Статті в журналах з теми "Tender management portal"

Resection of the hemangioma located in the caudate lobe is a major challenge in current liver surgery. This study aimed to present our surgical technique for this condition. Two consecutive patients with symptomatic hepatic hemangioma undergoing caudate lobectomy were investigated retrospectively. First, all the blood inflow of hemangioma from the portal vein and the hepatic artery at the base of the umbilical fissure was dissected. After the tumors became soft and tender, the short hepatic veins and the ligaments between the secondary porta hepatis were severed. At last the tumors were resected from the right lobe of the liver. The whole process was finished by a left-sided approach. Blood lost in Case 1 was 1650 mL because of ligature failing in one short hepatic vein, and in the other case, 210 mL. Operation time was 236 minutes and 130 minutes, respectively. Postoperative hospital stays were 11 and 5 days, respectively. The diameter of tumors was 9.0 cm and 6.5 cm. Case 1 required blood transfusion during surgery. No complications such as biliary fistula, postoperative bleeding, and liver failure occurred. The left-sided approach produced the best results for caudate lobe resection in our cases. The patients who recovered are living well and asymptomatic. Caudate lobectomy can be performed safely and quickly by a left-sided approach, which is carried out with optimized perioperative management and innovative surgical technique.

Purpose Over the past few decades, academic debates on small- and medium-sized establishments (SMEs) have focused on the challenges of globalisation, especially for the independent small producers outside the niche markets. However, the purpose of this paper is to highlight the limits of these sorts of evaluations arguing that globalisation can also provide opportunities for the valuable contributions of such enterprises. Design/methodology/approach Drawing on an ethnographic case study in Turkey, inquiries in the paper are essentially predicated on unstructured conversations with the owner/manager of a shipyard investigated, workplace observations and supplementary conversations with employees as well as elite interviews with the Portal Authorities. Additional interviews were also conducted with the owner/managers of three other shipyards. Findings The evidence suggests that the opportunities of globalisation can be consolidated with certain HRM strategies including a tailored demarcation of work-life balance, strategized retention for skills shortage, individualised grievance resolutions, employees-led work design, team work, “in-turn” and “mobile” employment. Likewise, logistic management strategies such as downsizing, investment diversification, “queasy-niche” production, use of communication technologies, networking and opening up to global markets may prove highly useful. Even so, the sustainability of independent smaller businesses requires responsive trade regulations about, for instance, tender offers, fair competition and the conflict of interests in addition to “tough-love policies” to protect employment rights. Originality/value The paper rectifies the lack of systematic research into the implications of globalisation for the SMEs in shipbuilding industry and their managerial responses.

Background Given the widespread electronic health record adoption, there is increasing interest to leverage patient portals to improve care. Objective To determine characteristics of patient portal users and the activities they accessed in the patient portal. Methods We performed a retrospective analysis of patient portal usage at University of California, Los Angeles, Health from July 2014 to May 2015. A total dataset of 505,503 patients was compiled with 396,303 patients who did not register for the patient portal and 109,200 patients who registered for a patient portal account. We compared patients who did not register for the online portal to the top 75th percentile of users based on number of logins, which was done to exclude those who only logged in to register. Finally, to avoid doing statistical analysis on too large of a sample and overpower the analysis, we performed statistical tests on a random sample of 300 patients in each of the two groups. Results Patient portal users tended to be older (49.45 vs. 46.22 years in the entire sample, p = 0.008 in the random sample) and more likely female (62.59 vs. 54.91% in the entire sample, p = 0.035 in the random sample). Nonusers had more monthly emergency room (ER) visits on average (0.047 vs. 0.014, p < 0.001). The most frequently accessed activity on the portal was viewing laboratory results (79.7% of users looked at laboratory results). Conclusion There are differences between patient portal users and nonusers, and further understanding of these differences can serve as foundation for further investigation and possible interventions to drive patient engagement and health outcomes.

The promotion of efficient and sustainable means of transport has been a key issue of public debate across the European Union (EU). Particularly, transport needs in peripheral and remote areas have a great importance for EU transport policies in order to ensure the mobility of goods and persons in these regions, and thus to achieve greater territorial cohesion in the member states concerned. Despite the remarkable efforts to improve the competitiveness of aviation in the EU single market, certain regional routes have traditionally suffered a lack of scheduled air routes. The internal market, once liberalized, has provided an instrument in order to ensure adequate transportation for the carriage of goods and persons in special cases. When this occurs, according to Regulation (CE) no. 1008/2008, national civil aviation authorities may impose a public service obligation (PSO) on specific air routes. In addition, this form of public intervention can lead to restriction on market access to one carrier, and even to the payment of compensation to the awarded airline through the launching of a tendering procedure for the operation of the required air service. In the case of Spain, this type of administrative concession has been shifting towards e-procurement processes by providing transparent electronic portals. This research aims, precisely, at encouraging a better understanding of how information technology may have systemic benefits to public bodies aiming to efficiently conduct a digital procurement ecosystem. To do this, the authors have analyzed the 23 PSO routes imposed so far, and the corresponding administrative procedures. The findings suggest that e-procurement has led to greater public transparency.

Objectives: To determine lessons learned from a consecutive series of patients admitted with cellulitis, regarding factors leading to admission, management and duration of hospitalization. Methods: Prospective data over a 12-month period within a district general hospital. Centralized admitting policy of all patients with a principle diagnosis of cellulitis under the vascular surgical department. Data comparison of younger patients vs older and of those hospitalized for less than one week vs more than one week. Results: Of 85 patients admitted, 44 had previous oedema and 50 had a skin lesion as a portal for entry of infection; only nine had neither prior to the attack. Thirty-two had had at least one previous attack of cellulitis. Younger patients tended to have a more virulent systemic infection whereas older patients had more comorbidity and social problems. Fourteen patients required surgical intervention: eight had arterial and six had venous contributory circulatory disorders. Microbiological information was of minimal practical value. Surgical intervention and social problems were associated with delayed discharge. Conclusions: The majority of patients with cellulitis had predisposing oedema/skin lesions and where these persisted or recurrent infection occurred long-term antibiotic prophylaxis may have been useful. Social problems and comorbidity remained complicating factors but more patients could probably have been managed in a domiciliary setting.

El estudio de los textiles, desde las ciencias sociales o el arte, puede tener múltiples focos de atención, dependiendo de los objetivos de investigación: materiales y medidas, técnicas de obtención de materiales y de elaboración, procesos económicos inmersos, condiciones de producción, procesos sociales, rituales y de comercio. Este artículo explora la importancia de la relación entre las mujeres y el bordado de un textil femenino llamado dhayemlaab, para la constitución cultural teenek en la Huasteca potosina. Con base en datos provenientes de la etnografía, se presenta una interpretación antropológica sobre cómo este textil –su bordado y su permanencia– es una prenda de resistencia cultural, pues narra, en sus diseños, la existencia histórica y cultural teenek de la Huasteca, elementos que permiten plantear cómo las mujeres encarnan el mundo al bordar y portar el dhayemlaab que cubre su torso.

Este artigo descreve um panorama geral da relação, limites e possibilidades das políticas educacionais e seu potencial emancipatório, assim como, do Gerencialismo em suas diversas formas no contexto educacional. O objetivo foi explicitar os limites do Nova Gestão Pública no tocante a avaliação das políticas educacionais. O procedimento metodológico utilizado foi a revisão de literatura, tendo como fonte o portal de “Periódicos CAPES”, assim como a base de dados “ERIC”, onde realizamos uma revisão descritiva, qualitativa, com avaliação crítica da literatura recuperada sobre (política educacional ‘and’ nova gestão pública). Os resultados desta pesquisa mostram alguns aspectos relevantes da NGP em casos do Reino Unido, Itália, Noruega, França, Quebec, Cataluña, Buenos Ayres e Chile. Este artigo destaca que as políticas educacionais possuem caráter emancipatório e que os princípios neoliberais do Gerencialismo tendem a descaracterizar a natureza das políticas educacionais, assim como, aprofunda a crise no sistema educacional. Concluímos que as escolas têm capacidade de ir além da lógica do capital, para tanto, antes se faz necessário formar cidadãos emancipados, para só depois pensar nas demandas do capital. Inverter essa ordem seria coadunar com o ideário da New Public Management, ou seja, acumulação de capital e a reprodução da força de trabalho.

Este estudo tem como objetivo analisar o diagnóstico do transtorno do espectro autista (TEA) e os seus impactos na família, bem como a importância do psicólogo neste processo. Foi usado como metodologia de pesquisa a revisão integrativa pelo processo de investigação da literatura, utilizada as bases de pesquisas Scientific Eletronic Library Online (SCIELO), a plataforma Portal Regional da BVS e a de Periódicos Eletrônicos em Psicologia (PEPSIC), entre os meses de julho e agosto de 2022, foram encontrados os descritores (em português e inglês) na plataforma Decs; Transtorno do espectro autista; autismo infantil; autismo. Os estudos incluídos são apresentados em um quadro-resumo e a análise dos resultados é realizada de forma expositiva, cada pessoa diagnosticada com transtorno do espectro autista é única, com isso podemos perceber neste estudo, que as consequências para a família são enormes, sendo necessário um processo contínuo de adaptação pós-diagnóstico. Considere-se que a família tem um papel relevante e impactante no diagnóstico do TEA, pois os pais da criança diagnosticada tendem a passar por muitas mudanças e dificuldades durante esse processo, buscando entender os sintomas diferentes que a criança apresenta.

Introdução: O envelhecimento populacional compreende um fenômeno em crescimento, tornando-se um desafio para todos e, em especial, para os serviços de saúde, pois impulsiona também o aumento da prevalência das doenças crônicas degenerativas e, consequentemente, a hospitalização dos idosos Objetivo: Identificar as práticas assistenciais de enfermagem voltadas à humanização direcionada ao atendimento do idoso hospitalizado. Método: Revisão Integrativa, uma Prática Baseada em Evidências (PBE), em que foram identificados 93 artigos extraídos das bases de dados indexadas na Biblioteca Virtual em Saúde (BVS): Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Scientific Electronic Library Online (SCIELO), Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (Portal CAPES) e Sistema Online de Busca e Análise de Literatura Médica (MEDLINE). Foram selecionados mediante a leitura analítica 10 artigos, considerando como critério de inclusão os artigos completos disponíveis na íntegra, no idioma português e publicados entre os anos de 2017 e 2021, com discussões relevantes ao idoso hospitalizado. Como critério de exclusão, artigos duplicados, fora do tema e do período definido para essa pesquisa. Resultados: Mediante a leitura dos artigos que compõem o corpus desta pesquisa, observa-se que, apesar de ser uma prática conhecida e desenvolvida por muitos, ainda se faz necessária a realização de novos estudos que possibilitem abordagens a partir das opiniões dos próprios idosos, não apenas dos profissionais, visto que essa é uma população que tende a crescer ainda mais e, sobretudo, porque a humanização durante o atendimento é uma prática preconizada em lei.

PurposeGovernment e-Procurement systems are generating tender-level process event data which are not being analyzed much. The purpose of this paper is to present a data visualization tool to benchmark the government tendering process. This tool collects, collates and presents e-Procurement process data in a meaningful way that enables comparisons and benchmarking leading to insights for process improvements and identification of the best practices. This tool is accessible on the website of South Asia’s first public procurement observatory (www.procurementobservatoryup.com) founded by the authors.Design/methodology/approachThe authors started with an initial set of key performance indicators (KPIs) based on extant literature and existing practices. The authors got them verified by various relevant stakeholders through a series of formal and informal discussions. Some of them were dropped due to observed variations or their inability to offer insights to arrive at the final set of KPIs. In this paper, the authors use actual process-level data. Government of India’s National Informatics Center has implemented e-Procurement portals in various states and public enterprises (PEs) in India which provide tender-wise detailed e-tendering process data. The authors designed a web crawler that collects these data in a tabular format, which allows an easy analysis and comparison to measure and compare government tendering process performance for the last five years for the two large PEs. The authors also engaged in discussions with the procurement executives of the two PSEs to derive meaningful managerial insights from the results obtained.FindingsUsing the public procurement data visualization tool, the authors compare the procurement process of two of the largest Indian PEs, Coal India Limited and Indian Oil Corporation on the developed KPIs and draw insights. The results show significant difference in their procurement process performance due to different practices followed by them. Through interaction with the procurement managers of these two organizations, the authors identify few good procurement practices that can be applied to improve public procurement process.Research limitations/implicationsThis paper uses actual process-level data which can be used not just to identify improvement opportunities but also to gauge the impact of any process-level change. It presents a data visualization tool to generate insights from data generated by a procurement/tendering system. Such visualization and benchmarking can uncover better procurement practices and provide an impetus toward data-driven policy formulation. Apart from the two PEs as reported in this paper, this tool has also been applied on the public procurement data of eight Indian states.Practical implicationsThe KPIs presented in this paper are aligned with the various dimensions of public procurement’s objectives. The visualization tool presented in this paper is based on the Open Contract Data Standard and has a universal application.Social implicationsThe use of technology and open data sharing as the enablers of benchmarking and process improvements help in establishing a dynamic competitive environment leading to financial savings, better services to citizens and proper use of taxpayers’ money.Originality/valueThis paper presents an original work carried out under the aegis of South Asia’s first procurement observatory at IIM Lucknow. The benchmarking tool presented in this paper uses open contract data standard and can be applied in most of the public procurement processes. This paper takes the discussions on e-Procurement to the next level, where the concern is no longer restricted to only adoption and assimilation issues, but also on how to make use of the data that these e-Procurement systems generate.

Estima-se que a população mundial será próxima a 9 bilhões em 2040. Na comparação com o consumo de 2010, para o atendimento a essa demanda será necessário um aumento de mais de 35% do fornecimento total de energia, o que demandará recursos energéticos mais diversificados. Nesse cenário, o uso de sistemas fotovoltaicos flutuantes tem progredido em muitos países, porém por se tratar de uma estratégia nova, ainda existem poucos estudos sobre estes sistemas. Entre as vantagens do uso destes dispositivos, se destacam a melhoria da eficiência de conversão, redução da evaporação da superfície da água e redução do crescimento de algas. Diante disso, este estudo teve como objetivo realizar uma revisão da literatura sobre os principais entraves e desafios de implantação dos sistemas fotovoltaicos flutuantes no Brasil. Foram utilizadas as plataformas de pesquisa acadêmica Google Acadêmico, Scientific Eletronic Library Online (SciELO) e Portal de Periódicos da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), considerando as publicações da área de ciências ambientais e engenharias. Na presente revisão foi possível observar que o segmento de energia vem se adaptando conforme os processos de crise energética, em que novas alternativas de produção tendem a atender uma grande parcela da população e são de suma importância tanto na prevenção de apagões como na perspectiva de se ter um sistema híbrido. Constatou-se também que cada local de estudo teve suas particularidades, mas os principais entraves e desafios ainda são a viabilidade econômica em detrimento de sistemas feitos em solo e o atendimento aos atuais requisitos técnicos e de segurança necessários para instalação e operação dos sistemas.

El profesor de enfermería está expuesto a varios estresores ocupacionales, y puede tener una experiencia emocional negativa provocada por el desequilibrio entre las necesidades del trabajo y su capacidad de respuesta y, como consecuencia presentar el Síndrome de Burnout (SB). El objetivo del estudio fue identificar causas y consecuencias del SB presentes en profesores de enfermería. Se trata de una revisión integrativa de la literatura, cuyos artículos se seleccionaron a través de la búsqueda en el Portal de Publicaciones Periódicos de la Coordinación para el Perfeccionamiento del Personal de Educación Superior (CAPES) y en las bases de datos Redib, Dialnet, BDENF, EBSCO y PsycINFO, publicados desde 2017 a octubre de 2022. La muestra final quedó conformada en 28 artículos, con nivel de evidencia IV. En las instituciones educativas, como principales causas del SB, se señalaron: la interferencia pedagógica, las condiciones precarias de trabajo, las debilidades en las relaciones interpersonales, la multifuncionalidad, la sobrecarga de trabajo y la dificultad de adaptación a la modalidad virtual en tiempos de COVID-19. En tanto en las inherentes al individuo: aquellos que tenían menor resiliencia y eran adictos al trabajo. Los profesores fijos más jóvenes y con más títulos son los más afectados. Entre las complicaciones generadas se destacan: la afectación de la salud mental, los trastornos del sueño y el desequilibrio en la vida personal-profesional. Se concluye que el estresor ocupacional fue la causa de mayor preponderancia para el SB y los impactos generados repercutieron negativamente en la salud física y mental, en la calidad de la enseñanza, además de provocar la intención de abandono de la carrera docente.

Purpose The purpose of this paper is to discuss the economic and legal rationale for the use of the competitive dialogue in complex procurement. The authors use the data set of public contracts awarded by European Union (EU) member states between 2010 and 2017 to analyse its usage patterns. In particular, the authors identify the types of contracting authorities that mainly use the procedure, the sectors and contract characteristics and the role of institutional factors related to the country’s perceived corruption and level of innovativeness. Design/methodology/approach The authors discuss economic and legal issues in the use of the competitive dialogue. The authors use a data set of public contracts awarded by EU member states, published on the EU’s public procurement portal Tenders Electronic Daily (TED) to analyse usage patterns and explore the types of contracting authorities that use the procedure, the sectors and type of tenders. The data covers a sample of 1.242.090 observations, which relates to all the contract award notices published on TED in the period 2010-2017 for all the 28 European member states. A probit model is used as a methodology. Findings The empirical analysis reveals that the use of competitive value is greater for larger value contracts, for national rather than local authorities, for the supply of other manufactured products and machinery; for research and development and business, as well as information technology services; and for construction works. The level of perceived corruption and the gross domestic product/capita do not have explanatory power in the use of the procedure, whilst a country’s degree of innovativeness, as measured by the global innovation index, positively affects the probability of adopting the procedure. A decreasing trend in the use of competitive dialogue over time is observed. Research limitations/implications In conclusion, the countries examined benefited from a long tradition of public–private partnerships (PPPs) and from a transposition of the 2004 directive, able to provide an inclusive interpretation of complexity, and therefore, stimulate the adoption of the competitive dialogue in different sectors. Conversely, the countries, which postponed a concrete transposition and the overcoming of the confusing concept of complexity, limited the scope for the application of competitive dialogue, relying on the easier alternative: the negotiated procedure. Those circumstances lead to visible difficulties in stimulating the adoption of the procedure even in the traditional sectors; indeed, only with the new directive’s provisions a slight change in the trend can be seen. Practical implications To foster the use of the competitive dialogue in countries that have so far used it to a limited extent is important to improve upon the definition of complexity and learn from the experience of the top usage countries, as identified in the analysis. Social implications Helping the use of the procedure may facilitate the procurement of complex contracts such as PPPs, and thus, ease the building and management of public infrastructures for the provision of public services. Originality/value The authors are not aware of previous studies that have used the TED data set and studied the law in a number of European countries so as to understand the usage patterns for the competitive dialogue.

Abstract Introduction: Splenectomy was historically regarded as the gold standard for treatment in chronic adult immune thrombocytopenic purpura (ITP). However, the recent emergence of new drugs has deeply modified ITP management and splenectomy is no longer viewed as an unavoidable step in adult chronic ITP in many countries. The estimation of the risk over benefit of this potential curative treatment remains challenging both for patients and physicians. A retrospective Italian study focused on long-term outcome of patients splenectomized for ITP gave reassuring data concerning safety. A recent study from a large cohort of American veterans showed an increased risk of death due to septicemia, pulmonary embolism, coronary artery disease and cancer more than 10 years after splenectomy. We reported here the results of the first single center case-control study evaluating the long-term incidence of splenectomy complications with a minimum follow-up of 10 years. Methods: We retrospectively selected in a clinical computer database all primary ITP patients splenectomized more than 10 years ago in our unit. We matched 1 by 1 to non-splenectomized ITP patients based on date and age at ITP diagnosis and sex criteria. Clinical data were then completed from medical charts. All patients were interviewed by phone and a standardized questionnaire was used. Medical records from general practitioner or from Medical care center have been systematically obtained if necessary, especially for deceased patients. Comparison between groups were made using Fisher’s test for qualitative variables, Kaplan-Meier method to estimate incidence and Rank test for comparison of cumulative incidence, with p<0.05 defining significance. Results: Seventy splenectomized ITP patients were included (19men/51women) with a median age at ITP diagnosis of 37 years (range: 3-92). Sixty one (87%) initially responded to splenectomy but only 34(48.5%) maintained a sustained response after a median follow-up of 189 months (range:120-528). Matched non-splenectomized ITP patients had a median age at diagnosis of 40 years (range: 3-93) and a median follow-up since ITP diagnosis of 197 months (range: 96-504).Cumulative incidence of thromboembolic events was higher in the splenectomized group (p=0.029) (Figure1). Four (6%) episodes of post-operative portal vein thrombosis were observed, 3 were complicated by portal cavernoma requiring long-term anticoagulation. They tended to present with more thromboembolic events on a long-term (n=7) than non-splenectomized ITP patients (n=3, p=0.113). Two splenectomized (2.8%) and 1 non-splenectomized (1.4%) patients were diagnosed with post-embolic pulmonary arterial hypertension. The incidence of cardiovascular events was significantly higher in splenectomized group (9(13%) versus 2(2.8%), p=0.005) (Figure 2) with 6 transient and/or ischemic strokes in splenectomized patients (none in non-splenectomized).Infectious events were similar in the two groups (splenectomized: 12 (17%) vs 10 (14%)) but infections were more frequent and severe in splenectomized patients. Indeed, 12 splenectomized patients presented 20 infectious events requiring hospitalization, 13 of them were pneumonia (Streptococcus Pneumoniae: n=4, Haemophilus Influenzae: n=1, undocumented: n=9). Five complicated septic-shocks leading to 3 deaths. In non-splenectomized group, 10 patients had 10 infectious events (Pneumonia n=4, Streptococcus Pneumoniae n=1), 7 were hospitalized, none had septic-hock. Incidence of cancer was similar in the 2 groups (splenectomized: 11 (16%), non-splenectomized: 10 (14%).Finally, the mortality rate was not different between two groups (splenectomized: n=14 (20%), non-splenectomized n=9, 13%). Ten (38%) of the 36 non-responders patients deceased, 7 from hemorrhage and/or septic shock. Other splenectomized and non-splenectomized patients died from malignant cancer/hemopathy (n=5), coronary artery disease (n=2),other (n=6). Conclusion: Based on this case control single center study, we observed that long-term splenectomized patients have not only an increase risk of life-threatening infections, but also an increased risk of thromboembolic, and cardiovascular events. A long-term follow-up is therefore recommended in this patient population regardless the status of ITP in order to better prevent and manage such complications. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare.

Summary Biodiversity loss is a complex issue and a risk that education cannot overlook. Teachers play a crucial role in how biodiversity, and in particular local biodiversity, is understood. To provide insight into how to improve communication on the subject, we investigate teachers’ perspectives and social representations regarding biodiversity, their fluency in terms of Internet use, their familiarity with biodiversity web portals and perceived pedagogical usefulness of technology. A sample of 243 K–12 schoolteachers of multiple scientific domains from eight Azorean islands answered an online survey, including three free-word association tests using inductive terms such as ‘Internet’, ‘biodiversity’ and ‘familiar biodiversity portals’. Overall, the schoolteachers failed to incorporate the multidimensionality of the biodiversity concept (including natural science teachers) or to show technological fluency, and they tended not to use biodiversity web portals as tools to engage students in teaching activities. Our results indicate that teachers’ perspectives about biodiversity need to be broadened and improved and that it is worth exploring whether information and communication technology represents a window of opportunity to do so. As an example, biodiversity web portals, which are widely recognized as trustworthy information repositories, may be used to engage teachers in this endeavour.

En este trabajo nos interesa reflexionar acerca de nuestro lugar como formadorxs que, atravesadxs y conmovidxs ante los escenarios actuales, reflexionamos acerca del abordaje de las instituciones y las organizaciones educativas como objetos de análisis y producción de conocimiento situado. Para ello proponemos un trabajo de elucidación permanente sobre nuestra posición implicada, como una oportunidad para pensar a otrxs y con otrxs, los efectos de dispersión que esos contextos portan y tienen sobre los procesos de subjetivación y de pensamiento colectivos, y entendiendo que se trata de un lugar que se construye en determinados tiempos y espacios institucionales, sociales, históricos, políticos. Nuestra reflexión se apoya en los trabajos de algunxs representantes del análisis institucional francés, latinoamericano y argentino que reconocieron que al pensar la posición que asumimos frente al análisis es importante tener en cuenta una serie de cuestiones relativas a la relación de las instituciones, las organizaciones, los grupos y los sujetos desde perspectivas situadas y contextualizadas.

Abstract Background Research on clinical trials that employ stem cells to treat children’s diseases is limited. The clinical trial registry database provides a unique window to us to get known about clinical trial researches with different statuses. However, few studies aimed to perform a comprehensive and thorough analysis of those registered trials in the aforementioned field based on ClinicalTrials.gov and the ICTRP portal site. Methods Our study covered the clinical researches about stem cell therapy enrolling subjects aged under 18 years old registered on ClinicalTrials.gov and WHO ICTRP before May 18, 2021. A cross-sectional study was implemented to comprehensively describe and analyze the included trials that met the criteria. Results were available on ClinicalTrials.gov, and publications related to the included trials were identified. All analyses were performed utilizing the SPSS 25.0 software. Results Eventually, 202 clinical trials were included and evaluated. The participant number of trials tended to be small; 71.3% were enrolled < 50. And 93.5% of the subjects were without gender restrictions. Till May 2020, 112 trials had been preliminary completed, of which only 39 trials had published papers or uploaded results. Most (73.6%) of 186 interventional trials were in phase 1 and phase 2, where 131 (70.4%) trials were conducted without masking, and 26.3% trials were randomized; 55.4% trials were performed single group assignment. Of 16 observational trials, case-only/series took up 37.5%. Hematopoietic stem cells (37.1%) and mesenchymal stem cells (36.1%) were mostly employed, while umbilical cord blood (UCB)-derived cells (24.3%) and bone marrow (BM)-derived cells (20.8%) were the major sources. Conclusions This study provided an overall picture of utilizing stem cells for treatment and management of childhood diseases. Since clinical trials in this area are insufficient in quantity and quality, there is an urgent need of larger, better-designed trials. Increased investment in clinical research of stem cell treatment products should be carried out to achieve the transformation of results as soon as possible. Moreover, it is important to optimize the management of the registration platform and shorten the time it takes for research results to be published.

Tremendous progress has been made in development of immunotherapeutic approaches for treatment of bladder urothelial carcinoma (BLCA). However, efficacy and safety of these approaches remain unsatisfactory, necessitating further investigations for identification of indicators for predicting prognosis and efficacy. In this study, we downloaded transcriptomic and clinical data of BLCA patients from The Cancer Genome Atlas (TCGA) database, and identified differentially expressed genes (DEGs) between tumor and normal tissues. We incorporated these DEGs in an intersection analysis with immune-related genes (IRGs) obtained from the Immunology Database and Analysis Portal (ImmPort) database, and identified immune-related DEGs. These genes were subjected to Cox and least absolute shrinkage and selection operator (LASSO) regression analyses, then a prognostic model containing AHNAK, OAS1, NGF, PPY and SCG2 genes was constructed, for prediction of prognosis of BLCA and efficacy of immunotherapy. Finally, we explored the relationship between the prognostic model and tumor mutational burden (TMB), abundance of tumor-infiltrating immune cells (TICs) and immunotherapeutic targets, and found that patients with higher risk score (RS) had poorer prognosis and significantly lower levels of TMB. Patients in the low-RS group exhibited higher numbers of lymphoid cells, whereas those in the high-RS group exhibited higher proportions of myeloid cells. However, patients with high-RS tended to respond better to immunotherapy relative to those in the low-RS group. The constructed prognostic model provides a new tool for predicting prognosis of BLCA patients and efficacy of immunotherapy, offering a feasible option for management of the disease.

Private car mobility registers today a high accident rate and around 70% of the overall CO2 emissions from transport were generated by road mode split (European Commission, 2016). Moreover, in urban areas they occur 38% of the overall fatalities from road transport, and 23% of the overall CO2 emissions (European Commission, 2013). As a result, a modal shift of at least a part of passenger transport in urban areas, from private car to sustainable transport systems is desirable. This research aims to promote sustainable mobility through two mutually reinforcing "main actions": firstly, there is a rewarding Open-Source platform, named as GOOD_GO; secondly, there is the SW/HW system connecting to the wide world of private and/or shared bicycles. Through the GOOD_GO platform Web portal and App, a user enters a so called 'social rewarding game' thought to incentive sustainable mobility habits, and gets access to the second item consisting of a system to disincentive bike-theft and based on the passive RFID technology. The low-cost deterrent bike-theft and bike monitoring/tracking system is functional to bring a big number of citizens inside the rewarding game. In 2018, a pilot test has implemented in the city of Livorno (Tuscany, It), and it involved around 1,000 citizens. Results were quite encouraging and today, the cities of Livorno, Pisa and Bolzano will enlarge the incentive system both to home-to-school and home-to-work mobility. The Good_Go platform is an actual M-a-a-S (Mobility-as-a-Service) application, and it becoming a Mobility Management decision system support, jointly with the opportunity of organizing more incentive tenders and rewarding systems types.

At least as far back as classical Greek times, humankind has speculated over the complexities of creativity as a concept and the modes of its transmission (Madden 133-134). This paper considers what happens when our inherited conceptions of creativity collide with the World Wide Web. It concludes with a brief survey of the Creativity Resource Portal, a current on-line project managed by the authors and related to the conceptual issues raised in the body of the text. Today, creativity has moved beyond its traditional home in the rhetoric of the philosopher and the exploits of the artist to form an integral part of both the theory and practice of a myriad of disciplines. Health professionals (Dossey; Kirklin & Meakin; Meites, Bein & Shafer; Rees; Satalof), scientists (Bohn 1-3, 13-15; Culross), educators (Guilford; Sawyer; Sternberg & Williams; Wilks) and those involved in the corporate world (Forbes & Domm; Mauzy & Harriman; Robinson & Stern) all consider creativity to be a fundamental criterion by which they measure and achieve their successes. In this way, however, creativity has become something of an over-burdened signifier. Now the market is flooded with highly idealised and ever expanding models for understanding and transmitting creativity, in which the medium (transmission) strives to outdo the message (creativity itself). We are not attempting here to arbitrate between these various models with a view to providing a rank order of creativity. Instead, we want to focus on and explore the ways in which recent technological developments, primarily the internet, have been, and might be, used to transmit and facilitate new directions and expressions of creativity and the creative process itself. Although the internet has no single inventor or birth date, its origins lie in the communication system devised by the RAND corporation in the 1960s: a system designed to survive a nuclear war because it had no central point of control. To this extent, one could say that its initial egalitarianism tips towards the expression of creativity. From here, the internet evolved through various mutations, such as APRANET and Bulletin Boards, to become the World Wide Web that emerged in the 1990s. Since then, the internet has encroached further and further into our everyday lives: we buy and sell goods at sites like Amazon or E-bay, we communicate to the world via email accounts at Hotmail or Yahoo, we court potential partners at Lavalife or Okcupid, and we engage in scholarly debates on sites such as M/C – Media and Culture. The point here is that the sheer ubiquity of the internet has brought about a quiet revolution in our everyday modes of creativity. Web navigation, for example, is heavily dependent on the creativity of the user to move through virtual space, even or perhaps especially when he/she must counter the ‘point and click’ inducements of advertising and marketing strategies. Little wonder then that the emergence of creativity as a fundamental tenet for success across a wide array of disciplines, coupled with the pervasiveness of cyberspace, has led to an explosion of both the production and transmission of creativity on-line. One such development is the transmission and dissemination of already created products via the web: that is, products hijacked from the ‘real’. In its most controversial and publicized form, the creative output of musicians has become tender for trade between individuals who subscribe to programs such as Napster and Limewire. Beyond this, the internet extends ever outwards in a panoply of both solicited and pirated images and video clips of people’s creative output. Here the internet seems to move beyond the liberating potential that Benjamin saw in technology’s ability to reproduce the image (Benjamin) towards the simulacra (or hyper-real copies of the ‘real’) proposed by Baudrillard (Baudrillard). On-line creativity has not, however, been limited to the reproduction of artistic output that exists in the ‘real’. As with any practice fundamental to the expression of the human condition, creativity has found new and exciting ways to express itself on-line. For example, digital art has emerged as a serious artistic pursuit since the late 20th century. Here, a number of artists have fused their creative ability and their technological skills to generate new ways in which their creativity can be transmitted. A cyber-poet may meld both the classical poetic forms of stanza and rhyme with the language of HTML or Java to create a cyber-poem (see the work of Komninos Zervos). Visual artists such as Han Hoogerbrugge have also been able to successfully adapt their works to the digital world: Hooderbrugge converted a comic strip he wrote in the mid-1990s to a series of digital animations. As well as this, new on-line formats such as blogs have been used by a number of artists to express their creativity in new and interesting ways (see the work of Olia Lialina). Other artists have dived even further into the simulacra, preferring the aesthetic value of the code itself over the presence of images or words that might signify something in the ‘real’ (see this work by Jason Nelson). Unlike traditional art forms, these emerging digital art forms are intensively interactive and thereby encourage the creativity of their audience. By allowing the artistic product itself to be manipulated, digital artists facilitate new ways of ‘reading’ art. It is tempting then to offer the internet up as something of a creative utopia – an Aladdin’s Cave – a place where creativity, in all its manifestations, can be transmitted to the masses. However, in the final chapter of her book The Pearly Gates of Cyberspace, Margaret Wertheim discusses the notion of a ‘cyber-utopia’ and asks “Who is this cyber-utopia really going to be for?” (Wertheim 295). She goes on to point out that not only do the majority of the world’s inhabitants not have access to the internet, but that out of those who do, many are discriminated against in the virtual world because of their gender, their sexuality, their skin colour or their ethnicity. (Of course, this does not necessarily make online space any less democratic than traditional technologies such as print forms). More recently, Lawrence Lessig has taken Wertheim’s questioning of cyber-utopia to its logical dystopian antithesis in his book Free Culture. Here, Lessig agues that the internet has had a direct impact on the way that culture is made. Specifically, the control that major media conglomerates and governments have over the internet has meant that “the ordinary ways in which individuals create and share culture fall within the reach of the regulation of the law, which has expanded to draw within its control a vast amount of culture and creativity that it never reached before” (Lessig 8). Have we therefore clicked open a Pandora’s Box through our incessant attempts to get wired? All technologies are open to abuse. Cyberspace is neither Aladdin’s Cave nor Pandora’s Box but simply a work in progress. And it is on this basis that we are currently creating an online Creativity Resource Portal. This portal does not attempt to resolve immediately the many debates over the nature and transmission of creativity, nor does it set out to completely resolve the quandaries raised by creativity’s cyber manifestations. Instead, it aims, at least initially, to disseminate a broad range of knowledge about creativity – thus encouraging inter-fertilization across disciplines and practices – and also to act as a catalyst for currently unrecognized ways of creating and expressing creativity in the online world. That being said, we hope that future refined manifestations of the site will possess the characteristics of a ‘laboratory’, in which the serious issues of creative freedom and control outlined in this paper – issues of transmission in the broadest sense – might be more directly engaged with. It is through this direct virtual engagement that we hope to reach conclusions capable of extending outwards to the wider, global online environment. This might happen via experiments with new types of non-hierarchical site structures, or with the level of control given to visitors over what happens in the site. But can any structures resist the exercise of power? Can egalitarianism (cyber or otherwise) ever fully eschew borders and margins? These are the questions that challenge and excite us as managers of the CRP. References Benjamin, Walter. “The Work of Art in the Age of Mechanical Reproduction.” In Illuminations. London: Fontana, 1992. Baudrillard, Jean. The Ecstasy of Communication. New York: Semiotext(e), 1988. Bohn, David. On Creativity. London: Routledge, 1998. Culross, Rita R. “Individual and Contextual Variables among Creative Scientists: The New Work Paradigm.” Roeper Review 26.3 (2004): 126-27. Dossey, Larry. “Creativity: On Intelligence, Insight, and the Cosmic Soup.” Alternative Therapies in Health and Medicine [NLM – MEDLINE] 6.1 (2000): 12-17, 108-117. Forbes, Benjamin J., and Donald R. Domm. “Creativity and Productivity: Resolving the Conflict.” S.A.M. Advanced Management Journal 69.2 (2004): 4-11. Guilford, J. P. Intelligence, Creativity, and Their Educational Implications. San Diego: Robert R. Knapp, 1968. Kirklin, Deborah, and Richard Meakin. “Editorial: Medical Students and Arts and Humanities Research: Fostering Creativity, Inquisitiveness, and Lateral Thinking.” Journal of Medical Ethics 29.2 (2003): 103. Lessig, Lawrence. Free Culture: How Big Media Uses Technology and the Law to Lock Down Culture and Control Creativity. New York: The Penguin Press, 2004. Madden, Christopher. “Creativity and Arts Policy.” Journal of Arts Management, Law, and Society 34.2 (2004): 133-139. Mauzy, Jeff, and Richard Harriman. Creativity, Inc.: Building an Inventive Organisation. Boston: Harvard Business School Press, 2003. Meites, E., S. Bein, and A. Shafer. “Researching Medicine in Context: The Arts and Humanities Medical Scholars Program.” Journal of Medical Ethics: Medical Humanities 29 (2003): 104-108. Rees, Colin. “Celebrate Creativity.” Nursing Standard 19.14-16 (2004): 20-21. Robinson, Alan G., and Sam Stern. Corporate Creativity: How Innovation and Improvement Actually Happen. San Francisco: Berrett-Koehler Publishers, 1998. Sataloff, Robert Thayer. “Interdisciplinary Opportunities for Creativity in Medicine.” Ear, Nose & Throat Journal 77.7 (1998): 530-533. Sawyer, Keith R. “Creative Teaching: Collaborative Discussion as Disciplined Improvisation.” Educational Researcher 33.2 (2004): 12-20. Sternberg, Robert J., and Wendy M. Williams. How to Develop Student Creativity. Alexandria: Association for Supervision and Curriculum Development, 1996. Wertheim, Margaret. The Pearly Gates of Cyberspace: A History of Space from Dante to the Internet. Sydney: Doubleday, 1999. Wilks, Susan. Critical and Creative Thinking: Strategies for Classroom Inquiry. Armadale: Eleanor Curtain Publishing, 1995. Citation reference for this article MLA Style Isakhan, Ben, Jason Nelson, and Patrick West. "creativity.com: Aladdin’s Cave or Pandora’s Box?." M/C Journal 9.1 (2006). echo date('d M. Y'); ?> <http://journal.media-culture.org.au/0603/07-isakhan_nelson_west.php>. APA Style Isakhan, B., J. Nelson, and P. West. (Mar. 2006) "creativity.com: Aladdin’s Cave or Pandora’s Box?," M/C Journal, 9(1). Retrieved echo date('d M. Y'); ?> from <http://journal.media-culture.org.au/0603/07-isakhan_nelson_west.php>.

Background: The COVID-19 pandemic has placed increased demands on clinical staff in primary dental care due to a variety of uncertainties. Current reports on staff responses have tended to be brief enquiries without some theoretical explanation supported by developed measurement systems.Aim: To investigate features of health and well-being as an outcome of the uncertainties surrounding COVID-19 for dentists and dental health professionals in primary dental care and for those in training. In addition, the study examined the well-being indices with reference to normative values. Finally a theoretical model was explored to explain depressive symptoms and investigate its generalisability across dentists and dental health professionals in primary dental care and those in postgraduate training.Methods: A cross-sectional survey of dental trainees and primary dental care staff in Scotland was conducted in June to October 2020. Assessment was through “Portal,” an online tool used for course bookings/management administered by NHS Education for Scotland. A non-probability convenience sample was employed to recruit participants. The questionnaire consisted of four multi-item scales including: preparedness (14 items of the DPPPS), burnout (the 9 item emotional exhaustion subscale and 5 items of the depersonalisation subscale of the MBI), the 22 item Impact of Event Scale-Revised, and depressive symptomatology using the Patient Health Questionnaire-2. Analysis was performed to compare the levels of these assessments between trainees and primary dental care staff and a theoretically based path model to explain depressive symptomology, utilising structural equation modelling.Results: Approximately, 27% of all 329 respondents reported significant depressive symptomology and 55% of primary care staff rated themselves as emotionally exhausted. Primary care staff (n = 218) felt less prepared for managing their health, coping with uncertainty and financial insecurity compared with their trainee (n = 111) counterparts (all p's &lt; 0.05). Depressive symptomology was rated higher than reported community samples (p &lt; 0.05) The overall fit of the raw data applied to the theoretical model confirmed that preparedness (negative association) and trauma associated with COVID-19 (positive association) were significant factors predicting lowered mood (chi-square = 46.7, df = 21, p = 0.001; CFI = 0.98, RMSEA = 0.06, SRMR = 0.03). Burnout was indirectly implicated and a major path from trauma to burnout was found to be significant in primary care staff but absent in trainees (p &lt; 0.002).Conclusion: These initial findings demonstrate the possible benefit of resourcing staff support and interventions to assist dental staff to prepare during periods of high uncertainty resulting from the recent COVID-19 pandemic.

As the single most successful social-networking Website to date, Facebook has caused a shift in both practice and perception of online socialisation, and its relationship to the offline world. While not the first online social networking service, Facebook’s user base dwarfs its nearest competitors. Mark Zuckerberg’s creation boasts more than 750 million users (Facebook). The currently ailing MySpace claimed a ceiling of 100 million users in 2006 (Cashmore). Further, the accuracy of this number has been contested due to a high proportion of fake or inactive accounts. Facebook by contrast, claims 50% of its user base logs in at least once a day (Facebook). The popular and mainstream uptake of Facebook has shifted social use of the Internet from various and fragmented niche groups towards a common hub or portal around which much everyday Internet use is centred. The implications are many, but this paper will focus on the progress what Mimi Marinucci terms the “Facebook effect” (70) and the evolution of lists as a filtering mechanism representing one’s social zones within Facebook. This is in part inspired by the launch of Google’s new social networking service Google+ which includes “circles” as a fundamental design feature for sorting contacts. Circles are an acknowledgement of the shortcomings of a single, unified friends list that defines the Facebook experience. These lists and circles are both manifestations of the same essential concept: our social lives are, in fact, divided into various zones not defined by an online/offline dichotomy, by fantasy role-play, deviant sexual practices, or other marginal or minority interests. What the lists and circles demonstrate is that even very common, mainstream people occupy different roles in everyday life, and that to be effective social tools, social networking sites must grant users control over their various identities and over who knows what about them. Even so, the very nature of computer-based social tools lead to problematic definitions of identities and relationships using discreet terms, in contrast to more fluid, performative constructions of an individual and their relations to others. Building the Monolith In 1995, Sherry Turkle wrote that “the Internet has become a significant social laboratory for experimenting with the constructions and reconstructions of self that characterize postmodern life” (180). Turkle describes the various deliberate acts of personnae creation possible online in contrast to earlier constraints placed upon the “cycling through different identities” (179). In the past, Turkle argues, “lifelong involvement with families and communities kept such cycling through under fairly stringent control” (180). In effect, Turkle was documenting the proliferation of identity games early adopters of Internet technologies played through various means. Much of what Turkle focused on were MUDs (Multi-User Dungeons) and MOOs (MUD Object Oriented), explicit play-spaces that encouraged identity-play of various kinds. Her contemporary Howard Rheingold focused on what may be described as the more “true to life” communities of the WELL (Whole Earth ‘Lectronic Link) (1–38). In particular, Rheingold explored a community established around the shared experience of parenting, especially of young children. While that community was not explicitly built on the notion of role-play, the parental identity was an important quality of community members. Unlike contemporary social media networks, these early communities were built on discreet platforms. MUDs, MOOs, Bulletin Board Systems, UseNet Groups and other early Internet communication platforms were generally hosted independently of one another, and even had to be dialled into via modem separately in some cases (such as the WELL). The Internet was a truly disparate entity in 1995. The discreetness of each community supported the cordoning off of individual roles or identities between them. Thus, an individual could quite easily be “Pete” a member of the parental WELL group and “Gorak the Destroyer,” a role-player on a fantasy MUD without the two roles ever being associated with each other. As Turkle points out, even within each MUD ample opportunity existed to play multiple characters (183–192). With only a screen name and associated description to identify an individual within the MUD environment, nothing technical existed to connect one player’s multiple identities, even within the same community. As the Internet has matured, however, the tendency has been shifting towards monolithic hubs, a notion of collecting all of “the Internet” together. From a purely technical and operational perspective, this has led to the emergence of the ISP (Internet service provider). Users can make a connection to one point, and then be connected to everything “on the Net” instead of individually dialling into servers and services one at a time as was the case in the early 1980s with companies such as Prodigy, the Source, CompuServe, and America On-Line (AOL). The early information service providers were largely walled gardens. A CompuServe user could only access information on the CompuServe network. Eventually the Internet became the network of choice and services migrated to it. Standards such as HTTP for Web page delivery and SMTP for email became established and dominate the Internet today. Technically, this has made the Internet much easier to use. The services that have developed on this more rationalised and unified platform have also tended toward monolithic, centralised architectures, despite the Internet’s apparent fundamental lack of a hierarchy. As the Internet replaced the closed networks, the wider Web of HTTP pages, forums, mailing lists and other forms of Internet communication and community thrived. Perhaps they required slightly more technological savvy than the carefully designed experience of walled-garden ISPs such as AOL, but these fora and IRC (Internet Relay Chat) rooms still provided the discreet environments within which to role-play. An individual could hold dozens of login names to as many different communities. These various niches could be simply hobby sites and forums where a user would deploy their identity as model train enthusiast, musician, or pet owner. They could also be explicitly about role-play, continuing the tradition of MUDs and MOOs into the new millennium. Pseudo- and polynymity were still very much part of the Internet experience. Even into the early parts of the so-called Web 2.0 explosion of more interactive Websites which allowed for easier dialog between site owner and viewer, a given identity would be very much tied to a single site, blog or even individual comments. There was no “single sign on” to link my thread from a music forum to the comments I made on a videogame blog to my aquarium photos at an image gallery site. Today, Facebook and Google, among others, seek to change all that. The Facebook Effect Working from a psychological background Turkle explored the multiplicity of online identities as a valuable learning, even therapeutic, experience. She assessed the experiences of individuals who were coming to terms with aspects of their own personalities, from simple shyness to exploring their sexuality. In “You Can’t Front on Facebook,” Mimi Marinucci summarizes an analysis of online behaviour by another psychologist, John Suler (67–70). Suler observed an “online disinhibition effect” characterised by users’ tendency to express themselves more openly online than offline (321). Awareness of this effect was drawn (no pun intended) into popular culture by cartoonist Mike Krahulik’s protagonist John Gabriel. Although Krahulik’s summation is straight to the point, Suler offers a more considered explanation. There are six general reasons for the online disinhibition effect: being anonymous, being invisible, the communications being out of sync, the strange sensation that a virtual interlocutor is all in the mind of the user, the general sense that the online world simply is not real and the minimisation of status and authority (321–325). Of the six, the notion of anonymity is most problematic, as briefly explored above in the case of AOL. The role of pseudonymity has been explored in more detail in Ruch, and will be considered with regard to Facebook and Google+ below. The Facebook effect, Marinucci argues, mitigates all six of these issues. Though Marinucci explains the mitigation of each factor individually, her final conclusion is the most compelling reason: “Facebook often facilitates what is best described as an integration of identities, and this integration of identities in turn functions as something of an inhibiting factor” (73). Ruch identifies this phenomenon as the “aggregation of identities” (219). Similarly, Brady Robards observes that “social network sites such as MySpace and Facebook collapse the entire array of social relationships into just one category, that of ‘Friend’” (20). Unlike earlier community sites, Ruch notes “Facebook rejects both the mythical anonymity of the Internet, but also the actual pseudo- or polynonymous potential of the technologies” (219). Essentially, Facebook works to bring the offline social world online, along with all the conventional baggage that accompanies the individual’s real-world social life. Facebook, and now Google+, present a hard, dichotomous approach to online identity: anonymous and authentic. Their socially networked individual is the “real” one, using a person’s given name, and bringing all (or as many as the sites can capture) their contacts from the offline world into the online one, regardless of context. The Facebook experience is one of “friending” everyone one has any social contact with into one homogeneous group. Not only is Facebook avoiding the multiple online identities that interested Turkle, but it is disregarding any multiplicity of identity anywhere, including any online/offline split. David Kirkpatrick reports Mark Zuckerberg’s rejection of this construction of identity is explained by his belief that “You have one identity … having two identities for yourself is an example of a lack of integrity” (199). Arguably, Zuckerberg’s calls for accountability through identity continue a perennial concern for anonymity online fuelled by “on the Internet no one knows you’re a dog” style moral panics. Over two decades ago Lindsy Van Gelder recounted the now infamous case of “Joan and Alex” (533) and Julian Dibbell recounted “a rape in cyberspace” (11). More recent anxieties concern the hacking escapades of Anonymous and LulzSec. Zuckerberg’s approach has been criticised by Christopher Poole, the founder of 4Chan—a bastion of Internet anonymity. During his keynote presentation at South by SouthWest 2011 Poole argued that Zuckerberg “equates anonymity with a lack of authenticity, almost a cowardice.” Yet in spite of these objections, Facebook has mainstream appeal. From a social constructivist perspective, this approach to identity would be satisfying the (perceived?) need for a mainstream, context-free, general social space online to cater for the hundreds of millions of people who now use the Internet. There is no specific, pre-defined reason to join Facebook in the way there is a particular reason to join a heavy metal music message board. Facebook is catering to the need to bring “real” social life online generally, with “real” in this case meaning “offline and pre-existing.” Very real risks of missing “real life” social events (engagements, new babies, party invitations etc) that were shared primarily via Facebook became salient to large groups of individuals not consciously concerned with some particular facet of identity performance. The commercial imperatives towards monolithic Internet and identity are obvious. Given that both Facebook and Google+ are in the business of facilitating the sale of advertising, their core business value is the demographic information they can sell to various companies for target advertising. Knowing a user’s individual identity and tastes is extremely important to those in the business of selling consumers what they currently want as well as predicting their future desires. The problem with this is the dawning realisation that even for the average person, role-playing is part of everyday life. We simply aren’t the same person in all contexts. None of the roles we play need to be particularly scandalous for this to be true, but we have different comfort zones with people that are fuelled by context. Suler proposes and Marinucci confirms that inhibition may be just as much part of our authentic self as the uninhibited expression experienced in more anonymous circumstances. Further, different contexts will inform what we inhibit and what we express. It is not as though there is a simple binary between two different groups and two different personal characteristics to oscillate between. The inhibited personnae one occupies at one’s grandmother’s home is a different inhibited self one plays at a job interview or in a heated discussion with faculty members at a university. One is politeness, the second professionalism, the third scholarly—yet they all restrain the individual in different ways. The Importance of Control over Circles Google+ is Google’s latest foray into the social networking arena. Its previous ventures Orkut and Google Buzz did not fare well, both were variously marred by legal issues concerning privacy, security, SPAM and hate groups. Buzz in particular fell afoul of associating Google accounts with users” real life identities, and (as noted earlier), all the baggage that comes with it. “One user blogged about how Buzz automatically added her abusive ex-boyfriend as a follower and exposed her communications with a current partner to him. Other bloggers commented that repressive governments in countries such as China or Iran could use Buzz to expose dissidents” (Novak). Google+ takes a different approach to its predecessors and its main rival, Facebook. Facebook allows for the organisation of “friends” into lists. Individuals can span more than one list. This is an exercise analogous to what Erving Goffman refers to as “audience segregation” (139). According to the site’s own statistics the average Facebook user has 130 friends, we anticipate it would be time-consuming to organise one’s friends according to real life social contexts. Yet without such organisation, Facebook overlooks the social structures and concomitant behaviours inherent in everyday life. Even broad groups offer little assistance. For example, an academic’s “Work People” list may include the Head of Department as well as numerous other lecturers with whom a workspace is shared. There are things one might share with immediate colleagues that should not be shared with the Head of Department. As Goffman states, “when audience segregation fails and an outsider happens upon a performance that was not meant for him, difficult problems in impression management arise” (139). By homogenising “friends” and social contexts users are either inhibited or run the risk of some future awkward encounters. Google+ utilises “circles” as its method for organising contacts. The graphical user interface is intuitive, facilitated by an easy drag and drop function. Use of “circles” already exists in the vocabulary used to describe our social structures. “List” by contrast reduces the subject matter to simple data. The utility of Facebook’s friends lists is hindered by usability issues—an unintuitive and convoluted process that was added to Facebook well after its launch, perhaps a reaction to privacy concerns rather than a genuine attempt to emulate social organisation. For a cogent breakdown of these technical and design problems see Augusto Sellhorn. Organising friends into lists is a function offered by Facebook, but Google+ takes a different approach: organising friends in circles is a central feature; the whole experience is centred around attempting to mirror the social relations of real life. Google’s promotional video explains the centrality of emulating “real life relationships” (Google). Effectively, Facebook and Google+ have adopted two different systemic approaches to dealing with the same issue. Facebook places the burden of organising a homogeneous mass of “friends” into lists on the user as an afterthought of connecting with another user. In contrast, Google+ builds organisation into the act of connecting. Whilst Google+’s approach is more intuitive and designed to facilitate social networking that more accurately reflects how real life social relationships are structured, it suffers from forcing direct correlation between an account and the account holder. That is, use of Google+ mandates bringing online the offline. Google+ operates a real names policy and on the weekend of 23 July 2011 suspended a number of accounts for violation of Google’s Community Standards. A suspension notice posted by Violet Blue reads: “After reviewing your profile, we determined the name you provided violates our Community Standards.” Open Source technologist Kirrily Robert polled 119 Google+ users about their experiences with the real names policy. The results posted to her on blog reveal that users desire pseudonymity, many for reasons of privacy and/or safety rather than the lack of integrity thought by Zuckerberg. boyd argues that Google’s real names policy is an abuse of power and poses danger to those users employing “nicks” for reasons including being a government employment or the victim of stalking, rape or domestic abuse. A comprehensive list of those at risk has been posted to the Geek Feminism Wiki (ironically, the Wiki utilises “Connect”, Facebook’s attempt at a single sign on solution for the Web that connects users’ movements with their Facebook profile). Facebook has a culture of real names stemming from its early adopters drawn from trusted communities, and this culture became a norm for that service (boyd). But as boyd also points out, “[r]eal names are by no means universal on Facebook.” Google+ demands real names, a demand justified by rhetoric of designing a social networking system that is more like real life. “Real”, in this case, is represented by one’s given name—irrespective of the authenticity of one’s pseudonym or the complications and dangers of using one’s given name. Conclusion There is a multiplicity of issues concerning social networks and identities, privacy and safety. This paper has outlined the challenges involved in moving real life to the online environment and the contests in trying to designate zones of social context. Where some earlier research into the social Internet has had a positive (even utopian) feel, the contemporary Internet is increasingly influenced by powerful and competing corporations. As a result, the experience of the Internet is not necessarily as flexible as Turkle or Rheingold might have envisioned. Rather than conducting identity experimentation or exercising multiple personnae, we are increasingly obligated to perform identity as it is defined by the monolithic service providers such as Facebook and Google+. This is not purely an indictment of Facebook or Google’s corporate drive, though they are obviously implicated, but has as much to do with the new social practice of “being online.” So, while there are myriad benefits to participating in this new social context, as Poole noted, the “cost of failure is really high when you’re contributing as yourself.” Areas for further exploration include the implications of Facebook positioning itself as a general-purpose user authentication tool whereby users can log into a wide array of Websites using their Facebook credentials. If Google were to take a similar action the implications would be even more convoluted, given the range of other services Google offers, from GMail to the Google Checkout payment service. 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