10 resultados para Procedural sedation

em Aston University Research Archive


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Data obtained from a manufacturing firm and a newspaper firm in India were used to examine the relationship between organizational politics and procedural justice in three separate studies. Study 1 constructively replicated research on the distinctiveness of the two constructs. Confirmatory factor analyses in which data from the manufacturing firm served as the development sample and data from the newspaper firm served as the validation sample demonstrated the distinctiveness of organizational politics and procedural justice. Study 2 examined the antecedents of the two constructs using data from the manufacturing firm. Structural equation modeling (SEM) results revealed formalization and participation in decision making to be positively related to procedural justice but negatively related to organizational politics. Further, authority hierarchy and spatial distance were positively related to organizational politics but unrelated to procedural justice. Study 3 examined the consequences of the two constructs in terms of task and contextual performance using data from the newspaper firm. Results of SEM analysis revealed procedural justice but not organizational politics to be related to task performance and the contextual performance dimensions of interpersonal facilitation and job dedication. © 2004 Elsevier Inc. All rights reserved.

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Paediatric intensive care is an expanding specialty that has been shown to improve the quality of care provided to critically ill children. An important aspect of the management of critically ill children includes the provision of effective sedation to reduce stress and anxiety during their stay in intensive care. However, to achieve effective and safe sedation in these children, is recognised as a challenge that is not without risk. Often children receive too much or too little sedation resulting in over sedation or under sedation respectively. These problems have arisen owing to a lack of information regarding altered pharmacokinetics and pharmacodynamics of medicines administered to critically ill children. In addition there are few validated sedation scoring systems in practice with which to monitor level of sedation and titrate medication appropriately. This study consisted of two stages. Stage 1 investigated the reproducibility and practicality of two observational sedation assessment scales for use in critically ill children. The two scales were different in design, the first being simple in design requiring a single assessment of the patient. The second was more complex in design requiring assessment of five patient parameters to obtain an overall sedation score. Both scales were found to achieve good reproducibility (kappa values 0.50 and 0.62 respectively). Practicality of each sedation scale was undertaken by obtaining nursing staff opinion about both scales using questionnaire and interview technique. It was established that nursing staff preferred the second, more complex sedation scale mainly because it was perceived to give a more accurate assessment of level of sedation and anxiety rather than merely level of sedation. Stage 2 investigated the pharmacokinetics and pharmacodynamics of midazolam in critically ill children. 52 children, aged between 0 and 18 years were recruited to the study and 303 blood samples taken to analyse midazolam and its metabolites, I-hydroxyrnidazolam (I-OR) and 4-hydroxymidazolam (4-0H). Analysis of plasma was undertaken using high performance liquid chromatography. A significant correlation was found between midazolam plasma concentration and sedative effect (r=0.598, p=O.OI). It was found that a midazolam plasma concentration of 223ng/ml (±31.9) achieved a satisfactory level of sedation. Only a poor correlation was found between dose of midazolam and plasma concentration of midazolam. Similarly only a poor correlation was found between sedative effect and dose of midazolam. Clearance of midazolam was found to be 6.3mllkglmin (±0.36), which is lower than that reported in healthy children (9.Il-13.3mllkg/min). Age related differences in midazolam clearance were observed in the study. Neonates produced the lowest clearance values (l.63mllkg/min), compared to children aged 1 to 12 months (8.52mllkg/min) who achieved the highest clearance values. Clearance was found to decrease after the age of 12 months to values of 5.34mllkglmin in children aged 7 years and above. Patients with renal (n=5) and liver impairment (n~4) were found to have reduced midazolam clearance (1.37 and 0.74ml/kg/min respectively). Plasma concentrations of I-OH and 4-0H ranged from 0-5 1 89nglml and 0-27 Inglml respectively. All children were found to be capable of producing both metabolites irrespective of age, although no trend was established between age and extent of production of either metabolite. Disease state was found to affect production of l-OH. Patients with renal impairment (n=5) produced the lowest I-OH midazolam plasma ratio (0.059) compared to patients with head injury (0.858). Patients with severe liver impairment were found to be capable of manufacturing both metabolites despite having a severely damaged liver.

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Procedural knowledge is the knowledge required to perform certain tasks. It forms an important part of expertise, and is crucial for learning new tasks. This paper summarises existing work on procedural knowledge acquisition, and identifies two major challenges that remain to be solved in this field; namely, automating the acquisition process to tackle bottleneck in the formalization of procedural knowledge, and enabling machine understanding and manipulation of procedural knowledge. It is believed that recent advances in information extraction techniques can be applied compose a comprehensive solution to address these challenges. We identify specific tasks required to achieve the goal, and present detailed analyses of new research challenges and opportunities. It is expected that these analyses will interest researchers of various knowledge management tasks, particularly knowledge acquisition and capture.

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Procedural knowledge is the knowledge required to perform certain tasks, and forms an important part of expertise. A major source of procedural knowledge is natural language instructions. While these readable instructions have been useful learning resources for human, they are not interpretable by machines. Automatically acquiring procedural knowledge in machine interpretable formats from instructions has become an increasingly popular research topic due to their potential applications in process automation. However, it has been insufficiently addressed. This paper presents an approach and an implemented system to assist users to automatically acquire procedural knowledge in structured forms from instructions. We introduce a generic semantic representation of procedures for analysing instructions, using which natural language techniques are applied to automatically extract structured procedures from instructions. The method is evaluated in three domains to justify the generality of the proposed semantic representation as well as the effectiveness of the implemented automatic system.

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This paper applies the concept of procedural justice to one of the most important focal points of interorganizational relations: the purchaser-supplier relationship. The few extant studies of the concept in the purchaser-supplier domain have overlooked an important aspect of this key relationship: that is, inclusiveness in procurement. This is despite the fact that interest in the specific empirical context of supply chain links between large purchasing organizations (LPOs) and ethnic minority suppliers (EMSs) from disadvantaged communities proceeds apace on both sides of the Atlantic. Institutional theory is used to examine the form that procedural justice takes in eight case studies of LPOs from the private and public sectors, which actively engage with inclusive procurement management initiatives in England. The guiding question is twofold: 'What may LPO approaches to installing procedural justice in procurement management entail?' and 'How are these approaches shaped?' This paper identifies specific approaches to installing procedural justice for inclusive procurement and submits theoretical propositions about how these are shaped. The study contributes to a macro-level assessment of procedural justice, i.e. interorganizational procedural justice, as a significant aspect of inclusive interorganizational relationships, which is a domain in need of theoretical development.

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Previous research has established that relationships with authority figures and procedural justice perceptions are important in terms of the way in which employees react to organizational procedures that affect them. What is less clear are the reasons why exchange quality with authorities is related to perceptions of process fairness and the role of procedural justice climate in this process. Results indicate that individual-level perceptions of procedural justice, but not performance ratings, partially mediate the relationship between exchange quality and reactions to performance appraisals, and that procedural justice climate is positively related to perceptions of procedural justice and appraisal reactions. These results support a more relational than instrumental view of justice perceptions in organizational procedures bound by exchange quality with an authority figure. Our study suggests that it is essential for managers to actively monitor and manage employee perceptions of process fairness at the group and individual levels. © 2015 Wiley Periodicals, Inc.