Thesis (M.S.)--University of Wisconsin--Madison, 1942. / Typescript. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 27-28).

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The plea of applying the exhaustion doctrine to intangible copies of copyrighted artistic works has been extensively discussed within scholar circles. Although, the debate substantially concerns provisions of the international treaties and the explanation of the exhaustion doctrine under European Union copyright law, the subject brings more uncertainties. Under the European Union copyright law the distribution right is exhausted after the first sale with the consent of a right holder. However, there is neither explicit regulation nor decision in regard to the exhaustion doctrine to the online resale of digital goods. As the act of distribution is shifting and fulfilled through digital means these days, the application of the first sale doctrine is challenged. The given work provides with the legal, organizational and technological analysis of the exhaustion doctrine under European Union copyright law and possible scenarios in respect to digital secondary market.

Magister Public Health - MPH / Burnout is a condition of emotional exhaustion (EE), depersonalization (DP), and a reduced sense of personal accomplishment (PA) that can occur among individuals who work with people in some capacity. Burnout is more prevalent in the helping professions, and high levels of burnout have been documented in all categories of nurses. A descriptive and analytical quantitative cross-sectional study was conducted to measure the level of burnout and its possible associated factors among nurses of two district hospitals in Kigali City. All 126 nurses working in the maternity and paediatric sections of Muhima and Kibagabaga District Hospitals were included in the study. A self-administered questionnaire was used to collect socio-demographic and workplace information as well as responses to 22 questions in the Maslach Burnout Inventory (MBI), which assesses burnout along its three dimensions of emotional exhaustion, depersonalisation and reduced personal accomplishment. Descriptive statistics such as percentage, mean score, and standard deviation were computed for each burnout category and Chi-square test statistic was performed to test the relationship between burnout (dependent variable) and personal factors, workplace demands, and access to resources (independent variables); and between burnout and hospital and service (paediatric or maternity). Of the 126 questionnaires distributed, 102 (81%) were returned and useable for analysis. The average age of respondents was 29.7 years and female nurses represented the majority (88.2%) of our sample. Just over half (52.9%) were married and 53.9% had at least on child. The average years of experience as a nurse was 5.6 years, while the average years of experience in the hospital was 4 years. High burnout was found with high levels of EE in 43.1% of respondents, high levels of DP in 48.0%, and low level of PA in 34.3%. Burnout was associated with being young and inexperienced, having less training, having at least one child, working longer hours, experiencing workloads as demanding, poor perceived control of the work, perceived staff shortages and workplace conflicts. However, good communication, job satisfaction and trust in colleagues and in hospital management, appeared to be protective for all three dimensions of burnout. In conclusion, burnout was found to be associated with personal, workplace demands and environmental factors. Improvement of nursing work conditions, conflict prevention and improved communication between hospital managers and staff would be expected to prevent burnout among nurses working in paediatric and maternity wards of Muhima and Kibagabaga District Hospitals.

The debate of recognition or non-recognition of the digital exhaustion doctrine of the right of distribution for the copyrighted objects other than computer programs has been actively carrying on within the last decades in the EU. The explosive growth of the electronic versions of works and digitalization of the traditional copyrighted objects leads to new questions and challenges about its dissemination and usage by consumers. This work examines and investigates whether, and if so to what extent, the exhaustion principle of the right of distribution can apply to e-books in the online realm after two landmark cases: the UsedSoft case and the Tom Kabinet case. These two cases offer a different interpretation of the exhaustion doctrine in the digital field in relation to the different copyrighted objects, namely digital books and computer programs. It is argued that despite the CJEU’s decision in the Tom Kabinet case and lack of explicit clarity in the EU Directives devoted to the copyrighted objects, there is some room for digital exhaustion of the distribution right for the electronic books. This paper will also analyze the hypothesis that the peculiarities of the book market itself may potentially influence the recognition of the digital exhaustion principle from an economic standpoint. However, it is shown that the digital marketing of the works per se entailing multiple reproductions of the e-files as a technical step of the dissemination process creates new challenges on the exhaustion doctrine application. The paper provides a legal, economic and technological analysis of the EU exhaustion doctrine and its potential admissibility on the second-hand market of electronic books.

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Yes / Given the devastating impact of austerity upon employment in the public sector and the re-prioritising of union funds, it is essential for PCS to continue to develop new and innovative ways of offering support to their officials in respect of their existing roles as well as their potential development into decision making positions and onto committees. Moreover, true influence and representation within the workplace is achieved through an effective voice within the union and as such PCS must continue to promote gender proportionality throughout decision making structures and leadership roles at all levels. Mentoring as a support strategy within business and the third sector has received much attention in recent years and is reportedly positively associated with career and job satisfaction, expectations for advancement, intention to stay (increased tenure), being better able to deal with negative work scenarios and conflict, improved confidence, feeling better prepared and supported and feeling better integrated into a wider organisation or network. This research report, therefore, ultimately seeks to generate empirical evidence to support the development of a national PCS mentoring programme as a means of providing support and encouraging the development of all officials whilst also providing a means for female officials to better circumvent barriers to activism and development. This report presents the headline findings from a large scale survey of almost 500 PCS lay officials and concludes that where informal mentoring already occurs officials receive tangible developmental benefits, moreover there is universal support for the development of a national PCS mentoring programme.

Sepsis is a systemic inflammatory response to infection, which may ultimately lead to multi-organ failure. Sepsis causes millions of deaths each year and creates tremendous financial burdens on the health care system, yet there is no effective cure for sepsis. Even years after the onset of sepsis, patients who have clinically recovered still die from sepsis-related complications due to chronic immune dysfunction. Neutrophils, the most dominant leukocytes in human circulatory systems, play a critical role in not only promoting inflammation to fight against microbe invasion but also facilitating inflammation resolution to restore immune homeostasis. While dysfunctional/exhausted neutrophils have been implicated in the long-term morbidity and mortality of sepsis, the cause of neutrophil exhaustion and the system to rejuvenate the dysregulated immunity are understudied. To fill in the missing piece here, we conducted our trilogy-like projects. First, we established an in vitro culture system to mimic sepsis-like conditions: murine neutrophils prolonged-stimulated with LPS exhibit exhaustion-related phenotype with the elevated expression of both proinflammatory and immunosuppressive makers on the cell surface as well as dysregulated swarming patterns. We found that by knocking out TRAM (TICAM2), an adaptive molecule regulating TLR4 downstream MyD88-independent signaling pathway, neutrophils exhibit attenuated exhaustion on both phenotypic and functional levels. Of note, TRAM contributes to the development of exhausted neutrophils through activating Src family kinases (SFKs)-STAT1 cascade, and deficiency in TRAM provides protective effects on systemic inflammation, reduces tissue injury, and improves survival in a murine colitis-induced sepsis model. Next, in my second project, we reported that neutrophils can be clustered into three subpopulations even at their naïve state based on the single-cell RNA sequencing (scRNAseq) analyses. Of note, neutrophils in one of the clusters are more mature but less apoptotic with the elevated expression of resolving-associated markers Cd86 and Cd200r, hence we termed these neutrophils as 'resolving neutrophils'. We found that the resolving neutrophil population can be expanded via pharmacologically reprogramming with sodium 4-phenylbutyrate (4-PBA) or genetic deletion of TRAM. Resolving neutrophils not only secrete more pro-resolving mediators, such as ResolvinD1 and SerpinB1, but also exert enhanced phagocytic and bactericidal capacities. Mechanistically, we discovered that the development of resolving phenotype in neutrophils is mediated by the PPARγ/LMO4/STAT3 signaling circuitry, which is constitutively suppressed by TRAM. To explore the translational applications of resolving neutrophils, in my third and final project, we conducted adoptive transfer experiments to examine the effects of TRAM-deficient resolving neutrophils in cecal slurry (CS)-induced septic mice. We found that TRAM-deficient mice are more resilient to severe sepsis with reduced tissue injury and less compromised lung integrity as compared to wild-type (WT) mice, and splenic neutrophils from TRAM deficient septic mice better preserve resolving-related features. Moreover, transfusing TRAM deficient neutrophils in WT septic mice renders therapeutic effects with alleviated lung and kidney damage. We also observed TRAM-deficient neutrophil-mediated resolving memory propagation in vitro to promote resolving features of neutrophils, monocytes, and T cells, as well as to strengthen endothelial cell barrier function. In terms of the mechanism, we reported that TRAM is critical for the secretion of neutrophil elastase, a potent protein to compromise endothelium; hence, endothelial cells cocultured with TRAM deficient neutrophils maintain higher levels of adhesion/tight junction markers than cocultured with WT neutrophils. Taken together, our trilogy projects better define exhausted and resolving neutrophils. And most importantly, our works demonstrate that TRAM, an underappreciated molecule, is responsible for inducing neutrophil exhaustion and suppressing resolving neutrophil generation. / Doctor of Philosophy / A 'good' inflammation upon the infection should include two steps: the initial proinflammatory response to combat invading pathogens followed by the later resolution process to repair damage and restore the balance of the host's immune system. The harmony of these reactions is essential to maintain immune homeostasis, and the disruption of immune homeostasis may lead to different pathogenic conditions, including sepsis. Neutrophils are the most dominant white blood cells in human circulation, and they play a critical role in both promoting proinflammatory response and facilitating inflammation resolution. While the dysfunction of neutrophils is associated with the pathogenesis of sepsis and implicated in long-term sepsis-related death, approaches to rejuvenate dysregulated/exhausted neutrophils to restore immune homeostasis in septic patients are still lacking. In our projects, we better defined the characteristics of exhausted neutrophils in a sepsis-mimicking condition and unveiled the underlying mechanisms of neutrophil exhaustion. In addition, we demonstrated that neutrophils with pro-resolving features can be expanded concurrently with the decrease of exhausted neutrophils by a genetic modification approach. Finally, we showed that neutrophils with pro-resolving features can offer therapeutic effects in sepsis mice to alleviate tissue injury and organ dysfunction.

In the past, copyrighted works were distributed exclusively through physical means, while copyright law developed to bestow copyright holder a privilege to decide when and under what circumstances a work should be put into circulation. The first sale doctrine, however, limited that ability in so far as, once a product is sold, copyright owners can no longer control the flow of that particular product, benefiting consumers and society in several ways. Today, as distribution is increasingly shifting into digital, the application of the first sale doctrine is challenged. This work provides for an analysis of the first sale doctrine under EU law and the ECJ case law in matters of digital exhaustion. It is shown that many of the benefits of first sale stem from traditional understandings of what means to own a physical copy and when it comes to the digital environment, the first sale doctrine seems to be undermined, and so do its benefits. It is argued that there is still some room for exhaustion, despite the lack of clarity of the wording of the InfoSoc Directive and Software Directive and the absence from the ECJ to provide for a final interpretation. Further to the analysis, it is shown that the promotion of a right to access and a right to transfer digital copies is still possible, even though they may not be the right answer to the issue of exhaustion in a digital economy by virtue of how market has developed and consumers response to it.

The purpose of this study was to investigate if a low mixed carbohydrate plus moderate protein supplement, provided during endurance exercise, would improve time to exhaustion in comparison to a traditional 6% carbohydrate supplement in female athletes exercising at or below their ventilatory threshold. Fourteen (n = 14) trained female cyclists and triathletes cycled on two separate occasions for three hours at intensities varying between 45% - 70% VO₂max, followed by a ride to exhaustion at an intensity approximating the individual's VT (average 75.06% VO₂max). Supplements (275ml) were provided every 20 min during exercise and were composed of a 3% carbohydrate mixture + 1.2% protein (CHO+PRO) or a 6% carbohydrate-only (CHO). The CHO+PRO treatment contained a mixture of dextrose, maltodextrin, fructose, and whey protein isolate. The CHO treatment was composed of dextrose only. Time to exhaustion (TTE) was significantly greater with CHO+PRO in comparison to CHO (49.94 ± 7.01 vs 42.36 ± 6.21 min, respectively, p < 0.05). Blood glucose was signifcantly lower during the CHO+PRO (4.07 ± 0.12 mmol x L⁻¹) trial compared to CHO (4.47 ± 0.12 mmol x L⁻¹), with treatment x time interactions occurring from 118 minutes of exercise until exhaustion (p < 0.05). Heart rate was significantly lowered in the CHO+PRO treatment during exercise as compared to CHO (p < 0.05). There were no significant differences for other blood measures, ratings of perceived exertion or carbohydrate and fat oxidation between trials. Results from the present study suggest that the addition of a moderate amount of protein to a low mixed carbohydrate supplement improves endurance performance in females above that of a traditional 6% carbohydrate supplement. Improvement in performance occurred despite CHO+PRO containing a lower carbohydrate and caloric content. It is likely the greater performance seen with CHO+PRO was a result of the carbohydrate protein combination and the use of a mixture of carbohydrate sources. / text