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The Symposium on "Protein Metabolism: Infiuence of Growth Hormone, Anabolie Steroids, and Nutrition in Health and Disease" is the fourth in the series of International Symposia sponsored by CIBA Limited, Basle. As in the case of the previous conferences, it was planned and organised with the help of experts in the field concerned. Special thanks are due to Prof. A. QuERIDO and Dr. A. A. H. KAssENAAR who, once the idea of the Symposium had been conceived in the course of joint discussions, embarked upon the project with enthusiasm and inspiration, although they must have known full weil what a great deal of time and trouble the organisation of such a meeting would inevitably cost them. For their untiring efforts, for the judicious manner in which they contrived to select precisely those subjects on which interest is chiefiy centred today, and-last but not least-for their success in finding competent specialists to participate in the proceedings, we wish to assure them of our sincere gratitude. To all the members of the Department of Clinical Endocrinology and Diseases of Metabolism, at the University Hospital in Leyden, who helped in preparing the meeting, we would likewise extend a warm vote of thanks. The fact that the present volume, featuring the papers and discussions of the Symposium, has been published only a few months after the event, was made possible thanks to the co operative help of all who participated.
Hypertension has certainly been one of the topics most fre quently discussed at symposia, meetings, and congresses during recent years. There may be several reasons for this; three of them are obvious: firstly, the fact that a large proportion of the world's population is suffering from various forms of hypertensive disease; secondly, increasing knowledge of the pathogenesis of hypertension and of the disturbances underlying it; and, thirdly, the marked progress which has been made in antihypertensive therapy over the past fifteen years. When plans for the present symposium were being drawn up, it was felt that it should not simply bring forth just another meeting on hypertension, but should place particular emphasis on those aspects which had not been adequately discussed at previous symposia of this kind. Curiously enough, the topic which appeared to have received least attention in the past was therapy, although from the practical point of view this is by far the most important. The choice of therapy as the main theme of the whole symposium also seemed to be warranted in view of the relatively long period that had elapsed since effective antihyper tensive treatment became available; the time had in fact come now to pass judgement on the benefits as well as the shortcomings of drug treatment as available today.
The pharmacokinetics of digitalis glycosides have been the subject of extensive re view (IISALO, 1977; ARONSON, 1980; PERRIER et ai., 1977). Research on glycoside kinetics has progressed at a rapid pace, requiring continuing reevaluation of the state of our understanding of this problem. The present article focuses on the effect of disease states (renal, gastrointestinal, thyroid, and cardiac) on the absorption, distribution, and clearance of a number of digitalis glycosides. Evidence is critically reviewed, and interpreted with respect to possible clinical implications. A. Renal Insufficiency I. Strophanthin Strophanthin disposition in renal failure has been evaluated in only two studies. KRAMER et ai. (1970) determined an elimination half-life of 14 h in normals as com pared to 60 h in anuric patients. Similar results were reported by BRASS and Pm LIPPS (1970) using tritiated strophanthin. They found a half-life value of 18 h in healthy individuals as compared to 68 h in anuric patients. The findings clearly in dicate that the elimination half-life of strophanthin is prolonged in renal failure."
Between 1950 and 1960, remarkable advances were made in the develQpment Qf antihypertensive drugs, but since then, prQgress has been less rapid. This dQes nQt mean that no. new drugs have been intrQduced: Qn the cQntrary, their number has increased sharply; but since the advent Qf the beta-adrenergic blQckers no. new pharmacQdynamic principle has been discQvered that CQuid be applied widely as an antihypertensive. This has nQt been fQr want Qf effQrts, because many attempts have been made to. find new ways and means Qf influencing blQQd- pressure regulatiQn Qr the mechanisms invQlved in the pathQgenesis Qf hypertensiQn. HQwever, the results Qf these endeavQrs have mQstly been disapPQinting. Even thQugh high blQQd pressure can be treated mQre satisfactQrily tQday than many Qther diseases, the success achieved in cQmbating Qne Qf man's mQst frequent ailments shQuld nQt induce cQmplacency, but rather stimulate research tQwards further imprQvements. The present standstill affQrds an QPPQrtunity to. review the field Qf antihy- pertensive agents, fQr it is unlikely that fundamentally new drugs will appear in the near future. AlthQugh greater knQwledge has been gained Qf the mechanisms Qf blQQd-pressure regulatiQn and Qf the pathQgenesis Qf hypertensiQn, these ad- vances have had no. direct cQnsequences in the search fQr new therapeutics.
Hypertension has certainly been one of the topics most fre quently discussed at symposia, meetings, and congresses during recent years. There may be several reasons for this; three of them are obvious: firstly, the fact that a large proportion of the world's population is suffering from various forms of hypertensive disease; secondly, increasing knowledge of the pathogenesis of hypertension and of the disturbances underlying it; and, thirdly, the marked progress which has been made in antihypertensive therapy over the past fifteen years. When plans for the present symposium were being drawn up, it was felt that it should not simply bring forth just another meeting on hypertension, but should place particular emphasis on those aspects which had not been adequately discussed at previous symposia of this kind. Curiously enough, the topic which appeared to have received least attention in the past was therapy, although from the practical point of view this is by far the most important. The choice of therapy as the main theme of the whole symposium also seemed to be warranted in view of the relatively long period that had elapsed since effective antihyper tensive treatment became available; the time had in fact come now to pass judgement on the benefits as well as the shortcomings of drug treatment as available today.
Im grundlegenden Wandel von der Industrie- zur Informationsgesellschaft suchen Unternehmen nach einer neuen Identitat. Strategische Identitat ist das schlussige Konzept von Vision und Kompetenz, das zu verteidigungsfahigen Wettbewerbsvorteilen fuhrt. Das Buch zeigt dafur den Weg: Auf der Basis der Planungsforschung der SIEMENS AG, die vor allem die Erfolgsursachen exzellenter Unternehmen erforscht hat, wird ein umfassender Transformationsprozess entworfen. Die systematische Ursache-Wirkungs-Kette zwischen Basiskompetenzen, Angebotskompetenz und Angebotsvorteilen ist der Weg zur Marktfuhrerschaft.
Die Hochdruckerkrankungen sind im letzten Jahrzehnt im besonderen MaBe in den Blickpunkt des arzdichen und wissenschaftlichen Interesses geriickt, da stati- stische Untersuchungen ergaben, daB jeder 5. Erwachsene an einem Hochdruck er- krankt und zunehmender Anstieg des diastolischen Blutdruckes iiber 80 mm Hg mit einem - gegeniiber Normotonikern - logarithmischen Anstieg der Mortalitat einhergeht. Aktualitat und Bedeutung der Hochdruckerkrankungen werden durch die Entdeckung neuer Hochdruckformen, die Fortschritte in der Diagnose und Differentialdiagnose der Hochdruckerkrankungen und die Entwick1ung wirksamer Antihypertonika sowie der GefaBchirurgie unterstrichen. Die zunehmenden Erkenntnisse der Pathogenese der primaren und sekundaren Hypertonie fiihrten zum Ausbau und zur Aufwertung der ambulanten Untersu- chungsmethoden der Hochdruckdiagnostik in der Praxis; die komplizierteren klini- schen Untersuchungsmoglichkeiten wurden diagnostisch treffsicherer und verfei- nert. 1m Rahmen einer sinnvoll durchdachten Stufendiagnostik konnen daher heute in der Praxis haufig, in der Klinik fast immer die bisher bekannten Ursa- chen der sekundaren Hypertonien abgeklart werden. Die Fortschritte unserer Kenntnisse in der Pathogenese der Hypertonie haben im Zusammenhang mit der Entwicklung effektiver und besser vertraglicher Anti- hypertonika zwangslaufig zu einem grundlegenden Wandel der operativen, diate- tischen, medikamentosen, allgemeinen und speziellen Behandlungsprinzipien in der Hypertonie gefiihrt. In Anbetracht der ernsten Prognose der unbehandelten Hyper- tonie und der iiberzeugenden Erfolge einer modernen Hochdruckbehandlung ist es ein folgenschweres Versaumnis, eine Hypertonie diagnostisch - soweit sich hier- aus therapeutische Konsequenzen ergeben - nicht abzuklaren oder nicht sofort effektiv zu behandeln bzw. sorgfaltig zu iiberwachen. Fiir das Schicksal des Hypertonikers sind Friihdiagnose und Friihbehandlung seines Leidens von eminen- ter Bedeutung.
Wenn wir uns mit dem mild en oder leichten Hochdruck befassen, miissen wir uns be- wuBt sein, daB es sich dabei flir den einzelnen urn eine verhaltnismaBig leichte Erkran- kung handelt, die nur ein geringes Risiko darstellt. 1m Hinblick auf die Gesamtbeurtei- lung stellt der leichte Hochdruck eher ein bedeutsames sozialmedizinisches Problem dar. Von allen Patienten mit hohem Blutdruck fallen etwa 80-85% in die Kategorie des leichten Hochdrucks. Wenn wir annehmen, daB von den iiber Vierzigjahrigen jeder flinfte einen erhohten Blutdruck hat, so bedeutet ein Anteil von 80-85% eine ganz be- trachtliche Zahl. Wir miissen damit rechnen, daB in Deutschland vier Millionen Pa- tienten einen leichten Hochdruck haben, ohne daB sie etwas von dieser Erkrankung wissen miissen und ohne daB sie dadurch Beschwerden haben. Andererseits miissen wir uns im klaren sein, daB diese Erhohung des Blutdrucks ein gesteigertes kardiovas- kulares Risiko bedeutet. Wie wird der leichte oder milde Hochdruck definiert? Die Weltgesundheitsorganisation hat mehrfach Expertengruppen zusammengerufen, die sich mit dieser Frage befaBt ha- ben (siehe z. B. Technical Report Nr. 628 von 1978). 1m vergangenen Jahr, also vier Jahre spater, ist diese Definition leicht modifiziert worden (Tabelle 1), besonders im Hinblick auf die endgiiltige Diagnose. Diese ist davon abhlingig, daB die erhOhten Druckwerte zu wiederholten Malen in bestimmten zeitlichen Abstanden festgestellt werden. Danach ist der milde Hochdruck auf diastolische Werte zwischen 90 und 105 mmHg definiert.
"If you pit a good person against a bad system, the system will win every time." --Geary Rummler Is it possible to raise the teaching competence of an entire faculty quickly and cost effectively? Now, the answer is YES The graduate training most faculty receive focuses on conveying the content of their discipline-with an eye to teaching them how to produce research. If an individual receives any training in how to teach, it is usually as a teaching assistant-and often less than holistically. Most newly minted instructors arrive on campus and are observed by someone who is senior to them-but who has received exactly the same preparation. To improve faculty observation outcomes for the institution, it is time to consider a new paradigm. Our approach is based on a norming process that identifies areas of strength and areas of training opportunity within a sampled population of teaching faculty. The norming process has two particularly useful features: 1. Because faculty selected represent a cross-college or cross-department sample, it becomes quickly obvious where critical deficiencies may exist across the institution. Since we work at a basic level of pedagogy, opportunities for a large number of faculty to improve become almost immediately obvious-and the data are not tied to discipline, type of faculty member, or type of class taught. 2. When teaching "stars" are identified, we know exactly why they are exceptional at what they do-so their expertise is transportable across college and discipline borders. This information can be particularly helpful for new fulltime or adjunct teaching faculty and can serve as an excellent guide for mentoring. This exciting new tool-the Teaching Observation Worksheet-is is available for sale online at www.amazon.com and other channels. About the Author: With a doctorate in adult and continuing education from Columbia University's Teachers College, Dr. Eric F. Grosse Jr. has worked in higher education for nearly 30 years. He has served as an adjunct and full-time faculty member, a department chair, a division chair, an academic dean and dean of academic development and training. Grosse has worked in a variety of educational environments, from a community college to a private Catholic liberal arts college to a high-ranking research university. During his decades of professional experience, he has observed or counseled nearly 700 faculty members. CONTACT Dr. Eric F. Grosse, Jr. Email: [email protected] Phone: (301) 377-2674 Website: www.efgassociatesinc.com
Structured self-study is a well known and widely accepted strategy for postsecondary institutions seeking re-accreditation. However, it is virtually unknown as a strategy for a Teaching & Learning Center seeking to learn about itself-what it is, what it can be, and the distance between these two points. The CTL Self-Study Tool has been developed by EFG Associates, Inc. to address this critical need. Whether you are starting a new (or recently re-opened) Center, facing the need to efficiently and effectively downsize an existing CTL, or simply desire a structured approach to improve your overall operation, the CTL Self-Study Tool gives you a step-by-step approach and the needed ancillary materials.
This scarce antiquarian book is a selection from Kessinger Publishing's Legacy Reprint Series. Due to its age, it may contain imperfections such as marks, notations, marginalia and flawed pages. Because we believe this work is culturally important, we have made it available as part of our commitment to protecting, preserving, and promoting the world's literature. Kessinger Publishing is the place to find hundreds of thousands of rare and hard-to-find books with something of interest for everyone
Studies of American industry frequently cite Lowell, Massachusetts, as an early model for business practices. Scholars have sought to explain the city's rise to prominence, the impact of its textile mills on workers and on commerce, and its part in regional development and American prosperity. Laurence Gross looks beyond these issues. Focusing on Lowell's Boott Cotton Mills, he examines the industry's struggle to maintain its prominence, the causes of its decline, and its ultimate flight south. Gross puts much of the blame for the pattern of events on the mill-owners themselves. They resisted reinvestment, so their operations became less efficient. They kept antiquated machinery running long after it was safe to do so, and they were slow to respond to issues of worker safety. The increased textile demands of World War II, Gross explains, only forestalled the mills' inevitable demise.
Behrman's prolific career as a Broadway playwright and Hollywood screenwriter spans a period from the 1920s to the mid-1960s. As a writer for popular performance, he had to contend with commercial influences and with producers and directors involved in the dynamics of the collaborative process. Though eminently successful, his works have not received adequate critical scrutiny. His ouevre probably will never be fully determined because of collaboration, numerous rewrites, and the many unpublished and unproduced plays and scripts. Author Robert F. Gross here provides an immensely detailed record of the primary materials, published and unpublished, including plays, filmscripts, fiction, and essays, and of the critical response, both reviews and analytical studies. Focusing on Behrman as a dramatist, Gross has written extensive plot summaries and critical overviews for each of fifty-one plays. Where applicable, full production credits are given for premieres and revivals, and references are made to reviews and commentary about specific productions as well as to the plays in general. The annotated secondary bibliography is divided into chronologically organized sections for reviews and for books, parts of books, and articles. Fully cross-referenced, the material is also accessible through an author index to the secondary bibliography and a general subject index. In an opening appraisal, Gross expresses his appreciation for Behrman, whose high comedies he finds to be informed by a probing ethical conscience and whose goal of scrupulosity he emulates in his own work. This scrupulous playwright is here given his due in a comprehensive sourcebook of value for theatre historians and theatre professionals.
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