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<p>Critical networks e.g. telecare services, telemonitoring, are implemented to provide the information security and reliability that the end user desires, especially during an emergency. Unlike business carrier systems that are planned for the general public’s use, critical communication systems are designed particularly for public protection and other serious communication situations. Availability and reliability of such networks is highly desirable. The following thesis works to compare and analyze a variety of communication access technologies to find out the best primary means of data transportation for health critical services and model reliable communication link by using redundancy. This study also provides an efficient failover mechanism to implement redundant links. This strategy is intended to provide the reliable communication and to protect the established communication link.</p>

Critical networks e.g. telecare services, telemonitoring, are implemented to provide the information security and reliability that the end user desires, especially during an emergency. Unlike business carrier systems that are planned for the general public’s use, critical communication systems are designed particularly for public protection and other serious communication situations. Availability and reliability of such networks is highly desirable. The following thesis works to compare and analyze a variety of communication access technologies to find out the best primary means of data transportation for health critical services and model reliable communication link by using redundancy. This study also provides an efficient failover mechanism to implement redundant links. This strategy is intended to provide the reliable communication and to protect the established communication link.

Class of 2008 Abstract / Objectives: Continuing pharmacy education (CPE) programs are required for pharmacists to maintain licensure and necessary to maintain current clinical knowledge. This study attempts to compare the quality of CPE programs from industry sponsored versus non-industry sponsored sources. Methods: Three CE programs were analyzed by comparison to an established guideline source. Diabetes mellitus was selected as the disease state because there was a recently published and widely accepted guideline document available. Two CPE programs were industry sponsored and one was independent of industry. The American Diabetes Association (ADA) guideline document on the management of type 2 diabetes was used to develop a scoring tool. Each CPE program was evaluated for consistency with the ADA guideline, using the scoring tool. The results were analyzed using the Fisher’s exact test. Also, the number of times that a drug name was mentioned in each program was recorded. Results: There was some discordance between the content of the three CPE programs and the ADA guidelines, but no discernible pattern was seen. There was a statistically significant difference between the non-industry sponsored programs. There were some inconsistencies among the three programs relative to “mentions” of drug names, but again no consistent pattern. Conclusions: This work does not provide convincing evidence of bias among industry-sponsored CPE programs. In retrospect, the choice of the specific CPE programs may have been inappropriate considering the nature of the guideline document and the evaluation tool that was developed from it.

A partir de los años noventa el sistema político en claro reconocimiento de la distancia entre ciudadanía y Parlamento, acordó iniciar un programa de reformas estructurales denominado de “segunda generación”. Estas reformas tienen como elemento fundamental al “diputado de circunscripción uninominal” elegido directamente por la ciudadanía y por simple mayoría de votos, características que posibilitan romper con la situación de “votar sin elegir”, con el consiguiente efecto arrastre de la elección presidencial a la configuración de todo el Poder Legislativo. Lo cuál sistemáticamente producía un creciente desprestigio de la institución congresal. En esa lógica, con la reforma del Articulo 60 de la Constitución Política del Estado, el sistema político se propone reducir el déficit de legitimidad electoral, representatividad y a la vez mejorar la representación política de la sociedad en el Parlamento Nacional. A diez años de puesta en práctica la reforma uninominal, de acuerdo al trabajo de campo, variables y unidades de análisis, se logra probar la hipótesis de trabajo, porque efectivamente existe ausencia de correspondencia entre las características de la elección uninominal (voto directo y cruzado) y la legitimidad electoral, representatividad y desempeño parlamentario uninominal. Debido fundamentalmente a la cultura política y ausencia de preparación normativa e institucional del Parlamento para recibir a este nuevo tipo de diputado nacional.

The Public vs. private movement has over the past decades identified numerous significant differences between public and private organizations. The observed differences covers almost every field in administrative economics ranging from organizational structure, management accounting, goal-setting and in the past few years even leadership. Strangely, in the majority of these studies little or no regards are given to organizational characteristics or fundamental differences between compared organizations and if these organizations really are comparable when studying the effect of sector. The aim of this study is to compare leadership in relatively similar organizations from both the public and private sector and so clarify if earlier identified differences in leadership styles still surface when leaders working with approximately the same thing in a similar work context are studied. A sample of 348 Swedish principals was drawn from both municipal and private elementary schools. The respondents answered a web-based survey based on the CPE-model resulting in leadership styles mapped according to three orientations: change, production and employee. Data was analyzed with several quantitative methods and the result failed to reproduce earlier observed differences with statistical significance or with satisfying strength when leaders working with approximately same thing in similar context were compared.

Syftet med denna studie har varit att undersöka ledarskap i Svenska kyrkan. Utifrån Svenska kyrkans organisation och framtida utmaningar så är det intressant att se på vilken typ av ledarskap som finns idag och även den typ som ses som det ideala. Frågorna som jag sökt svar på är: Hur ser kyrkoherdars ledarskapsstil ut idag? Vilken typ av ledarskapsstil är önskvärd inför framtiden? Genom en enkätundersökning riktad till 300 kyrkoherdar och komministrar så kom det in 105 svar. I enkäten har respondenterna fått bedöma dels hur deras nuvarande kyrkoherdar agerar (kyrkoherdarna gjorde här en självskattning) dels beskrivit hur en ideal kyrkoherde agerar. Frågorna i enkäten utgår från den tredimensionsmodell kring ledarskap som kallas CPE- modellen och frågorna och dess analysmatris har tagits fram av Farax Group AB.  CPE står för Förändring (Change), Struktur (Produktion) och Relation (Employee). Av svaren på frågorna i enkäten kan man utläsa vilken ledarskapsdimension som är den dominerande hos kyrkoherdarna. Resultatet visade att det är ganska jämt bland kyrkoherdarna mellan de två stilarna Förändring och Relation. När det gäller den ideala kyrkoherdens ledarskapsstil blev det en markant samstämmighet om att det som önskas är stilen Relation. I jämförelse med tidigare gjorda studier så framgår det att andelen kyrkoherdar som har stilen Förändring har ökat senaste åren.

Denna rapport är baserad utifrån ett examensarbete utfört hos Skellefteå Kraft Fibernät. Syftet var att jämföra ett antal olika modeller av tjänstefördelare och hitta en alternativ CPE till den som idag används. För att jämföra enheterna genomfördes ett antal tester såsom throughputtest, multicasttest och betygsättning av installationsvänligheten. Den gjordes en del intressanta upptäckter såsom att en uppgradering av mjukvaran förbättrade throughput och att bara en CPE hade lager 3 funktioner. I diskussionen görs slutligen en rekommendation på CPE baserat på resultaten i rapporten. / This report is based on a final project carried out at Skellefteå Kraft Fibernät. The aim was to compare a number of different models of CPE's and find an alternative CPE to the one currently used today. In order to compare the devices, a number of tests were carried out such as a throughput-test, multicast-test and a evaluation of the ease of installation. It was made some interesting discoveries such as that a firmware upgrade improved throughput and that only one CPE had layer 3 functionality. In the discussion, a recommendation on CPE is finally made based on the results in the report.

303 gesunde, deutsche Freiwillige, die in 53 verschiedene Länder (meist nach Asien, Afrika und Südamerika) reisten, wurden in eine prospektive Kohortenstudie aufgenommen. Stuhlproben und Daten über potenzielle reiseassoziierte Risikofaktoren (wie Reisestil, Essgewohnheiten, Auftreten von Gastroenteritis, Hygienemaßnahmen) wurden vor und nach der Reise mittels Fragebogen gesammelt. Mittels Selektivmedien (CHROMagar™ ESBL/KPC-Platten) wurden eine Untersuchung der Stuhlproben auf extended-spectrum beta-lactamase bildende Enterobacteriaceae (ESBL-PE) und Carbapenemase bildende Enterobacteriaceae (CPE) durchgeführt. Isolate mit bestätigtem ESBL-Phänotyp wurden auf das Vorhandensein von blaCTX-M-, blaTEM-, blaSHV-, blaVIM-, blaNDM-, blaKPC- und blaOXA-48-Genen mit Hilfe von PCR-Amplifikation und -Sequenzierung getestet. Bei den Antibiotikaempfindlichkeitstests wurde mit konventioneller Mikrobouillonverdünnung gearbeitet. Die Auswertung von 205 kompletten Teilnahmen zeigte vor Reiseantritt eine ESBL-PE Prävalenzrate von 6,8% (14/205). Unter den 191 Teilnehmern, die vor der Reise ESBL-negativ getestet wurden, waren nach Reiserückkehr 58 (30,4%) mit ESBL-bildenden Escherichia coli kolonisiert und 5 Reisende (8,6%) waren zusätzlich mit ESBL-produzierenden Klebsiella pneumoniae besiedelt. Carbapenem-resistente Enterobacteriaceae wurden nicht nachgewiesen. Die molekulargenetische ESBL-Typisierung zeigte, dass 52/54 (96,6%) der E. coli und 4/4 (100%) der K. pneumoniae-Stämme, die für die Sequenzierung verfügbar waren, CTX-M-Enzyme produzierten, und zwar überwiegend CTX-M-15 (33/56, 58,9%), und 2/54 (3,7%) der E. coli-Stämme SHV-12-Enzyme bildeten. Die Reisenden nach Indien wiesen die höchste Kolonisationsrate mit ESBL-PE (11/15, 73,3%: p=0.015) auf, gefolgt von Reisenden nach Südostasien (22/46, 47,8%; p=0.038). Die Auswertung der reiseassoziierten Risikofaktoren ergab allein für das Auftreten einer Gastroenteritis eine statistische Signifikanz (p=0.011). Strikte Händehygiene und ausschließliches Konsumieren abgepackter Getränke zeigten keinen protektiven Effekt. Die ESBL-PE-Persistenzrate nach 6 Monaten lag bei 8,6% (3/35). Daraus schlossen wir, dass weltweite Anstrengungen notwendig sind, um die weitere Ausbreitung von ESBL-PE in der Bevölkerung anzugehen. Eine aktive Überwachung und Kontaktisolation ist bei Aufnahme in eine medizinische Einrichtung speziell für Patienten, die innerhalb der letzten 6 Monate nach Indien und Südostasien gereist waren, empfehlenswert.

Clostridium perfringens é um dos microrganismos mais freqüentemente envolvidos em surtos de enfermidades transmitidas por alimentos. Este microrganismo pode ser classificado em cinco tipos toxigênicos (A-E), de acordo com a detecção dos genes codificadores de suas principais toxinas: alfa (cpa), beta (cpb), épsilon (etx) e iota (iap), sendo que técnicas moleculares empregando a PCR são atualmente utilizadas para genotipagem desses isolados. Alguns isolados de C. perfringens produzem uma enterotoxina (CPE) que é responsável pelos sintomas clínicos desenvolvidos em casos de toxinfecção alimentar, sendo que esta toxina é codificada pelo gene cpe. A simples detecção de C. perfringens em um alimento, mesmo naqueles suspeitos de causar surtos, não é suficiente para considerá-lo como de risco à saúde do consumidor. Isto porque dentre os isolados de C. perfringens apenas um número muito pequeno apresenta o gene cpe. Além disso, isolados de C. perfringens não produtores de CPE estão amplamente disseminados no ambiente, em alimentos e mesmo em fezes de pessoas. Desta forma, com o presente estudo verificou-se a freqüência de C. perfringens dentre isolados de clostrídios sulfito redutores, a freqüência de C. perfringens potencialmente enterotoxigênicos e sua variabilidade genética, de modo a evidenciar a importância dessas cepas como causadoras de doenças, além de fornecer subsídios para melhorar os conhecimentos sobre as características das cepas circulantes em nosso meio. Foram utilizados 335 isolados de clostrídios sulfito redutores provenientes de alimentos (126), solo (84) e fezes de animais (125). Dos 335 isolados, 146 (43,6%) foram caracterizados, através de reações bioquímicas e moleculares, comoC. perfringens, sendo 75 isolados (59,5%) provenientes de alimentos, 43 (51,2%) de solo e 28 (22,4%) de fezes de animais. Todas as cepas de C. perfringens analisadas foram tipadas como C. perfringens tipo A. Dos 75 isolados de C. perfringens provenientes de alimentos, 20 apresentaram o gene cpe, sendo 13 (65%) com localização cromossomal; nas demais cepas não foi possível determinar sua localização. Nos isolados de C. perfringens provenientes de solo e das fezes de animais não se verificou a presença desse gene. Das 20 cepas de C. perfringens que apresentaram o gene cpe detectou-se em 15 a produção de enterotoxina; as cinco cepas restantes não apresentaram esporulação no meio DUNCAN STRONG modificado, não sendo possível avaliar sua atividade enterotoxigênica. As 146 cepas de C. perfringens quando submetidas à PFGE geraram 69 perfis PFGE distintos, sendo 42 exclusivos para uma única cepa, indicando uma grande variabilidade genética, entre isolados provenientes de amostra de alimentos, fezes ou solo. A utilização de clostrídios sulfito redutores, ou mesmo de C. perfringens como indicador de possível risco à saúde dos consumidores pode levar à condenação desnecessária de alimentos, uma vez que existe baixa correlação entre costrídios sulfito redutores e C. perfringens, independente da fonte de isolamento, além da baixa freqüência do gene cpe nas cepas estudadas. / Clostridium perfringens is one of the most frequently microorganism involved in outbreaks of foodborne diseases. This microorganism can be classified into five toxigenic types (A to E), according to the detection of genes encoding its major toxins: alpha (cpa), beta (cpb), epsilon (etx) and iota (iap). Molecular techniques using PCR are currently used for genotyping this isolates. Besides the major toxins, some isolates of C. perfringens produce an enterotoxin (CPE) that is responsible for clinical symptoms developed in cases of food poisoning. This enterotoxin is encoded by the cpe gene. The simple detection of C. perfringens in food, even in those suspected of causing outbreaks, is not enough to consider it as a risk to consumers´ health. This happens because among the isolates ofC. perfringens only a very small number shows the cpe gene. In addition, isolates of C. perfringens that do not produce CPE are widespread in the environment, food and even in feces of humans. Thus, the present study examined the frequency of C. perfringens isolates among sulfite reducing clostridia, the frequency of potentially enterotoxigenic C. perfringens and its genetic variability in order to highlight the importance of these strains in causing diseases, and provides subsidies to improve the knowledge about the strains that are circulating in our environment. A total of 335 isolates of sulfite reducing clostridia from foods (126), soil (84) and animal feces (125) were used. Among the 335 isolates, 146 (43.6%) were characterized by biochemical and molecular reactions as C. perfringens, being 75 (59.5%) from foods, 43 (51.2%) from soil and 28 (22.4%) from animal feces. All strains of C. perfringens were typed as C. perfringens type A. Of the 75 isolates of C. perfringens from food, 20 had the cpe gene, and in 13 (65%) the gene was chromosomally located. In the other strains it was not possible to determine the location of this gene. In isolates of C. perfringens from soil and animal feces the cpe gene was not present. Amongst the 20 strains of C. perfringens positive for cpe, enterotoxin production was detected in 15. Five strains showed no sporulation in the medium modified Duncan Strong, being not possible to verify their enterotoxigenic activity. All C. perfringens were subjected to PFGE and generated 69 different PFGE profiles, being 42 unique to a single strain, indicating a great genetic variability among isolates from food, feces or soil. The use of sulfite reducing clostridia, or even C. perfringens as an indicator of possible health risk to consumers can lead to unnecessary condemnation of food, since there is low correlation between sulfite reducing clostridia and C. perfringens, regardless of source of isolation. This study also shows a low frequency of cpe gene in the strains indicating the low risk in causing foodborne disease.