A multiple case study of transformational leadership at struggling colleges

This qualitative multiple case study sought to understand the common factors that colleges at risk of closure have to navigate to move from struggling, to surviving, and on to thriving. The primary question for this research involved the changes, and communication and governance strategies between the president, trustees, and faculty that affected positive change at small colleges and universities who successfully transformed their organizations. Data was collected through one-on-one interviews with presidents who led each institution through transformation. This study identified similarities and differences between the cases allowing for the examination of the phenomenon in depth, using evidence obtained from interviews with those involved (Yin, 2014). Risk of closure was defined as schools that had a simple liquidity ratio of under 5%, who then moved to a liquidity ratio of over 10%. Findings from this study identified six themes related to leading small at-risk colleges. These factors were common among the schools studied and are areas for consideration for schools that are working to move from struggling to thriving. These themes include; transforming the dynamic between the president and board of trustees; faculty role in organizational change; a strong leadership team as part of transformation; transparency in communication with stakeholders; impact and import of decisive and entrepreneurial leadership; and leadership background. (Author abstract)Schifilliti, R. (2019). A multiple case study of transformational leadership at struggling colleges. Retrieved from http://academicarchive.snhu.eduDoctor of Philosophy (Ph.D.)Educational LeadershipSchool of Educatio

Effects of Combined Ketamine/Xylazine Anesthesia on Light Induced Retinal Degeneration in Rats

Objectives: To explore the effect of ketamine-xylazine anesthesia on light-induced retinal degeneration in rats. Methods: Rats were anesthetized with ketamine and xylazine (100 and 5 mg, respectively) for 1 h, followed by a recovery phase of 2 h before exposure to 16,000 lux of environmental illumination for 2 h. Functional assessment by electroretinography (ERG) and morphological assessment by in vivo imaging (optical coherence tomography), histology (hematoxylin/eosin staining, TUNEL assay) and immunohistochemistry (GFAP and rhodopsin staining) were performed at baseline (ERG), 36 h, 7 d and 14 d post-treatment. Non-anesthetized animals treated with light damage served as controls. Results: Ketamine-xylazine pre-treatment preserved retinal function and protected against light-induced retinal degeneration. In vivo retinal imaging demonstrated a significant increase of outer nuclear layer (ONL) thickness in the non-anesthetized group at 36 h (p,0.01) and significant reduction one week (p,0.01) after light damage. In contrast, ketamine-xylazine pre-treated animals showed no significant alteration of total retinal or ONL thickness at either time point (p.0.05), indicating a stabilizing and/or protective effect with regard to phototoxicity. Histology confirmed light-induced photoreceptor cell death and Müller cells gliosis in non-anesthetized rats, especially in the superior hemiretina, while ketamine-xylazine treated rats showed reduced photoreceptor cell death (TUNEL staining: p,0.001 after 7 d), thicker ONL and longer IS/OS. Fourteen days after light damage, a reduction of standard flash induced a-wave amplitudes and a-wav

Biochemical profile and in vitro neuroprotective properties of Carpobrotus edulis L., a medicinal and edible halophyte native to the coast of South Africa

This work reports the nutritional profile and in vitro neuroprotective properties of leaves of Carpobrotus edulis L, a medicinal and edible succulent species native to the coast of South Africa. Biomass was evaluated for proximate composition and for contents in carotenoids, liposoluble pigments and minerals. Hexane, dichloromethane, ethyl acetate and methanol extracts were prepared by Soxhlet extraction from dried biomass and evaluated for in vitro inhibition of acetylcholinesterase (AChE) and butyrylcholinesterase (BuChE), capacity to attenuate hydrogen peroxide (H2O2)-induced injury in the human dopaminergic cell line SH-SY5Y and for anti-neuroinflammatory potential on lipopolysaccharide (LPS)-stimulated microglia cells. Extracts were evaluated for antioxidant activity by four complementary methods, total content of phenolics, tannins and flavonoids. Finally the profile of the main phenolic compounds was determined by high performance liquid chromatography with diode array detection (HPLC-DAD). C edulis has a high moisture content, high levels of crude protein, fibre, ash, carotenoids, calcium and iron and a low fat level. The extracts were able to efficiently scavenge the free radical 2,2-diphenyl-1-picrylhydrazyl (DPPH), reduce iron and chelate copper and iron ions, and exhibited different levels of phenolic compounds in the order ethyl acetate > methanol > dichloromethane > hexane. The main compounds detected were gallic and salicylic acids and quercetin, all in the ethyl acetate extract. The extracts allowed a dual and potent inhibition of AChE and BuChE. The dichloromethane and methanol extracts had the strongest capacity to prevent cell death induced by H2O2, and the methanol extract had anti-neuronflammatory properties. All together our results suggest that consumption of leaves of C edulis can contribute for a balanced diet, and that they may add to the improvement of cognitive functions. It also suggests possible novel biotechnological applications of C. edulis such as source of molecules and/or products for the food and/or pharmaceutical industries. Studies aiming to the isolation and identification of the bioactive compounds are already in progress. (C) 2017 SAAB. Published by Elsevier B.V. All rights reserved.Portuguese National BudgetXtremeGourmet project [ALG-01-0247-FEDER-017676]FCT Investigator Programme [IF/00049/2012]info:eu-repo/semantics/publishedVersio

Elevated intracranial pressure and cerebral edema following permanent MCA occlusion in an ovine model

INTRODUCTION: Malignant middle cerebral artery (MCA) stroke has a disproportionately high mortality due to the rapid development of refractory space-occupying cerebral edema. Animal models are essential in developing successful anti-edema therapies; however to date poor clinical translation has been associated with the predominately used rodent models. As such, large animal gyrencephalic models of stroke are urgently needed. The aim of the study was to characterize the intracranial pressure (ICP) response to MCA occlusion in our recently developed ovine stroke model. MATERIALS AND METHODS: 30 adult female Merino sheep (n = 8-12/gp) were randomized to sham surgery, temporary or permanent proximal MCA occlusion. ICP and brain tissue oxygen were monitored for 24 hours under general anesthesia. MRI, infarct volume with triphenyltetrazolium chloride (TTC) staining and histology were performed. RESULTS: No increase in ICP, radiological evidence of ischemia within the MCA territory but without space-occupying edema, and TTC infarct volumes of 7.9+/-5.1% were seen with temporary MCAO. Permanent MCAO resulted in significantly elevated ICP, accompanied by 30% mortality, radiological evidence of space-occupying cerebral edema and TTC infarct volumes of 27.4+/-6.4%. CONCLUSIONS: Permanent proximal MCAO in the sheep results in space-occupying cerebral edema, raised ICP and mortality similar to human malignant MCA stroke. This animal model may prove useful for pre-clinical testing of anti-edema therapies that have shown promise in rodent studies.Adam J. Wells, Robert Vink, Stephen C. Helps, Steven J. Knox, Peter C. Blumbergs, Renée J. Turne

Analisi del cammino nei bambini pretermine per un monitoraggio quantitativo della traiettoria di sviluppo motorio tramite sensori inerziali

I bambini nati pretermine presentano un rischio maggiore di sviluppare deficit motori. Un'identificazione precoce di tali disturbi può essere decisiva per migliorare le capacità motorie a lungo termine. Tuttavia mancano ancora dei sistemi di monitoraggio standard della traiettoria di sviluppo basati su parametri che possano predire disturbi minori. A tal fine possono essere utili i metodi di analisi del movimento, i quali costituiscono un mezzo rapido ed efficace per la valutazione oggettiva di alcuni parametri indicativi lo stato di sviluppo del bambino. Lo scopo di questa tesi è analizzare il cammino dei bambini pretermine. Lo studio ha coinvolto 34 bambini con età media di 24 mesi nati pretermine e che al momento non presentano nessuna diagnosi. I bambini oggetto di studio sono inclusi in un percorso di follow-up nell’ambito di un progetto di ricerca in collaborazione con il “Centro Disabilità Linguistiche e Cognitive, Ausl di Bologna” e il DEI. I dati sono stati acquisiti tramite sensori inerziali indossabili (Opals, APDM) posizionati sul tronco e sulle caviglie. I dati estratti dai sensori sono stati convertiti ed elaborati in ambiente Matlab allo scopo di calcolare i parametri di Stance e Double Support (percentuali) e il tempo di Stride. A tal fine sono stati utilizzati sia algoritmi noti e già implementati che altri realizzati appositamente nel corso del seguente studio. Lo scopo è quello di confrontare tali parametri con quelli appartenenti a bambini nati a termine con gli stessi mesi di esperienza di cammino, al fine di evidenziarne le differenze anche tramite l'uso di indici di stabilità e di variabilità

Pain in Down's Syndrome

Pain is a homeostatic mechanism that intervenes to protect the organism from harmful stimuli that could damage its integrity. It is made up of two components: the sensory-discriminative component, which identifies the provenance and characteristics of the type of pain; and the affective-motivational component, on which emotional reflexes, following the painful sensation, depend.There is a system for pain control at an encephalic and spinal level, principally made up of the periaqueductal grey matter, the periventricular area, the nucleus raphe magnus, and the pain-inhibition complex situated in the posterior horns of the spinal cord. Through the activation of these pain-control systems, the nervous system suppresses the afference of pain signals. Endogenous opioids represent another analgesic system.In the course of various studies on pain transmission in Down patients, the reduced tolerance of pain and the incapacity to give a qualitative and quantitative description emerged in a powerful way. All of these aspects cause difficulty in evaluating pain. This is linked to several learning difficulties. However, it cannot be excluded that in these anomalies of pain perception, both the anatomical and the neurotransmitter alteration, typical of this syndrome, may hold a certain importance.This fact may have important clinical repercussions that could affect the choice of therapeutic and rehabilitative schemes for treatment of pathologies in which pain is the dominant symptom, such as postoperative pain. It could influence research on analgesics that are more suitable for these patients, the evaluation of the depth of analgesia during surgical operation, and ultimately, absence of obvious pain manifestations. In conclusion, alterations of the central nervous system, neurotransmitters, pain transmission, and all related problems should be considered in the management of pain in patients with Down's syndrome, especially by algologists and anesthesiologists

Anaesthetic-related neuroprotection: intravenous or inhalational agents?

In designing the anaesthetic plan for patients undergoing surgery, the choice of anaesthetic agent may often appear irrelevant and the best results obtained by the use of a technique or a drug with which the anaesthesia care provider is familiar. Nevertheless, in those surgical procedures (cardiopulmonary bypass, carotid surgery and cerebral aneurysm surgery) and clinical situations (subarachnoid haemorrhage, stroke, brain trauma and postcardiac arrest resuscitation) where protecting the CNS is a priority, the choice of anaesthetic drug assumes a fundamental role. Treating patients with a neuroprotective agent may be a consideration in improving overall neurological outcome. Therefore, a clear understanding of the relative degree of protection provided by various agents becomes essential in deciding on the most appropriate anaesthetic treatment geared to these objectives. This article surveys the current literature on the effects of the most commonly used anaesthetic drugs (volatile and gaseous inhalation, and intravenous agents) with regard to their role in neuroprotection. A systematic search was performed in the MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINHAL) and Cochrane Library databases using the following keywords: \u2018brain\u2019 (with the limits \u2018newborn\u2019 or \u2018infant\u2019 or \u2018child\u2019 or \u2018neonate\u2019 or \u2018neonatal\u2019 or \u2018animals\u2019) AND \u2018neurodegeneration\u2019 or \u2018apoptosis\u2019 or \u2018toxicity\u2019 or \u2018neuroprotection\u2019 in combination with individual drug names (\u2018halothane\u2019, \u2018isoflurane\u2019, \u2018desflurane\u2019, \u2018sevoflurane\u2019, \u2018nitrous oxide\u2019, \u2018xenon\u2019, \u2018barbiturates\u2019, \u2018thiopental\u2019, \u2018propofol\u2019, \u2018ketamine\u2019). Over 600 abstracts for articles published from January 1980 to April 2010, including studies in animals, humans and in vitro, were examined, but just over 100 of them were considered and reviewed for quality. Taken as a whole, the available data appear to indicate that anaesthetic drugs such as barbiturates, propofol, xenon and most volatile anaesthetics (halothane, isoflurane, desflurane, sevoflurane) show neuroprotective effects that protect cerebral tissue from adverse events \u2013 such as apoptosis, degeneration, inflammation and energy failure \u2013 caused by chronic neurodegenerative diseases, ischaemia, stroke or nervous system trauma. Nevertheless, in several studies, the administration of gaseous, volatile and intravenous anaesthetics (especially isoflurane and ketamine) was also associated with dosedependent and exposure time-dependent neurodegenerative effects in the developing animal brain. At present, available experimental data do not Approval for publication Signed Date Number of amended pages returned LEADING ARTICLE CNS Drugs 2010; 24 (11): 1-15 1172-7047/10/0011-0001/$49.95/0 \uaa 2010 Adis Data Information BV. All rights reserved. AUTHOR PROOF support the selection of any one anaesthetic agent over the others. Furthermore, the relative benefit of one anaesthetic versus another, with regard to neuroprotective potential, is unlikely to form a rational basis for choice. Each drug has some undesirable adverse effects that, together with the patient\u2019s medical and surgical history, appear to be decisive in choosing the most suitable anaesthetic agent for a specific situation. Moreover, it is important to highlight that many of the studies in the literature have been conducted in animals or in vitro; hence, results and conclusions of most of them may not be directly applied to the clinical setting. For these reasons, and given the serious implications for public health, we believe that further investigation \u2013 geared mainly to clarifying the complex interactions between anaesthetic drug actions and specific mechanisms involved in brain injury, within a setting as close as possible to the clinical situation \u2013 is imperative

Treatment Strategy for Dyslipidemia in Cardiovascular Disease Prevention: Focus on Old and New Drugs

Prevention and treatment of dyslipidemia should be considered as an integral part of individual cardiovascular prevention interventions, which should be addressed primarily to those at higher risk who benefit most. To date, statins remain the first-choice therapy, as they have been shown to reduce the risk of major vascular events by lowering low-density lipoprotein cholesterol (LDL-C). However, due to adherence to statin therapy or statin resistance, many patients do not reach LDL-C target levels. Ezetimibe, fibrates, and nicotinic acid represent the second-choice drugs to be used in combination with statins if lipid targets cannot be reached. In addition, anti-PCSK9 drugs (evolocumab and alirocumab) provide an effective solution for patients with familial hypercholesterolemia (FH) and statin intolerance at very high cardiovascular risk. Recently, studies demonstrated the effects of two novel lipid-lowering agents (lomitapide and mipomersen) for the management of homozygous FH by decreasing LDL-C values and reducing cardiovascular events. However, the costs for these new therapies made the cost–effectiveness debate more complicated