Linking response strategies adopted by construction firms during the 2007 economic recession to Porter’s generic strategies

The time period bridging the years 2007 to 2012 will be remembered as one characterised by dramatic changes in the Irish and UK construction industries. Construction companies witnessed unprecedented changes in the environment, namely the coincidence of a sharp economic downturn, the significant decline of public works, a reduction in lending, increased competition, and structural changes in the marketplace. Nevertheless, little has been documented on what response strategies construction companies adopt as a result of an economic recession. Based on four exploratory case studies, a taxonomy framework of the response strategies adopted by Irish and UK construction companies during the 2007 economic recession was developed relative to Porter’s (1980) generic strategies of cost leadership, differentiation, and focus. Porter’s model (1980) is a well known theoretical framework among business strategists and industrial economists worldwide. The analysis provides strong support for the adoption of cost leadership strategies as a means to surviving the 2007 economic recession. The case studies further suggest that cost control initiatives are one of the most important attributes in companies’ responses to the 2007 recession. The findings provide valuable assistance for construction contractors in developing effective strategies and thus reducing business failures during recessionary periods.

Chronic kidney disease and diabetes in the National Health Service:a cross-sectional survey of the UK National Diabetes Audit

We investigated the prevalence of chronic kidney disease and attainment of therapeutic targets for HbA1c and blood pressure in a large UK-based diabetes population.

Obesity and kidney disease in type 1 and 2 diabetes: an analysis of the National Diabetes Audit

Background: Obesity is increasingly prevalent in many countries. Obesity is a major risk factor for the development of type 2 diabetes but its relationship with diabetic kidney disease (DKD) remains unclear. Some studies have suggested that the metabolic syndrome (including obesity) may be associated with DKD in type 1 diabetes. Aim: To investigate the association between obesity and DKD. Design: Retrospective cross-sectional study. Methods: National Diabetes Audit data were available for the 2007–08 cycle. Type 1 and 2 diabetes patients with both a valid serum creatinine and urinary albumin:creatinine ratio were included. DKD was defined as an estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m2, albuminuria or both. Logistic regression was used to analyse associations of obesity (body mass index ≥30 kg/m2) and other variables including year of birth, year of diagnosis, ethnicity and stage of kidney disease. Results: A total of 58 791 type 1 and 733 769 type 2 diabetes patients were included in the analysis. After adjustment, when compared with type 1 diabetes patients with normal renal function those with DKD were up to twice as likely to be obese. Type 2 DKD patients were also more likely to be obese. For example, type 2 diabetes patients with an eGFR <15 ml/min/1.73 m2 and normoalbuminuria, microalbuminuria or macroalbuminuria were all more likely to be obese; odds ratios (95% CI) 1.65 (1.3–2.1), 1.56 (1.28–1.92) and 1.27 (1.05–1.54), respectively. Conclusions: This study has highlighted a strong association between obesity and kidney disease in type 1 diabetes and confirmed their association in type 2 diabetes.

Structural Capital of University Spin-Out Firms: The Moderating Role of University Incubators

University incubators (UI) are generally believed to be important in the successful commercialisation of university spin-outs (USO) with over half of all UK Universities having established an on-campus UI. In this chapter we examine the value of UIs in the spin-out process, focusing on the structural networks of USOs located in a UI as compared to USOs in a University with no access to a UI. Our primary research question is therefore: to what extent does the structural network of USOs with access to an on-campus UI differ from USOs without? The research therefore con-tributes to a growing critique of the effectiveness of UIs in commercialis-ing academic research and the recognition of positive direct and indirect externalities from participation in networks. Through network mapping of all USOs from two research intensive universities, we profile and ana-lyse the formal and informal network ties of USOs to various partners in-ternal and external to the host university. Through interviews we also consider how these networks enhance the resources and capabilities of USOs. Our findings highlight significant differences, with USOs located in a UI having more informal but fewer formal ties, both to other USOs as well as within the host University. In contrast, location in an incuba-tor was not found to affect the extent and nature of ties with external or-ganisations. Reasons for these differences are examined through inter-views with the USOs and point to various factors including the proactive brokering role of incubator and university staff, university bureaucracy, the hidden networks of executive board members across USOs, university equity investment policy and complementary technologies.

An audit of drug shortages in a community pharmacy practice

Background: There are no firm data on drug shortages in Irish community pharmacy. This prospective observational study aimed to characterise the drug shortage problem in an Irish community pharmacy.
Aims: The primary aim was to determine numbers and durations of drug shortages. Secondary aims included comparing these shortages with Irish Pharmacy Union (IPU) drug shortage lists and determining the frequency with which notifications were received prior to shortages. Further secondary aims were to examine relationships between causes of drug shortages and drug costs and between causes of drug shortages and shortage durations.
Methods: The study took place in a community pharmacy in a Limerick City suburb between October 2012 and February 2013. Data were collected daily regarding drugs that were dispensed, but unavailable to purchase. Suppliers/manufacturers provided data on the reasons for shortages.
Results: 65/1,232 dispensed drugs (5.3 %) were in short supply over the study period. Median shortage duration was 13 days (interquartile range 4–32 days) and median cost was €8.10. Numbers of unavailable drugs by month varied from 13 to 38. Monthly IPU drug shortage lists identified between six and eight of these shortages depending on the month. Two notifications were received from suppliers/manufacturers regarding shortages. Parallel exports had the highest mean costs (mean €38.05) and manufacturing problems were associated with the longest durations (mean 57.44 days).
Conclusions: This study highlights the drug shortage problem in an Irish community pharmacy. We propose that enhanced communication between all stakeholders is the most worthwhile solution. Further studies are needed.

Prospective clinical audit of chloral hydrate administration practices in a neonatal unit

Aim: Chloral hydrate is generally considered a safe and effective single dosing procedural sedative for neonates in the clinical setting. However, its safety profile as a repetitive dosing maintenance sedative is largely unknown. This study aimed to document current administration practices of chloral hydrate in the Neonatal Unit, Royal Children's Hospital, Melbourne, Australia, over a 6-month period.

Methods: Patients who had been prescribed chloral hydrate during the specified audit period were recruited into the study and prospectively followed for a period of 28 days, or until they were discharged from the unit. Demographic data were collected on recruitment, and daily documentation of chloral hydrate administration was recorded.

Results: A total of 238 doses of chloral hydrate were administered to a cohort of 32 patients during the study period. The majority of the audited doses (84%) were ordered as repeating doses. Doses were more likely to be given at night than during the day, and the median dosage for repetitive dosing was found to be above the study site's recommended dosing range. Pre-dose and/or post-dose assessment of distress/agitation accompanied dosage approximately half of the time. The audit did not reveal any recognisable pattern of sedation maintenance or weaning process for patients who received multiple doses.

Conclusions: Health-care professionals caring for hospitalised infants should be made aware of the potential risks of chloral hydrate as a repetitive dosing sedative, and of the importance of systematically evaluating the appropriateness and effectiveness of utilising such pharmacological intervention for managing and treating distress.