This paper argues that university strategic positioning is influenced by the organisational dimension, operationalised along the variables of organisational structure, identity and centrality. A ...comparative case study is presented including two English and two Italian universities and drawing on a set of sixty interviews with academic leaders, managers and administrators. The analysis of the trajectory of the four universities from 2004 to 2018 illustrates the articulation of the link between the three organisational variables and positioning and how this has changed over time. Finally, the paper outlines six propositions on the expected impact of the organisational structure, identity and centrality on positioning processes of universities.
Following the ideas of New Public Management, Quality Assurance (QA) practices have become a relevant concern for public organizations. In the Higher Education sector, QA policies have inspired ...different reforms, becoming a debated issue for universities' leaders and policy-makers. This article analyzes the implementation of a newly defined committee for quality assurance (QAC) within Italian universities in order to identify if, as happened in other NPM reforms, it represents a further example of 'implementation gap'; and to detect the key variables that promote a satisfactory QAC functioning. Based on both the analysis of the composition and the role of QAC in all the Italian public universities and significant case studies, we have identified some core variables that promote the implementation of an effective QAC and ultimately supports the overall QA policy.
Pregnancy is a risk factor for transient restless legs syndrome, which usually recovers during the postdelivery period. The goal of the present survey is to investigate whether restless legs syndrome ...during pregnancy represents a risk factor for later development of restless legs syndrome.
A long-term follow-up study, planned as an extension of a previous survey on restless legs syndrome during pregnancy, was carried out. After a mean interval of 6.5 years, 207 parous women were contacted again to compare the incidence of restless legs syndrome among subjects who never experienced the symptoms with those who reported restless legs syndrome during the previously investigated pregnancy.
Seventy-four women who experienced restless legs syndrome during previous pregnancy, and 133 who did not, were included in the study. The incidence of restless legs syndrome was 56% person/year in women who experienced the transient pregnancy restless legs syndrome form, and 12.6% person/year in subjects who did not, with a significant 4-fold increased risk of developing chronic restless legs syndrome in women who presented restless legs in the previous pregnancy. Considering further new pregnancies during the follow-up period, the restless legs symptoms reappeared in 58% of the cases, while they emerged for the first time in only 3% of women who had never experienced restless legs syndrome.
The transient pregnancy restless legs syndrome form is a significant risk factor for the development of a future chronic idiopathic restless legs syndrome form, and for a new transient symptomatology in a future pregnancy.
Inverted papilloma of the frontal sinus is a challenging disease. Given its rarity, only small case series are present in the literature. The objectives of the present study are to review our ...experience in the surgical management of inverted papillomas involving the frontal sinus and to propose a practical algorithm for selecting the most appropriate approach. Data on patients affected by inverted papilloma involving the frontal sinus and surgically treated between 2002 and 2016 were collected. The type of involvement of frontal sinus and extent of surgery performed (endoscopic endonasal, external or combined approaches) were analysed. A brief review of consistent literature was also carried out. Forty-seven consecutive patients were treated using an exclusive endoscopic endonasal approach (EEA) in 18 cases, while a combined endonasal with external osteoplastic approach was required in 29 cases. Most patients (29/47, 62%) had been treated previously, mainly by an endoscopic approach. A single intraoperative complication occurred (1/47, 2%), i.e. cerebrospinal fluid (CSF) leak, that was successfully repaired intraoperatively without any consequences. Recurrences were observed in only 2/47 cases (4%) after a mean follow-up of 43 months (range, 12-137). The management of inverted papilloma involving the frontal sinus requires great expertise and the surgical technique should be tailored to the site of attachment of the tumour, its extension and the anatomical conformation of each frontal sinus. The encouraging results obtained in this case series support the use of this practical treatment algorithm.
Palatal tremor after brachial plexus anaesthesia Tocco, P.; Turri, M.; Acler, M. ...
British journal of anaesthesia : BJA,
December 2014, 20141200, 2014-Dec, 2014-12-00, Letnik:
113, Številka:
6
Journal Article
Research regarding consumer choice and assortment size has led to contradictory findings. Extant research demonstrates that consumers prefer large product assortments, as they are more likely to find ...an item that matches their preferences). On the other hand, research has shown that large choice sets can overwhelm consumers and lead to increased decision difficulty and levels of regret. Experiment 1 examines the moderating effect filtering has on the relationship between assortment size and decision difficulty, decision process satisfaction, and regret. Experiment 2 examines filtering but adds situational involvement as a moderator. Results offer support for the moderating role of filtering and situational involvement in choice overload. The results of this research extend the choice overload literature and have managerial implications for the retail sector, particularly as it relates to omnichannel filtering technologies and product assortments.
Spasticity is classically defined as an increase of the velocity dependent stretch reflex and the H-reflex (HR) is commonly used to study the excitability of spinal motor circuitry. Some features of ...upper neuron syndrome like spasticity are associated with H-reflex alterations and different patterns of HR abnormalities have been reported. However, the simple evaluation of the soleus HR amplitude and H max/ M max ratio may lack clinical and physiological relevance when approaching spasticity. We studied HR stimulating tibial nerve at popliteal fossa and recording at soleus muscle bilaterally in 16 subjects with Multiple Sclerosis (MS) and spasticity. H max/ M max, recovery cycle (HRC) of HR with ISI ranging from 5 to 1000 ms were detected and results were compared with age-sex- matched controls. HRS was increased significantly in MS subjects at ISI 500 ms compared to healthy subjects. No difference was detected regarding H / M ratio. Our data demonstrated that HRC is more sensitive than H max/ M max ratio in MS patients affected by spasticity and may represent the neurophysiological correlate of spinal inhibitory interneurons and descending pathways impairment in MS patients with spasticity. These findings could serve as electrophysiological tool to assess spasticity and monitor efficacy of therapeutic interventions.
Background
The aim of this study was to explore the nociceptive system of patients affected by trigeminal neuralgia (TN) secondary to documented vascular contact who underwent microvascular ...decompression. For that purpose, we used the classical trigeminal reflexes and the trigeminal laser‐evoked potentials (tLEPs) before and after surgery, in order to verify any possible change after decompression and determine if there was any correlation between the neurophysiological parameters and the clinical outcome.
Methods
Eleven patients affected by TN caused by trigeminovascular contact and 10 age‐matched controls underwent conventional trigeminal reflexes (bilateral Blink Reflex/BR and Masseter Inhibitory Reflex stimulating infraorbital and mental nerves/MIR V2 and V3) and tLEPs. Patients repeated neurophysiological tests one week after surgery.
Results
Short‐latency BR and MIR were normal in all patients before surgery and there was no statistical difference before and after surgery. Conversely, in patients before surgery, tLEPs' amplitudes were significantly lower in the affected than in the healthy side (p = 0.017 for V2 and 0.037 for V3 branches). After surgery, on the affected side, tLEP amplitude increased and the pre/post‐operative difference was significant (p = 0.017 for V2 and 0.028 for V3 divisions). Nine patients referred satisfactory pain relief and the favourable clinical outcome correlated with the neurophysiological recovery.
Conclusions
This study demonstrates that TN caused by trigeminovascular compression may be related to Aδ fibres impairment, and tLEPs are more sensitive than conventional trigeminal reflexes to reveal small fibre dysfunction and to monitor the post‐surgical outcome in these patients.
High-resolution mapping of quantitative trait loci (QTL) in animals has proved to be difficult because the large effect sizes detected in crosses between inbred strains are often caused by numerous ...linked QTLs, each of small effect. In a study of fearfulness in mice, we have shown it is possible to fine map small-effect QTLs in a genetically heterogeneous stock (HS). This strategy is a powerful general method of fine mapping QTLs, provided QTLs detected in crosses between inbred strains that formed the HS can be reliably detected in the HS. We show here that single-marker association analysis identifies only two of five QTLs expected to be segregating in the HS and apparently limits the strategy's usefulness for fine mapping. We solve this problem with a multipoint analysis that assigns the probability that an allele descends from each progenitor in the HS. The analysis does not use pedigrees but instead requires information about the HS founder haplotypes. With this method we mapped all three previously undetected loci chromosome (Chr.) 1 logP 4.9, Chr. 10 logP 6.0, Chr. 15 logP 4.0. We show that the reason for the failure of single-marker association to detect QTLs is its inability to distinguish opposing phenotypic effects when they occur on the same marker allele. We have developed a robust method of fine mapping QTLs in genetically heterogeneous animals and suggest it is now cost effective to undertake genome-wide high-resolution analysis of complex traits in parallel on the same set of mice.
Pain is a common finding in patients affected by Multiple Sclerosis (MS). Many different types of pain can afflict MS patients, including neuropathic, nociceptive, or mixed pain. TSA-II-Thermotest ...(QST) and Laser evoked potentials (LEPs) are psychophysical and neurophysiological tests commonly used to explore pain. The study aims to determine psychophysical and neurophysiological correlates in MS patients. 16 MS patients (5 men, 11 women, mean age 59 years, mean EDSS 7) where clinically and neurophysiologically tested. 5 patients presented neuropathic central pain (according to NeuPSIG 2011 guidelines), 8 patients presented nociceptive or mixed pain, and 3 patients were pain-free. For QST, the dorsum of both hands and feet were examined; for LEPs, the dominant hand and both feet were tested. Results were collected and compared to age and sex matched controls. Pin-prick was altered in 37.5%, LEPs were abnormal in 57.8% and QST was pathological in 85.9% of examined sites. We detected a significant correlation between pain and clinical examination (0.022), pain and altered QST (0.042), while LEP abnormalities correlated well with the presence of neuropathic pain (0.012). Our results suggest that LEPs are more specific than QST to differentiate neuropathic from nociceptive pain.
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