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Biomedical subjects

L Tyler

Publications and source records attributed to L Tyler.

21 records · Page 2Linked to original sources
PubMedDate not supplied

CEO performance appraisal: review and recommendations.

CEO performance appraisal (PA) is very valuable to an organization, but the chances of obtaining a PA of high quality decrease as executive responsibility increases. The realities of CEO PA are that it: (1) is inevitable; (2) is creative and complex; (3) involves politics; and (4) has a significant effect on the organization and the executive. PA is conducted for legal and social requirements, to enhance communication, to provide opportunities for improvement, and to relate performance to compensation. This article discusses several problems with chief executive officer (CEO) PA and the contemporary approaches that seek to improve it. Three fundamental areas for evaluation are identified: (1) organizational success; (2) areawide health status; and (3) professional role fulfillment. These provide an outline for successful healthcare PA. In addition to a discussion of the strategic considerations behind a successful CEO PA system, several recommendations are offered for the implementation of the annual evaluation process. The final goal of CEO PA is to link its results to CEO incentive compensation. It is strongly recommended that some portion of the CEO's salary directly hinge on his performance in two critical areas: organizational effectiveness and community health status.

Chief Executive Officers, Hospital↗
PubMedDate not supplied

Interaction of adrenergic and opioid systems in the short-term regulation of cardiovascular activities.

Endogenous opioid peptides such as methionine enkephalin (met-enkephalin) are known to have a profound cardiovascular action in addition to actions mimicking morphine in many animal models. In the anesthetized rabbit, met-enkephalin, as little as 1 microgram/kg, decreased blood pressure and heart rate upon its intravenous injection. Little is known about the locus of action or the mechanism and the physiological implication of the peptide action. The primary objective of this study was to test influences of adrenergic and cholinergic agents on the cardiovascular effects of the peptide. Pentobarbital (30 mg/kg) anesthetized rabbits were tracheotomized and a femoral artery and vein were cannulated for the measurement of arterial blood pressure and drug injection. Through a left lateral abdominal incision, the left renal nerve was isolated and renal nerve activity (RNA) recorded. Met-enkephalin (1 to 300 micrograms/kg, i.v.) decreased RNA initially and reduced blood pressure and heart rate. The cardiodepressant action of the peptide was antagonized by naloxone (1 mg/kg), but not by naloxone methobromide (1.3 mg/kg). Both phentolamine (4 mg/kg) and prazosin (1 mg/kg) antagonized the cardiovascular effect of met-enkephalin. Both hexamethonium (5 mg/kg) and mecamylamine (2 mg/kg) completely masked most of the depressant cardiovascular effects of metenkephalin by an increase in the duration of RNA suppression. The inability of naloxone methobromide and ganglionic blockers to antagonize the hypotensive action of met-enkephalin suggests that the peptide effect is secondary to its action on the central adrenergic system.

Animals↗