945 resultados para Propofol, administration and dosage


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This article assesses the impact of education reform and the new public management (NPM) on the discretion of school teachers. The focal point of the study is Michael Lipsky's theory of discretion which casts public service professionals and others involved in service delivery as 'street-level bureaucrats' because their high degree of discretionary rule-making power enabled them to effectively make policy as well as implement it. The article considers the relationship between education reform and the NPM and focuses on the increased emphasis on skills-based teaching and changes in management and leadership in schools. The literature and survey of teachers demonstrate that discretion in the workplace has been eroded to such an extent due to a high degree of central regulation and local accountability as to question the applicability of Lipsky's model. The findings are based on the literature and a small survey undertaken by the author. © 2007 BELMAS.

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Inhaled human insulin (Exubera®) is a rapid-acting regular human insulin administered by oral inhalation before meals. It provides a non-invasive alternative to multiple subcutaneous injections for the treatment of hyperglycemia in adult patients with type 1 and type 2 diabetes. Compared with subcutaneous rapid-acting insulin analogs, Exubera provides equivalent HbA1c control. As a monotherapy or in combination with oral agents, Exubera also provides greater glycemic control than oral agents alone, at least in patients with high levels of HbA1c. Exubera demonstrates improved patient satisfaction compared with subcutaneous insulin or oral agents alone. When offered as a treatment option together with standard treatments in uncontrolled patients naive to insulin, Exubera increases acceptance of insulin therapy three-fold compared with patients offered standard regimens only. Exubera is well tolerated in comparison to subcutaneous insulin, with a similar incidence of mild to moderate hypoglycemia. Although cough is a common adverse effect early in therapy, this leads to treatment discontinuations in less than 1% of patients. Despite an increased incidence of insulin antibodies compared with subcutaneous administration, and a consistent but minor impact on pulmonary function, long-term safety data of up to 4 years continue to support the safety profile of Exubera.

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In recent decades, natural disasters have caused extensive losses and damages to human psychological wellbeing, economy, and society. It has been argued that cultural factors such as social values, traditions, and attachment to a location influence communities facing and responding to natural disasters. However, the issue of culture in disaster mental health seems to have received limited attention in policy and practice. This review highlights the importance of cultural background in the assessment of vulnerability to the psychological impacts of disasters, disaster preparedness, and provision of disaster mental health services. In particular, this paper suggests the importance of cultural competence in the planning and delivery of effective disaster mental health services. In order to address the varying circumstances of people with different cultural backgrounds, disaster mental health services must be developed in a culturally sensitive manner. Development of culturally competent disaster mental health services requires significant changes in policy making, administration, and direct service provision

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In a Ubiquitous Consumer Wireless World (UCWW) environment the provision, administration and management of the authentication, authorization and accounting (AAA) policies and business services are provided by third-party AAA service providers (3P-AAA-SPs) who are independent of the wireless access network providers (ANPs). In this environment the consumer can freely choose any suitable ANP, based on his/her own preferences. This new AAA infrastructural arrangement necessitates assessing the impact and re-thinking the design, structure and location of ‘charging and billing’ (C&B) functions and services. This paper addresses C&B issues in UCWW, proposing potential architectural solutions for C&B realization. Implementation approaches of these novel solutions together with a software testbed for validation and performance evaluation are addressed.

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During the past twenty years, Washington has oscillated between tentative engagement with Pyongyang under the Clinton administration and isolation and multilateralism under the Bush administration. With the Obama administration almost nearing its four-year tenure, the Six-Party Talks have stalled and North Korea's multiple attacks on the South in 2010 have created new instabilities. Why so little results despite promises of a radical departure away from the Axis of Evil rhetoric and hard-line politics? This paper suggests that the Obama administration has utilized approaches that no longer fit current circumstances and hence failed to create an original, coherent and effective foreign policy. © 2012 McFarland & Company, Inc.

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A kameralizmus a 16-18. századi német gyakorlati államtudomány és egyetemi tantárgy volt, amely összefoglalta a hivatalnokok képzéséhez szükséges elméleti és gyakorlati gazdasági ismereteket. Felfogása szerint az alattvalók jóléte és boldogsága feltétele az uralkodó gazdagságának, de az alattvalók önmaguktól nem képesek utat találni ehhez a boldogsághoz, szükség van az állandó külső irányításra. Igazgatásközpontúsága és egyetemi intézményesülése miatt nem tekinthető a merkantilizmus helyi változatának. Az 1840 és 1945 közötti német történeti iskola hagyományos ábrázolása több mint egy évszázadon át a német és a neoklasszikus tradíció szembenállását hangsúlyozta, kiemelve az organicizmus, a fejlődésgondolat és az egyediség jelentőségét, a szociális kérdés fontosságát, illetve a deduktív módszer és a gazdaság változatlan törvényeinek tagadását. A modern rekonstrukciók a történeti iskolát a posztklasszikus válságra adott egyik európai válaszként fogják fel, amely a történelemből levont, empirikusan megalapozott induktív alternatívát kínált. Az 1871-től kialakult osztrák iskola a neoklasszikus paradigmának egyszerre volt alkotórésze és versenytársa. A módszertani individualizmus, a szubjektivizmus, az idő fontossága, a tudás szerepe, az alternatív költségek elmélete stb. ugyan beépültek a mainstream közgazdaságtanba, de hangsúlyos kiemelésük lehetővé tette, hogy a társadalomelméleti magyarázat igényét őrző osztrák iskola megtartson valamit önálló beszédmódjából. / === / Cameralism was a practical political science and university subject in 16th–18th century Germany, summarizing the theoretical and practical economic knowledge required in the training of officials. The assumption was that the prosperity of the ruler depended on the welfare and happiness of the subjects, but the subjects themselves were not capable of achieving this happiness without permanent directions from above. Cameralism’s emphasis on administration and university institutionalization means that this approach cannot be seen as a local variant of mercantilism. The traditional account of the German historical school from 1840 to 1945 emphasized for over a century the contrast between the German and the Neoclassical traditions. It underlined the significance of the organic approach, the concept of development and individuality, the importance of the social question, and the denial of the deductive method and unalterable laws of the economy. Modern reconstructions see the historical school as one European response to the post-Classical crisis, offering an inductive alternative grounded empirically on history. The Austrian school formed in 1871 was at once a constituent of the Neoclassical paradigm and a rival to it. Methodological individualism, subjectivism, the importance of time, the role of knowledge, the theory of alternative costs etc. were absorbed into mainstream economics, but the focusing on these issues allowed the Austrian school, in keeping alive its demand for a social-theoretical explanation, to preserve something of an alternative discourse.

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A személyazonosság-menedzsment napjaink fontos kutatási területe mind elméleti, mind gyakorlati szempontból. A szakterületen megvalósuló együttműködés, elektronikus tudásáramoltatás és csere hosszú távon csak úgy képzelhető el, hogy az azonos módon történő értelmezést automatikus eszközök támogatják. A szerző cikkében azokat a kutatási tevékenységeket foglalja össze, amelyeket - felhasználva a tudásmenedzsment, a mesterséges intelligencia és az információtechnológia eszközeit - a személyazonosság-menedzsment terület fogalmi leképezésére, leírására használt fel. Kutatási célja olyan közös fogalmi bázis kialakítása volt személyazonosság-menedzsment területre, amely lehetővé teszi az őt körülvevő multidimenzionális környezet kezelését. A kutatás kapcsolódik a GUIDE kutatási projekthez is, amelynek a szerző résztvevője. ______________ Identity management is an important research field from theoretical and practical aspects as well. The task itself is not new, identification and authentication was necessary always in public administration and business life. Information Society offers new services for citizens, which dramatically change the way of administration and results additional risks and opportunities. The goal of the demonstrated research was to formulate a common basis for the identity management domain in order to support the management of the surrounding multidimensional environment. There is a need for capturing, mapping, processing knowledge concerning identity management in order to support reusability, interoperability; to help common sharing and understanding the domain and to avoid inconsistency. The paper summarizes research activities for the identification, conceptualisation and representation of domain knowledge related to identity management, using the results of knowledge management, artificial intelligence and information technology. I utilized the experiences of Guide project, in which I participate. The paper demonstrates, that domain ontologies could offer a proper solution for identity management domain conceptualisation.

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The purpose of this ethnographic study was to describe and explain the congruency of psychological preferences identified by the Myers-Briggs Type Indicator (MBTI) and the human resource development (HRD) role of instructor/facilitator. This investigation was conducted with 23 HRD professionals who worked in the Miami, Florida area as instructors/facilitators with adult learners in job-related contexts.^ The study was conducted using qualitative strategies of data collection and analysis. The research participants were selected through a purposive sampling strategy. Data collection strategies included: (a) administration and scoring of the MBTI, Form G, (b) open-ended and semi-structured interviews, (c) participant observations of the research subjects at their respective work sites and while conducting training sessions, (d) field notes, and (e) contact summary sheets to record field research encounters. Data analysis was conducted with the use of a computer program for qualitative analysis called FolioViews 3.1 for Windows. This included: (a) coding of transcribed interviews and field notes, (b) theme analysis, (c) memoing, and (d) cross-case analysis.^ The three major themes that emerged in relation to the congruency of psychological preferences and the role of instructor/facilitator were: (1) designing and preparing instruction/facilitation, (2) conducting training and managing group process, and (3) interpersonal relations and perspectives among instructors/facilitators.^ The first two themes were analyzed through the combination of the four Jungian personality functions. These combinations are: sensing-thinking (ST), sensing-feeling (SF), intuition-thinking (NT), and intuition-feeling (NF). The third theme was analyzed through the combination of the attitudes or energy focus and the judgment function. These combinations are: extraversion-thinking (ET), extraversion-feeling (EF), introversion-thinking (IT), and introversion-feeling (IF).^ A last area uncovered by this ethnographic study was the influence exerted by a training and development culture on the instructor/facilitator role. This professional culture is described and explained in terms of the shared values and expectations reported by the study respondents. ^

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This study examines the congruency of planning between organizational structure and process, through an evaluation and planning model known as the Micro/Macro Dynamic Planning Grid. The model compares day-to-day planning within an organization to planning imposed by organizational administration and accrediting agencies. A survey instrument was developed to assess the micro and macro sociological analysis elements utilized by an organization.^ The Micro/Macro Dynamic Planning Grid consists of four quadrants. Each quadrant contains characteristics that reflect the interaction between the micro and macro elements of planning, objectives and goals within an organization. The Over Macro/Over Micro, Quadrant 1, contains attributes that reflect a tremendous amount of action and ongoing adjustments, typical of an organization undergoing significant changes in either leadership, program and/or structure. Over Macro/Under Micro, Quadrant 2, reflects planning characteristics found in large, bureaucratic systems with little regard given to the workings of their component parts. Under Macro/Under Micro, Quadrant 3, reflects the uncooperative, uncoordinated organization, one that contains a multiplicity of viewpoints, language, objectives and goals. Under Macro/Under Micro, Quadrant 4 represents the worst case scenario for any organization. The attributes of this quadrant are very reactive, chaotic, non-productive and redundant.^ There were three phases to the study: development of the initial instrument, pilot testing the initial instrument and item revision, and administration and assessment of the refined instrument. The survey instrument was found to be valid and reliable for the purposes and audiences herein described.^ In order to expand the applicability of the instrument to other organizational settings, the survey was administered to three professional colleges within a university.^ The first three specific research questions collectively answered, in the affirmative, the basic research question: Can the Micro/Macro Dynamic Planning Grid be applied to an organization through an organizational development tool? The first specific question: Can an instrument be constructed that applies the Micro/Macro Dynamic Planning Grid? The second specific research question: Is the constructed instrument valid and reliable? The third specific research question: Does an instrument that applies the Micro/Macro Dynamic Planning Grid assess congruency of micro and macro planning, goals and objectives within an organization? The fourth specific research question: What are the differences in the responses based on roles and responsibilities within an organization? involved statistical analysis of the response data and comparisons obtained with the demographic data. (Abstract shortened by UMI.) ^

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The purpose of this research was to study the effect of the Florida A+ Plan accountability program on curriculum and instruction in four Title I public elementary schools in the Miami-Dade County Public Schools system. It focused on the experiences of the school principals and the classroom teachers of the four schools as they related to curriculum and instruction. The study included an analysis of the school improvement plans in curriculum and instruction for each school during the school years 1998-2004. ^ The study was conducted in the format of interviews with the school principals and principal selected classroom teachers who taught third, fourth, or fifth grade during the first six years of the Florida A+ Plan. The analysis of the school improvement plans focused on the implementation of curriculum and instruction for each of the four schools. It focused on the goals and measurable objectives selected by each school to improve its instructional program in the academic subjects of reading, mathematics, writing, and science. ^ The findings indicated that under the pressure to improve their school grade on the Florida A+ Plan, each of the target schools, based on individual needs assessments, and restructured their instructional program each school year as documented in their school improvement plans. They altered their programs by analyzing student performance data to realign curriculum and instruction. The analysis of the interviews with the principals and the teachers showed that each school year they restructured their program to align it with the FCAT content. This realigning was a collaborative effort on the part of the administration and the instructional staff. ^

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This study examined university students' writing skills as perceived by university students and their English instructors. The goal of the study was to provide English instructors with objective, quantified information about writing perceptions from both the students' and instructors' viewpoints. ^ A survey instrument was developed based on a survey instrument created by Newkirk, Cameron, and Selfe (1977) to identify instructors' perceived knowledge of student writing skills. The present study used a descriptive statistical design. It examined five writing skill areas: attitude, content, grammar and mechanics, literary considerations, and the writing process through a questionnaire completed by a convenience sample of summer and fall admitted freshmen who were enrolled in Essay Writing and Freshman Composition courses and English Department instructors at a large South Florida public university. ^ The study consisted of five phases. The first phase was modifying of the Newkirk, Cameron, and Selfe (1977) questionnaire. Two versions of the revised survey were developed - one for instructors and one for students. The second phase was pilot testing the questionnaire for evaluation of administration and scoring. The third phase was administering the questionnaire to 1,280 students and 48 instructors. The fourth phase was analyzing the data. The study found a significant difference in the perceptions of students and instructors in all areas of writing skills examined by the survey. Responses to 29 of 30 questions showed that students felt they had better attitudes toward writing and better writing skills than instructors thought. ^ The final phase was developing recommendations for practice. Based on findings and theory and empirical evidence drawn from the fields of adult education and composition research, learner-centered, self-directed curriculum guidelines are offered. ^ By objectively quantifying student and instructor perceptions of students' writing skills, this study contributes to a growing body of literature that: (a) encourages instructors to acknowledge the perception disparities between instructors and students; (b) gives instructors a better understanding of how to communicate with students; and (c) recommends the development of new curriculum, placement tests, and courses that meet the needs of students and enables English instructors to provide meaningful instruction. ^

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It is projected that by 2020, there will be 138 million Americans over 45, the age at which the increased incidence of heart diseases is documented. Many will require stents. This multi-billion dollar industry, with over 2 million patients worldwide, 15% of whom use Nitinol stents have experienced a decline in sales recently, due in part to thrombosis. It is a sudden blood clot that forms inside stents. As a result, the Food and Drug Administration and American Heart Association are calling for a new generation of stents, new designs and different alloys that are more adaptable to the arteries. The future of Nitinol therefore depends on a better understanding of the mechanisms by which Nitinol surfaces can be rendered stable and inert. In this investigation, binary and ternary Nitinol alloys were prepared and subjected to various surface treatments such as electropolishing (EP), magnetoelectropolishing (MEP) and water boiling & passivation (W&P). In vitro corrosion tests were conducted on Nitinol alloys in accordance with ASTM F 2129-08. The metal ions released into the electrolyte during corrosion tests were measured by Inductively Coupled Plasma Mass Spectroscopy (ICP-MS). Biocompatibility was assessed by observing the growth of human umbilical vein endothelial cells (HUVEC) on the surface of Nitinol alloys. Static and dynamic immersion tests were performed by immersing the Nitinol alloys in cell culture media and measuring the amount of metal ions released in solution. Sulforhodamine B (SRB) assays were performed to elucidate the effect of metal ions on the growth of HUVEC cells. The surfaces of the alloys were studied using Scanning Electron Microscopy (SEM) and X-ray Photoelectron Spectroscopy (XPS) respectively. Finally, wettability and surface energy were measured by Contact Angle Meter, whereas surface roughness was measured by Atomic Force Microscopy (AFM). All the surface treated alloys exhibited high resistance to corrosion when compared with untreated alloys. SRB assays revealed that Ni and Cu ions exhibited greater toxicity than Cr, Ta and Ti ions on HUVEC cells. EP and MEP alloys possessed relatively smooth surfaces and some were composed of nickel oxides instead of elemental nickel as determined by XPS. MEP exhibited lowest surface energy and lowest surface roughness.

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The purpose of this qualitative case study was to gain insight into the perspectives of experienced higher education administrators regarding faculty unionization, the collective bargaining process, and the interpersonal relationships between higher education faculty members and administrators. ^ The primary method of data collection was semi-structured face to face interviews with nine administrators from two community colleges and two universities in the south Florida area. All of the study participants worked with unionized faculty members and had direct experience participating in bargaining negotiations. ^ Upon the completion of each interview, the researcher listened to the taped audio recording of the interview several times and then transcribed all of the information from the audiotape into a Word file. Data collection and analysis for each participant were performed concurrently. Using a modified concept mapping approach, the research questions were written on large yellow sticky notes and placed in the middle of a wall in the researcher’s home with nine descriptive categorical themes written on smaller sticky notes placed around the study questions. The highlighted quotes and key phrases were cut from each transcript and placed under each of the descriptive categories. Over the course of a few months repeatedly reviewing the research questions that guided this study, the theory of symbolic interactionism, and relevant literature the categorical descriptive themes were refined and condensed into five descriptive themes. ^ Study findings indicated that the administrators: (a) must have a clear understanding of what it is that the faculty does to be an effective representative at the bargaining table, (b) experienced role ambiguity and role strain related to a lack of understanding as to their role at the bargaining table and a lack of organizational support, (c) were not offered any type of training in preparation for bargaining, (d) perceived a definite “us versus them” mentality between faculty and administration, and (e) saw faculty collective bargaining at public institutions of higher education in Florida as ineffectual. ^

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Rates of survival of victims of sudden cardiac arrest (SCA) using cardio pulmonary resuscitation (CPR) have shown little improvement over the past three decades. Since registered nurses (RNs) comprise the largest group of healthcare providers in U.S. hospitals, it is essential that they are competent in performing the four primary measures (compression, ventilation, medication administration, and defibrillation) of CPR in order to improve survival rates of SCA patients. The purpose of this experimental study was to test a color-coded SMOCK system on: 1) time to implement emergency patient care measures 2) technical skills performance 3) number of medical errors, and 4) team performance during simulated CPR exercises. The study sample was 260 RNs (M 40 years, SD=11.6) with work experience as an RN (M 7.25 years, SD=9.42).Nurses were allocated to a control or intervention arm consisting of 20 groups of 5-8 RNs per arm for a total of 130 RNs in each arm. Nurses in each study arm were given clinical scenarios requiring emergency CPR. Nurses in the intervention group wore different color labeled aprons (smocks) indicating their role assignment (medications, ventilation, compression, defibrillation, etc) on the code team during CPR. Findings indicated that the intervention using color-labeled smocks for pre-assigned roles had a significant effect on the time nurses started compressions (t=3.03, p=0.005), ventilations (t=2.86, p=0.004) and defibrillations (t=2.00, p=.05) when compared to the controls using the standard of care. In performing technical skills, nurses in the intervention groups performed compressions and ventilations significantly better than those in the control groups. The control groups made significantly (t=-2.61, p=0.013) more total errors (7.55 SD 1.54) than the intervention group (5.60, SD 1.90). There were no significant differences in team performance measures between the groups. Study findings indicate use of colored labeled smocks during CPR emergencies resulted in: shorter times to start emergency CPR; reduced errors; more technical skills completed successfully; and no differences in team performance.

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Best management practices in green lodging are sustainable or “green” business strategies designed to enhance the lodging product from the perspective of owners, operators and guests. For guests, these practices should enhance their experience while for owners and operators, generate positive returns on investments. Best management practices in green lodging typically starts with a clear understanding of each lodging firm’s role in society, its impact on the environment and strategies developed to mitigate negative environmental externalities generated from the production of lodging goods and services. Negative externalities of hotel operations manifest themselves in energy and water usage, waste generation and air pollution. Hence, best management practices in green lodging are dynamic, cost effective, innovative, stakeholder driven and environmentally sound technical and behavioral solutions that attempt to ameliorate or eliminate the negative environmental externalities associated with lodging operations, while simultaneously generate positive returns on green investments. Thus, best management practices in green lodging should reduce lodging firms’ operating costs, increase guest satisfaction, reduce or eliminate the negative environmental impacts associated with hotel operations while simultaneously enhance business operations.