Management and outcome of cholesterol embolus identified in a diabetic retinopathy screening program

Purpose. We examined the incidence, management, and outcomes of patients known to be at high cardiovascular risk, and to assess whether specialist referral to an ophthalmic medical clinic is worthwhile. Methods. Patients in the East Birmingham area with cholesterolembolus who were identified on digital diabetic retinopathy screening over a 3-year period were referred to a specialist ophthalmic medicine clinic within Heart of England NHS Trust for management and investigation. Results. A total of 33 patients were referred for clinical management.(male:female = 22:11, mean age 72 years). A total of 28 patients were known to be receiving medication: 14 anti hypertensive therapy(42%), 19 aspirin (59%), and 21 statin (64%). A total of 18 patients had known cardiovascular disease, 10 of whom had received carotid stenting or coronary artery bypass surgery. Ten patients diagnosed with embolus required and consented to carotid Doppler studies. Six patients were confirmed with significant carotid stenosis and 2 (6%)of these patients required carotid endarterectomy surgery. Overall, 4patients died, a mortality rate of 12% over 3 years. Conclusions. Annual diabetic retinopathy screening provide sopportunistic identification of asymptomatic cholesterol emboli and provides an opportunity for review of medical management in the high-risk patient group with appropriate identification and referral for carotid stenosis surgery. A total of 11 patients were identified with sub optimal cardiovascular risk management: e.g., statin use.

Le paradoxe de l'interprétation:À propos du calcul du sens de certains indéfinis

The meaning is involved all levels of language analysis. Located in the heart of phenomena such as the polysemy, the grammaticalisation, the role for interpretation of the syntax, the organisation of the metonymy, the structuring of the metaphor. It is subject to synchroniques and historical typological and social variations. These events allow you to reveal when they are considered under the representations that they involve, the Organization of the linguistic meaning report. It is this organisation that attach themselves to identify the contributions in this book. From the empirical study of problems typical semantics and prag-matique offer answers provide the most current approaches to questions the nature of the sense of the patterns they render account representations and constraints that shape.

Guadeloupe 2009:réponses politiques à une crise sociale?

In 2009, a group of unions and social movements in Guadeloupe (a French overseas department in the Caribbean), organised a 40-day strike against 'la vie chère et la 'profitation'' (expensive life and 'profiteering'). However beyond the economic crisis, the heart of the problem were social and identity issues. This chapter analyses the political objectives and means of the organisers, as well as the answers provided by the French Government during a crisis that threatened to shake the rest of the French overseas territories.

Dangerous brown men:exploiting sex, violence and feminism in the 'war on terror'

Why is the public presentation of the war on terror suffused with sexualised racism? What does this tell us about ideas of gender, sexuality, religious and political identity and the role of the state in the Western powers? Can we diffuse inter-ethnic conflicts and change the way the West pursues its security agenda by understanding the role of sexualised racism in the war on terror? In asking such questions, Gargi Bhattacharyya considers how the concepts of imperialism, feminism, terror and security can be applied, in order to build on the influential debates about the sexualised character of colonialism. She examines the way in which western imperial violence has been associated with the rhetoric of rights and democracy - a project of bombing for freedom that has called into question the validity of western conceptions of democracy, rights and feminism. Such rhetoric has given rise to actions that go beyond simply protecting western interests or securing access to scarce resources and appear to be beyond instrumental reason. The articulations of racism that appear with the war on terror are animated by fears and sexual fantasies inexplicable by rational interest alone. There can be no resolution to this seemingly endless conflict without understanding the highly sexualised racism that animates it. Such an understanding threatens to pierce the heart of imperial relations, revealing their intense contradictions and uncovering attempts to normalise violent expropriation.

Marketing strategy and competitive positioning

Marketing Strategy and Competitive Positioning deals with the process of developing and implementing a marketing strategy. The third edition focuses on competitive positioning at the heart of marketing strategy and includes in-depth discussion of the processes used in marketing to achieve competitive advantage.

Diversity faultlines, shared objectives, and top management team performance

Faultline theory suggests that negative effects of team diversity are better understood by considering the influence of different dimensions of diversity in conjunction, rather than for each dimension separately. We develop and extend the social categorization analysis that lies at the heart of faultline theory to identify a factor that attenuates the negative influence of faultlines: the extent to which the team has shared objectives. The hypothesized moderating role of shared objectives received support in a study of faultlines formed by differences in gender, tenure, and functional background in 42 top management teams. The focus on top management teams has the additional benefit of providing the first test of the relationship between diversity faultlines and objective indicators of organizational performance. We discuss how these findings, and the innovative way in which we operationalized faultlines, extend faultline theory and research as well as offer guidelines to manage diversity faultlines.

Marketing strategy and competitive positioning

Marketing Strategy and Competitive Positioning 5e deals with the process of developing and implementing a marketing strategy. The book focuses on competitive positioning at the heart of marketing strategy and includes in-depth discussion of the processes used in marketing to achieve competitive advantage. The book is primarily about creating and sustaining superior performance in the marketplace. It focuses on the two central issues in marketing strategy formulation – the identification of target markets and the creation of a differential advantage. In doing that, it recognises the emergence of new potential target markets born of the recession and increased concern for climate change; and it examines ways in which firms can differentiate their offerings through the recognition of environmental and social concerns.

Russia

Ruta Aidis, Julia Korosteleva and Tomasz Mickiewicz 1. Introduction to Russia Russia is the world’s largest country, a nuclear superpower with unsurpassed energy resources. It is also a country which finds itself at the crossroads of possible development paths. Market-oriented mechanisms have been introduced but Soviet era laws remain on the books. Corruption has become a way of life and freedom of the press has been gradually eliminated in the early 2000s. Within this backdrop, private entrepreneurship has emerged, albeit in a distorted way. As the heart of the Soviet empire, Russia had tremendous control of enormous amounts of natural resources and human capital. Yet, 20 years ago, in the late 1980s, it was a country where entrepreneurship was marginal, the economy was stagnant and the ruling communist hierarchy had no clear formula for solving the deepening crisis. Unfortunately the reforms characterizing Russia’s attempts at rebuilding statehood after the collapse of the Soviet Union in the 1990s, first under Mikhail Gorbachev and then Boris Y’eltsin, were inconsistent and did not foster macroeconomic stabilization. However, since 2000, under Vladimir Putin’s leadership, macroeconomic stabilization as well as institutional stability has been achieved. In addition, an unprecedented increase in the price and demand for oil and gas resources has resulted in a rapid growth of Russia’s gross domestic product (GDP). Russia now has a large private sector, though not without its limitations. At first glance, ‘de jure’ regulations often seem reasonable, yet it is the selective and arbitrary manner by which they are...

Climate change:what role for sociology? A response to Constance Lever-Tracy

In a previous issue of this journal, Constance Lever-Tracy called on sociologists to become more involved in the debates about anthropogenic climate change. In this response to her article, the authors support her general argument but query four of her tenets: (1) they see other reasons for the lack of interest in climate change among sociologists; (2) they argue that the true challenge to climate change research is interdisciplinarity (as opposed to multidisciplinarity); (3) they emphasize the virtues of constructivism; and (4), while Lever-Tracy argues that climate change should be at the heart of the discipline, in the authorsâ view, unless this is to be mere wishful thinking, there is a need to carefully consider the prospects of such an enterprise.

SCM's vital role in B2B

Mastering supply chains management lie at the heart of a successful B2B relationship

Jonathan Gibson

Professor Jonathan Gibson MB BS MD FRCSEd, FRCOphth (1966-1971) is a Consultant Ophthalmic Surgeon for the Heart of England NHS Trust, Birmingham and a Professor of Ophthalmology at the University of Aston. He looks back at his time at Merchant Taylors’ and his career.

O2 v Hutchison 3G comparative advertising:European trade mark law beyond compare?

Legislation: Directive 89/104 on trade marks art.5 Directive 84/450 on misleading advertising Directive 97/55 amending Directive 84/450 concerning misleading advertising so as to include comparative advertising Case: O2 Holdings Ltd v Hutchison 3G UK Ltd (C-533/06) [2008] E.C.R. I-4231 (ECJ (1st Chamber)) *Comms. L. 155 Long, long ago a trade mark allowed a craftsman to be identified and held accountable for shoddy goods. Today in the era of the ‘Lovemark,’1 due to extensive advertising hopes and aspirations a lifestyle can be purchased with a brand. For many products a trademark is no longer merely a badge of origin but has a commercial value of its own. Through advertising an emotional attachment is created in the heart of the consumer for particular brands. Brand owners are determined that the value of this attachment be preserved and protected against any encroachment into the aura that has been painstakingly created. Comparative advertising, the allusive use of a mark, is seen by the owners of such emotive brands as likely to jeopardise the character of the brand that they have so carefully nurtured. As they have invested so heavily in creating their concept these owners want to control its use by others. There is an issue however as to how far this control ought to extend when the image is used in the marketing of a rival's goods or services.

Histidine hydrogen bonding in MHC at pH 5 and pH 7 modeled by molecular docking and molecular dynamics simulations

Hydrogen bonds play important roles in maintaining the structure of proteins and in the formation of most biomolecular protein-ligand complexes. All amino acids can act as hydrogen bond donors and acceptors. Among amino acids, Histidine is unique, as it can exist in neutral or positively charged forms within the physiological pH range of 5.0 to 7.0. Histidine can thus interact with other aromatic residues as well as forming hydrogen bonds with polar and charged residues. The ability of His to exchange a proton lies at the heart of many important functional biomolecular interactions, including immunological ones. By using molecular docking and molecular dynamics simulation, we examine the influence of His protonation/deprotonation on peptide binding affinity to MHC class II proteins from locus HLA-DP. Peptide-MHC interaction underlies the adaptive cellular immune response, upon which the next generation of commercially-important vaccines will depend. Consistent with experiment, we find that peptides containing protonated His residues bind better to HLA-DP proteins than those with unprotonated His. Enhanced binding at pH 5.0 is due, in part, to additional hydrogen bonds formed between peptide His+ and DP proteins. In acidic endosomes, protein His79β is predominantly protonated. As a result, the peptide binding cleft narrows in the vicinity of His79β, which stabilizes the peptide - HLA-DP protein complex. © 2014 Bentham Science Publishers.

Using accreditation criteria for collaborative quality enhancement

This paper describes a process to enhance the quality of higher education. At the heart of the process is a cross-sparring collaborative model, whereby institutions are critical friends. This is based on a prior self-evaluation, where the institution / programme identifies quality criteria it wants to improve. Part of the process is to ensure the documentation of best practices so that they can be shared with others in a so called market place. Linking the best practices to a criterion makes them searchable on a large scale. Optimal pairings of institutions can then take place for the cross-sparring activities.

Milk for a girl and bananas for a boy:recipes and reasons for sex-preference practices in a British Internet forum

Using postings from an internet forum, this paper explores the ways in which some women try to influence the sex of a future child. The extensive reproductive work involved give an indication of the women’s commitment to being able to choose a particular sex; in this case a preference for girls rather than boys. The findings revealed stereotypical views of masculinity and femininity at the heart of the preference. The presumption of fixed gendered identities helped to frame this desire as ‘natural,’ lessen the threat to maternal identities, and reinforce the logic of ‘choice,’ and support their reproductive work practices.