Vertinant Besimokančios organizacijos bruožų raišką šiuolaikinio viešojo valdymo kontekste ir remiantis Karen E. Watkins ir Victoria J. Marsick sudarytu klausimynu [30], 2017 m. sausio – kovo mėn. atliktas tyrimas viešojoje ambulatorinėje asmens sveikatos priežiūros įstaigoje, apklausti 228 darbuotojai. Daugelyje viešojo sektoriaus organizacijų veiklos vadyba, vertinimas ir rezultatų analizė tampa vis svarbesne viešojo sektoriaus institucijų veiklos sudedamąja dalimi. Viešojo sektoriaus organizacijoms, siekiančioms įgyvendinti Besimokančios organizacijos koncepciją, reikia pertvarkyti savo organizacijos valdymo struktūrą. Ambulatorinės asmens sveikatos priežiūros įstaigos kritinis darbuotojų mokymosi taškas yra nepakankamas finansinės ir kitos pagalbos skyrimas visų pareigybių specialistams. Atlikto tyrimo metu nustatyta, kad aukščiausiai įvertintas mokymasis organizaciniame lygmenyje, toliau - grupių/ komandų, žemiausiai – individualiame lygmenyje. Galime teigti, kad tyrime dalyvavusios ambulatorinės asmens sveikatos priežiūros įstaigos kryptingas organizacinis mokymasis sąlygoja tobulėjimą, didina konkurencinį pranašumą ir leidžia prisitaikyti prie pokyčių bei juos valdyti, o kiekvienam jos darbuotojui suteikiama savirealizacijos galimybė. Tyrimo metu nustatyta, kad didžiausios ambulatorinės asmens sveikatos priežiūros organizacijos stiprybės: dėmesio kreipimas į kliento (paciento) nuomonę; organizacija suteikia darbuotojams priemones, reikalingas darbui atlikti; darbuotojai geba dirbti komandoje, padeda vieni kitiems mokytis, gerbia kito darbuotojo nuomonę; vadovai dalijasi naujausia informacija apie technologijas, naujoves, kryptis. Nustatyta, kad ši įstaiga atitinka Besimokančios organizacijos koncepciją, tačiau nepakanka organizacijoje vien mokytis, būtina organizacijos valdymą orientuoti į nuolatinį veiklos procesų tobulinimą, paremtą šiuolaikinio viešojo valdymo paradigma.
Background: Delayed food anaphylaxis upon consumption of red meat is attributed to specific IgE-antibodies directed to galactose-α-1,3-galactose (α-Gal). Anaphylactic reactions may occur after ingestion of meat from different mammals, mainly beef and pork, but reactions to lamb, rabbit or horse have also been reported. In particular, pork kidney has been shown to trigger symptoms that were more severe and occurred within a shorter delay. The objective of the present study was the identification and characterization of pork kidney proteins carrying α-Gal carbohydrates and mediating delayed allergic reactions through specific IgE to α-Gal. Materials and methods: A cohort of 59 patients with specific IgE to α-Gal was screened by immunoblot for IgE-reactive proteins in pork kidney extract. Proteins were purified by affinity chromatography and identified by Edman sequencing and peptide mass fingerprinting. Isolated proteins were used in immunoassays using patient sera and α-Gal specific antibodies. Allergenicity was assayed in basophil activation and skin prick test. Results: Multiple IgE-binding proteins were detected in protein extracts of pork kidney by immunoblot using patient sera and an anti-α-Gal antibody. Reactive bands were located in the high molecular weight range of 100 to ≥200 kDa. Two major IgE-binding proteins were identified as porcine angiotensin I converting enzyme (ACE I) and aminopeptidase N (AP-N). IgE-binding to both proteins was lost by periodate treatment, resulting in oxidation of carbohydrates. Addition of α-Gal inhibited IgE-reactivity to both peptidases. Allergenicity was confirmed by activation of patient basophils and positive skin prick tests. Conclusions: Two IgE-reactive cell membrane peptidases carrying α-Gal epitopes were identified in pork kidney, a tissue which is known as potent inducer of red meat-induced anaphylaxis. Allergenicity and clinical relevance of these proteins were confirmed in patients with delayed anaphylaxis to red meat by skin prick test and basophil activation.
Mykolo Romerio universitetas Edukologijos ir socialinio darbo institutas Ateities g. 20, LT-08303 Vilnius, LietuvaTelefonas (8 5
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