta eficacia. Su sentido del lugar no es otro que el Shopping, que se desenvuelve de forma análoga en todas partes. El hogar del consumidor. Las nuevas catedrales. Las catedrales del consumo. Destino místico. Lugar de peregrinación para el consumidor fervoroso. Espacio sagrado que integra al usuario en la cultura dominante. Cultura del consumo. Templos, donde el tiempo ha perdido su sentido. Paraíso. Un espacio donde la altura, la luz natural, la dimensión general refuerzan el carácter sacro de un espacio para una nueva religión laica. Un espacio seguro, protegido que nos acerca a ideas como la de útero materno, con su carga de calidez y de significación erótica aplicado al encuentro compra-comprador y, ligado a ello, la literatura especializada habla del Centro Comercial como nave espacial hiperesterilizada o de agujero negro que absorbe la energía cultural. Más allá, la simulación, donde se percibe un simulacro de ciudad. Simulacro coherente con todo lo que el Shopping desencadena a su alrededor. El lugar de los sueños, de la fantasía. Aquí los productos se han metamorfoseado en fetiches, en significados. Televisión tridimensional, donde el usuario actúa guiado por una pulsión similar al zapping. Espacio lúdico de la fascinación por comprar o de imaginar que se compra. Espacio de simulaciones que llevan a la ensoñación. Un nuevo lugar que sustituye al espacio cotidiano, con el señuelo de la protección, en un contexto imaginariamente público. Espacio de la hiperrealidad donde no se distingue la realidad de la fantasía, donde tras episodios de confusión y desconcierto, se borran las fronteras con lo imaginario. Espacio mágico, escenario del gran espectáculo del consumo, controlado milimétricamente, al modo de la visita a un gran monumento, que ha de sobrevivir a los tiempos para dar testimonio de nuestro momento. Un icono, un símbolo que transmite un mensaje, que solo el consumidor es capaz de interpretar. Una agitada mezcla, sin precedentes, de percepciones que hablan de perplejidad y asombro ante el fenómeno del Centro Comercial, su espacio y las reacciones del hombre contemporáneo. ¿Cuáles serían las claves que nos permitirían reconocer la calidad esencial de un Centro Comercial, en esta concurrencia de perplejidades? Primero, la función de servicio. Un espacio donde ocurren muchas más cosas que lo obvio, que la compra. Un edificio que se involucra con el entorno de la mano de lo inesperado, la sorpresa y las expectativas. Esta vocación de servicio conecta Centro Comercial y naturaleza arquitectónica. Función que sugiere percepciones ligadas a la experiencia de compra. Organismo que vive y late al unísono con su visitante, colocándose al servicio de sus necesidades, de su afán de consumo, del que vive. Segundo, la comunidad servida. El Centro comercial sirve a una sociedad concreta. La sociedad consumista. Una nueva sociedad que se identifica con el edificio desarrollando un sentido de comunidad al nivel de sus deseos. Esta comunidad que se configura a su alrededor, constituye el activo más poderoso para el éxito de su realidad cotidiana y de su futuro. Tercero, un compromiso de carácter holístico. La economía de la experiencia aplicada al afán consumista de una sociedad identificada con su Centro, da lugar a una experiencia holística planificada. Diseño emocional. Colaboración para el éxito de un conjunto de establecimientos comerciales que participan en la aventura espacio-comercial del Centro Comercial. Ellos son los inductores primarios del consumo. Pero esta colaboración tiene su culminación en la amplificación del mensaje, como un inmenso altavoz, que proviene de la unidad configurada por todos ellos. El reflejo de esta amplificación de mensajes, desde la poderosa unidad constituida, es el aumento de la rentabilidad, fin último de la operación. Cuarto, la forma a través de una identificación de carácter gestáltico. Desde la lectura gestáltica que hacemos de la unidad holística, se advierte una poderosa capacidad de comunicación del sistema con su contexto. Centro y entorno se tornan entonces cómplices que complementan sus realidades. El Centro Comercial, arquitectura estructurada como sistema se percibe –ha de percibirse- como forma unitaria que procede de una mirada de raíz gestáltica que continuamente la recompone desde una óptica espacial y física, ligada a la experiencia individual. Esta unidad formal, más allá de la forma real, se constituye en esencia de de su arquitectura. Quinto, el Centro Comercial como sistema. Un sistema soportado por la Teoría General de Sistemas. La consideración del Centro Comercial como sistema es consecuencia de su estructura holística. El todo no se comporta como la suma de las partes y estas no lo hacen como lo harían en solitario. De aquí surge la necesidad de diálogo permanente entre la comercialización –proceso de incorporación de partes- y su traducción al mundo del diseño –proceso de articular arquitectónicamente las partes. Como sistema así configurado, el Centro Comercial se inserta en el paradigma contemporáneo, lo que genera realidades duales que no son excluyentes y reacciones de perplejidad e incertidumbre que el sistema corrige con su capacidad de autorregulación. Aparece también el espectador cuántico, el visitante, el consumidor, que interactúa con el sistema. Desde las herramientas que nos aporta la idea de sistema complejo, afrontamos el Mix Comercial -en definitiva la eficaz localización de las piezas en orden a sus relaciones y al organismo resultante- y su incidencia en la arquitectura que estamos concibiendo. Una arquitectura impredecible por lo mutable, que se erige en reto de la operación y del diseñador. Diseño que, de la mano del concepto de sistema se convierte en herramienta a mayor gloria de la operación global. El debate del estilismo no será más que el resultado del análisis en busca del éxito de esta operación. Sexto, una arquitectura de la negociación. Negociación como mecanismo proyectual y como resultado. La solución de proyecto nunca resulta evidente en el Centro Comercial como consecuencia de lo imprevisible del propio proceso de configuración. Su concreción solo puede ser fruto del compromiso de todos los agentes por conseguir el objetivo de la operación. Esto se consigue desde el equilibrio de intereses. Comerciales y de diseño. Un compromiso con la negociación y una negociación íntimamente ligada a la coordinación. Séptimo, el espacio y el tiempo. El debate espacio-tiempo condiciona y estructura la percepción del Centro Comercial. Introducimos conceptos como cronotopo –el instante y el lugar donde ocurre algo- y paradoja –incoherencia de la relación causa efecto- que sitúan el vínculo entre el tiempo y el espacio del Centro Comercial en un contexto de Shopping. En el discurrir paralelo del tiempo histórico –el tiempo de fuera- y del tiempo interior, el de dentro del Centro Comercial –tiempo presente o intemporalidad-, se produce el triunfo social del Centro Comercial que se traduce en haber sabido resolver en el espacio y en el tiempo las paradojas postmodernas del hombre contemporáneo. Octavo, de lo global. Globalidad que no es ajena a lo local. Una arquitectura que insertada en la dinámica de una economía de ámbito mundial, refleja las contradicciones que ella impone, fundamentalmente en los procesos de inclusión y exclusión, afectando de manera decisiva al debate de lo local, que el Centro Comercial debe incorporar como herramienta ineludible de reconocimiento. Terminamos el capítulo segundo manifestando como estas ocho claves, asumidas en su conjunto, confirman que el Centro Comercial puede aparecer como un todo conceptual cohesionado, pasando a formar parte de una familia arquitectónica coherente, cuya estructura funcional somos capaces de establecer. El Capítulo Tercero presenta con detalle la figura del arquitecto Víctor Gruen, creador reconocido del moderno Centro Comercial. Presentamos su trayectoria profesional observando como las diferentes claves analizadas en capítulos anteriores van apareciendo de manera natural a lo largo de ella "Victor Gruen may well have been the most influential architect of the twentieth century." Malcolm Gladwell. The Terrazo Jungle. Fifty Years Ago, The Mall Was Born. America Never Would Be The Same. 2004. In The New Yorker. Hombre complejo, conflictivo. Las paradojas a lo largo de su carrera fueron notables. Sin embargo siempre apareció como un hombre recto. Garret Eckbo, reconocido paisajista y colaborador de Gruen en el Centro Comercial peatonal del Centro urbano de Fresno, California, se asombraba de que alguien como Gruen hubiese sido capaz de combinar cortesía y humanidad en la carrera de ratas (sic) en la que se convirtió el universo de la comercialización americana y mantener la integridad542. Philip Johnson, en 1962, ponderando las muchas habilidades de Gruen manifestó que no estaba seguro si alguno de ellos, arquitectos artistas, hubiera sido capaz de hacer lo que Gruen hizo. A más, sobre Gruen, manifestó lo siguiente: "... El va más allá de la creación de un bello edificio. En jugar con la gente y sugerir lo que tienen que hacer, es un maestro. Y obtiene buenos resultados como hace la escultura. El suyo es un arte cívico, un sentido cívico.... Él es capaz de sentarse y poner cosas juntas. No es pomposo ni vano. Yo no me reuniría con él para hablar del diseño (de edificios). Víctor siente que cuando se habla de diseño se está ignorando todo el contexto... Su arquitectura es poderosamente limpia, no vuela la fantasía. Pero cuando te haces con su complejidad, ves que has descubierto algo más allá del diseño.... No puedes decir que haya alguien como él. La arquitectura tiene la suerte de tenerle como arquitecto..." Philip Johnson. Article in Fortune Review. 1962. El Documento de tesis cierra la visión de Gruen realizando un recorrido por los diferentes capítulos de su libro esencial, Shopping Towns Usa: The Planning of Shopping Centers. Solo su índice resulta un monumento al proceso de gestación del Centro Comercial. El libro, aquí simplemente mostrado en su estructura básica como un silencioso testigo, es la referencia canónica los Centros Comerciales contemporáneos, desde su aparición. . El Cuarto Capítulo del Documento de tesis es una recapitulación del trabajo anterior, en el que se sintetizan los conceptos de función y estilo relacionados con el Centro Comercial, se define en qué consiste cada uno de ellos y como, a partir de ahí, podemos afirmar que nos encontramos ante un tipo arquitectónico nuevo en el panorama de la disciplina arquitectónica. Terminamos el Capítulo integrando el Centro Comercial con un cuerpo teórico de referencias que se remiten a un tipo arquitectónico concreto y particular, acogiendo su singularidad como fenómeno arquitectónico autónomo. Como Conclusión de la tesis, resultado de todo lo anterior es decir, como consecuencia de la integración de un torrente de percepciones e intuiciones en un cuerpo teórico de referencias, deducidas de la existencia de unas claves que estructuran y penetran la esencia del singular modelo estudiado, haciéndolo detectable y seductor, resultan las características de un tipo arquitectónico con entidad propia que ordena, orienta y supedita la realidad y la existencia de esta nueva arquitectura. Una arquitectura nunca antes definida como tal, en el panorama tipológico de la disciplina. Teoría tipológica para una nueva arquitectura, que hemos ido proponiendo a lo largo del trabajo y que es coherente con los diferentes parámetros que se han analizado. Un conjunto edificado que, desde el estudio de sus claves esenciales y de sus invariantes perceptibles, aparece ahora más cercano, más familiar. Tanto que es posible destilar desde este conocimiento cercano e íntimo, una síntesis útil como referencia proyectual y como referencia para las grandes cuestiones que preocupan al discurrir del debate arquitectónico y sus ideas. El debate de la disciplina. El objeto de esta tesis, que consistía en establecer que el conjunto edificado que conocemos como Centro Comercial se constituye en un nuevo tipo en el panorama de las tipologías arquitectónicas, entendido el Centro Comercial en sentido genérico como familia arquitectónica con características propias y específicas que la hacen autónoma y reconocible, queda a nuestro juicio argumentado y justificado. ABSTRACT Within the frame of the built heritage there is a construction that is recognized as Shopping Center. An ensemble understood as an architectural family with its own specific recognizable characteristics. This thesis aims to explain that this building complex constitutes a new type in the panorama of architectural typology. This typology, with its singular identity, is connected to a way of understanding the idea of the model beyond an orthodox conception of the term understood as virtual model. This typology comes from a theoretical structure that we called typological theory, and it serves as yet another tool to reference the study and development design of the architectural spaces. In this first section, the Method, we emotionally explore the opportunities of this thesis. Why this typology has been ignored and the interest this work has in the present moment. An opportunity and an interest explained from an experience of a life dedicated to the world of Shopping Centers. The text then introduces the need for a rigorous knowledge of the Shopping Center’s essence in order to understand its impact in the frame of a new society and a new physical environment. A frame time where the historical mechanisms of association of civic community have given way to other gathering spaces like the Shopping Center, which encourages individualism, but is demanded by a society that relates to them. Spaces that, according to Galbraith, are a result of the intrinsic perversity of the unstoppable movement of the wheel of consumption-production. A society that has turned to worship of material achievement. Worship that provokes the appearance of an increasing value of consumption, according to Koolhaas, the only goal of humanity. Worship that ends in the need to reach certain status levels in the plane of a permanent comparison where the need of possession excites the consumer and gives them the illusion of being special. The product of consumption rises up to consideration of social values, entering a dynamic of marketing values, not only objects, but the desire of the individual remains. The study appears also to clarify the meaning of a space that serves the consumer and its context. A meaning that makes sense with the appearance of the suburbanization, the massive utilization of the car, the increase of living standards and the new role of women in the society after the Second World War, giving rise to the Age of Consumption. A world now determined and controlled by media and unlimited offers, where it’s necessary to place them in the context of the ordinary. An architecture that has to be judged precisely for its relation with this specific contemporary man. This section ends justifying the term ignored that appears in the Title of the Thesis, considering it in relation with the lack of studies structured about the Shopping Center and its architecture, drawing from Pevsner's work, A history of building types, 1976. Finally, the Shopping Center is analyzed with the most critical of thoughts, which considers it as populist architecture. The First Chapter, Precedents, proposes an historical tour of the commercial architecture throughout history. The Document looks to place on record the characteristics of the commercial architecture to set the connection between them and the Mall itself. These correspondences are going to allow us to answer the rhetorical question: is it the architecture of the Shopping Center a subsidiary architecture, or does it have its own personality independent from that of the commercial world? The reason of this historical search, citing Bruno Zevi, is that it is indispensable to establish the relationship between architecture and history, understating that an analysis is only possible when researching for their roots. Moreover, according to Guy de Maupassant, we are sure that architecture has had the privilege, across the centuries, of symbolizing as it were each age(…), through the harmony of lines and the charm of ornamentation all the grace and grandeur of an epoch. This historical reading, inseparable from a consistent design action, begins interpreting the commercial architecture of the Minoan to the 20th Century. Though this analysis of the big commercial itineraries and the study of the Shopping Center itself. A reading where we have found a series of constants that make it possible to draw conclusions from this comparison. The Mall appears to give response to the needs of a consumerist society. Comparing to the calm pace of the evolution of other commercial solutions, it is relevant its fast implantation and evolution in a short period of sixty years. Though via different solutions, the commercial spaces are considered taking into account the public-private relation, the interior-exterior, the inside-out, the closed-opened. Through that, the 19th century galleries and the food markets represent a revolution in functionality, in the machine, the modern management and the relations of the citizen within the city. All of this, the Mall inheritor feels. Likewise, the Department Store is the reflection of another great revolution. Production and commercialization en-mass, communications, the fixed price and increase of the living standard. The Mall reinterprets these situations inserting them in a new model of management. Already in the 20th century Mall and mass technologies of sale, the hypermarket is enthusiastically incorporated into the configuration of this organic scheme, constituting the base of one of the models, the French, that will be highly developed in the European continent. The shop itself constitutes, on the other hand, the key piece that completes the puzzle of the Mall and is in this epoch when it starts taking off as architecture, has an autonomous character. After all this, finally, we come to the big commercial routes, which we propose as metaphor of the shopping. Citing Eugenio Ferrer we can conclude that “If we establish a relation between the space and the capitalism, then we can infer that the spaces of the consumption of masses (ECM) are new configurations with regard to the past (...), but the system that introduces it it is not completely” Now we arrive at this point and with the perspective of time it is necessary to ask us, what do we understand about the Shopping Center? How do we perceive it? The second Chapter approaches the problem of the perception of the Mall and from this it is possible to detect and to identify key drivers that orientate the architectural comprehension of the space. The efficiency of the Shopping Center is its main power of attraction. A world that has ensued from the synthesis of the revolution of consumption and management. An effective cavern-like place of entertainment where the user, the consumer, the postmodern man solves his daily life inside a considered habitat. The hyperbolic place of commercial transaction. An abundance of space, that makes us perceive it as destination of entertainment. An architecture has evolved this efficiency, where the sense of place is at one with the sense of the Shopping. The home of the consumer. The new cathedrals. The cathedral of consumption. The place of peregrination for the fervent consumer. A sacred space that integrates the user in the dominant culture. A temple, where time itself has stopped existing. In this paroxysm, an expression of the Garden of Eden or Paradise itself. A space where the height, the natural daylight and the spatial dimension reinforce the sacred character of a new lay religion. Another common perception is that of a protected area, which leads to metaphors and considerations that suggest the idea of maternal womb, with its weight of erotic meaning, referring to the encounter of the shopper making a purchase. The literature also tells us about its perception as a sterile space capsule, a black hole that absorbs all cultural energy. Likewise, a world simulation where a mock city is perceived at first instance. Consistent with all that shopping triggers inside. A city, a space conceived as a place of dreams, fantasy, where the products have been metamorphosed into fetishes. Entertaining a television, three-dimensional television, where the user acts guided by a drive similar to zapping. A play area where the latest fascination is in the act of buying. Space simulations that unite and transcend creating atmospheres that lead to reverie. A new space replacing the daily space with the lure of safe space in a public context. A hyper-reality space with reality and fantasy, where borders are erased with imaginary episodes of confusion and bewilderment, without distinction. The charm and fascination of a space that reads like magic. The magic of a space which is defined as stage extravaganza, the large theatre, the consumer surveys in the fine control mode in which you visit a national monument. The shopping center has to survive the times to be a testimony of our time. An icon, a symbol that conveys a message, the message reads ‘consumer’. In short, a Shopping Center is a mix of unprecedented insights that speak of a widespread phenomenon of bewilderment. Its space and the reactions of contemporary man unfold in it like a fish in water. What are the key aspects which allow us to recognize the essential quality of a shopping center in this concurrence of perplexities? First, we want to record a service function of space much deeper than the immediately obvious, i.e. a purchase occurs. A building that appears to be involved with the environment and its people from the hand of the unexpected circumstances; surprise and attention. And that, in turn, also involves the visitor beyond the purchase. This dedication to service closely links the mall with its architectural nature. It is not the function of a lifeless machine. It is a feature that suggests unsuspected perceptions linked to the purchase, which speaks of an organism that lives and breathes in unison with the visitor. Second, in addition to the vocation of service-oriented desire for consumption, the Mall environment serves a particular society - The consumer society. A new society which relates to building a sense of community developed to the level of their desires. This community also constitutes the most powerful asset to the success of the daily life of the Shopping Center. Third, we emphasize that the so called economy of the experience is combined with the consumer zeal of a company that is identified by the Shopping Center. It connects to form a holistic and planned experience. This experience takes shape in the entity that ensues from the premeditated association and synergy, in the sense of a collaboration for success. A set of concrete commercial and independent establishments, take part in the spatial and commercial adventure that is the Mall and they are the instigators of the consumption. This holistic behavior finds culmination in the amplification of a claim that becomes unitary, like an immense force that leads to an increased profitability to all the levels. Consummation is a reference of one human being overturned in an architecture assimilated into a legitimate, emotional design with stability. A holistic quality is born of the essence of the building - and by virtue of the Conditions of Alexander, Christopher Alexander, determines the system condition of the Shopping Center. Fourth, we propose to establish what character the Mall will form when joined with the concept of its typology. This is going to allow the architectural work to be formed. As a result of the holistic structure that we see, the Mall is perceived as a system whose parts have their own function, justifying their existence in the ecosystem. Across a gestalt there is a powerful capacity of communication between the system and its context. We visualize on the one that stands out our building, turning both, Center and environment, in accomplices of a few special relations who complement each other in his realities. This relationship within a complex and diverse environment gives the Mall a range of unique spatial perceptions, the result of disparate experiences, which because of its root origin of gestalt, are integrated into a unified and coordinated manner fully intelligible and organized. This is the final formal essence of the Shopping Center. We can conclude here that the Mall as architecture is a structured system and should be perceived as a unit both from a physical and spatial perspective as this is the essence of its architecture. Fifth, the Mall as a system. A system which is being supported by a broad theoretical corpus, the General Systems Theory, which offers sufficient methodology to descend into consideration and give an enlightened conclusion on the overall understanding of the Mall. Consideration of the Mall as a system is a result of its holistic structure. The whole does not behave like any of the parties and they do not behave the way they used to before belonging to the whole, because they inhibit many of their qualities to their advantage. It arises the need for an ongoing dialogue between marketing processes and its translation into the physical world, the design. The system generates multiple perceptions to be integrated into a body which is to be understood as unitary. As a system, the Mall is inserted into the contemporary paradigm, creating dual realities that are not exclusive and are reactions of uncertainty that the system be properly designed at all levels, faced with their ability to self-regulate. Likewise, considering the visitor, the customer, like the quantum spectator who interacts with the system permanently. Moreover, a complex system confronts us with the Commercial mix, the effective location of parts in order to relate to the body and its importance in the architecture we are conceiving. Unpredictable architecture, which stands as the challenge of the operation and the designer. Design that becomes the tool of the system to create success for the overall operation. The discussion of the styling is merely the result of analysis that also seeks the success of the system, i.e. the styling should send the right message for the environment to ensure its survival. Sixth, the idea of negotiation as an architecture project, a mechanism inherent to the status of the proposed system. The project solution is never evident at the Shopping Center because of the unpredictability of the process itself. It can only be the fruit of the commitment of all stakeholders to achieve the objective of the operation. This is achieved from the balance of interests, of commercial and design. A commitment to negotiation and a negotiation linked to coordination. The pursuit of stability is key, as instability is always present and constantly requires strategies to build the object you are configuring. Seventh, proposes space-time itself as a circumstance that determines and structures the perception of the Mall in a singular way. We introduce concepts as chronotope and paradox to help us place the relationship between time and space within the Mall in the context of shopping. A consequence of the parallel flow of historical time - the time outside - and the time inside the Mall, the big shopping center formula is precisely that of having the feeling of timelessness in the space. The social triumph of the mall is the ability to resolve in space and in time all postmodern paradoxes and, beyond that, of contemporary man, condensing into a small space and time an enormous amount of cultural symbols, often contradictory, but they attract the practice of consumerism. Eighth, global level. Globalization which doesn’t ignore the local level. Architecture that is inserted into the dynamics of a global economy, reflects the contradictions that it imposes, mainly in the processes of inclusion and exclusion. Inclusion and exclusion affect the debate of the local level, which the Mall must incorporate as an unavoidable tool of recognition. The eight fundamental principles, when applied as a whole, confirm that the built heritage, which corresponds to the general Mall idea, can be presented as a cohesive conceptual whole. This becomes part of a coherent architectural family, whose functional structures are able to be established. The Third chapter presents in a detailed way the figure of the architect Victor Gruen, recognized as the creator of the modern Mall. Studying his professional experience, it is shown how the different keys analyzed in previous chapters are appearing in a natural way. "Victor Gruen may well have been the most influential architect of the twentieth century." Malcolm Gladwell. The Terrazo Jungle. Fifty Years Ago, The Mall Was Born. America Never Would Be The Same. 2004. In The New Yorker. He was a complex, troubled man and the paradoxes along his career were notable. Nevertheless, always he appeared as a straight man. Garret Eckbo, the recognized landscape painter and collaborator of Gruen was astonished how Gruen had been capable of combining comity and humanity in this career of rates, into that the American commercialization turned, Johnson, in 1962, weighting many Gruen's skills demonstrated that he was not sure if anyone of them, architects artists, had been capable of doing what Gruen did. He goes beyond just the creation of a beautiful building. In playing on people and suggesting what they ought to do, he is a master. (…) his architecture is clean - hardly architecture, no flights of fancy. But when you get hold of its complexity, you've got something beyond the design... You can't say there's someone like him. Architecture is lucky to have him as an architect." Philip Johnson. Article in Fortune Review. 1962. The Document of the thesis closes with Gruen's vision of realizing a tour through the different chapters of his essential book, Shopping towns USA: The Planning of Shopping Centers. It’s mere index turns out to be a monument to the process of the gestation of the Mall. The book, simply acted in its basic structure as a silent witness, as the canonical reference for the contemporary Malls. The Fourth Chapter of the Document of the thesis is a recapitulation of the previous work, which synthesizes the concepts of function and style related to the Shopping Center, and clearly defines how they are defined so we can conclude that we have found an architectural new type in the panorama of the architectural discipline. Therefore, the Conclusion of the thesis integrates this development in a theoretical body of references that relate to an architectural specific and particular type, which receives the singularity of the Shopping Center as an architectural independent phenomenon as it has tried to demonstrate from the beginning of the work. To conclude, as a result of the integrative process and the development of the theoretical body of references, the essential characteristics of the order and concept of the architectural typology form the existence of a new architecture; architecture never before defined as such, in the theoretical typology of the discipline. A theoretical typology for a new architecture is proposed throughout the discussed research and forms a conclusion of the different parameters that have been analysed. As a building complex, from the study of the essential characteristics and of the perceptible constants, the typology is more clearly defined and thus, becomes a useful tool and precedent for the consideration of the discipline. The thesis then justifies how the building complex known as Shopping Center constitutes a new type of architectural typology.

A kinase associated with chromatin that can be activated by ligand-p185c-Neu or epidermal growth factor-receptor interactions.

Some growth factors transduce positive growth signals, while others can act as growth inhibitors. Nuclear signaling events of previously quiescent cells stimulated with various growth factors have been studied by isolating the complexed chromatin-associated proteins and chromatin-associated proteins. Signals from the plasma membrane are integrated within the cells and quickly transduced to the nucleus. It is clear that several growth factors, such as epidermal growth factor, transforming growth factor alpha (but not transforming growth factor beta), and platelet-derived growth factor, utilize similar intracellular signaling biochemistries to modulate nucleosomal characteristics. The very rapid and consistent phosphorylation of nuclear p33, p54, and low molecular mass proteins in the range of 15-18 kDa after growth factor stimulation implies that there is a coordination and integration of the cellular signaling processes. Additionally, phosphorylation of p33 and some low molecular mass histones has been found to occur within 5 min of growth factor treatment and to reach a maximum by 30 min. In this study, we report that Neu receptor activating factor also utilizes the same signaling mechanism and causes p33 to become phosphorylated. In addition, both the tumor promoter okadaic acid (which inhibits protein phosphatases 1 and 2A) and phorbol ester (phorbol 12-tetradecanoate 13-acetate) stimulate phosphorylation of p33, p54, and low molecular mass histones. However, transforming growth factor beta, which is a growth inhibitor for fibroblasts, fails to increase p33 phosphorylation. In general, p33 phosphorylation patterns correspond to positive and negative mitogenic signal transduction. p33 isolated from the complexed chromatin-associated protein fraction appears to be a kinase, or tightly associated with a kinase, and shares antigenicity with the cell division cycle-dependent Cdk2 kinase as determined by antibody-dependent analysis. The rapid phosphorylation of nucleosomal proteins may influence sets of early genes needed for the induction and progression of the cell cycle.

Increase Mather, his works; being a short-title catalogue of the published writings that can be ascribed to him,

"From our bibliography of his [Increase Mather's] works, now in the press."--Foreword signed: The William Gwinn Mather Library, T. J. H.

Factors that affect bone mineral accrual in the adolescent growth spurt

The development of bone mass during the growing years is an important determinant for risk of osteoporosis in later life. Adequate dietary intake during the growth period may be critical in reaching bone growth potential. The Saskatchewan Bone Mineral Accrual Study (BMAS) is a longitudinal study of bone growth in Caucasian children. We have calculated the times of maximal peak bone mineral content (BMC) velocity to be 14.0 +/- 1.0 y in boys and 12.5 +/- 0.9 y in girls; bone growth is maximal similar to6 mo after peak height velocity. In the 2 y of peak skeletal growth, adolescents accumulate over 25% of adult bone. BMAS data may provide biological data on calcium requirements through application of calcium accrual values to factorial calculations of requirement. As well, our data are beginning to reveal how dietary patterns may influence attainment of bone mass during the adolescent growth spurt. Replacing milk intake by soft drinks appears to be detrimental to bone gain by girls, but not boys. Fruit and vegetable intake, providing alkalinity to bones and/or acting as a marker of a healthy diet, appears to influence BMC in adolescent girls, but not boys. The reason why these dietary factors appear to be more influential in girls than in boys may be that BMAS girls are consuming less than their requirement for calcium, while boys are above their threshold. Specific dietary and nutrient recommendations for adolescents are needed in order to ensure optimal bone growth and consolidation during this important life stage.

Hand in hand:privatising five star hotels in Egypt through the stock market will enhance the latter's role as well as set an example of the benefits that could be gained from privatisation

This thesis examines the possibility of privatising public owned five star hotels in Egypt through its stock market in order to give a boost to the Egyptian privatisation programme and to help activate its stock market. To explore these aspects, two main technical exercises were executed. First the writer constructed, for the first time in Egypt, a daily price index for Cairo Stock Exchange and an index for the tourism sector, in order to analyze the efficiency of the capital market. This technical analysis showed that Cairo stock exchange is inefficient, stagnant and undergoes minimal fluctuations, especially when compared to other developed and emerging markets. Second, given the importance and complexity of the valuation of SOEs prior to their privatisation, a sample of three five star hotels that could be prime candidates for privatisation via the stock market in Egypt were selected and a detailed financial analysis for the three hotels was concluded. The result was a valuation range for the three hotels using various valuation methods. Nevertheless it was found out that the final value of hotels will be determined by the market itself. Depite the inefficiency of Cairo Stock Exchange, the thesis did not rule out privatisation through the stock market. On the contrary it cited several examples of developing countries that were able to successfully privatise some of their SOEs via their rudimentary capital markets. Finally, the thesis recommended that five star hotels could be pefect candidates for privatisation via the stock market in Egypt. This is because five star hotels are profitable, privately managed, non strategic and not highly capital intensive businesses. In addition, they do not suffer from overstaffing and the industry in which they operate i.e. tourism sector, has high growth prospects and is of an international nature. Therefore it is anticipated that privatisation of five star hotels can attract a lot of investors because of the relatively high returns. This in turn will help activate and popularize the capital market in Egypt. At the same time the benefits of privatisation would be more visible which will give more momentum to the privatisation programme and make it more politically acceptable.

Improving the management of behaviour that challenges associated with dementia in care homes:protocol for pharmacy-health psychology intervention feasibility study

INTRODUCTION: The inappropriate use of antipsychotics in people with dementia for behaviour that challenges is associated with an estimated 1800 deaths annually. However, solely focusing on antipsychotics may transfer prescribing to other equally dangerous psychotropics. Little is known about the role of pharmacists in the management of psychotropics used to treat behaviours that challenge. This research aims to determine whether it is feasible to implement and measure the effectiveness of a combined pharmacy-health psychology intervention incorporating a medication review and staff training package to limit the prescription of psychotropics to manage behaviour that challenges in care home residents with dementia. METHODS/ANALYSIS: 6 care homes within the West Midlands will be recruited. People with dementia receiving medication for behaviour that challenges, or their personal consultee, will be approached regarding participation. Medication used to treat behaviour that challenges will be reviewed by the pharmacist, in collaboration with the general practitioner (GP), person with dementia and carer. The behavioural intervention consists of a training package for care home staff and GPs promoting person-centred care and treating behaviours that challenge as an expression of unmet need. The primary outcome measure is the Neuropsychiatric Inventory-Nursing Home version (NPI-NH). Other outcomes include quality of life (EQ-5D and DEMQoL), cognition (sMMSE), health economic (CSRI) and prescribed medication including whether recommendations were implemented. Outcome data will be collected at 6 weeks, and 3 and 6 months. Pretraining and post-training interviews will explore stakeholders' expectations and experiences of the intervention. Data will be used to estimate the sample size for a definitive study. ETHICS/DISSEMINATION: The project has received a favourable opinion from the East Midlands REC (15/EM/3014). If potential participants lack capacity, a personal consultee will be consulted regarding participation in line with the Mental Capacity Act. Results will be published in peer-reviewed journals and presented at conferences.

Objective Methods for Characterizing Physical Exposures which may contribute to Work-related Musculoskeletal Disorders in Agricultural Workers

Thesis (Ph.D.)--University of Washington, 2016-08

Prévoir la Réussite des Étudiants en Techniques d’inhalothérapie et d’anesthésie

Abstract: Respiratory therapists must be able to care for their patients safely, efficiently and competently. They manage critically ill patients on life support systems. As a member of the anesthesia team they are responsible for the vulnerable patient undergoing surgery. Within all areas of the hospital they are called upon to make decisions and judgements concerning patient treatment. The environment that is found in the modern clinical setting is often stressful and demanding. The respiratory and anesthesia technology program has the responsibility of preparing competent practioners who graduate not only with a broad knowledge base but with the affective competencies that are required to meet these challenges. Faculty and clinical instructors in the program of Respiratory and Anesthesia Technology have been troubled by rising attrition rates and weak performance of students. It is apparent that this is not a problem unique to Vanier College. The rationale for this study was multi-fold; to establish a definition of student success, to determine whether pre-admission academic abilities can predict success in the program and whether scores on a professional behavioural aptitudes tool can predict success in the clinical year of the program. Predictors were sought that could be used either in the pre-program admission policies or during the course of study in order to ensure success throughout the program and beyond. A qualitative analysis involving clinical instructors and faculty (n=5) was carried out to explore what success signified for a student in the respiratory and anesthesia program. While this process revealed that a student who obtained a grade above 77.5% was considered “successful”, the concept surrounding success was a much more complex issue. Affective as well as cognitive and psychomotor abilities complete the model of the successful student. Appropriate behaviour and certain character traits in a respiratory therapy student are considered to be significant elements leading to success. Assessment of students in their clinical year of the respiratory & anesthesia technology program currently include little measurement of abilities in the affective domain, and the resulting grade becomes primarily a measure of academic and procedural skills. A quantitative study of preadmission records and final program grades was obtained from a single cohort of respiratory and anesthesia technology students who began the program in 2005 and graduated in 2008 (n=16). Data was collected and a descriptive analysis (analysis of variance, Pearson correlation) was used to determine the relationship between preadmission grades and success. The lack of association between the high school grades and grades in the program ran contrary to some of the findings in the literature and it can be cautiously inferred that preadmission grades do not predict success in the program. To ascertain the predictive significance of evaluating professional behavioural skills and success in clinical internship, a behaviour assessment tool was used by clinical instructors and faculty to score each student during a rotation in their third year of the program which was clinical internship. The results of this analysis showed that a moderately strong association could be made between a high score on the behavior assessment tool and final clinical grades. Therefore this tool may be effective in predicting success in the clinical year of the program. Refining the admissions process to meet the challenge and responsibility of turning out graduates who are capable of meeting the needs of the profession is difficult but essential. The capacity to predict which students possess the affective competencies necessary to cope and succeed in their clinical year is conceivably more important than their academic abilities. Although these preliminary findings contribute, to some degree, to the literature that exists concerning methods of predicting success in a respiratory and anesthesia technology program, much data is still unknown. Further quantitative and qualitative research is required using a broader population base to substantiate the findings of this small study.||Résumé: Les inhalothérapeutes doivent être capables de prodiguer des soins à leurs patients d’une manière sécuritaire, efficace et compétente. Ils/elles peuvent être appelé(e)s à gérer les soins aux personnes gravement malades branchées à un respirateur artificiel. En tant que membres de l’équipe d’anesthésie, ils/elles sont responsables des patients qui subissent une chirurgie. Ils/elles sont sollicité(e)s par tous les secteurs de l’hôpital pour décider ou juger des traitements à apporter aux malades. L’environnement dans lequel ils/elles travaillent est souvent stressant et exigeant. Le programme de Techniques d’inhalothérapie et d’anesthésie vise à former des inhalothérapeutes compétent(e)s qui possèdent non seulement les connaissances propres à la discipline mais également les aptitudes affectives nécessaires pour faire face à ces défis. Les enseignant(e)s et instructeur(e)s cliniques en Techniques d’inhalothérapie et d’anesthésie sont préoccupé(e)s par le taux d’abandon croissant et la faible performance des étudiant(e)s dans le programme. Il semble que ce problème ne soit pas unique au Collège Vanier. Le but de cette recherche est multiple : définir ce qu’est «réussir» pour les étudiant(e)s de ce programme; déterminer si les aptitudes scolaires acquises avant l’admission au programme peuvent aider à prévoir le succès des étudiant(e)s dans le programme; et si les résultats obtenus à un test mesurant les aptitudes comportementales professionnelles permettent de prévoir le succès des étudiant(e)s dans le stage clinique du programme. On a essayé d’identifier des facteurs qui pourraient être utilisés dans les politiques d’admission au programme ou celles régissant le cheminement dans le programme qui permettraient d’assurer le succès au cours du programme et par la suite. Une analyse qualitative a été conduite auprès des instructeur(e)s cliniques et des enseignant(e)s (n=5) afin d’étudier la notion de « réussite » des étudiant(e)s dans le programme. Bien qu’un(e) étudiant(e) ayant obtenu une note supérieure à 77.5% soit considéré(e) comme ayant « réussi », la notion de « réussite » est beaucoup plus complexe. Des aptitudes affectives, autant que cognitives et psychomotrices complètent le modèle d’un(e) étudiant(e) ayant réussi. Un comportement approprié et certains traits de caractère sont considérés comme des facteurs importants pour la réussite d’un(e) étudiant(e) en techniques d’inhalothérapie et d’anesthésie. L’évaluation qui se fait actuellement des étudiant(e)s dans le stage clinique du programme ne porte que peu sur les aptitudes affectives, et le résultat obtenu témoigne essentiellement des aptitudes scolaires et procédurales. Une analyse quantitative des dossiers des étudiant(e)s avant leur admission au programme et leurs notes finales a été conduite auprès d’une cohorte d’étudiant(e)s ayant commencé le programme en 2005 et gradué en 2008 (n=16). Des données ont été recueillies et une analyse descriptive (analyse de la variance, corrélation de Pearson) ont été faites afin de déterminer l’existence d’un lien entre les notes obtenues au secondaire et celles obtenues dans le programme. L’absence de corrélation entre les deux catégories de notes va à l’encontre de certaines recherches publiées et on peut déduire avec réserve que les notes obtenues avant l’admission au programme ne permettent pas de prévoir la réussite dans le programme. Afin de vérifier la portée de l’évaluation du comportement professionnel et de la réussite en milieu clinique quant à la prévision de réussite dans le programme, une méthode d’évaluation du comportement a été appliquée par les instructeurs(e) cliniques et les enseignant(e)s pour évaluer chaque étudiant(e) au cours d’une rotation dans leur troisième année de stage clinique. Les résultats de cette analyse ont démontré qu’une corrélation moyennement forte pouvait être faite entre une bonne note à l’évaluation comportementale et les notes finales du stage clinique. Perfectionner le processus d’admission au programme afin d’assumer la responsabilité de former des diplômé(e)s capables de répondre aux besoins de la profession est difficile mais essentiel. Avoir les moyens de prévoir quels/quelles étudiant(e)s ont les compétences affectives nécessaires pour faire face à la réussite de leur année de stage clinique est peut être plus important que d’avoir les aptitudes scolaires. Bien que ces observations préliminaires contribuent, à un certain degré, à la littérature existante sur les méthodes de prévoir la réussite dans le programme d’inhalothérapie et d’anesthésie, plusieurs données restent inconnues. Une recherche quantitative et qualitative plus élaborée, conduite sur un échantillon plus large de la population, est nécessaire afin de corroborer les résultats de cette étude limitée.

How automated speed enforcement may reduce travel time variability and result in travel time savings : the case study of the loop 101 speed enforcement program in Scottsdale, Arizona

The city of Scottsdale Arizona implemented the first fixed photo Speed Enforcement camera demonstration Program (SEP) on a US freeway in 2006. A comprehensive before-and-after analysis of the impact of the SEP on safety revealed significant reductions in crash frequency and severity, which indicates that the SEP is a promising countermeasure for improving safety. However, there is often a trade off between safety and mobility when safety investments are considered. As a result, identifying safety countermeasures that both improve safety and reduce Travel Time Variability (TTV) is a desirable goal for traffic safety engineers. This paper reports on the analysis of the mobility impacts of the SEP by simulating the traffic network with and without the SEP, calibrated to real world conditions. The simulation results show that the SEP decreased the TTV: the risk of unreliable travel was at least 23% higher in the ‘without SEP’ scenario than in the ‘with SEP’ scenario. In addition, the total Travel Time Savings (TTS) from the SEP was estimated to be at least ‘569 vehicle-hours/year.’ Consequently, the SEP is an efficient countermeasure not only for reducing crashes but also for improving mobility through TTS and reduced TTV.

The defence of joint illegal activity must be looked at in context

In Miller v Miller (2011) 85 ALJR 480; [2011] HCA 9 the High Court examined the complex issue of joint illegal activity. The issue before the court was whether a plaintiff who had engaged in an illegal activity with the defendant may claim damages in negligence. In its decision the court analysed the cases of Henwood v Municipal Tramways Trust (SA) (1938) 60 CLR 438, Smith v Jenkins (1970) 119 CLR 397, Jackson v Harrison (1978) 138 CLR 438 and Gala v Preston (1991) 172 CLR 243.

Intraoperative imaging in hallux valgus surgery

Background: This prospective study investigates the use of intraoperative fluoroscopy in 28 consecutive cases undergoing hallux valgus surgery. To our knowledge there have been no studies validating the use of intraoperative fluoroscopy in hallux valgus surgery. Methods: We performed a prospective investigation of 28 consecutive cases undergoing hallux valgus surgery. Fluoroscopic images were examined intraoperatively and any significant unforseen findings documented. A comparison was made between the fluoroscopic images and weight bearing films taken 6 weeks postoperatively to examine whether the intraoperative images are an accurate representation of the standard films obtained post-operatively. We excluded those patients that went on to have an Akin osteotomy. Results: There were no unforeseen intraoperative events that were revealed by the use of fluoroscopy and no surgical modifications were made as a result of the intraoperative images. The intraoperative films were found to be a reliable representation of the postoperative weight bearing films but a small increase in the hallux valgus angle was noted at six weeks and this is thought to be due to stretching of the medial soft tissue repair. Conclusions: Intraoperative fluoroscopy is a reliable technique. This study was performed at a centre which performs approximately 100 hallux valgus operations per year and that should be taken into consideration when reviewing our findings. We conclude that there may be a role for fluoroscopy for surgeons in the early stages of the surgical learning curve and for those that infrequently perform hallux valgus surgery. We cannot however recommend that fluoroscopy be used routinely in hallux valgus surgery.

Practice and procedure : an application under r367 of the Uniform Civil Procedure Rules may be of use in obtaining copies of otherwise unavailable documents held by government agencies.

In Bowenbrae Pty Ltd v Flying Fighters Maintenance and Restoration [2010] QDC 347 Reid DCJ made orders requiring the plaintiffs to make application under the Freedom of Information Act 1982 (Cth) (“the FOI Act”) for documents sought by the defendant.