This study investigates the link between global integration -- defined as the intra-firm cross-border transfer of operational resources -- and performance in multinational professional engineering companies. Using a combination of qualitative and quantitative techniques, we find some support for a positive association. We review two bodies of scholarship germane to our topic: the global integration - performance literature and the multinationality - performance literature. The inclusion of the latter is justified since the espoused performance benefits of multinationality are predominantly realised through global integration. Based upon an evaluation of these two bodies of scholarship and qualitative insights, we propose a positive relationship between global integration and performance as well as a mediating relationship, with global integration acting as a mediator between multinationality and performance. Hypothesis testing is performed in Partial Least Squares, a structural equation modelling technique ideally suited for small samples. Results reveal a significant positive association between global integration and MNC profitability. A separate research model testing the relationship between global integration and the alternative dependent, MNC growth, is rejected. Further analysis of the profitability-based research model provides support for the mediational hypothesis: the relationship between multinationality and profitability is fully mediated, suggesting no gains from multinationality per se. Supplementary tests reveal that the profitability effects of global integration are enhanced when it is strongly motivated by the desire to take advantage of specialised skills within the MNC; no such claim of moderation can be made when global integration is strongly motivated by a desire to improve staff utilisation on a global basis. The relationship between global integration and profitability is also unaffected by the origins (headquarters vs. subsidiaries) of the intra-firm operational resource transfers that constitute global integration.

Thesis (doctoral)--Rijksuniversiteit te Utrecht.

Proefschrift Universiteit Maastricht. / 905681444. Met biliogr., lit. opg. - Met samenvatting in het Nederlands.

Detta examensarbete handlar om de yngre barnens intra-aktion med ett matematiskt material i förskolan i form av ett sorteringsmaterial samt om detta material utmanar barns matematiska tänkande utan instruktioner från en vuxen. Här är det barnets görande som står i fokus.   Det teoretiska perspektivet i detta examensarbete är Barads (2007) teori om agentisk realism utifrån teorins centrala begrepp intra-agera tolkat av Lenz Taguchi (2012) och Franzén (2015). Intra-agera enligt Franzéns tolkning av Barads begrepp avser relationen mellan material och människor. Lenz Taguchi menar att ting och material inte kan ses som oaktiva redskap som människor beslutar sig för att använda. Istället kan ting och material ses som aktiva medaktörer som samverkar och samhandlar med människan. Fokus i denna teori är vad föremål såväl mänskliga som icke mänskliga gör när de möts i en intra-aktion. Lenz Taguchi förstår lärandet som summan av ett samhandlande där olika aktiva aktörer är inblandade. I detta sammanhang används samhandlande som ett begrepp för när mänskliga och icke mänskliga aktörer tillsammans skapar något eller ändrar det befintliga till något nytt eller något annat än det var innan. Det är kärnan i ett samhandlande och därmed även i intra-aktionen.   I denna undersökning deltog 19 barn i åldrarna 1-3 år som observerades och data samlades in med hjälp av fältanteckningar. Fältanteckningarna har sedan renskrivits och undersökningens resultat har delats in i fyra olika kategorier och tolkats utifrån studiens teoretiska perspektiv. Sorteringsmaterialet, i form av 72 bondgårdsdjur respektive 72 fordon i sex färger uppdelade i sex olika kategorier av bondgårdsdjur och fordon, låg kvar i sin burk med locket uppskruvat och placerades på en matta på golvet. Därmed skapades förutsättningarna för barnens möjlighet till intra-aktion med sorteringsmaterialet utan någon instruktion av en vuxen.   Studiens resultat visar de yngre barnens intra-agerande med sorteringsmaterialet. I intra-aktionen med sorteringsmaterialet startade en lärprocess hos barnen vilket resulterade i att barnen sorterade materialet efter en eller två egenskaper, använde sig av parbildning samt undersökte materialet med sin kropp och sina sinnen.

The Bosnian war was not a purely “ethnic conflict,” as both in-group members and out-group members were sacrificed for the higher political objective, namely, ethnic homogenization of divided Bosnian territories. In particular, I argue the sacrifice of in-group members, especially those who lived on the out-territory, was integral to the violence directed against out-group members. The process of resettlement of the ethnic kin was just as important as the expulsion of the ethnic “other” for re-creating a new ethnic and political balance in select strategic areas. Furthermore, the practice of the appropriation of existing and the creation of new parallel state structures were the main mechanisms of the process of the sacrifice of in-group members from the out-territory. In turn, nationalist narratives were constructed not only to justify those new structures, but also to portray ethnic minorities as potentially dangerous and threatening. In order to complete ethnic homogenization, Bosnian nationalists directly targeted the private household, expelling Bosnians from their homes and appropriating and destroying their private property. I argue that violence against the household rendered the private sphere political. In the second part of the thesis, I reflect on actions and words of ordinary Bosnians, both in-group and out-group members, who resisted violence and helped each other during the war. In particular, I argue that although the lack of basic needs brought Bosnians of different ethnicities together, a long-term result of this necessity-driven action was political: the restoration of their citizenship and the preservation of their community at the local level for after the war.

GORAB is a protein that localises to the trans-Golgi network (TGN) and is known to interact with Rab6. The loss of GORAB leads to gerodermia osteodysplastica (GO), an autosomal recessive disorder which results in lax skin, precocious skin aging, osteoporosis, susceptibility to fractures and joint hyperelasticity. Both the function of GORAB and the mechanism of pathogenesis in GO patients are poorly defined. In this study, the cellular functions of GORAB have been investigated. Using a variety of approaches (yeast two-hybrid assays, pull-downs with recombinant proteins, proximity biotinylation assays combined with mass spectrometry and co-immunoprecipitations) it was possible to establish a network of interactions with Golgi-localised proteins, including Arf GTPases and the COPI-associated protein Scyl1, that suggests a possible role of GORAB in COPI-mediated trafficking. Consistent with this hypothesis, ultrastructural changes of the Golgi apparatus were observed as were abnormal protein glycosylation in primary skin fibroblasts derived from GO patients, detected using both lectin binding assays and mass spectrometric glycan profiling. Moreover, immuno-electron microscopy studies revealed unequal distribution of GORAB within the TGN and fluorescence recovery after photobleaching experiments show GORAB being very stably associated with Golgi membranes. These properties of GORAB seem to result from its ability to oligomerise and to interact with vimentin filaments. Based on these data, a model of GORAB acting as a scaffolding protein that organises sites of COPI budding at the TGN has been proposed. Additionally, analysis of both published and newly identified GORAB mutations found in GO patients revealed that they affect various properties of GORAB including its interaction with small GTPases and GORAB ability to oligomerise, which suggests that these features are important for GORAB cellular functions. Together, these data suggest that the underlying cause of the skin and bone defects observed in GO patients is impaired COPI trafficking at the Golgi apparatus resulting in abnormal glycosylation of extracellular matrix proteins.

Depuis 1991, et l’apparition de matériels d’embolisation à détachement contrôlé, le traitement endovasculaire a remplacé progressivement la prise en charge chirurgicale des anévrismes intra cérébraux. Ce traitement endovasculaire des anévrismes est associé à un faible taux de morbidité et de mortalité. Différentes études ont montré sa fiabilité mais pour l instant toujours à court ou moyen terme. Il est par contre impératif de suivre les patients ayant été embolisés. L’artériographie cérébrale reste l’examen de référence même si l’IRM avec l’apparition de nouvelles séquences commence à être validée pour suivre ces patients. En 1998, nous avons rédigé un protocole de surveillance, des patients traités par voie endovasculaire en y incluant l’IRM. Depuis nous avons progressé sur la détection des reliquats et des patients à risque de nouveau saignement, en validant les premières séquences d’angioMR, puis en incluant des séquences de diffusion, des séquences avec injection de contraste à la recherche d’un rehaussement intra anévrismal, et maintenant des séquences de flux intra anévrismal. Toutes ces informations ont été comparées à l’examen de référence, l’artériographie cérébrale. Les contrôles IRM ont été réalisés sur des imageurs 1.5 Tesla et aussi sur l’imageur 3 Tesla pendant la période de mobilité au CHU de Reims. [...] / Since 1991 and the introduction of detachable intracranial coils, the endovasculary treatment of cerebral aneurysms has become an established treatment technique and has supplied surgical approach of these aneurysms. The rate of morbidity and mortality of this new technique is now well known and law. Initial Angiographic and clinical results were yet published with good outcome. Concern exists about long term reopening and the inherent risk of recurrent hemorrhage and long-term imaging follow-up is advocated. Digital Substract Hemorrhage was the gold standard for detection and follow-up of patients, but this diagnostic procedure is invasive and exposes the patient to a small risk of serious complication. MR angiography has been used as an alternative noninvasive imaging technique to assess the occlusion of coiled intracranial aneurysms with promising results. Since 1998, we have collected all patients with subarachnoid hemorrhage, and patients with cerebral aneurysms treated by endovascular approach. We have proposed different MRI sequences to valid this technique and improve this techniqueWe have compared 3D TOF to digital angiography, with sequences with injection of gadolinium. [...]

A inovação é reconhecida como o processo de renovação da firma, garantindo sua sobrevivência e sucesso. Devido ao ambiente constantemente em mudança, na era digital, as empresas exigem inovação tecnológica e resposta gerencial para se manterem competitivas. Embora, combinar e recombinar todos os recursos não é uma tarefa fácil. Em um mundo ideal e utópico, uma empresa seria composta por trabalhadores com conhecimentos iguais e completos sobre todas as operações, métodos, processos e técnicas das atividades da empresa. A crescente onda de empresas que cooperaram trouxe sucesso a algumas empresas, mas não a todas. Estudos como os de Nesheim (2015), Chatterji (2014) e Mina (2014) nos mostram que o conhecimento é complicado de se gerenciar e é comum que os pesquisadores identifiquem um conhecimento obtido de origem externa preso em certas unidades. Os autores argumentam que esse fenômeno pode acontecer devido a aspectos comportamentais, mas também devido a padrões de processo ou organizacionais. Do ponto de vista intra-firma, Paruchuri (2010) argumenta que uma empresa que melhore a difusão do conhecimento internamente ira aprimorar sua atividade inovadora. Aalbers (2015), refletindo sobre a governança do compartilhamento de conhecimento dentro das organizações, sugere que o conhecimento pode ser difícil de transferir por causa da dinâmica das interações. Essas dinâmicas podem criar uma relutância em compartilhar conhecimento com pessoas de outras unidades. Vários autores, como Hansen (1999 e 2002) e Cross (2003 e 2004) argumentam que os pesquisadores, em grande parte, que se concentraram no fluxo de conhecimento dentro de uma empresa, têm focado apenas nos indivíduos, independentemente da sua posição na organização, e acabam muitas vezes ignorando os limites das unidades da empresa, como possíveis obstáculos para que o conhecimento seja transferido. Devido a esta dinâmica, centrada na inovação, é importante criar novas formas de analisar e desenvolver as atividades da empresa, visando aprimorar seu desempenho e compreender melhor os facilitadores de soluções para que se gere inovação. Portanto, surge a questão da pesquisa: Como as empresas podem gerenciar interações intra-firma para melhorar as atividades inovadoras? Assim, este trabalho tem seu núcleo nas interações intra-firma para fins de inovação. Em outras palavras, exploramos fatores-chave que podem nos permitir analisar melhor as atividades inovadoras da empresa em uma perspectiva intra-firma. O principal objetivo é apresentar os aspectos chave na coordenação intra-firma, baseada nas interações, capaz de melhorar o fluxo de conhecimento para a inovação dentro da empresa. Assim, elaboramos e realizamos um estudo qualitativo com 8 FAI (Firmas Altamente Inovadoras), 4 localizadas no Brasil e 4 localizadas na França. 11 Utilizamos as dimensões e os papéis de corretagem adaptados de Aalbers (2015), Tsang (2015) e Indarti (2010) para desenvolver um instrumento semiestruturado para as entrevistas. Analisamos as interações de um projeto de desenvolvimento de produto em cada empresa e as interações foram classificadas de acordo com: Hierarquia (Horizontal ou Vertical); Alcance (unidade ou unidade cruzada); Tipo (Formal ou Informal) e utilizamos a Intensidade (Frequência) como base para a análise. Nossos resultados demonstram três formas de coordenação intra-firma usadas pelas empresas em suas atividades relacionadas a inovação e um mecanismo específico para a gestão do fluxo de conhecimento com o uso das interações intra-firmas. A primeira forma teve a hierarquia como base para a estrutura organizacional utilizada no projeto, centralizando o controle das interações no coordenador da unidade de desenvolvimento. A segunda forma foi orientada para as interações, os indivíduos com alta posição hierárquica estavam conscientes da importância do fluxo de conhecimento para os processos inovadores. As interações foram centralizadas e depois descentralizadas, em um movimento de interações que seguia o fluxo baixo para cima e cima para baixo. A terceira forma foi chamada de Coordenação do Fluxo de Conhecimento, pois seguiu uma sequência de interações inter-unidades e intra-unidades, usando interações informais para reunir as informações e as interações inter-unidades verticais formais para divulgar a informação. Além disso, as empresas adotaram uma nova abordagem, única para suas atividades inovadoras, atribuindo uma pessoa designada para reportar as atividades aos altos gerentes em uma interação formal, mas coletando informações com o uso de ferramentas para interações informais. A dinâmica das interações teve mudanças relevantes nas empresas analisadas. O compartilhamento de conhecimento sempre deve ser promovido, mas sem destruir o foco na inovação. No entanto, se é mais proveitoso formalizar as interações para o trabalho de ideação ou tentar usar interações informais de maneira mais sutil é uma questão que cada empresa deve responder. Esperamos que o nosso estudo forneça insights importantes sobre a inovação nas empresas. A definição das tipologias de interações foi um primeiro passo e mostrar a coordenação intra-firma, em um desenvolvimento de inovação, pode ajudar as empresas a entender o poder que as interações têm para gerenciar os processos de compartilhamento de conhecimento. / Innovation is recognized as the process of renovation of the company, ensuring its survival and success. Although, to combine and recombine all these aspects is not an easy task. In an ideal and utopic world, a firm would be composed by workers with equal and complete knowledge about all the operations, methods, processes and techniques enrolled in the firm’s activities. To the intra-firm perspective, Paruchuri (2010) argues that a firm that can improve the diffusion of knowledge internally will enhance its innovative activity. Aalbers (2015), reflecting on the governance of knowledge sharing inside organizations, suggests that knowledge may be difficult to transfer because of the boundaries dynamics. Due to this dynamic, innovation centered, it is important to create new ways of analyzing and developing the firm’s activities, aiming to enhance its performance and to better understand solution enablers for the new challenges to come. Therefore, the research question emerges: How can firms manage intra-firm interactions to enhance the innovative activities? To answer this question, we designed and performed a qualitative study with 8 HIFs (Highly Innovative Firms), 4 located in Brazil and 4 located in France. We used the dimensions of interactions and brokerage roles adapted from Aalbers (2015), Tsang (2015) and Indarti (2010) to develop a semi-structured instrument for the interviews. We analyzed the interactions during a project of product development in each firm, and the interactions were classified according to: Hierarchy (Horizontal or Vertical); Reach (Unit or Cross-unit); Type (Formal or Informal) and we used Intensity (Frequency) as the base for the analysis. Our results of the firms’ intra-firm coordination for innovative processes showed us three different forms of intra-firm coordination and one specific mechanism for the intra-firm coordination. We hope that this thesis can provide insights to the innovation studies, defining the interactions was a first step and showcasing the intra-firm coordination, at a product development, might help the firms to understand the power that the interactions have to manage the knowledge sharing processes.

BACKGROUND: Transport of patients is sometimes necessary and unavoidable. However, there are many risks related to it. For this reason, safety of intra-hospital transport has been thoroughly studied in critical care patients; however there is no literature on adverse events during transport of trauma patients. Due to the acute nature of injury, trauma patients are fundamentally different than other populations of patients and require special consideration during transport. Lack of data makes initiating new protocols for transport conditions difficult. METHODS/RESULTS: Data from all activated trauma response patients who required transport to and from the CT scanner from the period of January 01, 2010 to December 31st, 2013 (total of 1103 patients) were collected. From these patients, 17 adverse events were identified (2.0% excluding missing documentation). Vomiting was the most common adverse event followed by peripheral IV line dislodgment. There were no cardiac arrests or deaths resulting from transport related events. CONCLUSION: Defining adverse events is a key part of evaluating safety during transport. Fluctuations in vital signs and other objective measures may reflect patient disease rather than transport. Our study provides clear definitions of what an adverse event is using outcomes and objectively identifies measures necessary for safe transport as well as areas of improvement.

Dissertação (mestrado)—Universidade de Brasília, Faculdade de Ciências da Saúde, 2008. / Submitted by Ruthléa Nascimento (ruthlea@bce.unb.br) on 2008-10-30T16:19:55Z No. of bitstreams: 1 2008_AndreMeirelesBorba.pdf: 1660538 bytes, checksum: c73def3316ce4ede5a9909386f574365 (MD5) / Approved for entry into archive by Luanna Maia(luanna@bce.unb.br) on 2009-02-26T14:28:54Z (GMT) No. of bitstreams: 1 2008_AndreMeirelesBorba.pdf: 1660538 bytes, checksum: c73def3316ce4ede5a9909386f574365 (MD5) / Made available in DSpace on 2009-02-26T14:28:54Z (GMT). No. of bitstreams: 1 2008_AndreMeirelesBorba.pdf: 1660538 bytes, checksum: c73def3316ce4ede5a9909386f574365 (MD5) / Introdução: O sistema porta-hipofisário transporta fatores liberadores e faz o aporte sangüíneo da hipófise. Estudos sobre PIM têm registrado valores altos e relação com a presença de hipopituitarismo. A Síndrome de Compressão da Haste Hipofisária elevaria a prolactina sérica, associada a melhor prognóstico funcional, já que indicaria tecido hipofisário ainda viável. De grande importância devido à alta prevalência é o estudo da relação entre a síndrome metabólica (SM) e as alterações da PIM, pouco exploradas na literatura, mas possivelmente relacionadas a distúrbios hipotalâmicos. Desenho do estudo: Coorte mista analítica. Objetivos: Avaliar a relação entre a pressão intra-selar média (PIM) e a ocorrência de SM e hipopituitarismo no pré-operatório e em reavaliação tardia Métodos: A PIM foi medida com cateter de fibra óptica e definida pela média dos valores a cada 20 segundos por 10 minutos em portadores de adenoma hipofisário submetidos à cirurgia trans-esfenoidal via sub-labial. Exames físicos e laboratoriais definiram o status endócrino e os critérios para SM no pré-operatório e em seguimento tardio. Resultados: Vinte e cinco pacientes foram estudados com 48 ±11,6 meses de intervalo entre a primeira e a segunda reavaliação. A PIM foi de 33,3 ±12,1 mmHg e esteve acima de 30 mmHg em 56% dos casos. A SM esteve presente em 67% das vezes no pré-operatório e em 61% ao seguimento. A medida da circunferência abdominal pré-operatória em mulheres apresentou forte correlação com a PIM (rs = 0,829; ρ = 0,04). Exceto pelo nível de tiroxina livre (T4L) pré-operatório, com relação inversa e moderada (rs = -0,552; ρ = 0,03) com a PIM, os demais hormônios não apresentaram correlação significativa. A presença ou a gravidade do hipopituitarismo não se relacionou à PIM em nenhum momento avaliado. A prolactina préoperatória foi maior, porém não significativa, no grupo com hipertensão intra-selar, o que não ocorreu no seguimento. Conclusões: A circunferência abdominal em mulheres e o T4L pré-operatório correlacionaram-se com a PIM. ________________________________________________________________________________________ ABSTRACT / Introduction: The venous hypophiseal portal system is responsible for the blood supply to the pituitary and for the transport of hypothalamic and systemic releasing factors. The gland is located inside the well-defined limits of the sella turca. Reports on the pressure inside the sella have found high values, directly related to hypopituitarism. The pituitary stalk may be compressed and thus the serum prolactina would be raised because of interruption on hypothalamic inhibitory tonus. That may be associated to better functional outcome, considering it as an indication of still viable pituitary tissue. Other metabolical consequence of hypophiseal changes may be the occurrence of the metabolic syndrome (SM), a highly prevalent disease. Its association to intrasellar pressure is rarely discussed in literature, but probably related to hypothalamic disturbances. Study design: Analytical mixed cohort. Objectives: To analyze the relationship between mean intrasellar pressure (PIM) and the presence of metabolic syndrome and hypopituitarism at pre-operative and long term evaluations. Methods: Patients with pituitary adenomas were operated via transsphenoidal sublabial approach. Physical and laboratorial exams defined pre-operative and late follow-up endocrine status and criteria for SM. The PIM was measured right after a small opening of the sellar dura-mater with fiberoptical catheter and defined as the mean of 30 values taken during 10 minutes with 20 second intermeasure interval. Results: Twenty five patients were studied with a mean 48 ±11,6 months interval between pre-op and follow-up assessment. PIM was 33,3 ±12,1 mmHg, higher than 30 mmHg in 56% of cases. SM was seen in 67% and 61% of times in pre-operative and long term evaluations, respectively. Female pre-op waist was strongly related to PIM (rs = 0,829; = 0,04). Except for pre-op free tiroxine levels (T4L), with inverse and moderate relationship (rs = -0,552; = 0,03) to PIM, no other hormones presented any significant correlation. Neither the presence nor severity of hypopituitarism correlated to PIM in any moment. In the intrasellar hypertensive group, mean pre-op prolactina levels were higher than the group with normal PIM, although not significantly. Conclusions: Pre-op female waist and T4L correlated significantly to PIM.