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RISS 인기검색어
- 검색키워드
- 저자 : Vernis, Alfred (검색결과 2 건)
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Organizing services to the elderly: A tale of two cities (New York City)
Vernis, Alfred New York University 2000 해외박사(DDOD)
소속기관이 구독 중이 아닌 경우 오후 4시부터 익일 오전 9시까지 원문보기가 가능합니다.
In order to study public-private collaboration the thesis explores the home care service program offered by the New York City Department for the Aging and the Barcelona Department of Social Services. The subject of the analysis is not the home care service in itself, but the relationship between the public agencies that contract out the service and the private organizations that deliver it. The field studies in both cities examined a public or “focal agency”, and a number of private (nonprofit and for-profit) organizations that interact with this agency. The dissertation attempts to discover which factors are important for managing a relationship between a public and a private nonprofit organization over time. Nine interorganizational dimensions and twenty interorganizational variables were selected and studied in detail on both sides of the relationship in New York City and Barcelona. The research also attempts to discover the positive features of the New York City experience in order to try to translate them to Barcelona, and the negative features in order to avoid them. In Europe, there is a general movement by both conservative and liberal governments to provide social services through private organizations. Without doubt, one of the more interesting points on managing of public-private collaboration in social services that Barcelona can learn from New York is the relational model of contracting out compared to the traditional model based exclusively on competition. In order for Barcelona and other cities to adopt the relational model, it is necessary to convince both public managers and politicians of its advantages. In order to be able to translate the New York experience to Barcelona the thesis had to first thoroughly study certain points in both cities, among them evolution of the welfare state, social policies, demographic trends, development of the nonprofit sector, and so on. This clearly revealed that, if Barcelona wants to have a nonprofit sector similar to New York's, it will have to dedicate a great deal of effort toward building public trust.
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Role of Soluble Fibrin and Fibrin Degradation Products on Platelet Signaling During Trauma
Verni, Christopher C ProQuest Dissertations & Theses University of Penn 2020 해외박사(DDOD)
소속기관이 구독 중이 아닌 경우 오후 4시부터 익일 오전 9시까지 원문보기가 가능합니다.
Platelets and coagulation proteins work in concert to maintain proper blood flow through the vasculature. When an injury occurs, this hemostatic system must respond efficiently by sealing the wound to prevent excessive bleeding. Deviations from normal hemostasis arise in the clinic frequently; one such condition that is characterized by uncontrolled bleeding is known as trauma-induced coagulopathy (TIC). Severe platelet dysfunction is one key contributing factor to TIC, though its mechanistic causes are still yet to be fully understood. In order to investigate biological explanations for platelet dysfunction during trauma, various cell-based assays were designed and conducted in both healthy and patient populations. Specifically, intracellular calcium mobilization and other fluorescently tracked biomarkers were used as dynamic indicators of platelet activation in response to common agonists. Microtiter well plates prepared with liquid handling systems enabled high-throughput data collection and minimal manual pipetting. Significant platelet dysfunction in response to 31 unique stimulation conditions spanning several signaling pathways was observed in a cohort of trauma patients and tracked at multiple timepoints after initial hospital admission. In experiments designed to interrogate plasma effects on healthy platelet function, patient-derived plasma imparted significant inhibition which implied the presence of a unique soluble plasma species with downregulatory effects on endogenous and transfused platelets. With established knowledge of coinciding coagulant and lytic states during trauma, strategic addition of agonists to healthy platelet suspensions led to generation of soluble fibrin species and desensitization to agonist stimulation through glycoprotein VI (GPVI). Downstream platelet dysfunction was only observed when thrombin was added to the system to polymerize fibrin, whereas stimulation with other agonists or inhibition of various stages of coagulation had no effect on subsequent GPVI function. Maximal inhibition (~95%) was attained when tissue plasminogen activator (tPA) was also incorporated to lyse fibrin polymers into fibrin degradation products (FDP). Concentrations of a small FDP called D-dimer were elevated in trauma patient samples and inversely correlated with a quantitative measure of platelet function. Finally, preliminary results indicate potential binding affinity between platelet receptors and D-dimer. These results shed light on specific biological entities that may be responsible for platelet dysfunction in trauma patients.
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