Acute and chronic effects of dietary nitrate supplementation on blood pressure and the physiological responses to moderate-intensity and incremental exercise

Dietary nitrate (NO3���) supplementation with beetroot juice (BR) over 4���6 days has been shown to reduce the O2 cost of submaximal exercise and to improve exercise tolerance. However, it is not known whether shorter (or longer) periods of supplementation have similar (or greater) effects. We therefore investigated the effects of acute and chronic NO3��� supplementation on resting blood pressure (BP) and the physiological responses to moderate-intensity exercise and ramp incremental cycle exercise in eight healthy subjects. Following baseline tests, the subjects were assigned in a balanced crossover design to receive BR (0.5 l/day; 5.2 mmol of NO3���/day) and placebo (PL; 0.5 l/day low-calorie juice cordial) treatments. The exercise protocol (two moderate-intensity step tests followed by a ramp test) was repeated 2.5 h following first ingestion (0.5 liter) and after 5 and 15 days of BR and PL. Plasma nitrite concentration (baseline: 454 �� 81 nM) was significantly elevated (+39% at 2.5 h postingestion; +25% at 5 days; +46% at 15 days; P < 0.05) and systolic and diastolic BP (baseline: 127 �� 6 and 72 �� 5 mmHg, respectively) were reduced by ���4% throughout the BR supplementation period (P < 0.05). Compared with PL, the steady-state V��o2 during moderate exercise was reduced by ���4% after 2.5 h and remained similarly reduced after 5 and 15 days of BR (P < 0.05). The ramp test peak power and the work rate at the gas exchange threshold (baseline: 322 �� 67 W and 89 �� 15 W, respectively) were elevated after 15 days of BR (331 �� 68 W and 105 �� 28 W; P < 0.05) but not PL (323 �� 68 W and 84 �� 18 W). These results indicate that dietary NO3��� supplementation acutely reduces BP and the O2 cost of submaximal exercise and that these effects are maintained for at least 15 days if supplementation is continued.

Dasatinib, nilotinib and standard-dose imatinib for the first line treatment of chronic myeloid leukaemia: Systematic reviews and economic analyses

- Background Nilotinib and dasatinib are now being considered as alternative treatments to imatinib as a first-line treatment of chronic myeloid leukaemia (CML). - Objective This technology assessment reviews the available evidence for the clinical effectiveness and cost-effectiveness of dasatinib, nilotinib and standard-dose imatinib for the first-line treatment of Philadelphia chromosome-positive CML. - Data sources Databases [including MEDLINE (Ovid), EMBASE, Current Controlled Trials, ClinicalTrials.gov, the US Food and Drug Administration website and the European Medicines Agency website] were searched from search end date of the last technology appraisal report on this topic in October 2002 to September 2011. - Review methods A systematic review of clinical effectiveness and cost-effectiveness studies; a review of surrogate relationships with survival; a review and critique of manufacturer submissions; and a model-based economic analysis. - Results Two clinical trials (dasatinib vs imatinib and nilotinib vs imatinib) were included in the effectiveness review. Survival was not significantly different for dasatinib or nilotinib compared with imatinib with the 24-month follow-up data available. The rates of complete cytogenetic response (CCyR) and major molecular response (MMR) were higher for patients receiving dasatinib than for those with imatinib for 12 months' follow-up (CCyR 83% vs 72%, p < 0.001; MMR 46% vs 28%, p < 0.0001). The rates of CCyR and MMR were higher for patients receiving nilotinib than for those receiving imatinib for 12 months' follow-up (CCyR 80% vs 65%, p < 0.001; MMR 44% vs 22%, p < 0.0001). An indirect comparison analysis showed no difference between dasatinib and nilotinib for CCyR or MMR rates for 12 months' follow-up (CCyR, odds ratio 1.09, 95% CI 0.61 to 1.92; MMR, odds ratio 1.28, 95% CI 0.77 to 2.16). There is observational association evidence from imatinib studies supporting the use of CCyR and MMR at 12 months as surrogates for overall all-cause survival and progression-free survival in patients with CML in chronic phase. In the cost-effectiveness modelling scenario, analyses were provided to reflect the extensive structural uncertainty and different approaches to estimating OS. First-line dasatinib is predicted to provide very poor value for money compared with first-line imatinib, with deterministic incremental cost-effectiveness ratios (ICERs) of between ��256,000 and ��450,000 per quality-adjusted life-year (QALY). Conversely, first-line nilotinib provided favourable ICERs at the willingness-to-pay threshold of ��20,000-30,000 per QALY. - Limitations Immaturity of empirical trial data relative to life expectancy, forcing either reliance on surrogate relationships or cumulative survival/treatment duration assumptions. - Conclusions From the two trials available, dasatinib and nilotinib have a statistically significant advantage compared with imatinib as measured by MMR or CCyR. Taking into account the treatment pathways for patients with CML, i.e. assuming the use of second-line nilotinib, first-line nilotinib appears to be more cost-effective than first-line imatinib. Dasatinib was not cost-effective if decision thresholds of ��20,000 per QALY or ��30,000 per QALY were used, compared with imatinib and nilotinib. Uncertainty in the cost-effectiveness analysis would be substantially reduced with better and more UK-specific data on the incidence and cost of stem cell transplantation in patients with chronic CML. - Funding The Health Technology Assessment Programme of the National Institute for Health Research.

What does the future hold for our traditional department stores?

Years of buy-outs, takeovers, mergers and rebranding have whittled a once plentiful landscape of department store competitors down to two major players, Myer and David Jones. Now, despite David Jones confirming it refused a potential A$3 billion merger proposal approach from its arch-competitor in October 2013, we must face the distinct possibility of there only being room for one, full line, up-market department store in Australia.

Can teacher collaboration overcome barriers to interdisciplinary learning in a disciplinary university? A case study using climate change

A teacher network was formed at an Australian university in order to better promote interdisciplinary student learning on the complex social-environmental problem of climate change. Rather than leaving it to students to piece together disciplinary responses, eight teaching academics collaborated on the task of exposing students to different types of knowledge in a way that was more than the summing of disciplinary parts. With a part-time network facilitator providing cohesion, network members were able to teach into each other���s classes, and share material and student activities across a range of units that included business, zoology, marine science, geography and education. Participants reported that the most positive aspects of the project were the collegiality and support for teaching innovation provided by peers. However, participants also reported being time-poor and overworked. Maintaining the collaboration beyond the initial one year project proved difficult because without funding for the network facilitator, participants were unable to dedicate the time required to meet and collaborate on shared activities. In order to strengthen teacher collaboration in a university whose administrative structures are predominantly discipline-based, there is need for recognition of the benefits of interdisciplinary learning to be matched by recognition of the need for financial and other resources to support collaborative teaching initiatives.

The context of enterprise education: Insights into current practices

This paper presents the results of an investigation into contextual differences in the development and delivery of enterprise education in higher education globally. Using information gathered from an online survey distributed to enterprise educators, distinct differences in the provision of enterprise education are identified, as are differences of opinion among enterprise educators. The findings demonstrate that although enterprise education is highly diversified in terms of presentation, content and style, there are clear commonalities with regard to expected student outcomes. The respondents reported low levels of business start-up activity among students during enterprise education and/or within one year of graduation. Over 75% of the educators surveyed had personal start-up experience, and there was limited reliance on academic literature, with a preference for referencing broader stakeholder perspectives. With regard to the practical implications of this research, the international metric of enterprise education appears to be a broad set of enterprising skills that equip and enable students to recognize and exploit opportunities in order to navigate future unknowns. The commonly employed metric of business start-up appears less valid in light of this investigation.

The evolution of entrepreneurial learning

- Purpose The purpose of this paper is to present an evolutionary perspective on entrepreneurial learning, whilst also accounting for fundamental ecological processes, by focusing on the development of key recurring, knowledge components within nascent and growing small businesses. - Design/methodology/approach The paper relates key developments within the organizational evolution literature to research on entrepreneurial learning, with arguments presented in favor of adopting a multi���level co���evolutionary perspective that captures and explains hidden ecological process, such as niche���construction. - Findings It is argued in the paper that such a multi���level focus on key recurring knowledge components can shed new light on the process of entrepreneurial learning and lead to the cross���fertilization of ideas across different domains of study, by offering researchers the opportunity to use the framework of variation���selection���retention to develop a multi���level representation of organizational and entrepreneurial learning. - Originality/value Entrepreneurial learning viewed in this way, as a multi���level struggle for survival amongst competing knowledge components, can provide entrepreneurs with a set of evolutionary heuristics as they re���interpret their understanding of the evolution of their business.

Understanding the heterogeneity of entrepreneurship education: going beyond Gartner

This paper seeks to draw attention to the importance of appreciating and using ever-present diversity to achieve increased legitimacy for entrepreneurship education. As such, it aims to draw the reader into a reflective process of discovery as to why entrepreneurship education is important and how such importance can be prolonged. Design/methodology/approach - The paper revisits Gartner's 1985 conceptual framework for understanding the complexity of entrepreneurship. The paper proposes an alternative framework based on the logic of Gartner's framework to advance the understanding of entrepreneurship education. The authors discuss the dimensions of the proposed framework and explain the nature of the dialogic relations contained within. Findings - It is argued that the proposed conceptual framework provides a new way to understand ever-present heterogeneity related to the development and delivery of entrepreneurship education. Practical implications - The paper extends an invitation to the reader to audit their own involvement and proximity to entrepreneurship education. It argues that increased awareness of the value that heterogeneity plays in student learning outcomes and programme branding is directly related to the presence of heterogeneity across the dimensions of the conceptual framework. Originality/value - The paper introduces a simple yet powerlu1 means of understanding what factors contribute to the success or otherwise of developing and delivering entrepreneurship education. The simplicity of the approach suggested provides all entrepreneurship educators with the means to audit all facets of their programme.

Exploring the role of entrepreneurial marketing in entrepreneurship education

This is a conceptual paper that seeks to explore the role of entrepreneurial marketing in promoting entrepreneurship in tertiary education. We postulate that the subject of entrepreneurship is marketed in different ways as a means of introducing (a) new learners to the subject area of entrepreneurship and (b) the wide ranging possibilities of entrepreneurship education. This research explores both the entrepreneurial marketing and the entrepreneurship literature to capture how they meet at the interface to solve the issue of appropriately marketing entrepreneurship courses within the context of university education. Whilst empirical evidence of entrepreneurial marketing has tended to concentrate on profit-making and small organizations, fewer studies have sought to understand the role of entrepreneurial marketing in public sector organizations, including the university. Although this article is exploratory in nature, it shows the benefits of utilizing the extensive research within the fields of entrepreneurial marketing and entrepreneurship to determine the value of entrepreneurship education for policymakers, universities and students.

Teaching Entrepreneurship to Undergraduates

This book is deliberatively provocative, and awakens another level of thinking on how to teach entrepreneurship. It will be required reading for entrepreneurship educators and those building a university entrepreneurship programme for years to come.

Enterprise system investments for competitive advantage: An empirical study of Swiss SMEs

Previous research identifies various reasons companies invest in information technology (IT), often as a means to generate value. To add to the discussion of IT value generation, this study investigates investments in enterprise software systems that support business processes. Managers of more than 500 Swiss small and medium-sized enterprises (SMEs) responded to a survey regarding the levels of their IT investment in enterprise software systems and the perceived utility of those investments. The authors use logistic and ordinary least squares regression to examine whether IT investments in two business processes affect SMEs' performance and competitive advantage. Using cluster analysis, they also develop a firm typology with four distinct groups that differ in their investments in enterprise software systems. These findings offer key implications for both research and managerial practice.

Entrepreneurship education: revisiting our role and its purpose

This paper seeks to focus on two questions. First, what value is created by entrepreneurship education? Second, how could any such value be created? The aim therefore is to go beyond any assumed notion that entrepreneurship education is beneficial to students in higher education, to question its underlying value. Design/methodology/approach ��� A critical realist approach is used to discuss the ontological nature of entrepreneurship education. Specifically, the process through which enterprise knowledge is developed and used by students in higher education. This research is based on a single-site case study at UTAS with the data collected by the author and complemented by other recent work that sought to empirically consider the notion of student value from entrepreneurship education within the same (UTAS) context. Findings ��� The paper argues that students in higher education understand quite well the limitations of the knowledge they develop about entrepreneurship. That they (the educators) need to better understand the students' journeys so that they can better develop learning environments within which the students' personal development can be advanced. Practical implications ��� The degree to which educators understand their limitations and the limitations of their students as potential entrepreneurs is critical to maximizing the likely value of entrepreneurship education in higher education. Originality/value ��� The paper provides a unique way of understanding the process of learning to be entrepreneurial in higher education. As such it offers an alternative way to understand how educators can redefine their importance in the provision of entrepreneurship education. It also highlights the likely limitations of student advancement in the domain of entrepreneurship education in higher education.

Accounting for student/educator diversity: resurrecting coaction theory

This chapter challenges current approaches to defining the context and process of entrepreneurship education. In modeling our classrooms as a microcosm of the world our current and future students will enter, this chapter brings to life (and celebrates) the everpresent diversity found within. The chapter attempts to make an important (and unique) contribution to the field of enterprise education by illustrating how we can determine the success of (1) our efforts as educators, (2) our students, and (3) our various teaching methods. The chapter is based on two specific premises, the most fundamental being the assertion that the performance of student, educator and institution can only be accounted for by accepting the nature of the dialogic relationship between the student and educator and between the educator and institution. A second premise is that at any moment in time, the educator can be assessed as being either efficient or inefficient, due to the presence of observable heterogeneity in the learning environment that produces differential learning outcomes. This chapter claims that understanding and appreciating the nature of heterogeneity in our classrooms provides an avenue for improvement in all facets of learning and teaching. To explain this claim, Haskell���s (1949) theory of coaction is resurrected to provide a lens through which all manner of interaction occurring within all forms of educational contexts can be explained. Haskell (1949) asserted that coaction theory had three salient features.

Enterprise education: Learning through personal experience

This paper outlines the development of a reflective process through which student feelings are brought to the surface to advance their learning outcomes. A key notion in relation to the capacity of student development is the ability of students to alter their collective habits of thought and in turn the nature of the learning environment. The paper examines student reflection in the context of students' heightened awareness of self and their potential influence on their environment. The notion of 'surfacing feelings' is used to describe the outcome of individual and group reflection through which several parties become aware of the active reflections of individual students, thereby increasing the potential depth of overall reflection. Finally, the author considers the transferability of the ideas discussed to other educational contexts.

Best practice full-stop: Anticipating the spillover effects of enterprise education

This paper considers the potential flow-on benefits that may arise from the increasing provision of enterprise education. The issue of vulnerability is proposed to be a factor associated with superior learning outcomes. Therefore, this paper aims to highlight the use of student and facilitator vulnerability to increase the capacity for learning in Higher Education. It is argued that students benefit from having to struggle to find their identity within a learning environment. That group work can assist the development of confidence through which improved learning behaviours are adopted. Also, the development of good learning practices in the domain of enterprise education have the potential to aid student learning outcomes in other areas of study. This paper provides another means of valuing the potential gains to be received from enterprise education.

Using old concepts to gain new insights: Addressing the issue of consistency

Purpose ��� This paper aims to go beyond a bookkeeping approach to evolutionary analysis whereby surviving firms are better adapted and extinct firms were less adapted. From discussion of the preliminary findings of research into the Hobart pizza industry, evidence is presented of the need to adopt a more traditional approach to applying evolutionary theories with organizational research. Design/methodology/approach ��� After a brief review of the relevant literature, the preliminary findings of research into the Hobart pizza industry are presented. Then, several evolutionary concepts that are commonplace in ecological research are introduced to help explain the emergent findings. The paper concludes with consideration given to advancing a more consistent approach to employing evolutionary theories within organizational research. Findings ��� The paper finds that the process of selection cannot be assumed to occur evenly across time and/or space. Within geographically small markets different forms of selection operate in different ways and degrees requiring the use of more traditional evolutionary theories to highlight the causal process associated with population change. Research limitations/implications ��� The paper concludes by highlighting Geoffrey Hodgson���s Principle of Consistency. It is demonstrated that a failure to truly understand how and why theory is used in one domain will likely result in its misuse in another domain. That, at present, too few evolutionary concepts are employed in organisational research to ensure an appreciation of any underlying causal processes through which social change occurs. Originality/value ��� The concepts introduced throughout this paper, whilst not new, provide new entry points for organizational researchers intent on employing an evolutionary approach to understand the process of social change.