Specialized Procedures Research Articles

The founder's self-assessed competence and venture performance

A large body of recent research seeks to understand organizational founding and the performance of emerging businesses. Although much of this research has focused on the characteristics of the business founder, there is only mixed support for relationships between founders' characteristics and venture performance (Begley and Boyd 1987; Gartner 1988; Low and MacMillan 1988: Sexton and Bowman 1984). This study is based on research that identifies the entrepreneurial, managerial, and technical-functional functions as three roles that founders must competently enact in order to be successful (Hofer and Sandberg 1987; Mintzberg and Waters 1982; Pavett and Lau 1983; Schein 1987). Effective performance in the entrepreneurial role requires the founder to have the ability to recognize business opportunities and the drive to see firm creation through to fruition (Hofer and Sandberg 1987; Timmons et al. 1987). Effective execution of the managerial role requires conceptual, interpersonal, and political competence (Pavett and Lau 1983). To be competent in the technical-functional role, founders must be able to use the tools or procedures required in their specialized field (Pavett and Lau 1983). To measure the competencies necessary for effectiveness in the entrepreneurial, managerial, and technical-functional roles, we developed a questionnaire to allow founders to provide self-evaluations of their competencies. The results provide strong evidence for the reliability of measurement and the validity of the constructs. The relationships revealed in this study suggest some preliminary recommendations for potential entrepreneurs, career counselors, and educators. The number of businesses previously initiated and the years spent as an owner manager do not appear to be strongly related to the performance of the venture; however, the most successful entrepreneurs are strongly convinced of their ability to recognize business opportunity. They believe that they have the drive to see the venture through to fruition and report that they subjugate outside interests to the demands of their businesses. Thus, although self-assessed proficiency in the entrepreneurial function does not appear to be contingent on the length of previous experience as a founder; it does appear to be a necessary component in the development of high-performance companies. Founders of the most successful firms also gave themselves high ratings on the abilities associated with effective performance in the managerial role. They had high self-evaluation scores on the items measuring organizational and interpersonal skills. Competence in the managerial role appears to be enhanced by business education and the years of general managerial experience. The founders of highly successful firms also evaluated their technical skills highly. They believed they were experts in their fields and could use the specialized tools and procedures to produce high-quality products and services. Thus, the results indicate that the most successful founders—those whose firms show higher levels of growth and earnings—rate themselves as competent in the entrepreneurial, managerial, and technical-functional roles; they see themselves as competent generalists. And, in a result that is most gratifying for those in higher education, it appears that a business education and experience in general managerial positions lays the ground work for a successful entrepreneurial career.

Continuing Education Improves Professional Satisfaction and Productivity

Despite their high degree of technical sophistication, medical technologists continue to have a low level of job satisfaction and poor self-image among health care professionals. In our highly specialized Clinical Immunology Laboratory, technologies, procedures, and protocols change rapidly, necessitating a strong continuing education program. To improve interest in continuing education and job satisfaction, we designed a new program that required active participation by all members of the laboratory staff, from director to bench technologists. Each medical technologist selected a topic of current interest relevant to the laboratory, chose a faculty member for assistance in organizing the material, researched the topic, and presented a seminar to the rest of the laboratory staff. Although this required extra work, both inside and outside of the laboratory, the results were remarkable. Not only was the staff educated about such topics in clinical immunology as flow cytometry, OKT3 therapy of acute kidney transplant rejection, and human immunodeficiency virus (HIV) antibody and antigen testing, but motivation improved. Aware of the effort needed to prepare a seminar, staff members were attentive and supportive during the presentations. Technologists had the opportunity to add new accomplishments to their resumes, and several persons wrote articles for the clinical laboratory newsletter or provided diagrams that became permanent illustrations in the procedure manuals. Increased productivity and efficiency observed in the laboratory proved unexpected benefits of this continuing education program. Individually, each technologist came away from his or her presentation with a sense of accomplishment. With the increased responsibility of these presentations, each technologist found professional growth, which resulted in increased job satisfaction.

An inner city cancer prevention clinic: Design, methods, and early results

An American Cancer Society demonstration pilot project is underway that is designed to provide comprehensive cancer prevention-related services to the underserved community of West Oakland, California. An array of cancer prevention services are being made available through an inner-city clinic (West Oakland Health Center), including cancer risk assessments and education about cancer, physical examinations for cancer, teaching of self-examination procedures, smoking cessation, and nutrition counseling, appointments for Pap smears, sigmoidoscopy, mammography, and other more specialized screening procedures, case management for findings suspicious for cancer, and community education programs. Described is the process of implementing these services, their utilization, and their impact (after 6 months).

Planning the analysis of a breast cancer prevention trial

The analysis of cancer prevention trials necessitates specialized procedures. Differences in the analysis plan between cancer prevention and therapy trials are emphasized. Discussion is focused upon (a) how trial conduct influences the analysis, (b) how noncompliance affects the analysis and the considerations this raises during the design and conduct of the trial, (c) how delays in the effect of the intervention impinges upon the analysis, and (d) statistical methods available to carry out the analysis. The analysis of a cancer prevention trial represents a final step in the evaluation of the study intervention and requires an adaptive planning procedure.

An international standard for electroretinography.

An international standard procedure for electroretinography (ERG) has finally been established. It represents a minimum protocol to record five basic signals (rod response, scotopic maximal response, oscillatory potentials, single-flash cone response, 30-Hz flicker response). Individual laboratories may continue to do additional or specialized procedures, but the hope is that all laboratories will include "standard" responses in their routine protocols so ERG data can be compared throughout the world for patient care and for research.

ChemInform Abstract: Design of Reaction Systems for Specialty Organic Chemicals

Abstract Design of reaction systems for specialty organic chemicals requires utilization of chemical reaction engineering principles for a wide variety of kinetic problems. Kinetic analysis must include breakdown of the overall reaction into definable components in order to identify parallel and/or consecutive reactions that result in by-product formation. Once identified, methods of minimizing by-product formation can be developed. Examples are described of complex reaction systems which have required development of specialized procedures to minimize by-product formation. Each example represents a different kinetic problem and method of solution. Emphasis is placed on the close interaction between chemists and chemical engineers during laboratory development and plant reaction system design to achieve successful commercial operation.

Design of reaction systems for specialty organic chemicals

Design of reaction systems for specialty organic chemicals requires utilization of chemical reaction engineering principles for a wide variety of kinetic problems. Kinetic analysis must include breakdown of the overall reaction into definable components in order to identify parallel and/or consecutive reactions that result in by-product formation. Once identified, methods of minimizing by-product formation can be developed. Examples are described of complex reaction systems which have required development of specialized procedures to minimize by-product formation. Each example represents a different kinetic problem and method of solution. Emphasis is placed on the close interaction between chemists and chemical engineers during laboratory development and plant reaction system design to achieve successful commercial operation.

Aspects of the use of relative risk models in the design and analysis of cohort studies and prevention trials.

Relative risk regression methods provide a unifying and powerful approach to a range of problems in the design and analysis of cohort studies and prevention trials. Standard partial likelihood-based estimation procedures do not, however, encompass several features that are important in such contexts. Specifically, one may wish to relate disease rates marginally to 'recent' risk factor measurements, whereas a partial likelihood approach requires one to condition on an accumulating risk factor history. Secondly, risk factor values may be ascertained with considerable measurement error, thereby requiring specialized procedures to estimate relative risk parameters. Thirdly, analysis of raw materials to obtain desired covariate (risk factor) histories may involve considerable expense if carried out for the entire cohort. Case-control and case-cohort sampling procedures can avoid much of this expense, but once again partial likelihood estimation procedures require generalization. Such generalizations are described herein.

What Is Therapeutic Change?: Response to Discussants

I am grateful to the three discussants of my paper for their thoughtprovoking comments. All have, in different ways, clarified my thinking. Before replying to some of their specific criticisms I would like to preface my remarks with an apology. The paper to which they responded was written for a particular purpose-a dialogue with Don Meichenbaum-and thus it needed to be terse. Thus it was not possible to develop various points which, in turn, invited misunderstandings. In general, I am more impressed by the convergence between the discussants' points and mine rather than by the differences. This may be a tribute to the fact that theorists of different orientations are beginning to look more seriously at common processes we are all interested in explaining. Let me comment briefly on each critique. I agree with Brian Shaw that "at issue here is not the friendly interpersonal environment, but the therapist's skill or competence . . . in applying the treatment" (my emphasis). According to the dictionary definition, technique refers not only to competence but also to "the body of specialized procedures and methods used in any specific field . . . " As my research group has struggled to develop an adherence measure for our approach to Time-Limited Dynamic Psychotherapy (TLDP), we have become vitally interested in the problem of competence. Clearly, it is not enough to show that therapists adhere to particular operations characterizing a system, but perhaps more important, we need to evaluate how skillfully it is done. Needless to say, this often becomes a difficult judgment since standards differ among clinicians and there are often alternative ways of proceeding, none of which may be inherently superior to another. Only in recent years have efforts been made to study the problem of competence, and I see these efforts as promising. Since all discussants seem to criticize what they perceive to be my "pessimism" toward technique, let me clarify. Specifically, I do not want to be misunderstood as saying that the relationship is "everything" and that techniques don't matter. On the contrary, I am making the point that typically there is more to psychotherapy than a "good relationship," which I consider a necessary but not a sufficient condition. I also wish to reemphasize that therapeutic learning can be effected in many different ways. It is a flaw of many theoretical formulations to elevate one technical approach over another. While some technical interventions may be more promising than others, much depends on the quality of the relationship between the participants and the particular aspects to which a particular patient resonates. For example, a given patient may respond well to interpretations of transactions between patient and therapist in the here-and-now whereas another may be more receptive to homework assignments. I don't believe that we are likely to make much progress by searching for specific techniques that are "absolutely" and under all circumstances "superior" to others. Research efforts along these lines, it seems to me, have not borne fruit. I am in favor of studying specific therapy "events" to learn how they are addressed by particular therapists. However, it is often difficult to demarcate such events and to evaluate how effectively they were dealt with. The patient's immediate response cannot be taken as the criterion. All of this poses great difficulties for the researcher; however, I certainly believe that the effort is essential. Related to this point is Marvin Goldfried's discussion of what happens "between" rather than "within" sessions. I am certain that much therapeutic learning is silent learning (between sessions). This makes it all the more difficult to assess the effect of a particular therapist intervention or series of interventions. But how? Again, patients respond to and learn from a wide array of interventions and experiences although there may be certain interventions that are predictably counterproductive. …

Heparin free dialysis: Comparative data and results in high risk patients

Heparin free hemodialysis was compared to systemic heparinization, intermittent saline flushes and constant saline infusions in eight, stable chronic patients dialyzing on hollow-fiber artificial kidneys (HFAK) at blood flows of 250 to 300 ml/min. No significant differences in small molecule clearance, fluid removal or dialyzer clotting were noted. Since this data showed that heparin free hemodialysis without supplemental saline was feasible in a group of stable, chronic dialysis patients, we then prospectively studied twenty-nine patients judged to be at increased risk of hemorrhage from heparinization during 100 heparin-free dialyses. The incidences of severe and moderate dialyzer clotting were 7% and 20%, respectively. Seventeen of 27 treatments in which moderate or severe clotting occurred had identifiable factors thought to predispose to dialyzer clotting such as low blood flows, poor vascular-access function, severe hypotension and intradialytic blood transfusions. Although higher hematocrit values were associated with greater degrees of dialyser clotting, stepwise discriminant analysis employing blood flow, blood pressure, hematocrit and transfusion administration could not develop an accurate predictor or combination of predictors of clotting. No patient experienced de novo or increased bleeding and problems with inadequate dialysis were not observed. Since this method of heparin free dialysis is as safe and effective as previously reported strategies and requires no specialized equipment or procedures, it is a reasonable initial strategy for dialyzing high risk patients.

Linear, quadratic, and bilinear programming approaches to the linear complementarity problem

Traditional pivoting procedures for solving the linear complementarity problem can only guarantee convergence for problems having well defined structures. Recently, optimization procedures based on linear, quadratic, and bilinear programming have been developed to extend the class of problems that can be solved efficiently. These latter approaches are the focus of this paper. The strengths and weaknesses of each of the approaches are discussed. The linear programming approach, advanced by Mangasarian, is the most efficient once an appropriate objective function is found. This requires the solution of a system of linear and bilinear equations that is easily solvable only in some cases. Extensions to this approach, due to Shiau, show some promise but are still limited to special cases of the general problem. The quadratic programming approaches discussed here are restricted to specialized procedures for the complementarity problem. One, proposed by Cheng, is based on the levitin-Poljak gradient projection method, and the other, due to Cirina, is based on Karush-Kuhn-Tucker theory. Both are only successful on some problems. The two bilinear programming algorithms discussed are the most general. For any problem, they are guaranteed to find at least one solution or conclude that none exist. One is a specialization of the recent biconvex programming algorithm of Al-Khayyal and Falk and the other is an entirely new implicit enumeration procedure.

Data Abstraction Technique for Relational Database Query Processing

AbstractThis paper proposes a schema conversion approach for relational database query processing. The approach not only maintains high data independence by encapsulating the data and its physical structures for a query with the procedures that manipulate them, but also aims to achieve high‐speed processing by dedicating the procedures to individual functions. This approach is experimentally compared with the interpretive and compilation methods in terms of data independence, performance and the procedure program size. The following conclusions are drawn from the experiments.(1) Although the effect of the change in physical structure is greater than that of the interpretive approach in regard to data independence, only a limited number of parts are affected and they are easily reorganized by each dedicated procedure. (2) The performance is extremely close to that of the compilation approach regardless of the kind of computer and programming language. Furthermore, the overhead for calling the procedures can be further reduced with the use of microprograms and hardware. (3) Although the number of specialized procedures increases, this is compensated by the relatively small program size of each procedure.

Engaging the severely dysfunctional family in treatment: basic considerations.

The severely dysfunctional family is a clinical phenomenon that includes families with a wide range of serious symptoms. These families have been characteristically difficult to engage in treatment, and many do not respond well to traditional family therapy techniques. Some of these families do respond to innovative approaches such as paradox. However, many agencies do not have the capability to implement such highly specialized procedures, nor do all severely dysfunctional families respond well to these techniques. Thus, this paper presents a generic approach to the severely dysfunctional family; the emphasis is on facilitating engagement and maintaining sensitivity to the family's need for stability.

Inferior Turbinate Fracture in the Treatment of Congenital Nasolacrimal Duct Obstruction and Congenital Nasolacrimal Duct Anomaly

A group of 52 pediatric patients with lacrimal obstruction were considered to be high risk since they had been previously probed (27 patients) or were older (average age 23 months). At the time of probe and irrigation, a small, straight hemostat was placed into the nose to grasp the inferior turbinate and rotate it a full 90 degrees inward. All cases of congenital nasolacrimal duct obstruction (49) resolved following this maneuver. A small muscle hook with the tip directed upward was placed underneath the inferior turbinate to identify three patients with congenital nasolacrimal duct anomaly (absence or atresia of the nasolacrimal duct) who would not have benefitted from further probings and responded to dacryocystorhinostomy. Even though the results of our uncontrolled surgical trial cannot be compared to other treatment methods, the data suggest that even very difficult cases of congenital nasolacrimal duct obstruction will respond to a simple turbinate fracture with a hemostat without the necessity of complicated tubes or stents. A small muscle hook can be used to identify those rare cases of congenital nasolacrimal duct anomaly who may require specialized procedures such as dacryocystorhinostomy or inferior turbinectomy.

How the Gl pathologist can interact best with the Gl trainee

Effective collaboration between endoscopists is essential if optimal results from gastrointestinal biopsy are to be achieved. Agreed upon ways to enhance communication should be established, such as special requisition forms and regular conferences to discuss biopsy findings. Endoscopists and pathologists should know about and feel free to discuss the other specialist's procedures and techniques. Furthermore, all procedures and techniques for obtaining, handling, and reaching diagnostic conclusions from biopsy specimens need to be carefully examined and optimized. Recommended approaches are presented.

Matching of ultrasonic flaw sizing methods to the defect type and location

Sizing techniques are discussed; they are specialized techniques for fitness for purpose inspection on defects detected by other ultrasonic methods. Since amplitude evaluation is somewhat reserved for quality assurance applications and can only give a rough classification. Nevertheless it is necessary to point out that this is the most important approach in today's NDT-practice. The sizing accuracy which can be expected for amplitude evaluation is in general not better than 50% whereas with other specialized procedures 10%–15% sizing accuracy can be expected.

Noncardiac Surgery in the Cardiac Patient: Assessment and Management

The stated objective of this multiple-authored text is to provide information that can be used by the referring physician and the surgeon alike. It provides guidance and intelligent treatment of patients with heart disease who face the necessity of either elective or emergency noncardiac surgery. This subject is usually dealt with much more concisely in a few pages by current standard texts of cardiovascular disease. Considerable attention is given to the use of special, noninvasive procedures, which are often available chiefly at university hospitals. These procedures include echocardiography, oculopneumoplethysmography, supraorbital Doppler examination, Doppler-flow imaging, strain-gauge plethysmography, phleborrheography, continuous-wave Doppler-flow velocity determination, pulmonary function testing, exercise testing, invasive cardiac catheterization, and His bundle studies. These are all valuable, highly specialized procedures in resolving specific problems in a definitive cardiovascular evaluation. However, it is not believed that they are frequently required by an experienced cardiologist to establish a data base before deciding

A note on specialized versus unspecialized methods for maximum‐flow problems

Abstract : A study developing highly efficient versions of both primal simplex and labeling methods for maximum flow problems has disclosed the surprising superiority of specialized primal methods. These provocative findings not only overturn standard expectation about the relative performance of simplex versus labeling approaches, but also raise the intriguing question of whether--or to what extent--it is useful to develop specialized methods for maximum flow problems. This issue was investigated by testing both specialized and unspecialized primal simplex codes on the same maximum flow problems using the same computer and compiler. Considering the possibility that some general primal network codes may be better tuned to maximum flow applications than others, a code was obtained which was timed for maximum flow problems in terms of using a special tree orientation, pricing subroutine, and pivot selection subroutine. The specialized primal code used in the tests is the SEQCS code. Hereafter it is, respectively, refer to these codes as GENERAL and SPECIAL. The tests of the two methods were conducted on four types of network structures: random (R), multi-terminal random (MR), transit grid (TG), and hard (H). It is found after testing 185 maximum flow problems embodying these diverse structures that the SPECIAL code is substantially more efficient than GENERAL, in spite of th fact that GENERAL was demonstrated superior to the specialized maximum flow procedures it was previously tested against. The R problems were generated by randomly selecting ordered node pairs to identify the arcs (avoiding duplication), and these were in turn randomly assigned capacities from a predefined interval.

Data processing in clinical virology.

Laboratory diagnosis of viral diseases requires an individually defined course of highly specialized laboratory procedures. In order to obtain relevant results it is necessary to get detailed data concerning the patient as well as clinical information concerning the type of disease and the date of its onset, including any special symptoms which may be present. On the basis of this information, the diagnostician in the laboratory has to decide what type of tests are to be performed and, depending on the preliminary results, which additional diagnostic procedures are necessary. Finally, the results of the laboratory tests together with the clinical symptomatology and the epidemiological or endemiological situation enable a report to be compiled.

Ca2+ and calmodulin-dependent phosphorylation of endogenous synaptic vesicle tubulin by a vesicle-bound calmodulin kinase system.

Endogenous synaptic vesicle alpha- and beta-tubulin were shown to be the major substrates for a Ca2+-calmodulin-regulated protein kinase system in enriched synaptic vesicle preparations from rat cortex as determined by two-dimensional gel electrophoresis and peptide mapping. The activation of this endogenous tubulin kinase system was dependent on Ca2+ and the Ca2+ binding protein, calmodulin. Under maximally stimulated conditions, approximately 40% of the tubulin present in enriched synaptic vesicles was phosphorylated within less than 50 s by the vesicle Ca2+-calmodulin kinase. Evidence is presented indicating that the Ca2+-calmodulin tubulin kinase is an enzyme system distinct from previously described cyclic AMP protein kinases. alpha-Tubulin and beta-tubulin were identified as major components of previously designated vesicle phosphorylation bands DPH-L and DPH-M. The Ca2+-calmodulin tubulin kinase is very labile and specialized isolation procedures were necessary to retain activity. Ca2+-activated synaptic vesicle tubulin phosphorylation correlated with vesicle neurotransmitter release. Depolarization-dependent Ca2+ uptake in intact synaptosomes simultaneously stimulated the release of neurotransmitters and the phosphorylation of synaptic vesicle alpha- and beta-tubulin. The results indicate that regulation of the synaptic vesicle tubulin kinase by Ca2+ and calmodulin may play a role in the functional utilization of synaptic vesicle tubulin and may mediate some of the effects of Ca2+ on vesicle function and neurosecretion.