914 resultados para Model transformation analysis
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This paper examines the determinants of a multinational enterprise’s (MNEs) decision to invest in countries classified as tax havens. To the best of our knowledge this has not been analysed at the cross-country level before. We use the ownership-location-internalisation (OLI) paradigm and link it with financial specific advantages to develop a number of hypotheses which are subsequently tested by our empirical model. Our analysis is based on a large firm-level database covering 39,543 MNEs across the world for the period 2002- 2011. We find that higher corporate taxes faced by MNEs at home increase the likelihood of locating in a tax haven. Moreover, high technology manufacturing and services MNEs that possess large levels of intangible assets are also more likely to locate subsidiaries in tax havens. Finally, we find evidence that MNEs from countries with a more coordinated market orientation are less likely to locate in tax havens.
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It has widely been agreed that the distorted price system is one of the causes of inefficient ecooomic decisions in centrally planned economies. The paper investigates the possible effect of a price reform on the allocation of resources in a situation where micro-efficiency remains unchanged. Foreign trade and endogenously induced terms-of-trade changes are focal points ín the multisectoral applied general equilibrium analysis. Special attention is paid to some methodological problems connected to the representation of foreign trade in such models. The adoption of Armington's assumption leads to an export demand function and this in turn gives rise to the question of optimal export structure, different from the equilibrium one-an aspect so far neglected in the related literature. The results show, that the applied model allows for a more flexible handling of the overspecialization problem, than the linear programming models. It also becomes evident that the use of export demand functions brings unwanted terms-of-trade changes into the model, to be avoided by a suitable reformulation of the model. The analysis also suggests, that a price reform alone does not significantly increase global economic efficiency. Thus the effect of an economic reform on micro-efficiency appears to be a more crucial factor. The author raises in conclusion some rather general questions related to the foreign trade practice of small open economies.
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Unmanned Aerial Vehicles (UAVs) may develop cracks, erosion, delamination or other damages due to aging, fatigue or extreme loads. Identifying these damages is critical for the safe and reliable operation of the systems. ^ Structural Health Monitoring (SHM) is capable of determining the conditions of systems automatically and continually through processing and interpreting the data collected from a network of sensors embedded into the systems. With the desired awareness of the systems’ health conditions, SHM can greatly reduce operational cost and speed up maintenance processes. ^ The purpose of this study is to develop an effective, low-cost, flexible and fault tolerant structural health monitoring system. The proposed Index Based Reasoning (IBR) system started as a simple look-up-table based diagnostic system. Later, Fast Fourier Transformation analysis and neural network diagnosis with self-learning capabilities were added. The current version is capable of classifying different health conditions with the learned characteristic patterns, after training with the sensory data acquired from the operating system under different status. ^ The proposed IBR systems are hierarchy and distributed networks deployed into systems to monitor their health conditions. Each IBR node processes the sensory data to extract the features of the signal. Classifying tools are then used to evaluate the local conditions with health index (HI) values. The HI values will be carried to other IBR nodes in the next level of the structured network. The overall health condition of the system can be obtained by evaluating all the local health conditions. ^ The performance of IBR systems has been evaluated by both simulation and experimental studies. The IBR system has been proven successful on simulated cases of a turbojet engine, a high displacement actuator, and a quad rotor helicopter. For its application on experimental data of a four rotor helicopter, IBR also performed acceptably accurate. The proposed IBR system is a perfect fit for the low-cost UAVs to be the onboard structural health management system. It can also be a backup system for aircraft and advanced Space Utility Vehicles. ^
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Advances in multiscale material modeling of structural concrete have created an upsurge of interest in the accurate evaluation of mechanical properties and volume fractions of its nano constituents. The task is accomplished by analyzing the response of a material to indentation, obtained as an outcome of a nanoindentation experiment, using a procedure called the Oliver and Pharr (OP) method. Despite its widespread use, the accuracy of this method is often questioned when it is applied to the data from heterogeneous materials or from the materials that show pile-up and sink-in during indentation, which necessitates the development of an alternative method. ^ In this study, a model is developed within the framework defined by contact mechanics to compute the nanomechanical properties of a material from its indentation response. Unlike the OP method, indentation energies are employed in the form of dimensionless constants to evaluate model parameters. Analysis of the load-displacement data pertaining to a wide range of materials revealed that the energy constants may be used to determine the indenter tip bluntness, hardness and initial unloading stiffness of the material. The proposed model has two main advantages: (1) it does not require the computation of the contact area, a source of error in the existing method; and (2) it incorporates the effect of peak indentation load, dwelling period and indenter tip bluntness on the measured mechanical properties explicitly. ^ Indentation tests are also carried out on samples from cement paste to validate the energy based model developed herein by determining the elastic modulus and hardness of different phases of the paste. As a consequence, it has been found that the model computes the mechanical properties in close agreement with that obtained by the OP method; a discrepancy, though insignificant, is observed more in the case of C-S-H than in the anhydrous phase. Nevertheless, the proposed method is computationally efficient, and thus it is highly suitable when the grid indentation technique is required to be performed. In addition, several empirical relations are developed that are found to be crucial in understanding the nanomechanical behavior of cementitious materials.^
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A wide range of non-destructive testing (NDT) methods for the monitoring the health of concrete structure has been studied for several years. The recent rapid evolution of wireless sensor network (WSN) technologies has resulted in the development of sensing elements that can be embedded in concrete, to monitor the health of infrastructure, collect and report valuable related data. The monitoring system can potentially decrease the high installation time and reduce maintenance cost associated with wired monitoring systems. The monitoring sensors need to operate for a long period of time, but sensors batteries have a finite life span. Hence, novel wireless powering methods must be devised. The optimization of wireless power transfer via Strongly Coupled Magnetic Resonance (SCMR) to sensors embedded in concrete is studied here. First, we analytically derive the optimal geometric parameters for transmission of power in the air. This specifically leads to the identification of the local and global optimization parameters and conditions, it was validated through electromagnetic simulations. Second, the optimum conditions were employed in the model for propagation of energy through plain and reinforced concrete at different humidity conditions, and frequencies with extended Debye's model. This analysis leads to the conclusion that SCMR can be used to efficiently power sensors in plain and reinforced concrete at different humidity levels and depth, also validated through electromagnetic simulations. The optimization of wireless power transmission via SMCR to Wearable and Implantable Medical Device (WIMD) are also explored. The optimum conditions from the analytics were used in the model for propagation of energy through different human tissues. This analysis shows that SCMR can be used to efficiently transfer power to sensors in human tissue without overheating through electromagnetic simulations, as excessive power might result in overheating of the tissue. Standard SCMR is sensitive to misalignment; both 2-loops and 3-loops SCMR with misalignment-insensitive performances are presented. The power transfer efficiencies above 50% was achieved over the complete misalignment range of 0°-90° and dramatically better than typical SCMR with efficiencies less than 10% in extreme misalignment topologies.
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This study is about the enhancement of the elementary school in Natal/RN, (PCCR - Law No. 058/2004), concerning to the horizontal promotion through the performance evaluation. It uses as reference the education policy on the legislative field hegemony and the managerial model. The analysis of the teacher´s valorization is based on the policy of Funds (Fundef and Fundeb) in the Brazilian social and educational agenda. The study focuses on the Career Plan, Career and Remuneration of teachers in the period (2004-2010).The study focuses on the Career Plan, Career and Remuneration of teachers in the period (2004-2010). The thesis argues for the necessity to adopt a direct relationship between career development and horizontal promotion for more others fifteen classes, no matter to any conditioning variables. In addition, the performance shall be evaluated by interval of 25 years to reach at least the provisions decided in the law, which determines the salary adjustment in 5% at every two years, as pointed at the PCCR, about teachers remuneration, and teachers qualifications. A work of a bibliographic and a documental review about the education funding with the purpose of enhancement of educational work, career concepts, and also promotion and evaluation performance as well was performed based on experts authors in this field. The survey was organized with the aim of articulating quantitative and qualitative information, analyzing data from the teacher's salary - payrolls and paychecks - also applying a questionnaire. After the implementation of the PCCR, it was found that the wage indices for horizontal promotion during the teaching career are tied to a strategy for evaluating the performance which disqualifies the teacher‟s salaries in a minimum percentage of 25% (up to 25 years) and there are also elements that disturb the promotion strategy. The national minimum wage was set in three salaries by the PSPN Lei nº11.738/2008 but it never reaches the three salaries at Natal/RN educational system.Otherwise, the elements that structure the horizontal promotion in fifteen classes, throughout the career, flout the minimum years of teaching work, long established in 25 years. In addition, changes in terms in the salary increase depend on individual efforts by professional development through titration. Concerning to the career, despite of the category approving its PCCR, neither this instrument nor the Funds Policy managed to establish regulations were able to cope effective rules for valuing the teachers in the educational district system. It is necessary to ensure, in percentage terms and financial, the real remuneration of teachers with the attainment of horizontal promotion, reviewing the elements that structure the career and the determinants of performance evaluation.
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Abstract
The goal of modern radiotherapy is to precisely deliver a prescribed radiation dose to delineated target volumes that contain a significant amount of tumor cells while sparing the surrounding healthy tissues/organs. Precise delineation of treatment and avoidance volumes is the key for the precision radiation therapy. In recent years, considerable clinical and research efforts have been devoted to integrate MRI into radiotherapy workflow motivated by the superior soft tissue contrast and functional imaging possibility. Dynamic contrast-enhanced MRI (DCE-MRI) is a noninvasive technique that measures properties of tissue microvasculature. Its sensitivity to radiation-induced vascular pharmacokinetic (PK) changes has been preliminary demonstrated. In spite of its great potential, two major challenges have limited DCE-MRI’s clinical application in radiotherapy assessment: the technical limitations of accurate DCE-MRI imaging implementation and the need of novel DCE-MRI data analysis methods for richer functional heterogeneity information.
This study aims at improving current DCE-MRI techniques and developing new DCE-MRI analysis methods for particular radiotherapy assessment. Thus, the study is naturally divided into two parts. The first part focuses on DCE-MRI temporal resolution as one of the key DCE-MRI technical factors, and some improvements regarding DCE-MRI temporal resolution are proposed; the second part explores the potential value of image heterogeneity analysis and multiple PK model combination for therapeutic response assessment, and several novel DCE-MRI data analysis methods are developed.
I. Improvement of DCE-MRI temporal resolution. First, the feasibility of improving DCE-MRI temporal resolution via image undersampling was studied. Specifically, a novel MR image iterative reconstruction algorithm was studied for DCE-MRI reconstruction. This algorithm was built on the recently developed compress sensing (CS) theory. By utilizing a limited k-space acquisition with shorter imaging time, images can be reconstructed in an iterative fashion under the regularization of a newly proposed total generalized variation (TGV) penalty term. In the retrospective study of brain radiosurgery patient DCE-MRI scans under IRB-approval, the clinically obtained image data was selected as reference data, and the simulated accelerated k-space acquisition was generated via undersampling the reference image full k-space with designed sampling grids. Two undersampling strategies were proposed: 1) a radial multi-ray grid with a special angular distribution was adopted to sample each slice of the full k-space; 2) a Cartesian random sampling grid series with spatiotemporal constraints from adjacent frames was adopted to sample the dynamic k-space series at a slice location. Two sets of PK parameters’ maps were generated from the undersampled data and from the fully-sampled data, respectively. Multiple quantitative measurements and statistical studies were performed to evaluate the accuracy of PK maps generated from the undersampled data in reference to the PK maps generated from the fully-sampled data. Results showed that at a simulated acceleration factor of four, PK maps could be faithfully calculated from the DCE images that were reconstructed using undersampled data, and no statistically significant differences were found between the regional PK mean values from undersampled and fully-sampled data sets. DCE-MRI acceleration using the investigated image reconstruction method has been suggested as feasible and promising.
Second, for high temporal resolution DCE-MRI, a new PK model fitting method was developed to solve PK parameters for better calculation accuracy and efficiency. This method is based on a derivative-based deformation of the commonly used Tofts PK model, which is presented as an integrative expression. This method also includes an advanced Kolmogorov-Zurbenko (KZ) filter to remove the potential noise effect in data and solve the PK parameter as a linear problem in matrix format. In the computer simulation study, PK parameters representing typical intracranial values were selected as references to simulated DCE-MRI data for different temporal resolution and different data noise level. Results showed that at both high temporal resolutions (<1s) and clinically feasible temporal resolution (~5s), this new method was able to calculate PK parameters more accurate than the current calculation methods at clinically relevant noise levels; at high temporal resolutions, the calculation efficiency of this new method was superior to current methods in an order of 102. In a retrospective of clinical brain DCE-MRI scans, the PK maps derived from the proposed method were comparable with the results from current methods. Based on these results, it can be concluded that this new method can be used for accurate and efficient PK model fitting for high temporal resolution DCE-MRI.
II. Development of DCE-MRI analysis methods for therapeutic response assessment. This part aims at methodology developments in two approaches. The first one is to develop model-free analysis method for DCE-MRI functional heterogeneity evaluation. This approach is inspired by the rationale that radiotherapy-induced functional change could be heterogeneous across the treatment area. The first effort was spent on a translational investigation of classic fractal dimension theory for DCE-MRI therapeutic response assessment. In a small-animal anti-angiogenesis drug therapy experiment, the randomly assigned treatment/control groups received multiple fraction treatments with one pre-treatment and multiple post-treatment high spatiotemporal DCE-MRI scans. In the post-treatment scan two weeks after the start, the investigated Rényi dimensions of the classic PK rate constant map demonstrated significant differences between the treatment and the control groups; when Rényi dimensions were adopted for treatment/control group classification, the achieved accuracy was higher than the accuracy from using conventional PK parameter statistics. Following this pilot work, two novel texture analysis methods were proposed. First, a new technique called Gray Level Local Power Matrix (GLLPM) was developed. It intends to solve the lack of temporal information and poor calculation efficiency of the commonly used Gray Level Co-Occurrence Matrix (GLCOM) techniques. In the same small animal experiment, the dynamic curves of Haralick texture features derived from the GLLPM had an overall better performance than the corresponding curves derived from current GLCOM techniques in treatment/control separation and classification. The second developed method is dynamic Fractal Signature Dissimilarity (FSD) analysis. Inspired by the classic fractal dimension theory, this method measures the dynamics of tumor heterogeneity during the contrast agent uptake in a quantitative fashion on DCE images. In the small animal experiment mentioned before, the selected parameters from dynamic FSD analysis showed significant differences between treatment/control groups as early as after 1 treatment fraction; in contrast, metrics from conventional PK analysis showed significant differences only after 3 treatment fractions. When using dynamic FSD parameters, the treatment/control group classification after 1st treatment fraction was improved than using conventional PK statistics. These results suggest the promising application of this novel method for capturing early therapeutic response.
The second approach of developing novel DCE-MRI methods is to combine PK information from multiple PK models. Currently, the classic Tofts model or its alternative version has been widely adopted for DCE-MRI analysis as a gold-standard approach for therapeutic response assessment. Previously, a shutter-speed (SS) model was proposed to incorporate transcytolemmal water exchange effect into contrast agent concentration quantification. In spite of richer biological assumption, its application in therapeutic response assessment is limited. It might be intriguing to combine the information from the SS model and from the classic Tofts model to explore potential new biological information for treatment assessment. The feasibility of this idea was investigated in the same small animal experiment. The SS model was compared against the Tofts model for therapeutic response assessment using PK parameter regional mean value comparison. Based on the modeled transcytolemmal water exchange rate, a biological subvolume was proposed and was automatically identified using histogram analysis. Within the biological subvolume, the PK rate constant derived from the SS model were proved to be superior to the one from Tofts model in treatment/control separation and classification. Furthermore, novel biomarkers were designed to integrate PK rate constants from these two models. When being evaluated in the biological subvolume, this biomarker was able to reflect significant treatment/control difference in both post-treatment evaluation. These results confirm the potential value of SS model as well as its combination with Tofts model for therapeutic response assessment.
In summary, this study addressed two problems of DCE-MRI application in radiotherapy assessment. In the first part, a method of accelerating DCE-MRI acquisition for better temporal resolution was investigated, and a novel PK model fitting algorithm was proposed for high temporal resolution DCE-MRI. In the second part, two model-free texture analysis methods and a multiple-model analysis method were developed for DCE-MRI therapeutic response assessment. The presented works could benefit the future DCE-MRI routine clinical application in radiotherapy assessment.
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The Chinese Loess Plateau red clay sequences display a continuous alternation of sedimentary cycles that represent recurrent climatic fluctuations from 2.58 Ma to the Miocene. Deciphering such a record can provide us with vital information on global and Asian climatic variations. Lack of fossils and failure of absolute dating methods made magnetostratigraphy a leading method to build age models for the red clay sequences. Here we test the magnetostratigraphic age model against cyclostratigraphy. For this purpose we investigate the climate cyclicity recorded in magnetic susceptibility and sedimentary grain size in a red clay section previously dated 11Myr old with magnetostratigraphy alone. Magnetostratigraphy dating based on only visual correlation could potentially lead to erroneous age model. In this study the correlation is executed through the iteration procedure until it is supported by cyclostratigraphy; i.e., Milankovitch cycles are resolved in the best possible manner. Our new age model provides an age of 5.2Ma for the Shilou profile. Based on the new age model, wavelet analysis reveals the well-preserved 400 kyr and possible 100 kyr eccentricity cycles on the eastern Chinese Loess Plateau. Further, paleomonsoon evolution during 2.58-5.2Ma is reconstructed and divided into three intervals (2.58-3.6Ma, 3.6-4.5Ma, and 4.5-5.2Ma). The upper part, the youngest stage, is characterized by a relatively intensified summer monsoon, the middle stage reflects an intensification of the winter monsoon and aridification in Asia, and the earliest stage indicates that summer and winter monsoon cycles may have rapidly altered. The use of cyclostratigraphy along withmagnetostratigraphy gives us an effectivemethod of dating red clay sequences, and our results imply that many presently published age models for the red clay deposits should be perhaps re-evaluated.
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Nutrient addition experiments were performed during the austral summer in the Amundsen Sea (Southern Ocean) to investigate the availability of organically bound iron (Fe) to the phytoplankton communities, as well as assess their response to Fe amendment. Changes in autotrophic biomass, pigment concentration, maximum photochemical efficiency of photosystem II, and nutrient concentration were recorded in response to the addition of dissolved free Fe (DFe) and Fe bound to different model ligands. Analysis of pigment concentrations indicated that the autotrophic community was dominated by the prymnesiophyte Phaeocystis antarctica throughout most of the Amundsen Sea, although diatoms dominated in two experiments conducted in the marginal ice zone. Few significant differences in bulk community biomass (particulate organic carbon, nitrogen, and chlorophyll a) were observed, relative to the controls, in treatments with Fe added alone or bound to the ligand phytic acid. In contrast, when Fe was bound to the ligand desferrioxamine B (DFB), decreases in the bulk biomass indices were observed. The concentration of the diatom accessory pigment fucoxanthin showed little response to Fe additions, while the concentration of the P. antarctica-specific pigment, 19'-hexanoyloxyfucoxanthin (19'-hex), decreased when Fe was added alone or bound to the model ligands. Lastly, differences in the nitrate:phosphate (NO3- :PO4**3-) utilization ratio were observed between the Fe-amended treatments, with Fe bound to DFB resulting in the lowest NO3- :PO4**3- uptake ratios (~ 10) and the remaining Fe treatments having higher NO3- :PO4**3- uptake ratios (~ 17). The data are discussed with respect to glacial inputs of Fe in the Amundsen Sea and the bioavailability of Fe. We suggest that the previously observed high NO3- :PO4**3- utilization ratio of P. antarctica is a consequence of its production of dissolved organic matter that acts as ligands and increases the bioavailability of Fe, thereby stimulating the uptake of NO3-.
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In this work, a micellar system of benzathine penicillin G (BPG) in sodium deoxycholate (NaDC) was developed and evaluated physicochemically. The solubility profile of the drug in water and buffer solutions at various pH was determined, as well as its n-octanol/water partition coefficient. The Critical Micellar Concentration of NaDC and its ability to incorporate BPG were also assessed. The study was carried out at low and high ionic strength which was adjusted by the addition of sodium chloride. The results demonstrated the ability of the micellar system to incorporate BPG, as well as to increase its apparent solubility in water. The enhancement of the solubility of BPG by the presence of NaDC micelles could be analyzed quantitatively within the framework of the pseudo-phase model. Concentration analysis showed that the micellar system could attain up to 90% incorporation of BPG. The incorporated drug is expected to exhibit improved stability, since the antibiotic enclosed in the hydrophobic core of micelles is rather shielded from the aqueous external environment
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Cette thèse tente de comprendre l’impact des restructurations des entreprises multinationales sur les stratégies syndicales. Les acteurs syndicaux locaux sont-ils déterminés par l’appartenance à des régimes nationaux et à des contingences organisationnelles ou peuvent-ils influencer des décisions objectives comme les restructurations ? Cette recherche s’insère dans une problématique large qui fait la jonction entre la mondialisation économique sur une base continentale, la réorganisation productive des entreprises multinationales et l’action syndicale. Au plan théorique, nous confrontons trois grandes approches analytiques, à savoir : le néo-institutionnalisme et les structures d’opportunités ; l’économie politique critique et la question du pouvoir syndical ; la géographie économique critique mettant de l’avant les contingences, l’encastrement et l’espace concurrentiel. Sur la base de ces trois familles, nous présentons un modèle d’analyse multidisciplinaire. Au plan méthodologique, cette thèse est structurée autour de quatre études de cas locales qui ont subi des menaces de restructurations. Cette collecte a été effectuée dans deux pays (la France et le Canada) et dans un secteur particulier (les équipementiers automobiles). Trois sources qualitatives forment le cœur empirique de cette thèse : des statistiques descriptives, des documents de sources secondaires et des entretiens semi-dirigés (44), principalement avec des acteurs syndicaux. L’analyse intra et inter régime national éclaire plusieurs aspects de la question des stratégies syndicales en contexte de restructurations. Les principales contributions de cette thèse touchent : 1. l’impact des facteurs relationnels et des ressources de pouvoir développées par les syndicats locaux sur les structures d’opportunités institutionnelles; 2. l’importance des aspects « cognitifs » et d’envisager le pouvoir de manière multi-niveaux; 3. l’importance de l’encastrement social et des dynamiques relationnelles entre syndicats et patronats; 4. l’influence de la concurrence internationale/nationale/régionale/locale dans le secteur des équipementiers automobiles; et 5. l’importance des arbitrages et des relations entre les acteurs de l’entreprise par rapport à la théorie de la contingence pour comprendre les marges structurelles des syndicats locaux. Notre recherche invite les acteurs sociaux à repenser leur action dans le cadre des restructurations. En particulier, les syndicats locaux se doivent d’explorer de nouveaux répertoires stratégiques pour répondre aux nombreux défis que posent le changement économique et les restructurations.
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Pour parfaire les compétences des nouvelles directions d’école, nous constatons l’émergence de programmes de formation proposés par des universités, des districts scolaires, etc. Le but de notre étude est d’identifier les contextes de formation formel, non formel ou informel qui ont le plus aidé les nouvelles directions d’école dans le développement de leurs compétences d’une part, et ceux qui seraient mieux à même de les aider à l’avenir. Dans le cadre de cette recherche qualitative, 101 acteurs-trices de l’éducation ont été interrogé-es. Les résultats montrent que les trois contextes de formation (formel, non formel et informel) semblent avoir contribué au développement des compétences des nouvelles directions, alors que le contexte non formel, et plus particulièrement les ateliers et le soutien du district scolaire, s’avère être celui pouvant le plus aider les nouvelles directions à développer leurs compétences dans le futur. (DIPF/Orig.)
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Ce travail s’inscrit dans le champ des recherches concernant les pratiques inclusives en milieu scolaire ordinaire dans l’enseignement primaire. En France, le système éducatif propose de scolariser les élèves à besoins éducatifs particuliers soit en classe ordinaire, soit en classe spécialisée, bien que les gouvernements valorisent l’accueil en milieu ordinaire depuis la loi de 2005. Or, ceci questionne les pratiques des acteurs de l’école sur la prise en charge de ces élèves. Partant des travaux montrant que les enseignants utilisant l’évaluation formative gèrent mieux la diversité des élèves, nous étudions ici dans quelle mesure cette fonction de l’évaluation aiderait les élèves présentant des besoins éducatifs particuliers à acquérir des connaissances grâce aux feedbacks émis lors d’évaluations orales et de corrections collectives. L’analyse des données recueillies à l’aide d’entretiensavec des enseignants et d’observations d’élèves fait ressortir les attitudes des acteurs, les interactions et les régulations. (DIPF/Orig.)
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Purpose – The aim of this study is to investigate the role of key strategic factors in new service development (NSD). In particular, the role of service development strategy, a formalised development process, integrated development teams and customer co-creation were investigated and the results were compared with managers' beliefs. Design/methodology/approach – The study used a sample of more than 500 service development projects to test a NSD conceptual model. Regression analysis was used to test the relative importance of the key strategic factors, and the results were compared with managers' beliefs. Findings – The results show that managers believe that customer co-creation is most important in order to succeed with NSD. However, contrary to management belief, a service development strategy is the “missing link” in improving NSD performance. In addition, the research highlighted an interaction effect between integrated development teams and customer co-creation, which means that project managers should focus on individual competencies on the development team and how they interact with customers throughout the NSD process. Originality/value – For a long time, NSD has failed to receive the attention it deserves, not just in practice but also in service research. This study shows that the number of new services put on the market and then withdrawn because of low sales remains as high as 43 per cent. This paper contributes knowledge on how to reduce the number of failures in NSD by pointing out the key strategic factors that influence NSD performance.
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Background According to the Nursing Role Effectiveness Model, the structural components (nurses, patients, organizational variables) may directly BMC Health Services Research 2016, Volume 16 Suppl 3 Page 41 of 132 or indirectly influence the care outcomes through the process (actions developed by the nurses). Objectives: To identify the changes that, from the nurses' perspective, occurred during the provision of care to patients with peripheral venous catheters (PVCs) between the first and the second phase of the Action-Research (AR) study, and the components that influenced these changes. Methods During the second phase of the AR study (December, 2011), a focus group composed of six nurses was held at a medicine unit of a central hospital. A script was used with six open-ended questions. All ethical procedures were followed. Results Positive changes in nursing care provision to patients with PVCs were identified related to the type of dressing used, patient monitoring, aseptic care, and infusion rate. The nurses believed that some variables of the organizational component influenced those changes, such as the centralization of the material used for catheterization or the availability of materials, such as transparent dressings. The nurses also valued the following aspects: knowledge of the research findings of the first phase; training sessions on the topic; and, above all, the nurses' engagement throughout the process of change in care provision. Conclusions Considering the model of analysis used, we found that the changes identified in nursing care resulted from several factors, with the engagement of the professionals themselves in the change process being considered a key aspect.