Das Controlling des Outsourcings von IV-Leistungen

Der Trend zum Outsourcing von Informationsverarbeitungs-Leistungen (IV-Leistungen) ist seit dem Beginn der 90er Jahre zu beobachten. Begründen läßt sich diese Entwicklung einerseits durch die zunehmende Konzentration der Unternehmen auf ihre Kerngeschäfte und andererseits durch zunehmende Probleme innerhalb der Informationsverarbeitung, wie z. B. steigende IV-Kosten, Personalengpässe und Sicherheitsdefizite. Zu den Erfolgsfaktoren des Outsourcings von IV-Leistungen gehört die Durchführung eines am Outsourcing-Prozeß orientierten Controllings. In den Publikationen zum Outsourcing von IV-Leistungen sind Controlling-Maßnahmen zur effizienten Unterstützung des Outsourcings nur in geringem Umfang enthalten. Der vorliegende Beitrag zeigt auf, welche Controlling-Maßnahmen durchzuführen sind, um die einzelnen Phasen des Outsourcings wirkungsvoll zu unterstützen

A Time-Series Analysis of U.S. Kidney Transplantation and the Waiting List: Donor Substitution Effects and "Dirty Altruism"

This paper provides an econometric analysis of the relationship between live and deceased (cadaveric) kidney donations for the United States for the period 1992:IV through 2006:II. Statistical analysis shows that increases in deceased donor transplants reduce future live donor grafts, controlling for both waiting list effects and exogenous trends. This result has important, and potentially dire, implications for efforts to reduce the organ shortage by increasing use of cadaver donors.Kidney Transplantations; Donor Substitution Effects; Dirty Altruism; Cointegration

Comparison of intranasal versus intravenous midazolam for management of status epilepticus in dogs : a multi‐center randomized parallel group clinical study

Background: The intranasal (IN) route for rapid drug administration in patients with brain disorders, including status epilepticus, has been investigated. Status epilepticus is an emergency, and the IN route offers a valuable alternative to other routes, especially when these fail. Objectives: To compare IN versus IV midazolam (MDZ) at the same dosage (0.2 mg/kg) for controlling status epilepticus in dogs. Animals Client-owned dogs (n = 44) with idiopathic epilepsy, structural epilepsy, or epilepsy of unknown origin manifesting as status epilepticus. Methods: Randomized parallel group clinical trial. Patients were randomly allocated to the IN-MDZ (n = 21) or IV-MDZ (n = 23) group. Number of successfully treated cases (defined as seizure cessation within 5 minutes and lasting for >= 10 minutes), seizure cessation time, and adverse effects were recorded. Comparisons were performed using the Fisher's exact and Wilcoxon rank sum tests with statistical significance set at alpha < .05. Results: IN-MDZ and IV-MDZ successfully stopped status epilepticus in 76% and 61% of cases, respectively (P = .34). The median seizure cessation time was 33 and 64 seconds for IN-MDZ and IV-MDZ, respectively (P = .63). When the time to place an IV catheter was taken into account, IN-MDZ (100 seconds) was superior (P = .04) to IV-MDZ (270 seconds). Sedation and ataxia were seen in 88% and 79% of the dogs treated with IN-MDZ and IV-MDZ, respectively. Conclusions and Clinical Importance: Both routes are quick, safe, and effective for controlling status epilepticus. However, the IN route demonstrated superiority when the time needed to place an IV catheter was taken into account