Fear and desire in systems design : negotiating database usefulness

Thesis (Ph. D.)--Massachusetts Institute of Technology, Sloan School of Management, 2008.Includes bibliographical references (p. 224-235).Databases are ubiquitous. They are used for a host of functions including coordination, decision making, and memory archiving. Despite their importance and ubiquity, databases continue to frustrate us, often departing from the goals originally set for them. If databases are such essential ingredients for organizations, what diminishes their usefulness? Besides the nature of the data that is entered into the database, usefulness is also shaped by the fields, features, and functionalities that the database designers originally construct that then shape the kind of data that can be entered into the system. This dissertation examines the process of database design and the assumptions and concerns adopted by the stakeholders involved in it. I conducted a year long ethnographic study of a university that has been engaged in creating a self-sustaining Environment Health and Safety system to manage research related hazards and to ensure regulatory compliance. The integrated database system was envisioned as a tool that would allow the university to observe and improve compliance practices while keeping records that would be available for self-auditing and government inspection. My research observations suggest that actors imagine diverse purposes that the database, when complete, should serve. These purposes - entailing the three themes of accountability, efficiency and comparability - appear to guide the design process. As these imagined purposes gain momentum, they translate into both desires and fears for the features of the database. For instance, when efficiency is imagined as a purpose, it creates a desire for features such as drop-down menus that are easy enter information into. The inclusion of such features, however, creates a fear of oversimplification.(cont.) Through a negotiated process, features such as text boxes are added to address the fears. Yet, every design change negotiated within the database system creates ripple effects with regard to other purposes, generating the need for still further changes. The process of database design becomes highly dynamic and the final database system is a negotiated compromise between multiple trade-offs over time. By juxtaposing these fears and desires, and through the use of causal-flow models, I articulate the process by which databases depart from their original goals.by Tanu Agrawal.Ph.D

Effect of intrauterine copper device on cervical cytology and its comparison with other contraceptive methods

Background: The intrauterine device (IUD) is the most commonly used reversible family planning method all over the world .The risk of cervical neoplasia associated with use of an intrauterine device (IUD), specially the copper releasing one, has been an important concern. The aim and objectives of the study was to determine safety of copper IUCD with regard to changes in cervical cytology and to compare the changes with other methods of temporary contraception.Methods: This was a prospective study carried out at a tertiary care institute for a period of 3 years. A total of 200 women of age group 18-40 years were included. 100 subjects who opted Cu-T 380A IUD were compared with 100 controls that had either opted other mode of temporary contraception like barrier, injectable, oral or did not use any method. Detailed history and examination of all subjects were done. All the women were subjected to conventional Pap smear and were followed at 6 months of interval for 1 year and then yearly up to 3 years. In each visit thorough pelvic examination was done and PAP smears were taken.Results: Among women using IUCD, 67.7% showed normal cytology as compared to 72.0% of the controls. On follow up, the incidence of normal cytology decreased (40%) with increased duration of use (up to 3 years). Incidence of inflammatory smear though first decreased up to 1 year (21.8%) but then gradually increased up to 2 years (37.0%) of use and then again decreased to 20.0% up to 3 years of use. ASCUS was found in only one case that used the device up to 2 years of use. LSIL was detected in 2 cases (20%) using IUD up to 3 years. No case of high grade intraepithelial lesion (HSIL) or invasive cancer was seen.Conclusions: There was no significant risk of cervical dysplasia or invasive carcinoma in IUCD users up to 2 years of use while other contraceptives (except barrier one) showed increased incidence of mild dysplasia (LSIL) after 1 year of use. Though risk of cervical malignancy is less with intrauterine copper devices, regular follow up should be done in long term users

Primary aneurysmal bone cyst of coronoid process

BACKGROUND: Aneurysmal bone cysts are relatively uncommon in the facial skeleton. These usually affect the mandible but origin from the coronoid process is even rarer. To the best of our knowledge, this is the first reported case of a coronoid process aneurysmal bone cyst presenting as temporal fossa swelling. CASE PRESENTATION: A 17 year old boy presented with a progressively increasing swelling in the left temporal region developed over the previous 8 months. An expansile lytic cystic lesion originating from the coronoid process of the left mandible and extending into the infratemporal and temporal fossa regions was found on CT scan. It was removed by a superior approach to the infratemporal fossa. CONCLUSION: Aneurysmal bone cyst of the coronoid process can attain enormous dimensions until the temporal region is also involved. A superior approach to the infratemporal fossa is a reasonable approach for such cases, providing wide exposure and access to all parts of the lesion and ensuring better control and complete excision

The illusion of accountability: Information management and organizational culture

How do laws and regulations govern the activities of large, decentralized, and often geographically dispersed organizations? Under conditions of loose coupling, how does the organization coordinate action and know what it is doing so that accountability, and conformity, to law are achieved? Rather than relying on interpersonal trust, direct observation, or bureaucratic review, this paper describes the collaborative creation of a database as part of a surveillance technology for managing environmental, health and safety hazards in university research laboratories. Based on two years of observation, we show how the desire for information and the fear of misuse of information together fails the basic informational surveillance mission

RESEARCH AND REVIEWS: JOURNAL OF MEDICAL AND HEALTH SCIENCES Assessment of Right and Left Ventricular Function in Patients with Chronic Obstructive Pulmonary Disease and Their Co-Relation with the Severity of Disease

ABSTRACT The aim of this study was to evaluate both right ventricle (RV) and left ventricular (LV) function in patients with COPD by echocardiography and its correlation with severity of disease. Sixty two patients with COPD and twenty healthy subjects were assessed by echocardiography and pulmonary function test. LV parameters were similar in both groups while RV parameters were significantly different in COPD patients as compared to control group. LV diastolic dysfunction was significantly higher in COPD patients. Mild, moderate, severe, and very severe COPD were seen in 30.7%, 40.3 %, 22.5%, and 6.5% patients, respectively. Pulmonary hypertension (PH) was observed in 38.7% patients. Mild, moderate and severe PH were present in 45.8%, 41.7%, and 12.5% respectively cor pulmonale was observed in 41.9%, while RV and LV systolic dysfunction were present in 20.9% and 3.2% of all COPD patients respectively. There is high prevalence of pulmonary hypertension, cor pulmonale and right ventricular systolic dysfunction in COPD and severity increases with level of severity of COPD. Impairment of LV systolic function was rarely found, while LV diastolic function was very common

Bullous mastocytosis in an infant treated with the help of narrowband ultraviolet B

Mastocytosis represents a group of disorders characterized by abnormal accumulation of mast cells in the bone marrow, liver, spleen, lymph nodes, gastrointestinal tract, and skin. Skin involvement is seen in almost all the cases. A 1-year-old male child presented with complaints of multiple fluid-filled lesions all over the body since 2 months. Examination revealed multiple vesicles and tense bullae present on the face, neck and trunk along with surrounding erythema and multiple excoriation marks. Darier's sign was positive. Histopathology showed dense infiltrates of mast cells in the papillary dermis. Bone marrow aspiration showed no mast cells infiltrate. The patient was started on oral antihistamines, prednisolone, and narrowband ultraviolet B (NBUVB). The skin lesions showed dramatic improvement within a week and patient is on follow-up with NBUVB. Bullous mastocytosis (BM) is a rare variant of cutaneous mastocytosis manifested by diffuse infiltration of skin by mast cells, where cutaneous bullae are the predominant feature. This case is being presented for its rarity and highlights the effectivity of NBUVB for treating BM

A Study of Unusual Pacemaker Infection by Mycobacterium Tuberculosis in Indian Patients

Background: The expanding clinical indications of cardiac rhythm management have led to an increased use of pacemaker implantation which is associated with increased incidence of pacemaker infections. Staphylococcus aureus and epidermidis account for the vast majority of pacemaker infections. Pacemaker infection due to Mycobacterium tuberculosis (M. tuberculosis) is very rare, only few cases having been reported till date. Methods: We describe here a study of three patients of pacemaker pocket infection with M. tuberculosis. Conclusion: The possibility of mycobacterial pacemaker infection should always be kept in mind in patients with delayed pacemaker infection

Pierwotny nabłoniak chłonny gardła dolnego: niezwykle rzadka prezentacja pozanosogardłowa

Wstęp: 66-letni mężczyzna uskarżał się na dyskomfort gardła i ból przy przełykaniu. Wynik badania fiberoskopowego krtani był prawidłowy, natomiast podejrzenia budził obraz uzyskany z użyciem wąskiej wiązki obrazowania. Uzyskano dodatni wynik badania USG-FNAC pod kątem obecności złośliwych, przerzutowych komórek rakowych. W badaniu tomografii komputerowej szyi z kontrastem uwidoczniono zatarcie lewego zachyłka gruszkowatego do poziomu chrząstki pierścieniowatej, stykające się ze skrzydłami chrząstki tarczowatej, chrząstką nalewkowatą i mięśniami przedkręgowymi. W badaniu endoskopowym GOPP ujawniono obecność owrzodzonej masy w lewym zachyłku gruszkowatym. Badanie histopatologiczne wykazało obecność stratyfikowanej, wyścielonej niezrogowaciałym nabłonkiem płaskokomórkowym tkanki z dużymi kolistymi lub wielokątnymi komórkami nowotworowymi widocznymi w zrębie podnabłonkowym. Komórki nowotworowe były otoczone zrębem limfatycznym. W badaniu immunohistochemicznym komórki nowotworowe dały wynik dodatni dla pancytokeratyny i ujemny dla: CD45, chromograniny i synaptofizyny. Limfocyty dały wynik dodatni dla CD45. Postawiono rozpoznanie raka limfonabłonkowego. Ze względu na nieoperacyjność guza w leczeniu, zastosowano radioterapię. Wnioski: Nabłoniak chłonny jest pierwotnym guzem nosogardzieli, lecz rzadko obserwuje się go w miejscach, takich jak: gardło środkowe, krtań i gardło dolne. Do dzisiaj zgłoszono jedynie około 50 przypadków pozanosogardłowych, w tym jedynie 10–12 zlokalizowanych w gardle dolnym. Podstawą leczenia jest radioterapia, choć w przypadkach zmian miejscowych można rozważać operację chirurgiczną

Primary lymphoepithelial carcinoma of the hypopharynx: an extremely rare non-nasopharyngeal presentation

Introduction: A 66-year-old male complained of throat discomfort and odynophagia. Laryngeal fiber optic examination was normal but narrow band imaging was suspicious. USG-FNAC from a cervical lymph node was positive for malignant metastatic carcinoma cells. CECT revealed obliteration of the left pyriform fossa till the level of cricoid cartilage, abutting the ala of the thyroid cartilage, arytenoid cartilage and prevertebral muscles. UGIE revealed an ulcerated mass lesion in the left pyriform fossa. Histopathological examination revealed stratified non-keratinized squamous epithelial lined tissue with subepithelial stroma showing large round to polygonal tumour cells. The tumour cells were surrounded by a lymphoid stroma. On immunohistochemistry the tumour cells were positive for pancytokeratin and negative for CD45, chromogranin and synaptophysin. Lymphocytes were positive for CD45. The diagnosis of lymphoepithelial carcinoma was established. The tumour was inoperable and was treated by radiotherapy. Conclusions: Lymphoepithelial carcinoma is the primary entity of the nasopharynx but rarely seen at sites like oropharynx, larynx and hypopharynx. Only around 50 non-nasopharyngeal cases have been reported till date out of which only 10–12 were in the hypopharynx. Radiotherapy is the mainstay of treatment whereas surgery can be considered for a local disease

Evaluating Awareness and Practices Pertaining to Radioactive Waste Management among Scrap Dealers in Delhi, India

<div><p>Objectives</p><p>With nuclear technology rapidly taking the spotlight in the last 50 years, radiation accidents seem to be a harsh reality of the modern world. The Mayapuri Radiation accident of 2010 was the worst radiation accident India has yet dealt with. Two years thereafter, we designed a study to assess the awareness and practices regarding radioactive waste among scrap dealers aiming to assess deficiencies in radiation disaster preparedness.</p><p>Methodology</p><p>A community based cross-sectional study. The study population consisted of 209 volunteers (from 108 scrap dealerships) including 108 shop-owners and 101 workers segregated as Group A consisting of 54 dealerships in Mayapuri and Group B of 54 dealerships from the rest of the city. Subjects were then interviewed using a semi-structured questionnaire.</p><p>Results</p><p>Awareness about radioactive waste varied significantly with level of education (p = 0.024), Kuppuswamy's socio-economic scale (p = 0.005), age of the scrap dealer (p = 0.049) and his work experience (p = 0.045). The larger dealerships in Mayapuri were more aware about radioactive waste (p = 0.0004), the accident in 2010 (p = 0.0002), the symbol for radiation hazard (p = 0.016), as well as the emergency guidelines and the agencies to contact in the event of a radiation accident.</p><p>Conclusions</p><p>Our findings seem to signify that while governmental and non-governmental agencies were successful in implementing prompt disaster response and awareness programs, the community continues to be inadequately prepared. These go on to suggest that though concerted awareness and training programs do benefit the affected community, economic and social development is the key to disaster prevention and mitigation.</p></div