Synthesis and characterization of some Mn(II) and Mn(III) complexes of N,N′-o-phenylenebis(salicylideneimine)(LH2) and N,N′-o-phenylenebis(5-bromosalicylideneimine)(L′H2). Crystal structures of [Mn(L)(H2O)(ClO4)], [Mn(L)(NCS)] and an infinite linear chain of [Mn(L)(OAc)]

A series of manganese(II) [Mn(L)] and manganese(III) [Mn(L)(X)] (X = ClO4, OAc, NCS, N3, Cl, Br and I) complexes have been synthesized from Schiff base ligands N,N′-o- phenylenebis(salicylideneimine)(LH2) and N,N′-o-phenylenebis(5- bromosalicylideneimine)(L′H2) obtained by condensation of salicylaldehyde or 5-Br salicylaldehyde with o-phenylene-diamine. The complexes have been characterized by the combination of IR, UV-Vis spectroscopy, magnetic measurements and electrochemical studies. Three manganese(III) complexes 3 [Mn(L)(ClO4)(H2O)], 5 [Mn(L)(OAc)] and 13 [Mn(L)(NCS)] have been characterized by X-ray crystallography. The X-ray structures show that the manganese(III) is hexa-coordinated in 3, it is penta-coordinated in 13, while in 5 there is an infinite chain where the MnL moieties are connected by acetate ions acting as bridging bidentate ligand. The cyclic voltammograms of all the manganese(III) complexes exhibit two reversible/quasi-reversible/ irreversible responses assignable to Mn(III)/Mn(II) and Mn(IV)/Mn(III) couples. It was observed that the ligand L′H2 containing the 5-bromosal moiety always stabilizes the lower oxidation states compared to the corresponding unsubstituted LH2. Cyclic voltammograms of the manganese(II) complexes (1 and 2) exhibit a quasi-reversible Mn(III)/Mn(II) couple at E1/2 -0.08 V for 1 and 0.054 V for 2. © 2005 Elsevier B.V. All rights reserved.

An assessment of the alcohol content of medicines commonly used in paediatric liver and cystic fibrosis patients

Poster session - Paediatric cystic fibrosis and liver patients can be prescribed a number of different pharmaceutical preparations, often in liquid form - It is not uncommon for alcohol to be present in liquid preparations, often as a solvent - Although the quantity of alcohol present can be low, patients taking a number of alcohol-containing preparations may be at risk of toxicity - It has been found that only a few of the preparations used for both paediatric cystic fibrosis and liver patients contain alcohol - The quantity of alcohol present in these preparations is low and should not cause toxicity, even when the products are used in combination

Patient/carers' recollection of medicines related information from an out-patient clinic appointment

AIM: To identify what medicines related information children/young people or their parents/carers are able to recall following an out-patient clinic appointment. METHOD: A convenience sample of patients' prescribed at least one new long-term (>6 weeks) medicine were recruited from a single UK paediatric hospital out-patient pharmacy. A face-to-face semi-structured questionnaire was administered to participants when they presented with their prescription. The questionnaire included the following themes: names of the medicines, therapeutic indication, dose regimen, duration of treatment and adverse effects.The results were analysed using Microsoft Excel 2013. RESULTS: One hundred participants consented and were included in the study. One hundred and forty-five medicines were prescribed in total. Participants were able to recall the names of 96 (66%) medicines and were aware of the therapeutic indication for 142 (97.9%) medicines. The dose regimen was accurately described for 120 (82.8%) medicines with the duration of treatment known for 132 (91%). Participants mentioned that they had been advised about side effects for 44 (30.3%) medicines. Specific counselling points recommended by the BNFc1, were either omitted or not recalled by participants for the following systemic treatments: cetirizine (1), chlorphenamine (1), desmopressin (2), hydroxyzine (2), itraconazole (1), piroxicam (2), methotrexate (1), stiripentol (1) and topiramate (1). CONCLUSION: Following an out-patient consultation, where a new medicine is prescribed, children and their parents/carers are usually able to recall the indication, dose regimen and duration of treatment. Few were able to recall, or were told about, possible adverse effects. This may include some important drug specific effects that require vigilance during treatment.Patients, along with families and carers, should be involved in the decision to prescribe a medicine.2 This includes a discussion about the benefits of the medicine on the patient's condition and possible adverse effects.2 Treatment side effects have been shown to be a factor in treatment non-adherence in paediatric long-term medical conditions.3 Practitioners should explain to patients, and their family members or carers where appropriate, how to identify and report medicines-related patient safety incidents.4 However, this study suggests that medical staff may not be comfortable discussing the adverse effects of medicines with patients or their parents/carers.Further research in to the shared decision making process in the paediatric out-patient clinic when a new long-term medicine is prescribed is required to further support medicines adherence and the patient safety agenda.

What is the current practice of medicines reconciliation in children nationally in the UK?

INTRODUCTION: The National Institute for Health and Clinical Excellence/National Patient Safety Agency (NICE/NPSA) guidelines for medicines reconciliation (MR) on admission to hospital in adult inpatients were introduced in 2007, but they excluded children less than 16 years of age. METHOD: We conducted a survey of 98 paediatric pharmacists (each from a different hospital) to find out what the current practice of MR in children is in the UK. KEY FINDINGS: Responses showed that 67% (43/64) of pharmacists surveyed carried out MR in all children at admission and only a third 34% (22/64) had policies for MR in children. Of the respondents who did not carry out MR in all children, 80% (4/5) responded that they did so in selected children. Pharmacists considered themselves the most appropriate profession for carrying out MR. When asked whether the NICE guidance should be expanded to include children, 98% (54/55) of the respondents answered 'yes'. CONCLUSION: In conclusion, the findings suggest that MR is being conducted inconsistently in children and most paediatric pharmacists would like national guidance to be expanded to include children.

The clinical significance of medicines reconciliation in children admitted to hospital

Aims and Objectives: The NICE/NPSA guidance on Medicines Reconciliation in adults upon hospital admission excludes children under the age of 16.1 Hence the primary aim and objective of this study was to use medicines reconciliation to primarily identify if discrepancies occur upon hospital admission. Secondary objectives were to clinically assess for harm discrepancies that were identified in paediatric patients on long term medications at four hospitals across the UK. Method: Medicines reconciliation is a procedure where the current medication history of a patient prior to hospital admission would be taken and verifying the medication orders made at hospital admission against this history, addressing any discrepancies identified. Medicines reconciliation was carried out prospectively for 244 paediatric patients on chronic medication across four UK hospitals (Birmingham, London, Leeds and North Staffordshire) between January – May 2011. Medicines reconciliation was conducted by a clinical pharmacist using the following sources of information: 1) the patient's Pre-Admission Medication (PAM) from the patient's general practitioner 2) examination of the Patient's Own Medications brought into hospital, 3) a semi-structured interview with the parent-carers and 4) identification of admission medication orders written on the drug chart prior to clinical pharmacy input (Drug Chart). Discrepancies between the PAM and Drug Chart were documented and classified as intentional or unintentional. Intentional discrepancies were defined as changes that were made knowingly by the prescriber and confirmed. Unintentional discrepancies were assessed for clinical significance by an expert panel and assigned a significance score based on the likelihood of causing potential discomfort or clinical deterioration: class 1 unlikely, class 2 moderate and class 3 severe.2 Results: 1004 medication regimens were included from the 244 patients across the four sites. 588 of the 1004 (59%) medicines, had discrepancies between the PAM and Drug Chart; of these 36% (n = 209) were unintentional and included for clinically assessment. 189 drug discrepancies 30% were classified as class 1, 47% were class 2 and 23% were class 3 discrepancies. The remaining 20 discrepancies were cases where deviating from the PAM would have been the right thing to do, which might suggest that an intentional but undocumented discrepancy by the prescriber writing up the admission order may have occurred. Conclusion: The results suggest that medication discrepancies in paediatric patients do occur upon hospital admission, which do have a potential to cause harm and that medicines reconciliation is a potential solution to preventing such discrepancies. References: 1. National Institute for Health and Clinical Excellence. National Patient Safety Agency. PSG001. Technical patient safety solutions for medicines reconciliation on admission of adults to hospital. London: NICE; 2007. 2. Cornish, P. L., Knowles, S. R., Marchesano, et al. Unintended Medication Discrepancies at the Time of Hospital Admission. Archives of Internal Medicine 2005; 165:424–429

Technology transfer and sustainable industrial development for developing countries

This paper reports on a part of work for the UNIDO initiative on technology transfer for sustainable industrial development. The proposed technology transfer framework, adapted from the East Asian late industrialisers model, identifies two categories of countries requiring support for enhancing their technological capabilities: (a) very late industrialisers (“low income” developing countries), and (b) slow industrialisers (countries with sizeable manufacturing sectors but limited success in gaining international competitiveness) and three technology transfer routes: (a) through trade and aid to strengthen indigenous production for domestic markets (Route 1); (b) through FDI and contracting to develop export oriented firms (Route 2), and (c) through the supply chain of capital equipment and materials to develop local subcontracting capacity (Route 3). Very late industrialisers need support to start with Route 1 in selected sectors and upgrade through imported mature technologies. Appropriate product innovations are also possible. The slow industrialisers have more scope for increased technology transfer through Routes 2 and 3.

Measuring the assessment and counselling provided with the supply of non-prescription asthma reliever medication: a simulated patient study

BACKGROUND: Over one quarter of asthma reliever medications are provided without prescription by community pharmacies in Australia. Evidence that community pharmacies provide these medications with sufficient patient assessment and medication counseling to ensure compliance with the government's Quality Use of Medicines principles is currently lacking. OBJECTIVE: To assess current practice when asthma reliever medication is provided in the community pharmacy setting and to identify factors that correlate with assessment of asthma control. METHODS: Researchers posing as patients visited a sample of Perth metropolitan community pharmacies in May 2007. During the visit, the simulated patient enacted a standardized scenario of someone with moderately controlled asthma who wished to purchase a salbutamol (albuterol) inhaler without prescription. Results of the encounter were recorded immediately after the visit. Regression analysis was performed, with medication use frequency (a marker of asthma control) as the dependent variable. RESULTS: One hundred sixty community pharmacies in the Perth metropolitan area were visited in May 2007. Pharmacists and/or pharmacy assistants provided some form of assessment in 84% of the visits. Counseling was provided to the simulated patients in 24% of the visits. Only 4 pharmacy staff members asked whether the simulated patient knew how to use the inhaler. Significant correlation was found between assessment and/or counseling of reliever use frequency and 3 independent variables: visit length (p < 0.001), number of assessment questions asked (p < 0.001), and the simulated patient who conducted the visit (p < 0.02). CONCLUSIONS: Both patient assessment and medication counseling were suboptimal compared with recommended practice when nonprescription asthma reliever medication was supplied in the community pharmacy setting. Pharmacy and pharmacist demographic variables do not appear to affect assessment of asthma control. This research indicates the need for substantial improvements in practice in order to provide reliever medication in line with Quality Use of Medication principles of ensuring safe and effective use of medication.

Strategic positioning of manufacturing operations within global supply chains

In global environment, a company has to make many decisions that impact upon its position in global supply chain networks such as outsourcing, offshoring, joint venture, vertical/horizontal integration, etc. All these decisions impact on the company’s strategic position, and hence on competitive space and performance. Therefore, it is important for a company to carefully manage strategic positioning by making careful decisions about the adoption of alternative manufacturing and supply chain activities. Unfortunately, there is no complete process studied in strategic positioning of manufacturing operations within global supply chain. Therefore, the work presented in this paper has investigated leading research and industrial practices to create a formal and rational decision process. An analysis of previous literature, industrial practices, and the resulting decision process are all presented in this paper.

Success factors in a forming strategic positioning of manufacturing operations within global supply chains

Managing supply chains effectively has become a critical element in enhancing company profitability and has been identified as the new frontier of competitive advantage. An important element of effective supply chain management is the strategic positioning of the company. The strategic positioning process is concerned with the choice of production-centred activities a company carries out internally and those provided externally. Strategic positioning within manufacturing supply chains however is a relatively recent research topic with apparently few articles currently available that explicitly address associated issues directly. Moreover there is no previous research working strategic positioning of manufacturing operations in global context. Therefore the purpose of this paper is to explore strategic positioning within global supply chains. This paper is based on three cases drawn from the cross industry sector manufacturing companies. It describes an exploratory analysis which is aimed at gaining insight into the success factor to form a strategic positioning within global supply chains.

Strategic positioning of manufacturing operations within global supply chains

This paper describes research that has sought to create a structured and integrated methodology that guides manufacturers through the decision of strategic positioning within global supply chains. The position of a company is concerned with deciding a boundary and configuration of internal and external business activities to the company and is directly related to initiatives such as outsourcing, make or buy, and offshoring. This paper provides an in-depth description of this concept, describes work carried out to form a methodology for strategic positioning within the global supply chain, and presents the details of the methodology. This research has made a significant contribution to the knowledge on how manufacturing companies can form a strategic positioning within global supply chains.

Reverse resource exchanges in service supply chains:the case of returnable transport packaging

Purpose: The purpose of this paper is to understand how reverse resource exchanges and resource dependencies are managed in the service supply chain (SSC) of returnable transport packaging (RTP). Design/methodology/approach: A single case study was conducted in the context of automotive logistics focusing on the RTP SSC. Data were collected through 16 interviews, primarily with managers of a logistics service provider (LSP) and document analysis of contractual agreements with key customers of the packaging service. Findings: Resource dependencies among actors in the SSC result from the importance of the RTP for the customer’s production processes, the competition among users for RTP and the negative implications of the temporary unavailability of RTP for customers and the LSP (in terms of service performance). Amongst other things, the LSP is dependent on its customers and third-party users (e.g. the customer’s suppliers) for the timely return of package resources. The role of inter-firm integration and collaboration, formal contracts as well as customers’ power and influence over third-party RTP users are stressed as key mechanisms for managing LSP’s resource dependencies. Research limitations/implications: A resource dependence theory (RDT) lens is used to analyse how reverse resource exchanges and associated resource dependencies in SSCs are managed, thus complementing the existing SSC literature emphasising the bi-directionality of resource flows. The study also extends the recent SSC literature stressing the role of contracting by empirically demonstrating how formal contracts can be mobilised to explicate resource dependencies and to specify, and regulate, reverse exchanges in the SSC. Practical implications: The research suggests that logistics providers can effectively manage their resource dependencies and regulate reverse exchanges in the SSC by deploying contractual governance mechanisms and leveraging their customers’ influence over third-party RTP users. Originality/value: The study is novel in its application of RDT, which enhances our understanding of the management of reverse exchanges and resource dependencies in SSCs.

Local resources and procurement practices in humanitarian supply chains:an empirical examination of large-scale house reconstruction projects

Different procurement decisions taken by relief organizations can result in considerably different implications in regards to transport, storage, and distribution of humanitarian aid and ultimately can influence the performance of the humanitarian supply chain and the delivery of the humanitarian aid. In this article, we look into what resources are needed and how these resources evolve in the delivery of humanitarian aid. Drawing on the resource-based view of the firm, we develop a framework to categorize the impact of local resources on the configuration of humanitarian supply chains. In contrast to other papers, the importance of localizing the configuration of the humanitarian supply chain is not only conceptually recognized, but empirical investigations are also provided. In terms of methodology, this article is based on the analysis of secondary data from two housing reconstruction projects. Findings indicate that the use of local resources in humanitarian aid has positive effects on programs' overall supply chain performance and these effects are not only related to the macroeconomic perspective, but benefits expand to improvements related to the use of knowledge. At the same time, it was found that local sourcing often comes with a number of problems. For example, in one of the cases, significant problems existed, which were related to the scarcity of local supplies. Both housing reconstruction projects have indicated the continuous need for changes throughout the programs as a dynamic supply chain configuration is important for the long-term sustainability of reconstruction aid. © 2014 Decision Sciences Institute.

Developing a conceptual framework for investigating the resilience of construction SMEs and their supply chains against extreme weather events

Projections into future increasingly suggest that the intensity and frequency of Extreme Weather Events (EWEs) will increase in the future. This has demanded the business organisations as well to be prepared to face the increasing risk of EWEs, in order to ensure their business continuity. However, current evidence base suggests that businesses, especially SMEs, are not adequately prepared to face the threat of such events. Ability to adequately prepare them has been hindered by the lack of in depth studies addressing this issue. The paper presents a doctoral study designed to investigate the resilience of SMEs operating in the construction sector; which is said to be a highly vulnerable sector for the impacts of EWEs, and their supply chains to EWEs. A conceptual framework developed to investigate this issue is presented and explained. It is argued that the resilience of construction SMEs and their supply chains against EWEs can be improved by a combination of reducing their vulnerability, enhancing coping capacity and implementing coping mechanisms. Importance of undertaking a broader view to include the whole supply chain in making business decisions with regard to EWEs by SMEs is also highlighted.

EPCIS Event-Based traceability in pharmaceutical supply chains via automated generation of linked pedigrees

In this paper we show how event processing over semantically annotated streams of events can be exploited, for implementing tracing and tracking of products in supply chains through the automated generation of linked pedigrees. In our abstraction, events are encoded as spatially and temporally oriented named graphs, while linked pedigrees as RDF datasets are their specific compositions. We propose an algorithm that operates over streams of RDF annotated EPCIS events to generate linked pedigrees. We exemplify our approach using the pharmaceuticals supply chain and show how counterfeit detection is an implicit part of our pedigree generation. Our evaluation results show that for fast moving supply chains, smaller window sizes on event streams provide significantly higher efficiency in the generation of pedigrees as well as enable early counterfeit detection.