829 resultados para Critical to Satisfaction
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This paper takes the influential “direct democracy makes people happy”-research as a starting point and asks whether direct democracy impacts individual satisfaction. Unlike former studies we distinguish two aspects of individual satisfaction, namely satisfaction with life (“happiness”) and with how democracy works. Based on multilevel analysis of the 26 Swiss cantons we show that the theoretical assumption on which the happiness hypothesis is based has to be questioned, as there is very little evidence for a robust relationship between satisfaction with democracy and life satisfaction. Furthermore, we do not find a substantive positive effect of direct democracy on happiness. However, with respect to satisfaction with democracy, our analysis shows some evidence for a procedural effect of direct democracy, i.e. positive effects related to using direct democratic rights, rather than these rights per se.
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This thesis presents a metric for assessing the commonality and differentiation of packaging-family planning with application to medical labels along with supporting background research and findings. Consumable products such as medications rely on the package or label to represent the contents. Package confusion has been widely recognized as a major problem for both over-the-counter and pharmacy-dispensed medications with potentially lethal consequences. It is critical to identify a medication as a member of a product family and differentiate its contributing elements based on visual features on the package or label to avoid consumer confusion and reduce dispensing errors. Indices that indicate degrees of commonality and differentiation of features in consumer products such as batteries, light bulbs, handles, etc for platforms have been shown to benefit development of engineered product families [6]. It is possible to take a similar approach for visual features in packaging such as typography, shape/form, imagery and color to benefit packaging-family development. This thesis establishes a commonality differentiation index for prominence of visual features on over-the-counter and pharmacy-dispensed medications based on occurrence, size, and location of features. It provides a quantitative measure to assist package designers in evaluating alternatives to satisfy strategic goals and improve safety. The index is demonstrated with several medications that have been identified by the Institute for Safe Medication Practice as commonly confused.
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The synchronization of dynamic multileaf collimator (DMLC) response with respiratory motion is critical to ensure the accuracy of DMLC-based four dimensional (4D) radiation delivery. In practice, however, a finite time delay (response time) between the acquisition of tumor position and multileaf collimator response necessitates predictive models of respiratory tumor motion to synchronize radiation delivery. Predicting a complex process such as respiratory motion introduces geometric errors, which have been reported in several publications. However, the dosimetric effect of such errors on 4D radiation delivery has not yet been investigated. Thus, our aim in this work was to quantify the dosimetric effects of geometric error due to prediction under several different conditions. Conformal and intensity modulated radiation therapy (IMRT) plans for a lung patient were generated for anterior-posterior/posterior-anterior (AP/PA) beam arrangements at 6 and 18 MV energies to provide planned dose distributions. Respiratory motion data was obtained from 60 diaphragm-motion fluoroscopy recordings from five patients. A linear adaptive filter was employed to predict the tumor position. The geometric error of prediction was defined as the absolute difference between predicted and actual positions at each diaphragm position. Distributions of geometric error of prediction were obtained for all of the respiratory motion data. Planned dose distributions were then convolved with distributions for the geometric error of prediction to obtain convolved dose distributions. The dosimetric effect of such geometric errors was determined as a function of several variables: response time (0-0.6 s), beam energy (6/18 MV), treatment delivery (3D/4D), treatment type (conformal/IMRT), beam direction (AP/PA), and breathing training type (free breathing/audio instruction/visual feedback). Dose difference and distance-to-agreement analysis was employed to quantify results. Based on our data, the dosimetric impact of prediction (a) increased with response time, (b) was larger for 3D radiation therapy as compared with 4D radiation therapy, (c) was relatively insensitive to change in beam energy and beam direction, (d) was greater for IMRT distributions as compared with conformal distributions, (e) was smaller than the dosimetric impact of latency, and (f) was greatest for respiration motion with audio instructions, followed by visual feedback and free breathing. Geometric errors of prediction that occur during 4D radiation delivery introduce dosimetric errors that are dependent on several factors, such as response time, treatment-delivery type, and beam energy. Even for relatively small response times of 0.6 s into the future, dosimetric errors due to prediction could approach delivery errors when respiratory motion is not accounted for at all. To reduce the dosimetric impact, better predictive models and/or shorter response times are required.
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Clouds are one of the most influential elements of weather on the earth system, yet they are also one of the least understood. Understanding their composition and behavior at small scales is critical to understanding and predicting larger scale feedbacks. Currently, the best method to study clouds on the microscale is through airborne in situ measurements using optical instruments capable of resolving clouds on the individual particle level. However, current instruments are unable to sufficiently resolve the scales important to cloud evolution and behavior. The Holodec is a new generation of optical cloud instrument which uses digital inline holography to overcome many of the limitations of conventional instruments. However, its performance and reliability was limited due to several deficiencies in its original design. These deficiencies were addressed and corrected to advance the instrument from the prototype stage to an operational instrument. In addition, the processing software used to reconstruct and analyze digitally recorded holograms was improved upon to increase robustness and ease of use.
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CONTEXT Aims of bladder preservation in muscle-invasive bladder cancer (MIBC) are to offer a quality-of-life advantage and avoid potential morbidity or mortality of radical cystectomy (RC) without compromising oncologic outcomes. Because of the lack of a completed randomised controlled trial, oncologic equivalence of bladder preservation modality treatments compared with RC remains unknown. OBJECTIVE This systematic review sought to assess the modern bladder-preservation treatment modalities, focusing on trimodal therapy (TMT) in MIBC. EVIDENCE ACQUISITION A systematic literature search in the PubMed and Cochrane databases was performed from 1980 to July 2013. EVIDENCE SYNTHESIS Optimal bladder-preservation treatment includes a safe transurethral resection of the bladder tumour as complete as possible followed by radiation therapy (RT) with concurrent radiosensitising chemotherapy. A standard radiation schedule includes external-beam RT to the bladder and limited pelvic lymph nodes to an initial dose of 40Gy, with a boost to the whole bladder to 54Gy and a further tumour boost to a total dose of 64-65Gy. Radiosensitising chemotherapy with phase 3 trial evidence in support exists for cisplatin and mitomycin C plus 5-fluorouracil. A cystoscopic assessment with systematic rebiopsy should be performed at TMT completion or early after TMT induction. Thus, nonresponders are identified early to promptly offer salvage RC. The 5-yr cancer-specific survival and overall survival rates range from 50% to 82% and from 36% to 74%, respectively, with salvage cystectomy rates of 25-30%. There are no definitive data to support the benefit of using of neoadjuvant or adjuvant chemotherapy. Critical to good outcomes is proper patient selection. The best cancers eligible for bladder preservation are those with low-volume T2 disease without hydronephrosis or extensive carcinoma in situ. CONCLUSIONS A growing body of accumulated data suggests that bladder preservation with TMT leads to acceptable outcomes and therefore may be considered a reasonable treatment option in well-selected patients. PATIENT SUMMARY Treatment based on a combination of resection, chemotherapy, and radiotherapy as bladder-sparing strategies may be considered as a reasonable treatment option in properly selected patients.
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The performance of tasks that are perceived as unnecessary or unreasonable, illegitimate tasks, represents a new stressor concept that refers to assignments that violate the norms associated with the role requirements of professional work. Research has shown that illegitimate tasks are associated with stress and counterproductive work behaviour. The purpose of this study was to provide insight into the contribution of characteristics of the organization on the prevalence of illegitimate tasks in the work of frontline and middle managers. Using the Bern Illegitimate Task Scale (BITS) in a sample of 440 local government operations managers in 28 different organizations in Sweden, this study supports the theoretical assumptions that illegitimate tasks are positively related to stress and negatively related to satisfaction with work performance. Results further show that 10% of the variance in illegitimate tasks can be attributed to the organization where the managers work. Multilevel referential analysis showed that the more the organization was characterized by competition for resources between units, unfair and arbitrary resource allocation and obscure decisional structure, the more illegitimate tasks managers reported. These results should be valuable for strategic-level management since they indicate that illegitimate tasks can be counteracted by means of the organization of work.
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Truth and Reconciliation Commissions (TRC) have emerged in the last few decades as a mechanism for a state to overcome widespread, grave, human rights violations. There are numerous approaches to a TRC all with an ultimate goal: that formerly warring factions, perpetrators, witnesses, and victims can move forward as a united people. I propose that the provision of amnesty is critical to the success of a TRC. I hypothesize that the form of amnesty chosen (i.e. blanket v. conditional amnesty) determines the revelation of truth and realization of justice, which in turn dictates whether a TRC can achieve reconciliation. To test this hypothesis, I use two case studies: South Africa, which has utilized conditional amnesty, and Sierra Leone which has employed blanket amnesty. I create a model for measuring reconciliation. I can then look at the implications of both types of amnesty and assess which, in the end, is more effective. My overarching conclusion is that the provision of conditional amnesty is more effective than blanket amnesty in achieving reconciliation. Ultimately, I hope that this conclusion can be generalized to other TRCs.
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Membrane proteins are critical to every aspect of cell physiology, with their association mediating important biological functions. The transmembrane and cytoplasmic domains are known to be important for their association. In order to characterize their role in detail, we have applied different biophysical techniques in detergent micelles to two model systems. The first study involves FcRγ, a single transmembrane domain protein existing as a disulfide linked homodimer. We investigated the role of a conserved transmembrane polar residue and the cytoplasmic tail in FcRγ homo-interactions. Our results by various biophysical techniques including SDS-PAGE, circular dichroism and sedimentation equilibrium in detergent micelles indicate importance of both the transmembrane polar residue and cytoplasmic tail in maintaining proper conformation for FcRγ homo-interactions. A contrasting second study was on L-selectin, another single transmembrane domain protein with a large extracellular domain and a short cytoplasmic tail. Previous cross-linking experiments indicate its possible dimerization. However, the purified fragment of L-selectin and corresponding mutants did not dimerize when analyzed by TOXCAT assay, sedimentation equilibrium and fluorescence resonance energy transfer. It was likely that the presence of juxtamembrane positively charged residues led to decreased migrational rates in SDS PAGE. In conclusion, complementary biophysical techniques should be used with care when studying membrane protein association in detergent micelles. As an extension to our study on L-selectin, we also investigated its interaction with Calmodulin (CaM) in detergent micelles. CaM was found to interact with different detergents. We applied fluorescence and NMR spectroscopy to characterize the interaction of both the apo and Ca 2+ bound form of CaM, with commonly used detergents, below and above their respective critical micelle concentrations. The interaction of apo-CaM with detergents was found to vary with the nature of the detergent head group, whereas Ca2+-CaM interacted with individual detergent molecules irrespective of the nature of their head group. NMR titration experiments of CaM with detergents indicated involvement of specific residues from the N-lobe, linker and C-lobe of CaM. ^
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Decades of research show that environmental exposure to the chemical benzene is associated with severe carcinogenic, hematoxic and genotoxic effects on the human body. As such, the Environmental Protection Agency (EPA) has designated the chemical as a Hazardous Air Pollutant and prescribed benzene air concentration guidelines that provide cities with an ideal ambient level to protect human health. However, in Houston, Texas, a city home to the top industrial benzene emitters in the US who undoubtedly contribute greatly to the potentially unsafe levels of ambient benzene, regulations beyond the EPA’s unenforceable guidelines are critical to protecting public health. Despite this, the EPA has failed to establish National Ambient Air Quality Standards (NAAQS) for benzene. States are thus left to regulate air benzene levels on their own; in the case of Texas, the Texas Commission on Environmental Quality (TCEQ) and state legislature have failed to proactively develop legally enforceable policies to reduce major source benzene emissions. This inaction continues to exacerbate a public health problem, which may only be solved through a legal framework that restricts preventable benzene emissions to protect human health and holds industrial companies accountable for violations of such regulations and standards. This analysis explores legal barriers that the City of Houston and other relevant agencies currently face in their attempt to demand and bring about such change. ^
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Candida albicans causes opportunistic fungal infections in humans and is a significant cause of mortality and morbidity in immune-compromised individuals. Dectin-2, a C-type lectin receptor, is required for recognition of C. albicans by innate immune cells and is required for initiation of the anti-fungal immune response. We set out to identify components of the intracellular signaling cascade downstream of Dectin-2 activation in macrophages and to understand their importance in mediating the immune response to C. albicans in vivo. Using macrophages derived from Phospholipase-C-gamma 1 and 2 (PLCγ1and PLCγ2) knockout mice, we demonstrate that PLCγ2, but not PLCγ1, is required for activation of NF-κB and MAPK signaling pathways after C. albicans stimulation, resulting in impaired production of pro-inflammatory cytokines and reactive oxygen species. PLCγ2-deficient mice are highly susceptible to infections with C. albicans, indicating the importance of this pathway to the anti-fungal immune response. TAK1 and TRAF6 are critical nodes in NF-κB and MAPK activation downstream of immune surveillance and may be critical to the signaling cascade initiated by C-type lectin receptors in response to C. albicans. Macrophages derived from both TAK1 and TRAF6-deficient mice were unable to activate NF-κB and MAPK and consequently failed to produce inflammatory cytokines characteristic of the response to C. albicans. In this work we have identified PLCγ2, TAK1 and TRAF6 as components of a signaling cascade downstream of C. albicans recognition by C-type lectin receptors and as critical mediators of the anti-fungal immune response. A mechanistic understanding of the host immune response to C. albicans is important for the development of anti-fungal therapeutics and in understanding risk-factors determining susceptibility to C. albicans infection.
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Cold-water coral (CWC) reefs constitute one of the most complex deep-sea habitats harboring a vast diversity of associated species. Like other tropical or temperate framework builders, these systems are facing an uncertain future due to several threats, such as global warming and ocean acidification. In the case of Mediterranean CWC communities, the effect may be exacerbated due to the greater capacity of these waters to absorb atmospheric CO2 compared to the global ocean. Calcification in these organisms is an energy-demanding process, and it is expected that energy requirements will be greater as seawater pH and the availability of carbonate ions decrease. Therefore, studies assessing the effect of a pH decrease in skeletal growth, and metabolic balance are critical to fully understand the potential responses of these organisms under a changing scenario. In this context, the present work aims to investigate the medium- to long-term effect of a low pH scenario on calcification and the biochemical composition of two CWCs from the Mediterranean, Dendrophyllia cornigera and Desmophyllum dianthus. After 314 d of exposure to acidified conditions, a significant decrease of 70 % was observed in Desmophyllum dianthus skeletal growth rate, while Dendrophyllia cornigera showed no differences between treatments. Instead, only subtle differences between treatments were observed in the organic matter amount, lipid content, skeletal microdensity, or porosity in both species, although due to the high variability of the results, these differences were not statistically significant. Our results also confirmed a heterogeneous effect of low pH on the skeletal growth rate of the organisms depending on their initial weight, suggesting that those specimens with high calcification rates may be the most susceptible to the negative effects of acidification.
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Ocean acidification driven by rising levels of CO2 impairs calcification, threatening coral reef growth. Predicting how corals respond to CO2 requires a better understanding of how calcification is controlled. Here we show how spatial variations in the pH of the internal calcifying fluid (pHcf) in coral (Stylophora pistillata) colonies correlates with differential sensitivity of calcification to acidification. Coral apexes had the highest pHcf and experienced the smallest changes in pHcf in response to acidification. Lateral growth was associated with lower pHcf and greater changes with acidification. Calcification showed a pattern similar to pHcf, with lateral growth being more strongly affected by acidification than apical. Regulation of pHcf is therefore spatially variable within a coral and critical to determining the sensitivity of calcification to ocean acidification.
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The ensuing bloodshed and deteriorating humanitarian crisis in Syria, the failure of the United Nations Security Council to reach a consensus on what action to take, and the involvement of contending external actors partially reflect the complexity of the current impasse. Despite the importance of regional and international factors, however, this papers attempts to argue that the domestic dynamics of the Syrian crisis have been vitally important in determining the course of the popular uprising and the regime’s response. In this, Syria’s crisis belongs with the Arab Spring the trajectories and prospects of which have been shaped by dynamics within regimes. It will be seen that the formal and informal institutional structure of the Ba‘thist regime in Syria has been critical to its resilience and ability to stay united so far while attempting to crush a peaceful popular uprising that turned into insurgency in the face of the regime’s violent crackdown.
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Durante décadas y aun en la actualidad muchas organizaciones, a nivel mundial, continúan afrontando pérdidas significativas debido a fracasos parciales y totales respecto a sus inversiones en sistemas de información (SI), planteando serios retos a los niveles gerenciales y los profesionales de SI. Estadísticas alarmantes y décadas de experiencia en la praxis en el área de SI en diversas organizaciones llevan al autor a poner el énfasis en los usuarios finales internos (UF) que son designados como representantes (UFR) de sus pares en los proyectos de desarrollo de SI (PDSI) por considerarlos como factores influyentes de manera significativa en el problema. Particularmente, con enfoque en ciertos factores de los UFR críticos para el éxito de los PDSI, con dimensiones analizadas de forma aislada o incompleta en otros estudios empíricos, a la fecha. No se encontraron estudios en Latinoamérica ni en otras latitudes que abordasen el fenómeno del éxito/fracaso de los SI desde el punto de vista adoptado en esta tesis. Por ello, esta investigación empírica ha evaluado en qué grado estos factores pudiesen influenciar los resultados durante el desarrollo e implementación de SI y su posible impacto en la satisfacción de los UF, siendo esta última aceptada por variados autores como la principal medida del éxito de los SI. Este estudio fue realizado en América Latina en las cuatro grandes empresas industriales que integran verticalmente el sector aluminio de Venezuela, sometidas a un macro PDSI para instalar el paquete, de tipo ERP, SAP/R3. Experimentados profesionales fueron encuestados o entrevistados, tales como altos ejecutivos, desarrolladores, líderes de proyecto y líderes de los UF. Un enfoque metodológico de triangulación permitió combinar un análisis cuantitativo con un análisis cualitativo interpretativo del tipo hermenéutico/dialéctico, hallándose resultados convergentes y complementarios. Un análisis estadístico, utilizando Partial Least Squares (PLS), seguido de un análisis hermenéutico/dialéctico. Los resultados confirmaron un hecho importante: en los casos problemáticos, paradójicamente, los orígenes de las razones de rechazo de esos SI argumentadas por los UF, en alto grado, apuntaron a los UFR o a ellos mismos. Los resultados también confirmaron la prevalencia de factores de orden cognitivo, conductual y político en estas organizaciones sobre los tecnológicos, al igual que el alto riesgo de dar por sentado la presencia y calidad de los factores requeridos de los UFR y de los otros factores estudiados. La validación estadística del modelo propuesto reveló al constructo conocimientos de los UFR como la principal variable latente, con los variables indicadoras que componen este constructo ejerciendo la mayor influencia sobre la calidad y el éxito de los SI. Un hallazgo contrario al de otros estudios, mostró que los conocimientos sobre las tecnologías de la información (TI) fueron los menos relevantes. Los SI de nómina y de administración de los RRHH fueron los más problemáticos, como suele ser el caso, por su complejidad en organizaciones grandes. Las conclusiones principales confirman el decisivo rol de los UF para el éxito de los PDSI y su relación con la creciente problemática planteada, la cual amerita más investigación y de las organizaciones una mayor atención y preparación. Descuidar los factores humanos y sociales así como una efectiva planificación y gestión de los mismos en preparación para estos proyectos origina serios riesgos. No obstante las limitaciones de este trabajo, la problemática analizada suele influir en los PDSI en diversas organizaciones, indistintamente de su tamaño o tipo de SI, estimándose, por tanto, que los resultados, conclusiones y recomendaciones de esta investigación tienen un alto grado de generalización. Una relación de indicadores claves es suministrada con fines preventivos. Finalmente, los factores evaluados pueden usarse para ampliar el modelo reconocido de DeLone y McLean (2003), conectándolos como variables latentes de sus variables independientes calidad de la información y calidad del SI. ABSTRACT For decades, many organizations worldwide have been enduring heavy losses due to partial and total failures regarding their investments in information systems (IS), posing serious challenges to all management levels and IS practitioners. Alarming statistics in this regard and decades of practice in the IS area lead the author to place an emphasis on the end users (EU) who are appointed in representation of their peers (EUR) to IS development projects (ISDP), considering them as highly influential factors on the problem. Especially, focusing on certain EUR success factors, and their dimensions, deemed critical to any IS development and implementation, omitted or not thoroughly analyzed neither in the theory nor in the empirical research on the subject, so far. No studies were found in Latin America or elsewhere addressing the phenomenon of IS success/failure from the perspective presented herein. Hence, this empirical research has assessed to what degree such factors can influence the outcomes of an ISDP and their feasible impact on the EU´s satisfaction, being the latter accepted by several authors as the main measure of IS success. This study was performed in Latin America embracing four major industrial enterprises, which vertically integrate the aluminum sector of Venezuela, subjected to a macro ISDP to install the ERP-type package SAP/R3. The field work included surveying and interviewing experienced professionals such as IS executives, IS developers, IS project leaders and end-user project leaders. A triangulation methodological approach allowed combining quantitative and interpretive analyses, obtaining convergent and complementing results. A statistical analysis, using Partial Least Squares (PLS), was carried out followed by a hermeneutical/dialectical analysis. Results confirmed a major finding: in problematic cases, paradoxically, the origins of IS rejection reasons argued by the EU, at a high degree, were usually traceable to the EUR and themselves. The results also confirmed the prevalence of cognitive, behavioral and political factors in these organizations as well as the high risk of taking for granted the presence and quality of those factors demanded from the EUR. The statistical validation of the proposed model revealed the construct EUR knowledge as the main latent variable, with its items exerting a major influence on IS quality and success. Another finding, in contradiction with that of other studies, proved knowledge of information technology (IT) aspects to be irrelevant. The payroll and the human resources administration IS were the most problematic, as is usually the case in large companies. The main conclusions confirm the EU´s decisive role for IS success and their relationship with the problem, which continues, demanding more research and, from organizations, more attention and preparation. Neglecting human and social factors in organizations as well as their effective planning and management in preparation for ISDP poses serious risks. Despite the limitations of this work, the analyzed problem tends to influence ISDP in a wide range of organizations; regardless of their size or type of IS, thus showing a high degree of generalization. Therefore it is believed that the results, conclusions and suggestions of this research have a high degree of generalization. A detailed checklist comprising key measures is provided for preventive actions. Finally, the factors evaluated can be used to expand the well-known model of DeLone & McLean (2003), by connecting them as latent variables of its independent variables information quality and IS quality.
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An inverse optimization strategy was developed to determine the single crystal properties from experimental results of the mechanical behavior of polycrystals. The polycrystal behavior was obtained by means of the finite element simulation of a representative volume element of the microstructure in which the dominant slip and twinning systems were included in the constitutive equation of each grain. The inverse problem was solved by means of the Levenberg-Marquardt method, which provided an excellent fit to the experimental results. The iterative optimization process followed a hierarchical scheme in which simple representative volume elements were initially used, followed by more realistic ones to reach the final optimum solution, leading to important reductions in computer time. The new strategy was applied to identify the initial and saturation critical resolved shear stresses and the hardening modulus of the active slip systems and extension twinning in a textured AZ31 Mg alloy. The results were in general agreement with the data in the literature but also showed some differences. They were partially explained because of the higher accuracy of the new optimization strategy but it was also shown that the number of independent experimental stress-strain curves used as input is critical to reach an accurate solution to the inverse optimization problem. It was concluded that at least three independent stress-strain curves are necessary to determine the single crystal behavior from polycrystal tests in the case of highly textured Mg alloys.