Pervasive Business Intelligence

In the last few years, a new generation of Business Intelligence (BI) tools called BI 2.0 has emerged to meet the new and ambitious requirements of business users. BI 2.0 not only introduces brand new topics, but in some cases it re-examines past challenges according to new perspectives depending on the market changes and needs. In this context, the term pervasive BI has gained increasing interest as an innovative and forward-looking perspective. This thesis investigates three different aspects of pervasive BI: personalization, timeliness, and integration. Personalization refers to the capacity of BI tools to customize the query result according to the user who takes advantage of it, facilitating the fruition of BI information by different type of users (e.g., front-line employees, suppliers, customers, or business partners). In this direction, the thesis proposes a model for On-Line Analytical Process (OLAP) query personalization to reduce the query result to the most relevant information for the specific user. Timeliness refers to the timely provision of business information for decision-making. In this direction, this thesis defines a new Data Warehuose (DW) methodology, Four-Wheel-Drive (4WD), that combines traditional development approaches with agile methods; the aim is to accelerate the project development and reduce the software costs, so as to decrease the number of DW project failures and favour the BI tool penetration even in small and medium companies. Integration refers to the ability of BI tools to allow users to access information anywhere it can be found, by using the device they prefer. To this end, this thesis proposes Business Intelligence Network (BIN), a peer-to-peer data warehousing architecture, where a user can formulate an OLAP query on its own system and retrieve relevant information from both its local system and the DWs of the net, preserving its autonomy and independency.

Survival of the warzone interpreter; behind the untold story

This dissertation examines the complicated and still little-known role of the interpreters in conflict zones. After a brief overview of the figure of the community interpreters, the thesis focuses on the interpreters in conflict zones, local civilians who risk their lives every day in the front line in order to help the Western countries in war. This dissertation shows the danger interpreters face because of their job: they are seen as traitors by their fellow citizens, the Taliban and other insurgent groups and for this reason they are hunted and killed. The purpose of this thesis is to show that Western countries are not doing enough to protect these interpreters, and in particular the United States' case will be analyzed: this country does not offer interpreters the right protection backing exchange, leaving them in the hands of the enemy once the US troops have finished their mission. The latter part of the dissertation presents the main organizations and international projects aimed at helping interpreters who are still trapped in their countries.

Rituximab, bendamustine, and lenalidomide in patients with aggressive B cell lymphoma not eligible for high-dose chemotherapy or anthracycline-based therapy: phase I results of the SAKK 38/08 trial

This phase I trial was designed to develop a new effective and well-tolerated regimen for patients with aggressive B cell lymphoma not eligible for front-line anthracycline-based chemotherapy or aggressive second-line treatment strategies. The combination of rituximab (375 mg/m(2) on day 1), bendamustine (70 mg/m(2) on days 1 and 2), and lenalidomide was tested with a dose escalation of lenalidomide at three dose levels (10, 15, or 20 mg/day) using a 3 + 3 design. Courses were repeated every 4 weeks. The recommended dose was defined as one level below the dose level identifying ≥2/6 patients with a dose-limiting toxicity (DLT) during the first cycle. Thirteen patients were eligible for analysis. Median age was 77 years. WHO performance status was 0 or 1 in 12 patients. The Charlson Comorbidity Index showed relevant comorbidities in all patients. Two DLTs occurred at the second dose level (15 mg/day) within the first cycle: one patient had prolonged grade 3 neutropenia, and one patient experienced grade 4 cardiac adverse event (myocardial infarction). Additional grade 3 and 4 toxicities were as follows: neutropenia (31 %), thrombocytopenia (23 %), cardiac toxicity (31 %), fatigue (15 %), and rash (15 %). The dose of lenalidomide of 10 mg/day was recommended for a subsequent phase II in combination with rituximab 375 mg/m(2) on day 1 and bendamustine 70 mg/m(2) on days 1 and 2.

Treatment of relapsing acute lymphoblastic leukemia in childhood. III. Experiences with 54 first bone marrow, nine isolated testicular, and eight isolated central nervous system relapses observed 1985-1989

Of 54 children with acute lymphoblastic leukemia (ALL) and first hematological recurrence observed between 1985 and 1989, 31 relapsed while still on treatment and 23 after cessation of therapy. Of the former, only one survived. Of the latter, 11 children survived after a minimum follow-up of 25 months. During the same period, a first isolated testicular relapse was observed in nine boys, of whom six survived, and an isolated CNS relapse in eight patients, of whom three survived. As a rule, survivors of a bone marrow or testicular relapse were doing well while those surviving a CNS relapse had considerable neuropsychological sequelae. These results, compared with those of two preceding studies, suggest that with intensification of front-line treatments, it becomes more difficult to rescue children who relapse, particularly those with a bone marrow relapse while on therapy.

Using Single-Case Participatory Action Research as a Methodology to Explore Appalachian Summer Camp Communities

Community educators have long known the value of direct experience in the learning process. Participatory action research extends this philosophy to the realm of research. This article examines the value of involving front line camp staff, members of the camp community in Appalachia as practitioner researchers with university scientists in studying the type and conditions of transformative learning in young adult camp staff. A young adult who was a camp community member assisted the researchers with methodology, data analysis, data interpretation, and dissemination of findings. This resulted in a more accurate, richer, and thicker description of the camp community member’s transformative learning experience. The benefits of involving practitioner researchers are examined, as well as promising practices for conducting participatory action research in community education environments.

Health Care Providers' Training Needs Related to Human Trafficking: Maximizing the Opportunity to Effectively Screen and Intervene

Human trafficking is a complex and multifaceted problem that takes the form of economic, physical and sexual exploitation of people, both adults and children, who are reduced to simple products for commerce. Human trafficking in the United States also has both a domestic and an international aspect. Health care providers are in a unique position to screen for victims of trafficking and may provide important medical and psychological care for victims while in captivity and thereafter. Trafficked persons are likely to suffer a wide spectrum of health risks that reflect the unique circumstances and experiences in a trafficked victim’s life. Although trafficked victims typically have experienced inadequate medical care, once contact is made by the victim with the health care professionals, the opportunity then exists to identify, treat, and assist such victims. The range of services and supports required to appropriately respond to human trafficking victims once identified is broad and typically goes beyond just what is immediately provided by the health care professional and includes safe housing, legal advice, income support, and, for international victims, immigration status related issues. An informed and responsive community is necessary to serve both the international and domestic victims of human trafficking, and needs assessments demonstrated a number of barriers that hindered the delivery of effective services to human trafficking victims. One of the consistent needs identified to combat these barriers was enhanced training among all professionals who might come in contact with human trafficking victims. We highlight the efforts of the Houston Rescue and Restore Coalition (HRRC), a local grassroots non-profit organization whose mission focuses on raising awareness of human trafficking in the Greater Houston Metropolitan area. HRRC responded to the consistent recommendation from various community needs assessments for additional training of front line professionals who would have the opportunity to identify human trafficking victims and supported the design and pilot testing of a health professions training program around human trafficking. Dissemination of this type of training along with careful evaluation and continued refinement will be one way for health care professionals to engage in a positive manner with human trafficking victims.

Nutrition knowledge and attitudes of physician assistants in Texas

Physician Assistants (PAs) are increasingly assuming more responsibilities as "front-line" health providers due to emphasis on primary care and cost-containment in the rapidly changing health care environment. Nutrition plays an important role in health promotion and disease prevention. Primary care providers, including PAs, have enormous potential as nutrition counselors and advocates. There have been no studies to date that address the PAs' adequacy of nutrition education or their attitudes toward the value of nutrition. Therefore, it was the purpose of the study to determine the nutrition knowledge and attitudes of PAs in Texas.^ All certified physician assistants in Texas were eligible for the study. A mailed survey was sent to 1,482 PAs in Texas with a response rate of 54.2%. The sample utilized for data analysis was 764 PAs.^ The study compared the nutrition knowledge mean scores for PAs who graduated from a PA program greater than 11 years ago with those who graduated less than 11 years ago. The study also examined Texas PAs' attitudes about their nutrition education training, the value of nutrition counseling, and their perceived ability to provide such nutrition counseling. Demographic and practice information was collected from the PAs. Demographically, PAs in Texas were found to be comparable to the national population of PAs surveyed in 1996.^ The overall mean level of nutrition knowledge was 70% correct. The mean level of nutrition knowledge was significantly related to the type of PA program that the PA graduated from (i.e., Certificate only or Master's degree level). No significant relationships were found between the mean nutrition knowledge score and age, year of graduation, length of practice, or the type of nutrition education provided in PA program.^ The majority of the PAs surveyed felt that diet and nutrition has an important role in disease prevention and felt that PA programs should place a greater emphasis on nutrition education. Many PAs surveyed were not satisfied with the amount of nutrition education they had received in their PA education programs and were not confident in their ability to provide nutrition counseling to patients.^ Suggestions are offered for improvement in PA nutrition education in the areas of both nutrition knowledge and patient counseling skills. In addition, this study recommends developing and strengthening partnerships between PAs and nutrition organizations. ^

Outcome of aplastic anaemia in children. A study by the severe aplastic anaemia and paediatric disease working parties of the European group blood and bone marrow transplant.

This study analysed the outcome of 563 Aplastic Anaemia (AA) children aged 0-12 years reported to the Severe Aplastic Anaemia Working Party database of the European Society for Blood and Marrow Transplantation, according to treatment received. Overall survival (OS) after upfront human leucocyte antigen-matched family donor (MFD) haematopoietic stem cell transplantation (HSCT) or immunosuppressive treatment (IST) was 91% vs. 87% (P 0·18). Event-free survival (EFS) after upfront MFD HSCT or IST was 87% vs. 33% (P 0·001). Ninety-one of 167 patients (55%) failed front-line IST and underwent rescue HSCT. The OS of this rescue group was 83% compared with 91% for upfront MFD HSCT patients and 97% for those who did not fail IST up-front (P 0·017). Rejection was 2% for MFD HSCT and HSCT post-IST failure (P 0·73). Acute graft-versus-host disease (GVHD) grade II-IV was 8% in MFD graft vs. 25% for HSCT post-IST failure (P < 0·0001). Chronic GVHD was 6% in MFD HSCT vs. 20% in HSCT post-IST failure (P < 0·0001). MFD HSCT is an excellent therapy for children with AA. IST has a high failure rate, but remains a reasonable first-line choice if MFD HSCT is not available because high OS enables access to HSCT, which is a very good rescue option.

From The Hague to Geneva: The protection of civilians and refugees in the perspective of legal history, 1899-1951

The presentation proposed here shall focus on international (and as far as possible some cases of national) legal protection of civilians and refugees between the first Hague Convention of 1899 and the Geneva Convention for the Protection of Refugees in 1951. An analysis of international legal texts as well as, if possible, some exemplary national constitutions will form the core of the presentation, which will try to find out, to what extent not only the civilian population remaining close to front-line fighting, but also under occupation was supposed to be protected by legal norms, but also to what extent the issue of forcing civilian to leave their homes became part of the international legal discourse as well as of international legal norms.

Similar outcome of upfront-unrelated and matched sibling stem cell transplantation in idiopathic paediatric aplastic anaemia. A study on behalf of the UK Paediatric BMT Working Party, Paediatric Diseases Working Party and Severe Aplastic Anaemia Working Party of EBMT

Abstract We explored the feasibility of unrelated donor haematopoietic stem cell transplant (HSCT) upfront without prior immunosuppressive therapy (IST) in paediatric idiopathic severe aplastic anaemia (SAA). This cohort was then compared to matched historical controls who had undergone first-line therapy with a matched sibling/family donor (MSD) HSCT (n = 87) or IST with horse antithymocyte globulin and ciclosporin (n = 58) or second-line therapy with unrelated donor HSCT post-failed IST (n = 24). The 2-year overall survival in the upfront cohort was 96 ± 4% compared to 91 ± 3% in the MSD controls (P = 0·30) and 94 ± 3% in the IST controls (P = 0·68) and 74 ± 9% in the unrelated donor HSCT post-IST failure controls (P = 0·02).The 2-year event-free survival in the upfront cohort was 92 ± 5% compared to 87 ± 4% in MSD controls (P = 0·37), 40 ± 7% in IST controls (P = 0·0001) and 74 ± 9% in the unrelated donor HSCT post-IST failure controls (n = 24) (P = 0·02). Outcomes for upfront-unrelated donor HSCT in paediatric idiopathic SAA were similar to MSD HSCT and superior to IST and unrelated donor HSCT post-IST failure. Front-line therapy with matched unrelated donor HSCT is a novel treatment approach and could be considered as first-line therapy in selected paediatric patients who lack a MSD. © 2015 John Wiley & Sons Ltd.

Patient Safety Net Update

It’s been three months since we’ve gone live with Patient Safety Net, and it has been a great success! Managers and front line staff have been trained on how to input, review, and submit event reports that formerly were detailed on the hard copy “RIR” forms. Utilization of the webbased PSN system has been better than expected. PSN has enabled us to greatly improve the way we document and react to patient safety related events.

An epidemiologic evaluation of a worksite based intervention

The healthcare industry spends billions on worker injury and employee turnover. Hospitals and healthcare settings have one of the highest rates of lost days due to injuries. The occupational hazards for healthcare workers can be classified into biological, chemical, ergonomic, physical, organizational, and psychosocial. Therefore, interventions addressing a range of occupational health risks are needed to prevent injuries and reduce turnover and reduce costs. ^ The Sacred Vocation Program (SVP) seeks to change the content of work, i.e., the meaningfulness of work, to improve work environments. The SVP intervenes at both the individual and organizational level. First the SVP attempts to connect healthcare workers with meaning from their work through a series of 5 self-discovery group sessions. In a sixth session the graduates take an oath recommitting them to do their work as a vocation. Once motivated to connect with meaning in their work, a representative employee group meets in a second set of five meetings. This representative group suggests organizational changes to create a culture that supports employees in their calling. The employees present their plan in the twelfth session to management beginning a new phase in the existing dialogue between employees and management. ^ The SVP was implemented in a large Dallas hospital (almost 1000 licensed beds). The Baylor University Medical Center (BUMC) Pastoral Care department invited front-line caregivers (primarily Patient Care Assistants, PCAs, or Patient Care Technicians, PCTs) to participate in the SVP. Participants completed SVP questionnaires at the beginning and following SVP implementation. Following implementation, employer records were collected on injury, absence and turnover to further evaluate the program's effectiveness on metrics that are meaningful to managers in assessing organizational performance. This provided an opportunity to perform an epidemiological evaluation of the intervention using the two sources of information: employee self-reports and employer administrative data. ^ The ability to evaluate the effectiveness of the SVP on program outcomes could be limited by the strength of the measures used. An ordinal CFA performed on baseline SVP questionnaire measurements examined the construct validity and reliability of the SVP scales. Scales whose item-factor structure was confirmed in ordinal CFA were evaluated for their psychometric properties (i.e., reliability, mean, ceiling and floor effects). CFA supported the construct validity of six of the proposed scales: blocks to spirituality, meaning at work, work satisfaction, affective commitment, collaborative communication, and MHI-5. Five of the six scales confirmed had acceptable measures of reliability (all but MHI-5 had α>0.7). All six scales had a high percentage (>30%) of the scores at the ceiling. These findings supported the use of these items in the evaluation of change although strong ceiling effects may hinder discerning change. ^ Next, the confirmed SVP scales were used to evaluate whether the intervention improved program constructs. To evaluate the SVP a one group pretest-posttest design compared participants’ self-reports before and after the intervention. It was hypothesized that measurements of reduced blocks to spirituality (α = 0.76), meaning at work (α = 0.86), collaborative communication (α = 0.67) and SVP job tasks (α = 0.97) would improve following SVP implementation. The SVP job tasks scale was included even though it was not included in the ordinal CFA analysis due to a limited sample and high inter-item correlation. Changes in scaled measurements were assessed using multilevel linear regression methods. All post-intervention measurements increased (increases <0.28 points) but only reduced blocks to spirituality was statistically significant (0.22 points on a scale from 1 to 7, p < 0.05) after adjustment for covariates. Intensity of the intervention (stratifying on high participation units) strengthened effects; but were not statistically significant. The findings provide preliminary support for the hypothesis that meaning in work can be improved and, importantly, lend greater credence to any observed improvements in the outcomes. (Abstract shortened by UMI.)^

La idea de Monumentalidad en la Segunda Posguerra: Debates y Propuestas

El presente trabajo aborda el análisis de la idea de monumentalidad, así como el diseño y la construcción de monumentos concretos, a la finalización de la Segunda Guerra Mundial, prestando especial atención al intento del Movimiento Moderno de introducirse en un campo que hasta entonces le había sido ajeno. Entendiendo que el monumento es ante todo un artefacto para la memoria, y analizando las teorías de sociólogos como Émile Durkheim, Maurice Halbwachs, Jan Assmann o Iwona Irwin-Zarecka, la tesis se propone explicar el papel que juegan los monumentos en la creación de una memoria colectiva que, a diferencia de la historia, es una recopilación selectiva de acontecimientos del pasado cuyo fin es procurar y celebrar la permanencia del grupo social. También se propone analizar el papel del monumento como elemento de estabilidad en el paisaje urbano que genera de forma natural el apego de los ciudadanos, puesto que forma parte destacada del marco espacial en el que se han desarrollado sus vidas. Desde estas dos facetas se pretende justificar la necesidad de monumentos que experimenta cualquier grupo social, y por qué las guerras, que ponen en peligro la estructura, e incluso la propia vida del grupo, son acontecimientos que generan una tendencia especial a la construcción de monumentos que conjuren el peligro al que éste se ha visto sometido. Se explicarán las razones por las que la conmemoración de la Segunda Guerra Mundial se volvió especialmente problemática. Entre las principales, la desaparición de fronteras entre frente y retaguardia, entre objetivos militares y civiles; por otra parte la despersonalización de la acción bélica como consecuencia de la aplicación de la tecnología; en tercer lugar el papel de los medios de comunicación de masas, que por primera vez en la historia irrumpieron de forma masiva en una guerra, y ofrecían imágenes instantáneas, más impactantes y con un aura de realidad con la que el monumento convencional no era capaz de competir; en cuarto lugar el inicio de la era atómica, que enfrentaba por primera vez a la humanidad a la posibilidad de su destrucción total; y finalmente la experiencia del Holocausto, en cuanto que aniquilación carente de objetivo e ideología, que se servía del progreso de la ciencia para ganar en eficiencia, y que puso de manifiesto la manipulabilidad de la tecnología al servicio de unos intereses particulares. Como respuesta a esta dificultad para la conmemoración, se popularizaron dos fórmulas hasta entonces marginales que podemos considerar características del momento: una de ellas es el living memorial, que trataba de ofrecer una lectura constructiva de la guerra poniendo de relieve determinadas funciones prácticas de carácter democrático, cultural, deportivo, etc. que se presentaban como los frutos por los que se había combatido en la guerra. En esta fórmula es donde el Movimiento Moderno encontró la posibilidad de abordar nuevos proyectos, en los que la función estaba presente pero no era el ingrediente determinante, lo que obligaría a un enriquecimiento del lenguaje con el que responder a la dimensión emotiva del monumento. Y si bien hay en esta época edificios modernos que podemos calificar justamente de monumentos, el desplazamiento del centro del debate teórico hacia cuestiones estilísticas y expresivas limitó considerablemente la claridad de los enunciados anteriores y la posibilidad de consenso. Dentro de los living memorials, las sedes de la Organización de Naciones Unidas y sus correspondientes agencias representaron la mayor esperanza del Movimiento Moderno por construir un auténtico monumento. Sin embargo, el sistema de trabajo en grupo, con su correspondiente conflicto de personalidades, la ausencia de proyección de los edificios sobre el espacio urbano anexo, y sobre todo el propio descrédito que comenzaron a sufrir las instituciones con el comienzo de la Guerra Fría, frustraron esta posibilidad. La segunda fórmula conmemorativa sería el monumento de advertencia o mahnmal, que renuncia a cualquier rasgo de heroísmo o romanticismo, y se concentra simplemente en advertir de los riesgos que implica la guerra. Dicha fórmula se aplicó fundamentalmente en los países vencidos, y generalmente no por iniciativa propia, sino como imposición de los vencedores, que de alguna forma aprovechaban la ocasión para hacer examen de conciencia lejos de la opinión pública de sus respectivos países. ABSTRACT This paper explores the idea of monumentality through the analysis of the design and construction of several monuments at the end ofWorldWar II. It pays particular attention to the attempt of the Modern Movement to enter a field that had been ignored until this moment. With the assumption that a monument is primarily a mnemonic device, this thesis focuses on the thinking of sociologists like Émile Durkheim, Maurice Halbwachs, Jan Assmann or Iwona Irwin-Zarecka, with the aim of explaining the role of monuments in the creation of a collective memory which, unlike history, consists of past events selected in order to secure and celebrate the permanence of a social group. It also considers the role of monuments as elements of stability in the urban landscape that naturally get assimilated by society, since they are prominent elements in the shared spaces of daily life. These two features explain the need felt by any society for monuments, and how wars, events that endanger the structure and even the existence of that same society, generate a special tendency to build monuments to conjure that inherent danger. The reasons why the memorializing of World War II became especially problematic will be explained. Primary among them is the blurring of boundaries between the front line and the domestic front, between military and civilian targets; moreover, the depersonalization of warfare as a result of advances in technology; thirdly, the role of mass media, which for the first time in history extensively covered a war, instantly broadcasting images of such power and with such an aura of reality that conventional monuments became obsolete; fourthly, the beginning of the atomic age, which meant that mankind faced the possibility of complete destruction; and finally the Holocaust, a racial annihilation devoid of purpose and ideology, which took advantage of scientific progress to gain efficiency, manipulating technology to serve particular interests. In response to this difficulty in commemorating wars, two formulas hitherto marginal gained such popularity as to become prototypes: one was the living memorial, offering a constructive reading of the war by hosting certain practical functions of democratic, cultural or sporting nature. Living memorials presented themselves as the image of the outcome for which the war had been fought. The Modern Movement found in this formula the opportunity for tackling new projects, in which function was present but not as the determining ingredient; in turn, they would require an enhancement of language in order to account for the emotional dimension of the monument. And while there are modern buildings at this time that we can justly describe as monuments, the displacement of the focus of the theoretical debate to stylistic and expressive issues considerably limited the clarity of previous statements and the possibility of consensus. Among all living memorials, the headquarters of the United Nations Organization and its satellite agencies represented the ultimate hope of the Modern Movement to build an authentic monument. However, the group-based design process, the fight of egos it caused, the lack of presence of these buildings over the adjacent urban space, and especially the very discredit that these institutions began to suffer with the onset of the Cold War, all thwarted this expectation. The second commemorative formula was the warning monument or Mahnmal, which rejects any trace of heroism or romanticism, and simply focuses on warning about the risks of war. This formula was mainly used in defeated countries, and generally not on their own initiative, but as an imposition of the victors, which seized the opportunity to do some soul-searching far away from the public opinion of their respective countries.

Molecular basis for the exquisite sensitivity of Mycobacterium tuberculosis to isoniazid

The exceptional sensitivity of Mycobacterium tuberculosis to isonicotinic acid hydrazide (INH) lacks satisfactory definition. M. tuberculosis is a natural mutant in oxyR, a central regulator of peroxide stress response. The ahpC gene, which encodes a critical subunit of alkyl hydroperoxide reductase, is one of the targets usually controlled by oxyR in bacteria. Unlike in mycobacterial species less susceptible to INH, the expression of ahpC was below detection limits at the protein level in INH-sensitive M. tuberculosis and Mycobacterium bovis strains. In contrast, AhpC was detected in several series of isogenic INH-resistant (INHr) derivatives. In a demonstration of the critical role of ahpC in sensitivity to INH, insertional inactivation of ahpC on the chromosome of Mycobacterium smegmatis, a species naturally insensitive to INH, dramatically increased its susceptibility to this compound. These findings suggest that AhpC counteracts the action of INH and that the levels of its expression may govern the intrinsic susceptibility of mycobacteria to this front-line antituberculosis drug.

The Healthy Workplace of the 21st Century: The Benefit of Organizational Wellness Programs on Employee Health and Absenteeism

Every year, obesity rates continue to rise and have reached epidemic proportions throughout the United States. The costs associated with obesity are staggering and many researchers feel that the workplace should be the new front line in the battle for a healthier workforce. Employers must take action to address this worsening health crisis and help reduce spiraling medical costs and absenteeism rates. This capstone reviews the current literature on wellness programs and discusses different companies' approaches to wellness programs that have special emphasis on nutrition and physical activity. It also provides strategies and recommendations for companies eager to initiate a comprehensive, dynamic and directed wellness program to improve the current and future health of their workforce.