Search

The issue of leadership is one of the most topical. The focus of the research is on identifying the characteristics a person must possess to be a leader, where the term indicates anyone who has a role in coordinating and guiding a group of people. In a globalised world in which production processes are carried out by teams of people, the possibility of identifying people with leadership skills or, better still, of training people to be leaders acquires fundamental importance. The article attempts to identify the intellectual, personality, emotional and relational characteristics of a leader and suggest ways to 'educate' for leadership, highlighting the centrality of psychology in the study, identification and enhancement of these characteristics.

The increase in the elderly population is a phenomenon of growing importance with various repercussions on the economic side, both in terms of costs that society has to bear from a social and health care point of view, and in terms of opportunities for the various economic sectors that can see the third age as a possible market. The change in attitudes towards ageing has led to an increase in the proportion of older people who are actively living in the third age. Travelling, visiting new places and/or spending time away from home, even abroad, are activities that are now part of the lives of older people, at least those with an adequate income level. Consequently, the elderly have become potential users of the tourism sector: this article attempts to outline the dimensions and characteristics of this phenomenon.

To review the literature relevant to diagnosis and management of meningococcal disease (MD).Non-systematic review of medical literature through the MEDLINE database using the terms meningococcal, septic shock, diagnosis, and treatment. Articles were selected according to their relevance to the objective of the study and according to the authors' opinion.MD is a leading cause of death due to infection in children. It progresses rapidly and a high level of suspicion is necessary for early diagnosis. Early intervention with aggressive fluid resuscitation and antibiotic therapy can significantly improve outcome. In the pediatric intensive care unit, a large amount of fluids may be required during the first few days and vasoactive drug infusions are often needed. Coagulopathy is frequent, but it has no specific treatment. The use of colloids and steroids may be beneficial, but other new therapies such as insulin and activated protein C still need further assessment. Rescue therapy with extracorporeal membrane oxygenation may be appropriate in cases complicated by severe acute respiratory distress syndrome, but not for refractory shock. Meningitis is often not diagnosed in MD because of the severity of illness and the inability to perform a lumbar puncture safely in a patient with coagulopathy, coma, or hemodynamic instability. When present, cerebral edema and altered cerebral blood flow are the main concerns. The use of osmolar solution may be necessary, but the main therapeutic intervention is to ensure adequate blood pressure for adequate cerebral perfusion. Seizures and hyponatremia should be aggressively treated. Steroids do not appear to affect outcome in meningococcal meningitis.MD is a life-threatening infection that requires early recognition and treatment. Time sensitive fluid resuscitation and antibiotic therapy are the most effective therapies for MD. Other therapies such as steroids may have a place in MD treatment but more definitive studies are necessary.

L'articolo esamina i risultati di una riforma organizzativa di comunicazione istituzionale ala luce dell'approccio della traslazione.

In 2006, paediatric intensive care-related subjects were discussed in a number of papers published in various journals, including Critical Care. Because they focused on the cardiovascular system and its support, we summarize them here. In particular, these papers highlighted the management of refractory septic shock, extracorporeal support, outcome markers in sepsis, and outcome after cardiac arrest.

OBJETIVO: Revisar a literatura pertinente ao diagnóstico e tratamento de doença meningocócica (DM). FONTES DOS DADOS: Revisão não-sistemática da literatura médica através de busca na base de dados MEDLINE usando os seguintes termos: meningocócico, choque séptico, diagnóstico, e tratamento. Os artigos foram selecionados de acordo com sua relevância para o objetivo do trabalho e de acordo com a opinião dos autores. SÍNTESE DOS DADOS: A DM é uma das principais causas de morte em crianças, devido à infecção. Ela progride rapidamente e é preciso um alto grau de suspeita para se estabelecer o diagnóstico precocemente. Intervenção precoce com fluidoterapia agressiva e antibioticoterapia podem melhorar significativamente o desfecho. Na unidade de tratamento intensivo pediátrico, uma grande quantidade de volume pode ser necessário durante os primeiros dias e drogas vasoativas são geralmente usadas. Coagulopatia é freqüente, mas não tem tratamento específico. O uso de colóides e esteróides pode ser benéfico, mas outros tratamentos novos tais como insulina e proteína C ativada ainda precisam ser investigados em mais detalhe. O tratamento de resgate com circulação extracorpórea pode ser adequado em casos com complicações causadas pela síndrome do desconforto respiratório agudo grave, mas não no caso de choque refratário. A meningite geralmente não é diagnosticada na DM por causa da gravidade da doença e da incapacidade de realização de uma punção lombar com segurança em um paciente com coagulopatia, coma, ou instabilidade hemodinâmica. Quando presentes, edema cerebral e fluxo sangüíneo cerebral anormal são as principais preocupações. O uso de solução hiperosmolar pode ser necessário, mas a principal intervenção terapêutica é garantir pressão sangüínea adequada para que a perfusão cerebral seja adequada. Convulsões e hiponatremia devem ser tratadas agressivamente. Esteróides parecem não afetar o desfecho na meningite meningocócica. CONCLUSÕES: DM é uma infecção com risco de vida que necessita reconhecimento e tratamento precoces. Ressuscitação volumétrica e antibioticoterapia em tempo adequado são as terapias mais efetivas no tratamento da DM. Outras terapias, como uso de esteróides, podem ser úteis em seu tratamento mas ainda necessitam estudos confirmatórios. OBJECTIVE: To review the literature relevant to diagnosis and management of meningococcal disease (MD). SOURCES: Non-systematic review of medical literature through the MEDLINE database using the terms meningococcal, septic shock, diagnosis, and treatment. Articles were selected according to their relevance to the objective of the study and according to the authors’ opinion. SUMMARY OF THE FINDINGS: MD is a leading cause of death due to infection in children. It progresses rapidly and a high level of suspicion is necessary for early diagnosis. Early intervention with aggressive fluid resuscitation and antibiotic therapy can significantly improve outcome. In the pediatric intensive care unit, a large amount of fluids may be required during the first few days and vasoactive drug infusions are often needed. Coagulopathy is frequent, but it has no specific treatment. The use of colloids and steroids may be beneficial, but other new therapies such as insulin and activated protein C still need further assessment. Rescue therapy with extracorporeal membrane oxygenation may be appropriate in cases complicated by severe acute respiratory distress syndrome, but not for refractory shock. Meningitis is often not diagnosed in MD because of the severity of illness and the inability to perform a lumbar puncture safely in a patient with coagulopathy, coma, or hemodynamic instability. When present, cerebral edema and altered cerebral blood flow are the main concerns. The use of osmolar solution may be necessary, but the main therapeutic intervention is to ensure adequate blood pressure for adequate cerebral perfusion. Seizures and hyponatremia should be aggressively treated. Steroids do not appear to affect outcome in meningococcal meningitis. CONCLUSIONS: MD is a life-threatening infection that requires early recognition and treatment. Time sensitive fluid resuscitation and antibiotic therapy are the most effective therapies for MD. Other therapies such as steroids may have a place in MD treatment but more definitive studies are necessary.

522 Low and Stardard Doses of Synthetic Acth in the Assessment of Adrenal Function of Children with Septic Shock

Starting from the assumption that any technology embeds the ideology, politics and culture of the society where it was created, this chapter reconstructs the specific historical and political link between the affirmation of neo-liberal paradigm, which has occurred since the 1970s in Western industrialized capitalist countries, and the dissemination of ICT. More in particular, it analyses the problem of measurement of ICT, emerged functionally to the need to identify new tools to legitimize the hierarchy of development, giving some countries the label of “most advanced” and the others of “developing” or “underdeveloped”. Indeed, the measurement, acting as a scientific justification for the Western superiority, is a part of those structures of knowledge which constitute an essential element in the functioning and legitimacy of the political, economic and social structures of the existing world-system. This contribution reconstructs this methods of knowledge deployed first at the international level, within and through the work of those actors who have taken the leading role in defining the interpretative lines of the measurement of ICT: the OECD, ITU, the World Bank.

The challenge of convergence has become a core issue in the European agenda, as the existence of widely accepted administrative standards represents one of the most important preconditions to promote sociopolitical development and to reinforce the single Market. Indeed many initiatives have been launched by European institutions to ensure uniformity in terms of administrative action and structures, and several communications by the European Commission have considered the impact of new technologies in creating systems of integrated and interoperable administration in the Old Continent. In this chapter it will be investigated the role of communication and information technologies in the formation of an European administrative space, the process for which administrations become more similar and close to a common European model. The contribution will consider ICTs as a key element of Europe’s economic competitiveness agenda as well as the interconnection between e-government programs and the social dimension of development. In addition to this, in the final part of the chapter it will be also analyzed the nature and implications of the process of uniformity produced by the new digital infrastructures, a peculiar mix of attractiveness and imposition.

Following the diffusion of e-government in the technologically advanced high income countries, international organizazions, notably UN, OECD, World Bank, have promoted the implementation of e-government practices in developing countries as priority means to further good governance, democracy and development. ICTs can, indeed, be very useful in order to make public administration more transparent, accountable and participated or in connecting and networking faraway places, especially where transports and phisical infrastructures are lacking or insufficient. However, a decade later, the few researches conducted in the field show that the overwhelming majority of e-government projects in developing countries end up in total or partial failure. The best practices identified in high income countries prove difficult to be reproduced in settings that are very different in terms of organizational traditions and development. Despite the recognition of the need to take into account local specificities and to get the locals involved in the process, e-government in developing countries still appears essentially as a mere transfer operated by donor countries' firms with western technologies. Moreover, as these technologies are mostly proprietary, they prevent institutions and users from developing countries to modify and adapt the tools to their particular needs and lock them in a position of permanent technological dependency For what concerns the cost efficiency of e-government projects, it must be said that the advantages observed in developed countries, where the cost of hardware and software is more than compensated for by the savings in terms of costly human labor, are less likely to be obtained in developing countries, where the cost of labor is a small fraction of that in developing countries and the cost of ICTs is proportionally much higher. The claim that e-government diffusion in developing countries can improve the prospects for democracy is based on a normative assumption supported by little evidence. The causality chain between e-government, good governance, and democracy (with the frequent addition of economic growth as a further stage), if at all plausible, looking at history should be probably read the other way around. In fact, some scholars consider the contribution of e-government to overall development irrelevant, if not negative, in the measure in which it diverts funds from higher priorities.

The chapter is dedicated at analyzing the strategic use of new technologies in the United States. An evident synergy has been noted between the digital policy projects and the neo-liberal ideology wave that has traced origin in the fiscal crisis of the State in the 1970s. About four decades have transformed some political directions in true imperatives: public sector downsizing, cost-cutting in public agencies, decision-making privatization, and the principle of efficiency as a measure of collective action. If new public management has been imposed as a dominant paradigm for administrative restructuring, ICTs programs sustain reform objectives by putting emphasis on the sure advantages of technological applications. In addition to this, administrative reforms seem to be in continuity with some American historical tradition, in reasserting a central role of private actor in public activities and realizing a significant “fusion of political and economic power”. Digital era seems to have added a new chapter to the American corporate liberalism history, with the difference – and the aggravating circumstance – that private organizations have now more powerful instruments to control and regulate society. New technological instruments seem to be used essentially to produce a neo-liberal interpretation of government activities.