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R U Underwood – One of the best experts on this subject based on the ideXlab platform.

  • 096 REGADENOSON IN EUROPE: FIRST- YEAR EXPERIENCE OF REGADENOSON STRESS COMBINED WITH SUBMAXIMAL EXERCISE IN PATIENTS UNDERGOING MPS
    Heart, 2013
    Co-Authors: M B Brinkert, E R Reyes, S W Walker, K L Latus, A M Maenhout, K S Standbridge, R M Mizumoto, S N Nkomo, K W Wechalekar, R U Underwood

    Abstract:

    Background Regadenoson is a selective A2a specific adenosine receptor agonists. It has been developed to avoid side effects associated with common pharmacological stress agents. European approval was granted by the EMA in 2010. The aim of this study was to assess the side effect profile of regadenoson and to compare this experience with other forms of stress used over the same period. Methods Since July 2011 we prospectively studied 1764 consecutive patients referred for MPS. All clinical, stress and imaging data have been recorded and analysed using the Excel Data Analysis Toolpak and SPSS. Symptoms during stress were recorded and defined as mild, moderate or severe. An adverse event was defined as any symptom that persisted for more than 30 min or that required investigation or treatment. Adenosin, dobutamine and dynamic exercise were administered and done according to Royal Brompton Patient Group Direction (PGD). Regadenoson was given as a 400 µg bolus intravenously over 10–30 s followed by a saline flush over 10 s and then the radiopharmaceutical. Results 130 patients underwent adenosine stress, 1581 regadenoson stress, 39 dobutamine stress and 14 dynamic exercise stress. Symptoms were common with all forms of pharmacological stress occurring in 75% with adenosine, 63% with regadenoson and 46% with dobutamine. Chest discomfort and flushing occurred more commonly with adenosine (29% and 25% respectively) than with regadenoson (12% and 7%), but light headedness more common with regadenoson (7%) than with adenosine (1%). Twelve patients with regadenoson (1%) had diarrhoea compared with none with adenosine. The severity of symptoms did not differ between agents being mild, moderate and severe 84.1%, 14% and 1.9% with adenosine, 88.1%, 10.1%, 1.7% respectively with regadenoson and 82.4%, 17.7%, 0% with dobutamine. Eight patients had adverse events, all with regadenoson, although the difference was not statistically significant (p=0.818). Three events were moderate and two severe, the latter with sinus arrest and asystole lasting 30 s and 10 s and requiring CPR. All patients recovered fully without sequelae or admission to hospital. No patient developed bronchospasm with regadenoson with the exception of a single patient without known airways disease who developed mild bronchospasm that responded to salbutamol inhaler. Conclusions We have studied 1764 stress tests for MPS over a 12-month period in order to assess the symptom profile of regadenoson in the largest European cohort to date. Regadenoson combined with exercise is well tolerated, notably also in patients with asthma/COPD. The majority of adverse events were vaso-vagal episodes without sequelae. There is no clear direct mechanism by which regadenoson might cause vaso-vagal syncope.

Jane Njoroge – One of the best experts on this subject based on the ideXlab platform.

  • TECHNOLOGICAL CHANGE MANAGEMENT AND PERFORMANCE OF EMPLOYEES OF THE PARLIAMENTARY SERVICE COMMISSION IN KENYA
    , 2019
    Co-Authors: Andrew Shangarai Jumanne, Jane Njoroge

    Abstract:

    Purpose: the purpose of the study was to investigate the effect of Technological Change Management on employee performance Public Sector Organizations in Kenya; Case of Parliamentary Service Commission (PARLSCOM ) .  Methodology : A descriptive research design was employed to describe the performance of employees in PSC after changes in organizational technologies.  The target population was all the 914 employees of PARLSCOM on permanent and pensionable terms. The study used stratified and simple random sampling techniques to draw a sample of 91 employees from the target study population.  Self-administered questionnaire and interview guides were used to collect primary. Secondary data was obtained from PARLSCOM’s annual reports, government publications and earlier research. Data was analyzed using descriptive and inferential statistics. Descriptive statistics was used to summarize data while inferential statistics, specifically multiple linear regression was used to test hypotheses. The Analysis was done using Microsoft Excel 2013 Analysis Toolpak. Findings : The study found out that technological change management was significant in affecting the performance of employees of Parliamentary Service Commission in Kenya. Unique Contribution to Policy:  Managers should invest in technology through automation of their functions as much as possible. Human resource managers need to implement policies on training and development for employees to enhance knowledge and skills in the emerging technologies. They should also ensure that their employees are involved in deciding which technologies to be adopted and how they are managed.

  • STRUCTURAL CHANGE MANAGEMENTAND EMPLOYEE PERFORMANCE IN PUBLIC SECTOR ORGANIZATIONS IN KENYA: CASE OF THE PARLIAMENTARY SERVICE COMMISSION
    Journal of Strategic Management, 2018
    Co-Authors: Andrew Shangarai Jumanne, Jane Njoroge

    Abstract:

    Purpose: The purpose of this study was to analyze the effect of structural change management on employee performance in the Parliamentary Service Commission (PARLSCOM) and it was undertaken through descriptive research design. Methodology: The study targeted all the nine hundred and fourteen employees of PARLSCOM. Stratified and simple random sampling techniques were used to select a sample of ninety one participants from the target population.  Self-administered questionnaire and interview guides were used to collect primary. Secondary data was obtained from PARLSCOM’s annual reports, government publications and earlier research.  Reliability of the instruments was tested using Cronbach’s alpha reliability. Data was analyzed using descriptive and inferential statistics. Multiple linear regression Analysis was done using Microsoft Excel 2013 Analysis Toolpak and output used to test study hypotheses. Results: The results indicated that structural change management had a positive significant effect on performance of employees in PARLSCOM.Unique contribution to the theory, practice and policy: The study recommends that structural change management is a critical factor in increasing employee performance, therefore HR managers should ensure clarity and stability in the organization’s structure during change management in order to enhance employee performance.  Finally, the study recommends further research be done by replicating the same study in other organizations and also using other independent variables other than the ones used in this study.

M B Brinkert – One of the best experts on this subject based on the ideXlab platform.

  • 096 REGADENOSON IN EUROPE: FIRST- YEAR EXPERIENCE OF REGADENOSON STRESS COMBINED WITH SUBMAXIMAL EXERCISE IN PATIENTS UNDERGOING MPS
    Heart, 2013
    Co-Authors: M B Brinkert, E R Reyes, S W Walker, K L Latus, A M Maenhout, K S Standbridge, R M Mizumoto, S N Nkomo, K W Wechalekar, R U Underwood

    Abstract:

    Background Regadenoson is a selective A2a specific adenosine receptor agonists. It has been developed to avoid side effects associated with common pharmacological stress agents. European approval was granted by the EMA in 2010. The aim of this study was to assess the side effect profile of regadenoson and to compare this experience with other forms of stress used over the same period. Methods Since July 2011 we prospectively studied 1764 consecutive patients referred for MPS. All clinical, stress and imaging data have been recorded and analysed using the Excel Data Analysis Toolpak and SPSS. Symptoms during stress were recorded and defined as mild, moderate or severe. An adverse event was defined as any symptom that persisted for more than 30 min or that required investigation or treatment. Adenosin, dobutamine and dynamic exercise were administered and done according to Royal Brompton Patient Group Direction (PGD). Regadenoson was given as a 400 µg bolus intravenously over 10–30 s followed by a saline flush over 10 s and then the radiopharmaceutical. Results 130 patients underwent adenosine stress, 1581 regadenoson stress, 39 dobutamine stress and 14 dynamic exercise stress. Symptoms were common with all forms of pharmacological stress occurring in 75% with adenosine, 63% with regadenoson and 46% with dobutamine. Chest discomfort and flushing occurred more commonly with adenosine (29% and 25% respectively) than with regadenoson (12% and 7%), but light headedness more common with regadenoson (7%) than with adenosine (1%). Twelve patients with regadenoson (1%) had diarrhoea compared with none with adenosine. The severity of symptoms did not differ between agents being mild, moderate and severe 84.1%, 14% and 1.9% with adenosine, 88.1%, 10.1%, 1.7% respectively with regadenoson and 82.4%, 17.7%, 0% with dobutamine. Eight patients had adverse events, all with regadenoson, although the difference was not statistically significant (p=0.818). Three events were moderate and two severe, the latter with sinus arrest and asystole lasting 30 s and 10 s and requiring CPR. All patients recovered fully without sequelae or admission to hospital. No patient developed bronchospasm with regadenoson with the exception of a single patient without known airways disease who developed mild bronchospasm that responded to salbutamol inhaler. Conclusions We have studied 1764 stress tests for MPS over a 12-month period in order to assess the symptom profile of regadenoson in the largest European cohort to date. Regadenoson combined with exercise is well tolerated, notably also in patients with asthma/COPD. The majority of adverse events were vaso-vagal episodes without sequelae. There is no clear direct mechanism by which regadenoson might cause vaso-vagal syncope.