The management of systemic hypertension in optometric practice

Aim: Systemic hypertension is a silent killer that may have very few warning signs. This study examines detection and management of patients with cardiovascular disease (CVD) by optometrists in the UK. Method: A survey was sent out to 1402 optometrists who practice in the UK to investigate the nature and knowledge of detection of systemic hypertension. Results: The survey response rate was 37%. Optometrists were neutral to slightly positive towards the use of blood pressure (BP) monitors, but not on a routine basis. The most frequently asked question during history and symptoms concerned the patient's prescribed medication for systemic hypertension, and the least was that of specifying the last BP measurement. The additional test most widely used in the examination of the systemic hypertensive patient was direct ophthalmoscopy with red-free filter. Over one-tenth of optometric practices had a BP monitor, with automated devices being the most popular. Patients most likely to have their BP measured were suspect systemic hypertensives. Retinal haemorrhages are the most important finding in influencing an optometrist's referral criteria for suspected systemic hypertension. Conclusion: Although optometrists monitor the retina for signs of damage from systemic hypertension, further education in this important condition is warranted. © 2005 The College of Optometrists.

A combination of cyclone and vert techniques for the management of construction projects

Many planning and control tools, especially network analysis, have been developed in the last four decades. The majority of them were created in military organization to solve the problem of planning and controlling research and development projects. The original version of the network model (i.e. C.P.M/PERT) was transplanted to the construction industry without the consideration of the special nature and environment of construction projects. It suited the purpose of setting up targets and defining objectives, but it failed in satisfying the requirement of detailed planning and control at the site level. Several analytical and heuristic rules based methods were designed and combined with the structure of C.P.M. to eliminate its deficiencies. None of them provides a complete solution to the problem of resource, time and cost control. VERT was designed to deal with new ventures. It is suitable for project evaluation at the development stage. CYCLONE, on the other hand, is concerned with the design and micro-analysis of the production process. This work introduces an extensive critical review of the available planning techniques and addresses the problem of planning for site operation and control. Based on the outline of the nature of site control, this research developed a simulation based network model which combines part of the logics of both VERT and CYCLONE. Several new nodes were designed to model the availability and flow of resources, the overhead and operating cost and special nodes for evaluating time and cost. A large software package is written to handle the input, the simulation process and the output of the model. This package is designed to be used on any microcomputer using MS-DOS operating system. Data from real life projects were used to demonstrate the capability of the technique. Finally, a set of conclusions are drawn regarding the features and limitations of the proposed model, and recommendations for future work are outlined at the end of this thesis.

Impacts of flood hazards on small and medium companies:strategies for property level protection and business continuity

Worldwide floods have become one of the costliest weather-related hazards, causing large-scale human, economic, and environmental damage during the recent past. Recent years have seen a large number of such flood events around the globe, with Europe and the United Kingdom being no exception. Currently, about one in six properties in England is at risk of flooding (EA, 2009), and the risk is expected to further increase in the future (Evans et al., 2004). Although public spending on community-level flood protection has increased and some properties are protected by such protection schemes, many properties at risk of flooding may still be left without adequate protection. As far as businesses are concerned, this has led to an increased need for implementing strategies for property-level flood protection and business continuity, in order to improve their capacity to survive a flood hazard. Small and medium-sized enterprises (SMEs) constitute a significant portion of the UK business community. In the United Kingdom, more than 99% of private sector enterprises fall within the category of SMEs (BERR, 2008). They account for more than half of employment creation (59%) and turnover generation (52%) (BERR, 2008), and are thus considered the backbone of the UK economy. However, they are often affected disproportionately by natural hazards when compared with their larger counterparts (Tierney and Dahlhamer, 1996; Webb, Tierney, and Dahlhamer, 2000; Alesch et al., 2001) due to their increased vulnerability. Previous research reveals that small businesses are not adequately prepared to cope with the risk of natural hazards and to recover following such events (Tierney and Dahlhamer, 1996; Alesch et al., 2001; Yoshida and Deyle, 2005; Crichton, 2006; Dlugolecki, 2008). For instance, 90% of small businesses do not have adequate insurance coverage for their property (AXA Insurance UK, 2008) and only about 30% have a business continuity plan (Woodman, 2008). Not being adequately protected by community-level flood protection measures as well as property- and business-level protection measures threatens the survival of SMEs, especially those located in flood risk areas. This chapter discusses the potential effects of flood hazards on SMEs and the coping strategies that the SMEs can undertake to ensure the continuity of their business activities amid flood events. It contextualizes this discussion within a survey conducted under the Engineering and Physical Sciences Research Council (EPSRC) funded research project entitled “Community Resilience to Extreme Weather — CREW”.