This article examines a trend in managerial practices that has had some success in recent times: the freedom-form company and its doubles. In a context where the question of discomfort at work is the ...focus, this trend appears to have all the characteristics of a somewhat exotic vogue, if it is not actually a sort of staging, detached from reality and masking it. The inquiry, conducted with a computer-related business fine-tunes this image, without however slipping into some form of enchantment. It shows that the freedom-form company and its doubles gain in being understood as ushering new accountability and responsibility assumption standards into the workplace. The areas studied try to play the game of “liberation” through organizational actions that are binding on employees who, for their part, more or less take them on board. In concrete terms, this “liberation” stands revealed in the form of a metamorphosis of individualization at work which, at one and the same time, tries to go further in terms of coupling accountability and empowerment processes, all in correcting some of the excesses of earlier trends. Given this, could it be the rise of this new managerial vogue is nothing short of irresistible? In reality, not at all. Employees turn out to be ambivalent, caught between a partial internalisation of managerial categories and their often lively – and in themselves paradoxical – challenges. Thus, finally, while the freedom-form company allows managers to recover a democratic demand – they, at the same time, in limiting themselves to that horizon – run the risk of arousing growing discontent.
Hope takes on particular significance at this historical moment, which is defined by the prospect of a climate-altered future. Young people (aged 18–29) from climate action groups in New Zealand were ...interviewed about how they perceived the future. Deploying a unique combination of conceptual tools and in-depth analysis of a small set of interviews, I explore young New Zealanders’ complex relationships with despair and hope. Paulo Freire claimed his despair as a young man ‘educated’ what emerged as hope. I extend Freire’s concept in two ways by considering: (a) how hope might also ‘educate’ despair and (b) how hope and despair might operate at a collective level, drawing on Rosemary Randall’s psychotherapeutic analysis of societal responses to climate change. Participants identified collective processes as generating hope. Collectivizing hope and despair is important so that young people do not feel climate change is only their burden to solve.
Variable effects limit the efficacy of transcranial direct current stimulation (tDCS) as a research and therapeutic tool. Conventional application of a fixed-dose of tDCS does not account for ...inter-individual differences in anatomy (e.g. skull thickness), which varies the amount of current reaching the brain. Individualised dose-control may reduce the variable effects of tDCS by reducing variability in electric field (E-field) intensities at a cortical target site.
To characterise the variability in E-field intensity at a cortical site (left primary motor cortex; M1) and throughout the brain for conventional fixed-dose tDCS, and individualised dose-controlled tDCS.
The intensity and distribution of the E-field during tDCS was estimated using Realistic Volumetric Approach to Simulate Transcranial Electric Stimulation (ROAST) in 50 individual brain scans taken from the Human Connectome Project, for fixed-dose tDCS (1 mA & 2 mA) and individualised dose-controlled tDCS targeting left M1.
With a fixed-dose (1 mA & 2 mA), E-field intensity in left M1 varied by more than 100% across individuals, with substantial variation observed throughout the brain as well. Individualised dose-control ensured the same E-field intensity was delivered to left M1 in all individuals. Its variance in other regions of interest (right M1 and area underneath the electrodes) was comparable with fixed- and individualised-dose.
Individualised dose-control can eliminate the variance in E-field intensities at a cortical target site. Assuming that the current delivered to the brain directly determines its physiological and behavioural consequences, this approach may allow for reducing the known variability of tDCS effects.
•Applying a fixed-dose of tDCS varies E-field in the brain by over 100%.•Individualised dose-control of tDCS minimises variance in a cortical target site.•Current flow modelling can be used to effectively dose-control tES.•Dose-controlling may reduce variance in the effects of tES.
Resumo Este trabalho toma como ponto de partida o texto de Nestor Perlongher, intitulado “O desaparecimento da homossexualidade”, que descreve um esvaziamento da identidade homossexual masculina com ...o surgimento da aids e propõe uma nova leitura a partir da implementação da profilaxia pré-exposição ao HIV (PrEP) pelo sistema público de saúde no Brasil. Distribuída a partir do início de 2018 e considerada como uma das mais novas medidas de prevenção ao HIV/aids, a PrEP se configura como um esquema antirretroviral de uso contínuo direcionado aos sujeitos que não foram infectados pelo vírus. Tomando como referência empírica o Protocolo Clínico de Diretrizes Terapêuticas para PrEP, identificamos como, a partir da noção de risco, a profilaxia possibilita o retorno da homossexualidade aos consultórios médicos e, mais do que isso, opera como objeto discursivo de problematizações de caráter sanitário e social. Diante disso, a PrEP produz uma nova categoria de homossexual, atrelada a tecnologias disciplinares e biopolíticas, que se apoiam na individualização e responsabilização dos indivíduos pelo cuidado de si.
Abstract This paper takes its starting point the text by Nestor Perlongher, entitled O desaparecimento da homossexualidade The disappearance of homosexuality, depicting an emptying of male homosexual identity with the emergence of aids, and proposes a new reading about the pre-exposure prophylaxis (PrEP) implementation by the public health system in Brazil. Distributed from early 2018 and considered as one of the newest HIV/aids prevention measures, PrEP is a continuous antiretroviral therapy aimed for subjects who have not been infected with the virus. Taking as an empirical reference the Clinical Protocol of PrEP Therapeutic Guidelines, we identified how, from the notion of risk, prophylaxis enables the return of homosexuality to doctors' offices and, furthermore, operates as a discursive object of sanitary and social problematizations. Thus PrEP produces a new homosexual category, linked to disciplinary and biopolitical technologies, which rely on the individualization and accountability of individuals for self-care.
Spatial media has received impetus in recent studies, arguing that its function as a mediator of meaning and enabler of intimacy are critical in late modernity. We suggest that spatial media not only ...liquefies key institutions of modernity but also replaces them. We conducted interviews with men who use spatial media to realize intimacy. In our analysis, we reference the fictional Star Trek universe to illustrate how spatial media may function as an institution. In the figure of the Borg, human-tech borders are eliminated, control is exerted through collective decisions, and bodies are assimilated into an expanding beehive-like community. Similarly, spatial media enables the liquefaction of human-tech borders, the creation of new sets of rules and hierarchies, and the assimilation of intimacy practices. We thereby conclude that digital media not only drive a process of liquefaction but also the forging of new institutional structures that condition the realization of intimacy.
Aims
Current FDA‐approved label recommends that the dosage of polymyxin B should be adjusted according to renal function. However, the correlation between polymyxin B pharmacokinetics (PK) and ...creatinine clearance (CrCL) is poor. This study aimed to develop a population PK model of polymyxin B in adult patients with various renal functions and to identify a dosing strategy.
Methods
A retrospective PK study was performed in 32 adult patients with various renal function. Nonlinear mixed effects modelling was applied to build a population PK model of polymyxin B followed by Monte Carlo simulations which designed polymyxin B dosing regimens across various renal function.
Results
Polymyxin B PK analyses included 112 polymyxin B concentrations at steady state from 32 adult patients, in which 71.9% of them were critically ill. In the final PK model, CrCL was the significant covariate on CL (typical value 1.59 L/h; between‐subject variability 13%). The mean (SD) individual empirical Bayesian estimate of CL was 1.75 (0.43) L/h. In addition, a new dosing strategy combining the PK/pharmacodynamic (PD) targets and Monte Carlo simulation indicated that the reduction of polymyxin B dose in patients with renal insufficiency improved the probability of achieving optimal exposure. For severe infections caused by organisms with minimum inhibitory concentration (MIC) ≥ 2 mg/L, a high daily dose of polymyxin B might be possible for bacterial eradication, but the risk of nephrotoxicity is increased.
Conclusions
Renal function plays a significant role in polymyxin B PK, and the dose of polymyxin B should be adjusted according to CrCL in patients with renal insufficiency.
The ubiquity of digital devices has made it feasible to assign different tasks and levels of support to different learners, also in the classroom. Ideally, this is done with the help of formative ...assessment software or intelligent tutoring systems. However, personalized assignment of tasks and support levels by a teacher or teaching agent has limitations and is only one path to successful personalization. Self-regulated learning and adaptable learning activities, such as generative learning strategies and differentiating tasks, are promising paths to personalization, too, and combine well with personalized assignment. Initial examples of such combinations are presented. I argue that, in order to be maximally effective, different paths to personalized education need to be combined. This combination promises to boost both immediate learning outcomes and successful learning in the long term, and it is facilitated by recent advances in artificial intelligence.
We derive hypotheses from popular accounts of how use of social media affects our strong ties. Several authors have suggested that social media use erodes our strong ties by increasing the volume of ...social interactions and decreasing their depth. Using two-wave panel data representative of the Dutch population between 15 and 45 years, we examine changes in the core discussion networks (CDNs) of 5312 respondents (with 10,896 relations). Contradicting an erosion of strong ties, we found positive effects of social media use on CDN size, both cross-sectionally and longitudinally. Social media use was positively related to talking to CDN members in our cross-sectional model. Finally, we found that the CDNs of frequent social media users were more dynamic than those of less frequent users: they are more likely to both lose old and gain new ties. This suggests that Internet use is associated with more, and more dynamic, social interaction.
The interaction of muscle and tendon is of major importance for movement performance and a balanced development of muscle strength and tendon stiffness could protect athletes from overuse injury. ...However, muscle and tendon do not necessarily adapt in a uniform manner during a training process. The development of a diagnostic routine to assess both the strength capacity of muscle and the mechanical properties of tendons would enable the detection of muscle-tendon imbalances, indicate if the training should target muscle strength or tendon stiffness development and allow for the precise prescription of training loads to optimize tendon adaptation. This perspective article discusses a framework of individualized muscle-tendon assessment and training and outlines a methodological approach for the patellar tendon.
The main objective of individualization of treatment in IVF is to offer every single woman the best treatment tailored to her own unique characteristics, thus maximizing the chances of pregnancy and ...eliminating the iatrogenic and avoidable risks resulting from ovarian stimulation. Personalization of treatment in IVF should be based on the prediction of ovarian response for every individual. The starting point is to identify if a woman is likely to have a normal, poor or a hyper response and choose the ideal treatment protocol tailored to this prediction. The objective of this review is to summarize the predictive ability of ovarian reserve markers, such as antral follicle count (AFC) and anti-Mullerian hormone (AMH), and the therapeutic strategies that have been proposed in IVF after this prediction.
A systematic review of the existing literature was performed by searching Medline, EMBASE, Cochrane library and Web of Science for publications in the English language related to AFC, AMH and their incorporation into controlled ovarian stimulation (COS) protocols in IVF. Literature available to May 2013 was included.
The search generated 305 citations of which 41 and 25 studies, respectively, reporting the ability of AMH and AFC to predict response to COS were included in this review. The literature review demonstrated that AFC and AMH, the most sensitive markers of ovarian reserve identified to date, are ideal in planning personalized COS protocols. These sensitive markers permit prediction of the whole spectrum of ovarian response with reliable accuracy and clinicians may use either of the two markers as they can be considered interchangeable. Following the categorization of expected ovarian response to stimulation clinicians can adopt tailored therapeutic strategies for each patient. Current scientific trend suggests the elective use of the GnRH antagonist based regimen for hyper-responders, and probably also poor responders, as likely to be beneficial. The selection of the appropriate and individualized gonadotrophin dose is also of paramount importance for effective COS and subsequent IVF outcomes.
Personalized IVF offers several benefits; it enables clinicians to give women more accurate information on their prognosis thus facilitating counselling especially in cases of extremes of ovarian response. The deployment of therapeutic strategies based on selective use of GnRH analogues and the fine tuning of the gonadotrophin dose on the basis of potential ovarian response in every single woman can allow for a safer and more effective IVF practice.
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