A fast track SAP R/3 implementation at Guilbert Niceday

This paper examines the approach of Guilbert, a European stationery company, which has chosen a fast track strategy towards implementation of enterprise resource planning.

Will Obama fast-track the Trans-Pacific Partnership?

This week there has been discussions between leaders from the Pacific Rim over the Trans-Pacific Partnership in Bali, Indonesia at APEC...

Can Genetics Predict Response to Complex Behavioral Interventions? Evidence from a Genetic Analysis of the Fast Track Randomized Control Trial.

Early interventions are a preferred method for addressing behavioral problems in high-risk children, but often have only modest effects. Identifying sources of variation in intervention effects can suggest means to improve efficiency. One potential source of such variation is the genome. We conducted a genetic analysis of the Fast Track randomized control trial, a 10-year-long intervention to prevent high-risk kindergarteners from developing adult externalizing problems including substance abuse and antisocial behavior. We tested whether variants of the glucocorticoid receptor gene NR3C1 were associated with differences in response to the Fast Track intervention. We found that in European-American children, a variant of NR3C1 identified by the single-nucleotide polymorphism rs10482672 was associated with increased risk for externalizing psychopathology in control group children and decreased risk for externalizing psychopathology in intervention group children. Variation in NR3C1 measured in this study was not associated with differential intervention response in African-American children. We discuss implications for efforts to prevent externalizing problems in high-risk children and for public policy in the genomic era.

Fast-track construction with slag cement concrete: Adiabatic strength development and strength prediction

The early-age strength development of concrete containing slag cement has been investigated to give guidance for its use in fast-track construction. Measurements of temperature rise under adiabatic conditions have shown that high levels of slag cement-for example, 70% of the total binder-are required to obtain a significant reduction in the peak temperature rise. Despite these temperature rises being lower than those for portland cement mixtures, however the early-age strength under adiabatic conditions of slag cement concrete can be as high as 250% of the strength of companion cubes cured at 20 degrees C (68 degrees F). The maturity and, hence, strength development were calculated from the adiabatic temperature histories based on several Maturity functions available in the literature. The predicted strength development with age was compared with the experimental results. Maturity functions that take into account the lower ultimate strengths obtained at elevated curing temperatures were found to be better at predicting the strength development.

Dexmedetomidina vs Remifentanil en fast track (transito rápido) durante cirugía cardiaca

Actualmente las técnicas de anestesia de tránsito rápido en cirugía cardiaca se basan en la utilización de remifentanil, sin embargo este al tener una vida media tan corta hace que sea necesaria la utilización de opioides durante el posoperatorio inmediato presentandose el riesgo de depresión ventilatoria, y complicaciones respiratorias, es por esto que la dexmedetomidina podría ser una opción bastante atractiva debida a que no produce depresión de los centros respiratorios, y disminuye el consumo de opioides en el postoperatorio hasta un 66%. Previa aprobación del comité de ética se realizó un estudio clínico controlado y aleatorizado en dos grupos de 20 pacientes, El primer grupo recibió inducción con propofol 2mg/Kg, pancuronio 0.8mg/kg, y fentanil 2mcg/kg seguido de un bolo de dexmedetomidina de 0.5mcg/kg y una infusión de 0.3 - 0.7 mcg/kg/h la cual fue suspendida al finalizar la colocación de los alambres esternales, el grupo de remifentanil recibió una inducción con propofol y pancuronio a las mismas dosis, seguido de una infusión de remifentanil de 0.1 - 0.5 mcg/kg/min suspendida al finalizar el cierre de la piel, ambos grupos recibieron analgesia con dipirona 50mg/kg, morfina 0.1mg/kg seguida de dosis de rescate de 3mg según necesidad, e infiltración de la herida quirurgica con 40cc de Bupivacaina al 0.25%. Se midio el tiempo y lugar de extubación, el consumo de medicamentos vasopresores y vasodilatadores durante la cirugiaasi como el consumo de morfina el VAS y la incidencia de nausea y vomito durante las primeras 24h posoperatorias. El 85% de los pacientes fueron extubados en salas de cirugia, sin encontrarse diferencias estadiscamente significativas entre los tiempos de extubación de ambos grupos (11.7min) para remifentanil, y (9.6min) para dexmedetomidina, en cuanto al consumo de morfina este fue significativamente menor en el grupo de dexmedetomidina 4mg vs 15mg en el grupo de remifentanil así como también lo fue la incidencia de nausea y vomito 42.9% remifentanil vs 5.2% dexmedetomidina p:0.00009. A nuestro saber este es el primer estudio clínico en la literatura en el cual se ha propuesto a la dexmedetomidina como una alternativa para técnicas anestésicas de transito rápido en cirugia cardiaca. Los resultados sugieren que es tan eficaz como el remifentanil para permitir la extubación temprana de este grupo de pacientes con una menor consumo de morfina y una menor incidencia de nauseas y vomito durante el posoperatorio. Se recomiendan la realización de estudios adicionales que permitan ratificar los resultados previamente encontrados.

On the fast track speeding nurses into the future: a two year Bachelor of Nursing for graduates of other disciplines

It has been suggested in nursing literature that a bachelor's degree should be the pre-requisite to professional nursing education and registration. The perceived advantages of graduates entering the nursing profession led faculty in the School of Nursing La Trobe University to introduce in 1997 an innovative two-year Bachelor of Nursing (BN) program, believed to be the first in Australia, for graduates of other disciplines. A problem-based learning (PBL) approach was selected to facilitate the teaching learning process. Data to evaluate the progress of the accelerated students were collected by examining their previous degree background, conducting a focus group discussion mid year and comparing the students' academic results with those completing the traditional three-year course. Findings indicate that students in the accelerated course were highly motivated but experienced significant stress. In part the stress emanated from the need to identify their own learning needs. However, despite their concerns most accelerated students scored at least as well both clinically and academically as traditional students. Moreover, in six of the seven final year subjects each group studied the accelerated students performed better.

Effect of emergency department fast track on emergency department length of stay : a case-control study

Objective: To examine the effect of fast track on emergency department (ED) length of stay (LOS).

Design and setting: Pair-matched case–control design in a public teaching hospital in metropolitan Melbourne, Australia.

Participants: Patients treated by the ED fast track (cases) between 1 January and 31 March 2007 were compared with patients treated by the usual ED processes (controls) from 1 July to 15 November 2006 (n = 822 matched pairs).

Intervention: ED fast track was established in November 2006 and focused on the management of patients with non-urgent complaints.

Main outcome measures: The primary outcome measure was ED LOS for fast-track patients. Secondary outcomes were waiting times and ED LOS for other ED patients.

Results: Median ED LOS for non-admitted patients was 132 minutes (interquartile range (IQR) 83–205.25) for controls and 116 minutes (IQR 75.5–159.0) for cases (p<0.01). Fast-track patients had a significantly higher incidence of discharge within 2 h (53% vs 44%, p<0.01) and 4 h (92% vs 84%, p<0.01).

Conclusions: ED fast track decreased ED LOS for non-admitted patients without compromising waiting times and ED LOS for other ED patients