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ستعرف في هذا الكتاب عزيزي القارئ كيف وصل بيل جيتس إلى هذا المركز المالي المرموق رغم صغر سنه هذا الفتى الذي يتجاوز عمره أوائل الأربعينات وعن تلك الثروة الضخمة التي تقدر بالمليارات والتي تزداد يوما بعد يوم بل ساعة بعد ساعة فهو في حد ذاته ثورة في عالم الكمبيوتر وثروة في عالم المال وكيف نجح هذا النجاح المذهل في عالم الكمبيوتر.
BOOK
Deafness in children: a national survey of aetiological investigations
Objective The aim of this study was to obtain national data regarding adherence to national guidelines for aetiological investigations for hearing loss in children and highlight any variations in practice. Information was also collected on possible factors affecting lack of adherence. Design An online questionnaire based on the national guidelines for aetiological investigations for deafness was designed. Setting The questionnaire was distributed to the leads of all the Newborn Hearing Screening Programme (NHSP) sites across England through the Medical Research Council Hearing & Communication Group. Participants The questionnaire was sent to 100 recipients; from this 52 responses were obtained. Outcome measures Variability in the investigations offered for hearing loss. Results There was a 52% response rate. Analysis of the responses showed that audiovestibular physicians and paediatricians in audiology were more likely than other specialists to request level 1 investigations (investigations that are recommended to be offered in all cases). Respondents from London and the North West were more likely to request level 1 investigations compared with those from other regions. In all, 14 of the 19 audiovestibular physicians and paediatricians in audiology requested level 1 investigations routinely, but only 11 of 33 from other specialties did likewise. Of the 20 respondents from London and the Northwest, 15 requested level 1 investigations routinely, whereas only 10 of the 32 respondents from the other regions did the same. The difference was statistically significant in both cases. The geographical variation was specially marked for family audiograms and MRI. Conclusions There is significant variation from the national guidelines in requesting aetiological investigations for permanent hearing impairment (PHI) in children, depending on the specialty of the clinician and the geographical region, these variations appear partly to be due to the availability of local resources but also due to lack of awareness of the importance of some investigations.
Journal Article
Reimbursement for School Nursing Health Care Services
Children come to school with a variety of health conditions, varying from moderate health issues to multiple, severe chronic health illnesses that have a profound and direct impact on their ability to learn. The registered professional school nurse (hereinafter referred to as school nurse) provides medically necessary services in the school setting to improve health outcomes and promote academic achievement. The nursing services provided are reimbursable services in other health care settings, such as hospitals, clinics, and home care settings. The National Association of School Nurses (NASN) believes that school nursing services that are reimbursable nursing services in other health care systems should also be reimbursable services in the school setting, while maintaining the same high quality care delivery standards. Traditionally, local and state tax revenues targeted to fund education programs have paid for school nursing health services. School nurses are in a strategic position to advocate for improving clinical processes to better fit with community health care providers and to align reimbursements with proposed changes. Restructuring reimbursement programs will enable health care funding streams to assist in paying for school nursing services delivered to students in the school setting. Developing new innovative health financing opportunities will help to increase access, improve quality, and reduce costs. The goal is to promote a comprehensive and cost-effective health care delivery model that integrates schools, families, providers, and communities.
Journal Article
G‐protein receptor kinase 3 (GRK3) influences opioid analgesic tolerance but not opioid withdrawal
Tolerance to opioids frequently follows repeated drug administration and affects the clinical utility of these analgesics. Studies in simple cellular systems have demonstrated that prolonged activation of opioid receptors produces homologous receptor desensitization by G‐protein receptor kinase mediated receptor phosphorylation and subsequent β‐arrestin binding. To define the role of this regulatory mechanism in the control of the electrophysiological and behavioral responses to opioids, we used mice having a targeted disruption of the G‐protein receptor kinase 3 (GRK3) gene. Mice lacking GRK3 did not differ from wild‐type littermates neither in their response latencies to noxious stimuli on the hot‐plate test nor in their acute antinociceptive responses to fentanyl or morphine. Tolerance to the electrophysiological response to the opioid fentanyl, measured in vitro in the hippocampus, was blocked by GRK3 deletion. In addition, tolerance to the antinociceptive effects of fentanyl was significantly reduced in GRK3 knockouts compared to wild‐type littermate controls. Tolerance to the antinociceptive effects of morphine was not affected by GRK3 deletion although morphine tolerance in hippocampal slices from GRK3 knockout mice was significantly inhibited. Tolerance developed more slowly in vitro to morphine than fentanyl supporting previous work in in vitro systems showing a correlation between agonist efficacy and GRK3‐mediated desensitization. The results of these studies suggest that GRK3‐mediated mechanisms are important components of both electrophysiologic and behavioral opioid tolerance. Fentanyl, a high efficacy opioid, more effectively produced GRK3‐dependent effects than morphine, a low efficacy agonist. British Journal of Pharmacology (2004) 141, 55–64. doi:10.1038/sj.bjp.0705595
Journal Article
Integrating learning with life: a study of higher education students in a further education college: 2000-2003
In Scotland, further education colleges provide 28% of all higher education; this includes over half of part-time undergraduate higher education. This provision has contributed to wider participation in higher education in Scotland by “non traditional” students and to progress towards a mass system of higher education within a learning society. This thesis is a case study of higher education students in a Scottish further education college. It explores the nature of the students’ experience and its relevance to institutional management and higher education policy. Evidence is drawn from the college’s records, from focus groups and from a questionnaire survey of whole year groups (full-time and part-time students) over three successive years. The theoretical focus is upon a new definition of lifelong learning as learning integrated with life, drawn from literature on motive, motivation, participation and retention. The research explores the students’ experiences of combining study with work and family life. The student experience is found to be heterogeneous, complex and distinct from the stereotype of a young full-time university student. Vocational motives predominate and there is evidence of a significant investment of meaning, expectation and purpose in the experience of higher education. The students’ ability to balance and integrate learning with life is a determining factor in the achievement of sustained participation. The quality of support networks both in college and in the students’ work and family lives are found to be more significant than personal or demographic characteristics. The case study contributes to current thinking about the professional role of college senior managers in creating a student-centred institutional culture that responds to the complexity of the students’ experience. A case is made for a review of the current inequity of financial support for full-time and part-time higher education students and of the marginal status of colleges in the development of higher education policy.
Dissertation
Multinational Leaders
Typical meganational corporate leaders have the following characteristics: 1. They are company men for the most part. 2. They often are isolated from the public. 3. Some have blood lines to the company. 4. They are well connected. 5. Many have close relationships with government leaders. 6. They tend to be married, well educated, and near the twilight of their careers. 7. Most are urbane, intelligent, and have iron-clad personalities and philosophies. While most chief executives have passed through a rigorous selection process while working their way to the top, they are mostly self-selected. They are ambitious and will protect their jobs at great cost. Once at the top, elected by a small, incestous board of directors, chief executives can rule unchallenged.
Journal Article
The Schools Everyone Loves
MOST Americans can't help but keep a tender spot in their hearts for the \"little red schoolhouse.\" It reminds us of simpler days-- before education was big business, before it became a massive political and social issue. The images of George Washington rowing to school on the Potomac River; Tom Sawyer, Huck Finn, and their schoolmarm; pioneer children riding to class on horseback-- all seem etched in the nation's memory.
Journal Article
Bank Loans Give Entrepreneurs Growth Options
Lisa Richards spotted a trend. And as a smart entrepreneur, she made a business of it. She noticed that San Diegans, who would rather be out of doors than in, needed help staging big outdoor events. On a shoestring, Richards started The Picnic People, now one of San Diego's most successful catering firms. When she started her home-based business six years ago, Richards lacked financing, but success pushed her into the loan market. \"I had the choice to do it right or forget it,\" said Richards. Last year Picnic People pulled in gross sales of $3 million. Today, her firm employs 28 full-time people and is planning a national expansion. (excerpt)
Journal Article