Impact of Routine Fractional Flow Reserve Evaluation During Coronary Angiography on Management Strategy and Clinical Outcome: One-Year Results of the POST-IT.

Penetration of fractional flow reserve (FFR) in clinical practice varies extensively, and the applicability of results from randomized trials is understudied. We describe the extent to which the information gained from routine FFR affects patient management strategy and clinical outcome. METHODS AND RESULTS: Nonselected patients undergoing coronary angiography, in which at least 1 lesion was interrogated by FFR, were prospectively enrolled in a multicenter registry. FFR-driven change in management strategy (medical therapy, revascularization, or additional stress imaging) was assessed per-lesion and per-patient, and the agreement between final and initial strategies was recorded. Cardiovascular death, myocardial infarction, or unplanned revascularization (MACE) at 1 year was recorded. A total of 1293 lesions were evaluated in 918 patients (mean FFR, 0.81±0.1). Management plan changed in 406 patients (44.2%) and 584 lesions (45.2%). One-year MACE was 6.9%; patients in whom all lesions were deferred had a lower MACE rate (5.3%) than those with at least 1 lesion revascularized (7.3%) or left untreated despite FFR≤0.80 (13.6%; log-rank P=0.014). At the lesion level, deferral of those with an FFR≤0.80 was associated with a 3.1-fold increase in the hazard of cardiovascular death/myocardial infarction/target lesion revascularization (P=0.012). Independent predictors of target lesion revascularization in the deferred lesions were proximal location of the lesion, B2/C type and FFR. CONCLUSIONS: Routine FFR assessment of coronary lesions safely changes management strategy in almost half of the cases. Also, it accurately identifies patients and lesions with a low likelihood of events, in which revascularization can be safely deferred, as opposed to those at high risk when ischemic lesions are left untreated, thus confirming results from randomized trials.

Defining a management strategy for the azorean natural thermal resources : valuing criteria identification

Dissertação de Mestrado, Gestão de Empresas (MBA), 23 de Maio de 2016, Universidade dos Açores.

Commissioning for purpose: investigating commissioning as a collecting strategy for municipal museums and galleries 2000-present

The use of the ‘commission-accession’ principle as a mechanism for sustainable collecting in public museums and galleries has been significantly under-researched, only recently soliciting attention from national funding bodies in the United Kingdom (UK). This research has assessed an unfolding situation and provided a body of current evaluative evidence for commission-based acquisitions and a model for curators to use in future contemporary art purchases. ‘Commission-accession’ is a practice increasingly used by European and American museums yet has seen little uptake in the UK. Very recent examples demonstrate that new works produced via commissioning which then enter permanent collections, have significant financial and audience benefits that UK museums could harness, by drawing on the expertise of local and national commissioning organisations. Very little evaluative information is available on inter-institutional precedents in the United States (US) or ‘achat par commande’ in France. Neither is there yet literature that investigates the ambition for and viability of such models in the UK. This thesis addresses both of these areas, and provides evaluative case studies that will be of particular value to curators who seek sustainable ways to build their contemporary art collections. It draws on a survey of 82 museums and galleries across the UK conducted for this research, which provide a picture of where and how ‘commission-accession’ has been applied, and demonstrates its impacts as a strategy. In addition interviews with artists and curators in the UK, US and France on the social, economic and cultural implications of ‘commission-accession’ processes were undertaken. These have shed new light on issues inherent to the commissioning of contemporary art such as communication, trust, and risk as well as drawing attention to the benefits and challenges involved in commissioning as of yet unmade works of art.

Customer needs in innovation and R&D strategy development

Tutkimuksen kohteena oleva yritys avasi innovaatiokeskuksen 2015 vuoden loppupuolella. Tutkimuksen tavoite on tutkia keinoja löytää asiakastarpeita innovaatiokeskuksessa sekä selvittää, kuinka asiakastarpeet sisällytetään innovaatio- ja tuotekehitysstrategiaan. Kattava prosessi asiakastarvekartoituksesta esitellään ja prosessi säädetään yritykselle sopivaksi asiakkaille tehdyn kyselyn tulosten mukaan. Lisäksi yrityksen tuotepäälliköille järjestettiin haastattelu, jotta heidän näkemyksiään asiakastarvekartoituksen kehittämisestä ja tarpeiden lisäämisestä strategiaan päästiin myös hyödyntämään. Asiakastarpeiden kartoittamiseen soveltuvaksi menetelmäksi löydettiin ryhmätyömalliin perustuva menetelmä, jossa tarpeita kerätään innovaatiokeskuksessa. Lisäksi tietokoneita hyödyntävä GDSS-kokous auttaa välttämään useita yleisiä kokousten ongelmia. Tutkimuksen mukaan asiakastarpeiden suuret kehityslinjat ja kaikista tärkeimmät tarpeet voidaan lisätä strategiaan hyödyntämällä innovaatiokenttiä, skenaarioita ja roadmappeja sekä asiakastarvetaulukkoja.

"Last-Mile" preparation for a potential disaster - Interdisciplinary approach towards tsunami early warning and an evacuation information system for the coastal city of Padang, Indonesia

Extreme natural events, like e.g. tsunamis or earthquakes, regularly lead to catastrophes with dramatic consequences. In recent years natural disasters caused hundreds of thousands of deaths, destruction of infrastructure, disruption of economic activity and loss of billions of dollars worth of property and thus revealed considerable deficits hindering their effective management: Needs for stakeholders, decision-makers as well as for persons concerned include systematic risk identification and evaluation, a way to assess countermeasures, awareness raising and decision support systems to be employed before, during and after crisis situations. The overall goal of this study focuses on interdisciplinary integration of various scientific disciplines to contribute to a tsunami early warning information system. In comparison to most studies our focus is on high-end geometric and thematic analysis to meet the requirements of smallscale, heterogeneous and complex coastal urban systems. Data, methods and results from engineering, remote sensing and social sciences are interlinked and provide comprehensive information for disaster risk assessment, management and reduction. In detail, we combine inundation modeling, urban morphology analysis, population assessment, socioeconomic analysis of the population and evacuation modeling. The interdisciplinary results eventually lead to recommendations for mitigation strategies in the fields of spatial planning or coping capacity. © Author(s) 2009.

User Interface Abstraction for enabling TV set based Inclusive Access to the Information Society

199 p.

A Fuzzy Decision Strategy for Topic Identification and Dynamic Selection of Language Models

International audience

The library of the Institute of Alajuela address the information and communication technologies: User training and information literacy

The Library of the Institute of Alajuela made an induction experience and training of users and ventured into the information literacy and engaged in the work of the teaching-learning as an integral part of the curriculum. The actions of the library in developing search strategies, location, selection and use of information brought inthe health service, changes to the role of the library, the librarian, the book and the information in the educational environment.By sharing this experience is intended to provide information that can motivate staff of educational institutions that wish toenter the field of information literacy as a strategy to support the development oflifelong independent learning skills and meaningful learning. Currently, the library should be a proactive part in the education of students but also teachers, administrative and family.This will result in a benefit to Costa Rica: the development of youth and their proper integration into the workplace.

Flooded with Information from Social Media: Effects of Disaster Information Source and Visuals on Viewers' Cognitive, Affective, and Behavioral Responses

While a variety of crisis types loom as real risks for organizations and communities, and the media landscape continues to evolve, research is needed to help explain and predict how people respond to various kinds of crisis and disaster information. For example, despite the rising prevalence of digital and mobile media centered on still and moving visuals, and stark increases in Americans’ use of visual-based platforms for seeking and sharing disaster information, relatively little is known about how the presence or absence of disaster visuals online might prompt or deter resilience-related feelings, thoughts, and/or behaviors. Yet, with such insights, governmental and other organizational entities as well as communities themselves may best help individuals and communities prepare for, cope with, and recover from adverse events. Thus, this work uses the theoretical lens of the social-mediated crisis communication model (SMCC) coupled with the limited capacity model of motivated mediated message processing (LC4MP) to explore effects of disaster information source and visuals on viewers’ resilience-related responses to an extreme flooding scenario. Results from two experiments are reported. First a preliminary 2 (disaster information source: organization/US National Weather Service vs. news media/USA Today) x 2 (disaster visuals: no visual podcast vs. moving visual video) factorial between-subjects online experiment with a convenience sample of university students probes effects of crisis source and visuals on a variety of cognitive, affective, and behavioral outcomes. A second between-subjects online experiment manipulating still and moving visual pace in online videos (no visual vs. still, slow-pace visual vs. still, medium-pace visual vs. still, fast-pace visual vs. moving, slow-pace visual vs. moving, medium-pace visual vs. moving, fast-pace visual) with a convenience sample recruited from Amazon’s Mechanical Turk (mTurk) similarly probes a variety of potentially resilience-related cognitive, affective, and behavioral outcomes. The role of biological sex as a quasi-experimental variable is also investigated in both studies. Various implications for community resilience and recommendations for risk and disaster communicators are explored. Implications for theory building and future research are also examined. Resulting modifications of the SMCC model (i.e., removing “message strategy” and adding the new category of “message content elements” under organizational considerations) are proposed.

Nutritional guide for a modern woman: a strategy for health education

"In the present article, we introduce a Health Education instrument that stems from a refection on the lay knowledge, salutogenic habits and daily nutritional practices of modern women in our current society. We developed a guide aimed at modern women, where the different food groups and food hygiene and safety measures are addressed. The guide includes eleven original pictograms that help the reader to locate and look up specific issues. The guide employs the label reading and interpretation principles, following the nutrition traffic-light internationally instituted, for it renders scientific information on nutrition clear and accessible to the general population. We believe that using this guide as a central strategy in health promotion will lead its users to adopt essential changes in their eating patterns and, in so doing, contribute to prevent diseases associated to bad eating habits. We also emphasize the role of mass media in spreading the conveyed information."

Information security value in e-entrepreneurship

This paper researches the information security value in e-entrepreneurship by revising the literature that establishes the entrepreneurial domain and by relating it with the development of technological resources that create value for the customer in an online business. It details multiple paradigms regarding consumer’s values of information security, while relating them with common practices and previous researches in technological entrepreneurship. This research presents and discusses the benefits of information security standards in e-entrepreneurship. It details and discusses the ISO 27001 and PCI-DSS information security standards that can be used to differentiate security initiatives to achieve competitive advantage, while preserving information leadership as a critical resource for online business success. Based on the literature review, a theoretical research model is presented and research hypotheses are discussed. This model believes that information security affects information leadership and that information leadership, as a unique resource in e-business, contributes to e-entrepreneurship success. The adoption of information security standards affects customer’s trust in e-business, which also benefits e-entrepreneurial strategy.

O curso de literacia da informação da NOVA Escola Doutoral: The road to information literacy

Descrevem-se as diversas fases do “Projeto para uma Estratégia de Literacia Informacional na NOVA” com vista à implementação de uma estratégia transversal de literacia da informação que abrangesse todas as Unidades Orgânicas da NOVA e o modo como a sua orientação de topo, dinâmica, metodologia e objetivos conduziram, posteriormente, à inclusão de um curso de Literacia Informacional no programa da NOVA Escola Doutoral. Realçando que a implementação do curso de Literacia Informacional nesse projeto passou a constituir um dos poucos exemplos de oferta formativa e de efetiva concretização de um projeto de intervenção curricular e pedagógica ao nível da literacia da informação no ensino superior em Portugal, promovendo a colaboração entre colegas e indo ao encontro de uma transferência de saberes e de uma partilha de competências abertas à colaboração de doutorandos e orientadores, enunciamse os objetivos do curso de Literacia Informacional e de cada módulo que o constitui e os resultados esperados ao nível do ensino e da aprendizagem. Conclui-se que a diversificação dos percursos formativos em contexto universitário, em estreita convergência com outras aprendizagens ao nível sociocultural, confere aos bibliotecários a responsabilidade de desempenhar um papel ativo no ensino e na promoção e consolidação das competências transversais dos estudantes, contribuindo a literacia da informação para o sucesso académico também ao nível do ensino superior.

Coaching or gaming? Implications of strategy choice for home based stroke rehabilitation

Background: The enduring aging of the world population and prospective increase of age-related chronic diseases urge the implementation of new models for healthcare delivery. One strategy relies on ICT (Information and Communications Technology) home-based solutions allowing clients to pursue their treatments without institutionalization. Stroke survivors are a particular population that could strongly benefit from such solutions, but is not yet clear what the best approach is for bringing forth an adequate and sustainable usage of home-based rehabilitation systems. Here we explore two possible approaches: coaching and gaming. Methods: We performed trials with 20 healthy participants and 5 chronic stroke survivors to study and compare execution of an elbow flexion and extension task when performed within a coaching mode that provides encouragement or within a gaming mode. For each mode we analyzed compliance, arm movement kinematics and task scores. In addition, we assessed the usability and acceptance of the proposed modes through a customized self-report questionnaire. Results: In the healthy participants sample, 13/20 preferred the gaming mode and rated it as being significantly more fun (p < .05), but the feedback delivered by the coaching mode was subjectively perceived as being more useful (p < .01). In addition, the activity level (number of repetitions and total movement of the end effector) was significantly higher (p <.001) during coaching. However, the quality of movements was superior in gaming with a trend towards shorter movement duration (p=.074), significantly shorter travel distance (p <.001), higher movement efficiency (p <.001) and higher performance scores (p <.001). Stroke survivors also showed a trend towards higher activity levels in coaching, but with more movement quality during gaming. Finally, both training modes showed overall high acceptance. Conclusions: Gaming led to higher enjoyment and increased quality in movement execution in healthy participants. However, we observed that game mechanics strongly determined user behavior and limited activity levels. In contrast, coaching generated higher activity levels. Hence, the purpose of treatment and profile of end-users has to be considered when deciding on the most adequate approach for home based stroke rehabilitation.

Ambient Water Monitoring Strategy for Iowa: 2016-2021, November 30, 2016

The Iowa Department of Natural Resources (DNR) Ambient Water Monitoring Program provides consistent, unbiased information about the condition of Iowa’s water resources to support decisions affecting the development, management and protection of these resources. To strengthen its services, the program worked with a variety of stakeholders and other DNR programs to develop a five-year strategy for Iowa’s ambient water monitoring efforts. The strategy identifies opportunities to improve the program’s effectiveness in several categories: monitoring objectives, sampling design, data management, products and services, and program evaluation and coordination. Iowa DNR managers and technical staff will use the new strategy to guide decisions affecting the ambient monitoring program over the next five years. The strategy should also serve as a robust informational resource for stakeholders, policy makers, legislators and the public.

Iowa Nutrient Reduction Strategy : a science and technology-based framework to assess and reduce nutrients to Iowa waters and the Gulf of Mexico (2014)

In May 2014, the Iowa Department of Agriculture and Land Stewardship, Iowa State University College of Agriculture and Life Sciences, and the Iowa Department of Natural Resources met to identify needed updates to the Iowa Nutrient Reduction Strategy. Updates were necessary to keep the text of the strategy up¬‐to¬‐date based on current information and status of efforts related to the strategy. Proposed updates were presented to the Water Resources Coordinating Council (WRCC) at its July 29 meeting, along with the annual strategy progress report. Comments were requested from both the WRCC and the Watershed Planning Advisory Council. Based on those comments, the draft report was updated and presented to the WRCC again on September 18, and finalized following that meeting. Below is a summary of the updates that have been made to the May 29, 2013 strategy document.