مقایسه محتوای طرح تکریم در مقایسه با اصول و مبانی مشتری‌مداری

چکیده: (۶۰۷۷ مشاهده) مقدمه: اصل مشتری‌مداری در نظریه‌های نوین مدیریت به عنوان یکی از جهت گیری‌های اصلی سازمان‌های امروزی تلقی می‌شود، زیرا در عمل با جلب رضایت مشتریان درون و برون سازمان، کارآیی خود را در راستای بهره‌وری سازمانی به اثبات رسانده است. طرح تکریم نیز به عنوان یکی از برنامه‌های تحول اداری کشور، با محور قرار دادن جلب رضایت ارباب‌رجوع در این راستا به اجراء در آمده است. هدف از انجام این پژوهش، بررسی محتوای طرح تکریم در مقایسه با اصول و مبانی مشتری‌مداری است. روش بررسی: در این مقاله که به روش مروری و با استفاده ازمنابع کتابخانه‌ای و اینترنت و ثبت و آنالیز تجربیات عینی، مستقیم و گسترده نویسنندگان در سازمان‌های دولتی تهیه؛و سعی شده است علاوه بر بیان اهداف طرح تکریم و معرفی آن به عنوان یک راهکار مشتری‌مدار در راستای برنامه‌های تحول اداری کشور، اهمیت جلب رضایت مشتریان داخلی سازمان (کارکنان) و توانمندسازی و انگیزش آنها به عنوان پیش شرط اجرای این طرح بررسی شده و میزان تطابق این طرح با اصول و مبانی مشتری‌مداری مورد بحث و بررسی قرار گیرد. به دلیل تازه‌گی، ضرورت اجرا و گستردگی این طرح در سطح کشور، انجام این پژوهش‌هایی در این زمینه بسیار ضروری به نظر می‌رسد. مروری بر مطالعات: عمده مطالعات انجام شده نشان داده اند که بیشترین مشکلات نظام اداری کشور در بخش نیروی انسانی است که اهم آن نداشتن انگیزه، عدم تامین اقتصادی و نیازها؛ وجود محافظه کاری وروابط کار نامطلوب است. در بخش سیستم‌ها و روش‌ها نیز کم توجهی به مشتری گرایی و مدیریت کیفیت ذکر شده است. توجه به مشتری‌مداری به عنوان راهکار مشترک تمام پژوهش‌های مذکور مطرح گردیده است. در مصوبه طرح تکریم تامین منافع ارباب‌رجوع بر منافع مؤسسه و ارائه دهندگان خدمت ترجیح داده شده است، که این کم توجهی موفقیت سازمان را در این راستا به چالش کشیده است . نتیجه‌گیری: طرح تکریم به عنوان یک راهکار مشتری‌مدار در راستای ایجاد تحول اداری کشور، باید با توانمندسازی، حمایت همه‌جانبه وانگیزش ارائه دهندگان خدمات از طریق اعمال مدیریت علمی و کارآمد، مشتریان داخلی رادر اولویت توجه قرار داده تا از طریق جلب رضایت آنها، بهبود مستمر کیفیت خدمات تحقق یافته و رضایت مشتریان خارجی سازمان نیز جلب شود

Relationship between respiratory, endocrine, and cognitive-emotional factors in response to a pharmacological panicogen

Background : The cholecystokinin agonist pentagastrin has been used to study panic attacks in the laboratory and to investigate hypothalamic–pituitary–adrenal axis activity. Its mechanism of panicogenesis remains unclear. Data from other models suggest that respiratory stimulation itself may induce panic, but pentagastrin's effects on respiration are not well established. Data from another model also suggest links between respiratory and HPA axis reactivity and cognitive modulation of both. To further explore these phenomena, we added respiratory measures to a study of cognitive modulation of HPA and anxiety responses to pentagastrin. Methods : Healthy subjects received pentagastrin and placebo injections, with measurement of cortisol and subjective responses, on two different laboratory visits. They were randomly assigned to receive standard instructions or one of two versions of previously studied cognitive interventions (to either facilitate coping or increase sense of control), given before each visit. Capnograph measures of heart rate (HR), respiratory rate (RR), and end-tidal pCO 2 were obtained on 24 subjects. Results : Relative to placebo, pentagastrin induced a significant decline in pCO 2 with no change in RR. Cortisol and HR increased, as expected. Cognitive intervention reduced the hyperventilatory response to pentagastrin. Conclusions : Pentagastrin stimulates respiration, likely via increases in tidal volume. Respiratory stimulation could play a role in its panicogenic potency, though perhaps indirectly. As with HPA axis responses, higher-level brain processes may be capable of modulating pentagastrin-induced hyperventilation. This model may be useful for further study of cortical/cognitive control of interacting emotional, respiratory, and neuroendocrine sensitivities, with potential relevance to panic pathophysiology. Depression and Anxiety, 2010.  © 2010 Wiley-Liss, Inc.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/78296/1/20725_ftp.pd

Dyspnea affective response: comparing COPD patients with healthy volunteers and laboratory model with activities of daily living

Background: Laboratory-induced dyspnea (breathing discomfort) in healthy subjects is widely used to study perceptual mechanisms, yet the relationship between laboratory-induced dyspnea in healthy volunteers and spontaneous dyspnea in patients with chronic lung disease is not well established. We compared affective responses to dyspnea 1) in COPD patients vs. healthy volunteers (HV) undergoing the same laboratory stimulus; 2) in COPD during laboratory dyspnea vs. during activities of daily living (ADL). Methods: We induced moderate and high dyspnea levels in 13 COPD patients and 12 HV by increasing end-tidal CO2 (PETCO2) during restricted ventilation, evoking air hunger. We used the multidimensional dyspnea profile (MDP) to measure intensity of sensory qualities (e.g., air hunger (AH) and work/effort (W/E)) as well as immediate discomfort (A1) and secondary emotions (A2). Ten of the COPD subjects also completed the MDP outside the laboratory following dyspnea evoked by ADL. Results: COPD patients and HV reported similar levels of immediate discomfort relative to sensory intensity. COPD patients and HV reported anxiety and frustration during laboratory-induced dyspnea; variation among individuals far outweighed the small differences between subject groups. COPD patients reported similar intensities of sensory qualities, discomfort, and emotions during ADL vs. during moderate laboratory dyspnea. Patients with COPD described limiting ADL to avoid greater dyspnea. Conclusions: In this pilot study, we found no evidence that a history of COPD alters the affective response to laboratory-induced dyspnea, and no difference in affective response between dyspnea evoked by this laboratory model and dyspnea evoked by ADL

Subjective evaluation of experimental dyspnoea: effects of isocapnia and repeated exposure

Resistive respiratory loading is an established stimulus for the induction of experimental dyspnoea. In comparison to unloaded breathing, resistive loaded breathing alters end-tidal CO2 (PETCO2), which has independent physiological effects (e.g. upon cerebral blood flow). We investigated the subjective effects of resistive loaded breathing with stabilized PETCO2 (isocapnia) during manual control of inspired gases on varying baseline levels of mild hypercapnia increased PETCO2). Furthermore, to investigate whether perceptual habituation to dyspnoea stimuli occurs, the study was repeated over four experimental sessions. Isocapnic hypercapnia did not affect dyspnoea unpleasantness during resistive loading. A post hoc analysis revealed a small increase of respiratory unpleasantness during unloaded breathing at +0.6 kPa, the level that reliably induced isocapnia. We didnot observe perceptual habituation over the four sessions. We conclude that isocapnic respiratory loading allows stable induction of respiratory unpleasantness, making it a good stimulus for multi-session studies of dyspnoea

Application of long-period-grating sensors to respiratory plethysmography

A series of in-line curvature sensors on a garment are used to monitor the thoracic and abdominal movements of a human during respiration. These results are used to obtain volumetric tidal changes of the human torso in agreement with a spirometer used simultaneously at the mouth. The curvature sensors are based on long-period gratings (LPGs) written in a progressive three-layered fiber to render the LPGs insensitive to the refractive index external to the fiber. A curvature sensor consists of the fiber long-period grating laid on a carbon fiber ribbon, which is then encapsulated in a low-temperature curing silicone rubber. The sensors have a spectral sensitivity to curvature, dλ/dR from ∼7-nm m to ∼9-nm m. The interrogation technique is borrowed from derivative spectroscopy and monitors the changes in the transmission spectral profile of the LPG's attenuation band due to curvature. The multiplexing of the sensors is achieved by spectrally matching a series of distributed feedback (DFB) lasers to the LPGs. The versatility of this sensing garment is confirmed by it being used on six other human subjects covering a wide range of body mass indices. Just six fully functional sensors are required to obtain a volumetric error of around 6%. © 2007 Society of Photo-Optical Instrumentation Engineers

Kann die Verknüpfung von CSR-Maßnahmen und Sportsponsoring zur Optimierung der Unternehmenskommunikation beitragen?

kein Abstract vorhande

Sub-cortical and brainstem sites associated with chemo-stimulated increases in ventilation in humans

We investigated the neural basis for spontaneous chemo-stimulated increases in ventilation in awake, healthy humans. Blood oxygen level dependent (BOLD) functional MRI was performed in nine healthy subjects using T2weighted echo planar imaging. Brain volumes (52 transverse slices, cortex to high spinal cord) were acquired every 3.9 s. The 30 min paradigm consisted of six, 5-min cycles, each cycle comprising 45 s of hypoxic-isocapnia, 45 s of isooxic-hypercapnia and 45 s of hypoxic-hypercapnia, with 55 s of non-stimulatory hyperoxic-isocapnia (control) separating each stimulus period. Ventilation was significantly (p < 0.001) increased during hypoxic-isocapnia, isooxic-hypercapnia and hypoxic-hypercapnia (17.0, 13.8, 24.9 L/min respectively) vs. control (8.4 L/min) and was associated with significant (p < 0.05, corrected for multiple comparisons) signal increases within a bilateral network that included the basal ganglia, thalamus, red nucleus, cerebellum, parietal cortex, cingulate and superior mid pons. The neuroanatomical structures identified provide evidence for the spontaneous control of breathing to be mediated by higher brain centres, as well as respiratory nuclei in the brainstem

What’s trending in Breathlessness research? Proceedings from the 8th Annual Meeting of the Breathlessness Research Interest Group

Breathlessness remains a challenging symptom, common to a multitude of malignant and non-malignant diseases, for which there are limited effective therapies once disease control is optimised. The American Thoracic Society (ATS) statement on dyspnoea reports that: i)Progress in dyspnoea management has not matched progress in elucidating underlying mechanisms; ii)There is a critical need for interdisciplinary translational research to connect dyspnoea mechanisms with treatments; iii)There is a need to validate dyspnoea measures as patient-reported outcomes for clinical trials. Research into the many dimensions of breathlessness and its significance to patients and their carers has increased in recent years. This meeting is convened yearly to bring together researchers across various disciplines including respiratory medicine, anaesthetics, medical humanities, engineering and palliative care, to further understanding of the symptom, discuss new techniques and advances in research, and pave the way forward for future studies and interventions. The presentations generated much vibrant discussion amongst the multidisciplinary attendees and highlighted areas where care for breathless patients could be improved. This is a positive time for breathlessness research, with several ATS research priorities being addressed and it is clear that further studies and ensuing interventions are on the horizon.This is the author accepted manuscript. The final version is available from Maney at http://www.maneyonline.com/toc/ppc/current

Breathlessness and the body: neuroimaging clues for the inferential leap

Breathlessness debilitates millions of people with chronic illness. Mismatch between breathlessness severity and objective disease markers is common and poorly understood. Traditionally, sensory perception was conceptualised as a stimulus-response relationship, although this cannot explain how conditioned symptoms may occur in the absence of physiological signals from the lungs or airways. A Bayesian model is now proposed, in which the brain generates sensations based on expectations learnt from past experiences (priors), which are then checked against incoming afferent signals. In this model, psychological factors may act as moderators. They may alter priors, change the relative attention towards incoming sensory information, or alter comparisons between priors and sensations, leading to more variable interpretation of an equivalent afferent input. In the present study we conducted a supplementary analysis of previously published data (Hayen et al., 2017). We hypothesised that individual differences in psychological traits (anxiety, depression, anxiety sensitivity) would correlate with the variability of subjective perceptions of equivalent breathlessness challenges. To better understand the resulting inferential leap in the brain, we explored where these behavioural measures correlated with functional brain activity across subjects. Behaviourally, anxiety sensitivity was found to positively correlate with each subject's variability of intensity and unpleasantness during mild breathlessness, and with variability of unpleasantness during strong breathlessness. In the brain, anxiety sensitivity was found to negatively correlate with precuneus activity during anticipation, positively correlate with anterior insula activity during mild breathlessness, and negatively correlate with parietal sensorimotor areas during strong breathlessness. Our findings suggest that anxiety sensitivity may reduce the robustness of this Bayesian sensory perception system, increasing the variability of breathlessness perception and possibly susceptibility to symptom misinterpretation. These preliminary findings in healthy individuals demonstrate how differences in psychological function influence the way we experience bodily sensations, which might direct us towards better understanding of symptom mismatch in clinical populations