Tracing client interests in the course of a project: why are some client interests incorporated whereas others are not?

Many construction professionals and policy-makers would agree that client expectations should be accommodated during a building project. However, this aspiration is not easy to deal with as there may be conflicting interests within a client organization and these may change over time in the course of a project. This research asks why some client interests, and not others, are incorporated into the development of a building project. Actor-Network Theory (ANT) is used to study a single building project on a University campus. The building project is analysed as a number of discussions and negotiations, in which actors persuade each other to choose one solution over another. The analysis traces dynamic client engagement in decision-making processes as available options became increasingly constrained. However, this relative loss of control was countered by clients who continued the control over the timing of participants' involvement, and thus the way to impose their interests even at the later stage of the project.

A informática como uma ferramenta de apoio a inclusão do deficiente visual

An inclusive environment has its foundations in the belief that all people are entitled to participate, to live as normal a life as possible, without discrimination, especially in education. This is to ensure equal opportunities. For individuals with special needs, the use of computers and digital materials is not an alternative, but one of the only forms of access to information. For the visually impaired, they start from the beginning to enter the university, through the selection processes, not always accessible. For those who can, other difficulties arise, undermining the initial enthusiasm and generating a large rate of dropouts. In most cases, these students will depend on the goodwill of colleagues and volunteers for the reading of texts in the basic literature of the disciplines studied. The high cost of technology assisted allied to a lack of resources and knowledge of curricular adaptations, prevents many teachers help these students in an appropriate manner. This thesis seeks to contribute to the inclusion of the visually impaired student pointing alternatives that can help in caring education. The research was conducted specifically for the doctorate during the period 2001 to 2006, the cities of Natal, Salvador and Curitiba, and is based mainly on the methodology of action research. The objective was the construction of Virtual Teaching Support Center , structured in a Web portal that can serve as a resource to help support teachers, staff and other users concerned with the process of inclusion of people with needs special education, with the goal of assimilation of educational opportunities, with the support of resources and methods. The inclusion is for everyone because we are all different

Millennium development goals: progress towards the right to health in Latin america and the Caribbean

Includes bibliography

Ontogenesis and functional morphology of the digestive system of the freshwater prawn, Macrobrachium amazonicum (Decapoda: Palaemonidae)

The appropriate feeding regime for larvae and post-larvae of crustacean decapods is essential for successful larval culture. Reports on the development and morphology of the mouthparts and foregut of these crustaceans have aided in the selection of appropriate larval foodstuffs and consequently increased larval survival and growth rate during development. In the present study, the functional morphology of foregut and mouthparts was investigated in larvae and post-larvae of the freshwater prawn M. amazonicum (Heller, 1862). From observations gathered on both the outer and inner feeding apparati the first stage larvae have obligatory lecithotrophy and feeding behaviour is initiated after molting to the second stage. The foregut of the larvae undergoes diverse morphological changes during larval development and the larval foregut of this species is primarily a mixing organ due to the absence of gastric mills and similar structures. After metamorphosis into post-larvae, drastic morphological changes occur in the foregut and mouthparts to adapt the animals to feed on the greater diversity of foods that are available in their new benthic habitat.

Disturbance detection for optimal database storage in electrical distribution systems using artificial immune systems with negative selection

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

A utilização das tecnologias nos processos de recrutamento e seleção de pessoas: análises, desafios e tendências

Pós-graduação em Desenvolvimento Humano e Tecnologias - IBRC

Políticas de acesso ao cargo de diretor de escola pública da educação básica – novas perspectivas a partir da realidade do município de Franca/SP

Pós-graduação em Planejamento e Análise de Políticas Públicas - FCHS

Anwendungen des Komplexe-Masse-Renormierungsschemas in effektiver Feldtheorie

Der erste Teil der vorliegenden Dissertation befasst sich mit der Untersuchung der perturbativen Unitarität im Komplexe-Masse-Renormierungsschema (CMS). Zu diesem Zweck wird eine Methode zur Berechnung der Imaginärteile von Einschleifenintegralen mit komplexen Massenparametern vorgestellt, die im Grenzfall stabiler Teilchen auf die herkömmlichen Cutkosky-Formeln führt. Anhand einer Modell-Lagrangedichte für die Wechselwirkung eines schweren Vektorbosons mit einem leichten Fermion wird demonstriert, dass durch Anwendung des CMS die Unitarität der zugrunde liegenden S-Matrix im störungstheoretischen Sinne erfüllt bleibt, sofern die renormierte Kopplungskonstante reell gewählt wird. Der zweite Teil der Arbeit beschäftigt sich mit verschiedenen Anwendungen des CMS in chiraler effektiver Feldtheorie (EFT). Im Einzelnen werden Masse und Breite der Deltaresonanz, die elastischen elektromagnetischen Formfaktoren der Roperresonanz, die elektromagnetischen Formfaktoren des Übergangs vom Nukleon zur Roperresonanz sowie Pion-Nukleon-Streuung und Photo- und Elektropionproduktion für Schwerpunktsenergien im Bereich der Roperresonanz berechnet. Die Wahl passender Renormierungsbedingungen ermöglicht das Aufstellen eines konsistenten chiralen Zählschemas für EFT in Anwesenheit verschiedener resonanter Freiheitsgrade, so dass die aufgeführten Prozesse in Form einer systematischen Entwicklung nach kleinen Parametern untersucht werden können. Die hier erzielten Resultate können für Extrapolationen von entsprechenden Gitter-QCD-Simulationen zum physikalischen Wert der Pionmasse genutzt werden. Deshalb wird neben der Abhängigkeit der Formfaktoren vom quadrierten Impulsübertrag auch die Pionmassenabhängigkeit des magnetischen Moments und der elektromagnetischen Radien der Roperresonanz untersucht. Im Rahmen der Pion-Nukleon-Streuung und der Photo- und Elektropionproduktion werden eine Partialwellenanalyse und eine Multipolzerlegung durchgeführt, wobei die P11-Partialwelle sowie die Multipole M1- und S1- mittels nichtlinearer Regression an empirische Daten angepasst werden.

High precision tools for slepton pair production processes at hadron colliders

In this thesis, we develop high precision tools for the simulation of slepton pair production processes at hadron colliders and apply them to phenomenological studies at the LHC. Our approach is based on the POWHEG method for the matching of next-to-leading order results in perturbation theory to parton showers. We calculate matrix elements for slepton pair production and for the production of a slepton pair in association with a jet perturbatively at next-to-leading order in supersymmetric quantum chromodynamics. Both processes are subsequently implemented in the POWHEG BOX, a publicly available software tool that contains general parts of the POWHEG matching scheme. We investigate phenomenological consequences of our calculations in several setups that respect experimental exclusion limits for supersymmetric particles and provide precise predictions for slepton signatures at the LHC. The inclusion of QCD emissions in the partonic matrix elements allows for an accurate description of hard jets. Interfacing our codes to the multi-purpose Monte-Carlo event generator PYTHIA, we simulate parton showers and slepton decays in fully exclusive events. Advanced kinematical variables and specific search strategies are examined as means for slepton discovery in experimentally challenging setups.

[Recombinant proteins as therapeutic compounds in clinical oncology]

The in vitro production of recombinant protein molecules has fostered a tremendous interest in their clinical application for treatment and support of cancer patients. Therapeutic proteins include monoclonal antibodies, interferons, and haematopoietic growth factors. Clinically established monoclonal antibodies include rituximab (targeting CD20-positive B-cell lymphomas), trastuzumab (active in HER-2 breast and gastric cancer), and bevacizumab (blocking tumor-induced angiogenesis through blockade of vascular-endothelial growth factor and its receptor). Interferons have lost much of their initial appeal, since equally or more effective treatments with more pleasant side effects have become available, for example in chronic myelogenous leukaemia or hairy cell leukaemia. The value of recombinant growth factors, notably granulocyte colony stimulating factor (G-CSF) and erythropoietin is rather in the field of supportive care than in targeted anti-cancer therapy. Adequately powered clinical phase III trials are essential to estimate the true therapeutic impact of these expensive compounds, with appropriate selection of clinically relevant endpoints and sufficient follow-up. Monoclonal antibodies, interferons, and growth factors must also, and increasingly so, be subjected to close scrutiny by appropriate cost-effectiveness analyses to ensure that their use results in good value for money. With these caveats and under the condition of their judicious clinical use, recombinant proteins have greatly enriched the therapeutic armamentarium in clinical oncology, and their importance is likely to grow even further.

Medical treatment of vertebral osteoporosis

Although osteoporosis is a systemic disease, vertebral fractures due to spinal bone loss are a frequent, sometimes early and often neglected complication of the disease, generally associated with considerable disability and pain. As osteoporotic vertebral fractures are an important predictor of future fracture risk, including at the hip, medical management is targeted at reducing fracture risk. A literature search for randomized, double-blind, prospective, controlled clinical studies addressing medical treatment possibilities of vertebral fractures in postmenopausal Caucasian women was performed on the leading medical databases. For each publication, the number of patients with at least one new vertebral fracture and the number of randomized patients by treatment arm was retrieved. The relative risk (RR) and the number needed to treat (NNT, i.e. the number of patients to be treated to avoid one radiological vertebral fracture over the duration of the study), together with the respective 95% confidence intervals (95%CI) were calculated for each study. Treatment of steroid-induced osteoporosis and treatment of osteoporosis in men were reviewed separately, based on the low number of publications available. Forty-five publications matched with the search criteria, allowing for analysis of 15 different substances tested regarding their anti-fracture efficacy at the vertebral level. Bisphosphonates, mainly alendronate and risedronate, were reported to have consistently reduced the risk of a vertebral fracture over up to 50 months of treatment in four (alendronate) and two (risedronate) publications. Raloxifene reduced vertebral fracture risk in one study over 36 months, which was confirmed by 48 months' follow-up data. Parathormone (PTH) showed a drastic reduction in vertebral fracture risk in early studies, while calcitonin may also be a treatment option to reduce fracture risk. For other substances published data are conflicting (calcitriol, fluoride) or insufficient to conclude about efficacy (calcium, clodronate, etidronate, hormone replacement therapy, pamidronate, strontium, tiludronate, vitamin D). The low NNTs for the leading substances (ranges: 15-64 for alendronate, 8-26 for risedronate, 23 for calcitonin and 28-31 for raloxifene) confirm that effective and efficient drug interventions for treatment and prevention of osteoporotic vertebral fractures are available. Bisphosphonates have demonstrated similar efficacy in treatment and prevention of steroid-induced and male osteoporosis as in postmenopausal osteoporosis. The selection of the appropriate drug for treatment of vertebral osteoporosis from among a bisphosphonate (alendronate or risedronate), PTH, calcitonin or raloxifene will mainly depend on the efficacy, tolerability and safety profile, together with the patient's willingness to comply with a long-term treatment. Although reduction of vertebral fracture risk is an important criterion for decision making, drugs with proven additional fracture risk reduction at all clinically relevant sites (especially at the hip) should be the preferred options.

Knowledge Transfer Processes in the IS Offshore Outsourcing Transition: A Conceptual Model

Despite promising cost saving potential, many offshore software projects fail to realize the expected benefits. A frequent source of failure lies in the insufficient transfer of knowledge during the transition phase. Former literature has reported cases where some domains of knowledge were successfully transferred to vendor personnel whereas others were not. There is further evidence that the actual knowledge transfer processes often vary from case to case. This raises the question whether there is a systematic relationship between the chosen knowledge transfer process and know-ledge transfer success. This paper introduces a dynamic perspective that distinguishes different types of knowledge transfer processes explaining under which circumstances which type is deemed most appropriate to successfully transfer knowledge. Our paper draws on knowledge transfer literature, the Model of Work-Based Learning and theories from cognitive psychology to show how characteristics of know-ledge and the absorptive capacity of knowledge recipients fit particular knowledge transfer processes. The knowledge transfer processes are conceptualized as combinations of generic knowledge transfer activities. This results in six gestalts of know-ledge transfer processes, each representing a fit between the characteristics of the knowledge process and the characteristics of the knowledge to be transferred and the absorptive capacity of the knowledge recipient.

Preinterventional screening of the TAVI patient: how to choose the suitable patient and the best procedure.

Transcatheter aortic valve implantation (TAVI) is a novel therapy, which has transformed the management of inoperable patients presenting with symptomatic severe aortic stenosis (AS). It is also a proven and less invasive alternative therapeutic option for high-risk symptomatic patients presenting with severe AS who are otherwise eligible for surgical aortic valve replacement. Patient age is not strictly a limitation for TAVI but since this procedure is currently restricted to high-risk and inoperable patients, it follows that most patients selected for TAVI are at an advanced age. Patient frailty and co-morbidities need to be assessed and a clinical judgment made on whether the patient will gain a measureable improvement in their quality of life. Risk stratification has assumed a central role in selecting suitable patients and surgical risk algorithms have proven helpful in this regard. However, limitations exist with these risk models, which must be understood in the context of TAVI. When making final treatment decisions, it is essential that a collaborative multidisciplinary "heart team" be involved and this is stressed in the most recent guidelines of the European Society of Cardiology. Choosing the best procedure is contingent upon anatomical feasibility, and multimodality imaging has emerged as an integral component of the pre-interventional screening process in this regard. The transfemoral route is now considered the default approach although vascular complications remain a concern. A minimal vessel diameter of 6 mm is required for currently commercial available vascular introducer sheaths. Several alternative access routes are available to choose from when confronted with difficult iliofemoral anatomy such as severe peripheral vascular disease or diffuse circumferential vessel calcification. The degree of aortic valve leaflet and annular calcification also needs to be assessed as the latter is a risk factor for post-procedural paravalvular aortic regurgitation. The ultimate goal of patient selection is to achieve the highest procedural success rate while minimizing complications and to choose patients most likely to derive tangible benefit from this procedure.

German Total Ankle Replacement Register of the German Foot and Ankle Society (D. A. F.) - presentation of design and reliability of the data as well as first results

INTRODUCTION Even though arthroplasty of the ankle joint is considered to be an established procedure, only about 1,300 endoprostheses are implanted in Germany annually. Arthrodeses of the ankle joint are performed almost three times more often. This may be due to the availability of the procedure - more than twice as many providers perform arthrodesis - as well as the postulated high frequency of revision procedures of arthroplasties in the literature. In those publications, however, there is often no clear differentiation between revision surgery with exchange of components, subsequent interventions due to complications and subsequent surgery not associated with complications. The German Orthopaedic Foot and Ankle Association's (D. A. F.) registry for total ankle replacement collects data pertaining to perioperative complications as well as cause, nature and extent of the subsequent interventions, and postoperative patient satisfaction. MATERIAL AND METHODS The D. A. F.'s total ankle replacement register is a nation-wide, voluntary registry. After giving written informed consent, the patients can be added to the database by participating providers. Data are collected during hospital stay for surgical treatment, during routine follow-up inspections and in the context of revision surgery. The information can be submitted in paper-based or online formats. The survey instruments are available as minimum data sets or scientific questionnaires which include patient-reported outcome measures (PROMs). The pseudonymous clinical data are collected and evaluated at the Institute for Evaluative Research in Medicine, University of Bern/Switzerland (IEFM). The patient-related data remain on the register's module server in North Rhine-Westphalia, Germany. The registry's methodology as well as the results of the revisions and patient satisfaction for 115 patients with a two year follow-up period are presented. Statistical analyses are performed with SAS™ (Version 9.4, SAS Institute, Inc., Cary, NC, USA). RESULTS About 2½ years after the register was launched there are 621 datasets on primary implantations, 1,427 on follow-ups and 121 records on re-operation available. 49 % of the patients received their implants due to post-traumatic osteoarthritis, 27 % because of a primary osteoarthritis and 15 % of patients suffered from a rheumatic disease. More than 90 % of the primary interventions proceeded without complications. Subsequent interventions were recorded for 84 patients, which corresponds to a rate of 13.5 % with respect to the primary implantations. It should be noted that these secondary procedures also include two-stage procedures not due to a complication. "True revisions" are interventions with exchange of components due to mechanical complications and/or infection and were present in 7.6 % of patients. 415 of the patients commented on their satisfaction with the operative result during the last follow-up: 89.9 % of patients evaluate their outcome as excellent or good, 9.4 % as moderate and only 0.7 % (3 patients) as poor. In these three cases a component loosening or symptomatic USG osteoarthritis was present. Two-year follow-up data using the American Orthopedic Foot and Ankle Society Ankle and Hindfoot Scale (AOFAS-AHS) are already available for 115 patients. The median AOFAS-AHS score increased from 33 points preoperatively to more than 80 points three to six months postoperatively. This increase remained nearly constant over the entire two-year follow-up period. CONCLUSION Covering less than 10 % of the approximately 240 providers in Germany and approximately 12 % of the annually implanted total ankle-replacements, the D. A. F.-register is still far from being seen as a national registry. Nevertheless, geographical coverage and inclusion of "high-" (more than 100 total ankle replacements a year) and "low-volume surgeons" (less than 5 total ankle replacements a year) make the register representative for Germany. The registry data show that the number of subsequent interventions and in particular the "true revision" procedures are markedly lower than the 20 % often postulated in the literature. In addition, a high level of patient satisfaction over the short and medium term is recorded. From the perspective of the authors, these results indicate that total ankle arthroplasty - given a correct indication and appropriate selection of patients - is not inferior to an ankle arthrodesis concerning patients' satisfaction and function. First valid survival rates can be expected about 10 years after the register's start.

Selection bias and the cross-validation of regression models for prediction

Strategies are compared for the development of a linear regression model with stochastic (multivariate normal) regressor variables and the subsequent assessment of its predictive ability. Bias and mean squared error of four estimators of predictive performance are evaluated in simulated samples of 32 population correlation matrices. Models including all of the available predictors are compared with those obtained using selected subsets. The subset selection procedures investigated include two stopping rules, C$\sb{\rm p}$ and S$\sb{\rm p}$, each combined with an 'all possible subsets' or 'forward selection' of variables. The estimators of performance utilized include parametric (MSEP$\sb{\rm m}$) and non-parametric (PRESS) assessments in the entire sample, and two data splitting estimates restricted to a random or balanced (Snee's DUPLEX) 'validation' half sample. The simulations were performed as a designed experiment, with population correlation matrices representing a broad range of data structures.^ The techniques examined for subset selection do not generally result in improved predictions relative to the full model. Approaches using 'forward selection' result in slightly smaller prediction errors and less biased estimators of predictive accuracy than 'all possible subsets' approaches but no differences are detected between the performances of C$\sb{\rm p}$ and S$\sb{\rm p}$. In every case, prediction errors of models obtained by subset selection in either of the half splits exceed those obtained using all predictors and the entire sample.^ Only the random split estimator is conditionally (on $\\beta$) unbiased, however MSEP$\sb{\rm m}$ is unbiased on average and PRESS is nearly so in unselected (fixed form) models. When subset selection techniques are used, MSEP$\sb{\rm m}$ and PRESS always underestimate prediction errors, by as much as 27 percent (on average) in small samples. Despite their bias, the mean squared errors (MSE) of these estimators are at least 30 percent less than that of the unbiased random split estimator. The DUPLEX split estimator suffers from large MSE as well as bias, and seems of little value within the context of stochastic regressor variables.^ To maximize predictive accuracy while retaining a reliable estimate of that accuracy, it is recommended that the entire sample be used for model development, and a leave-one-out statistic (e.g. PRESS) be used for assessment. ^