The influence of marketing factors and substance characteristics on pharmaceutical sales in a state-controlled prescriptions pharmaceuticals market

The present dissertation investigates the influence of brand as well as substance-related marketing attributes on prescription pharmaceutical sales within a state-controlled market. For this purpose, a systematic literature review was conducted in the first instance, during which knowledge about the most relevant research within this field was gathered. Consequently, over 538 publications were reviewed and indicated as being potentially relevant, leading to an eventual count of 98 core publications. However, most of these studies had been conducted in the mainly unrestricted US market. These findings were then summarised and statistically evaluated. In a second step, based on the literature review, a qualitative study, containing focus and Delphi groups, was then performed. The participants in these studies were involved in pharmaceutical marketing within a state-controlled prescriptions pharmaceuticals market. Consequently, the findings were slightly different to those derived by the systematic literature review. Based on this second step, seven hypotheses were proposed. In the third step, these hypotheses were tested, using collected data and a secondary market dataset provided by a market research institute. A statistical analysis was then performed, applying descriptive as well as multiple regression analytical methods. The evaluation of the results resulted in a conceptual model of physician targeting, leading to several theoretical, methodological and managerial implications.

Clinical characteristics of unilateral myopic anisometropia in a juvenile optometric practice population

Purpose: A retrospective study of longitudinal case histories, undertaken to establish the clinical and statistical characteristics of unilateral myopic anisometropia (UMA) amongst the juvenile and adolescent population at an optometric practice, is reported. UMA was defined as that specific refractive state where an unequivocally myopic eye is paired with a 'piano' [spherical equivalent refraction, (SER) = ±0.25 Dioptres (D)] companion eye. Methods: The clinical records of all patients aged <19 years on file at an established independent optometric practice were categorised as 'myopic' (SER ≤-0.50 D), 'hypermetropie' (≥+0.75 D) or 'emmetropic' (≥-0.37≤+0.62 D). Subsequently all juvenile patients matching the UMA criterion, together with a case-matched group of bilaterally myopic individuals, were selected as the comparative study populations. Results: A total of 14.4% (n = 21 of 146) of the juvenile myopic case histories were identified as cases of UMA. More than half of these UMA cases emerged between the ages of 11.5 and 13.5 years. There was a marked female gender bias. The linear gradient of the age-related mean refractive trend in the myopic eye of the UMA population was not statistically significantly different (p > 0.1) to that fitted to the ametropic progression recorded in either eye of the case-matched population of young bilateral myopes; uniquely the slope associated with the companion eye of UMA cases was statistically significantly (p < 0.025) less steep. Compared with bilateral myopes fewer cases of UMA required a refractive correction to relieve visual or asthenopic symptoms, and this initial correction was dispensed on average 1 year later (at age 12.7 years) in UMA patients. Conclusions: Individuals identified as demonstrating clinically-defined UMA can be considered as distinct but functionally normal cases on the continuum of human refractive error. However, any unilaterally-acting determining factor(s) underlying the genesis of the condition remain obscure. © 2004 The College of Optometrists.

Fundamental characteristics of space-charge waves in photorefractive sillenite crystals

We investigate experimentally the fundamental characteristics of space-charge waves excited in a photorefractive crystal of Bi12SiO20. Features such as their transient rise and decay as well as their steady-state frequency response are investigated. Based on this, we find the dependence of the space-charge waves' quality factor on spatial frequency and electric-field biasing. The experimental findings are compared with the linear space-charge wave theory developed previously by Sturman et al. [J. Opt. Sec. Am. B 10, 1919 (1993)].

Bending characteristics of fiber long-period gratings with cladding index modified by femtosecond laser

A femtosecond laser has been used to asymmetrically modify the cladding of fiber containing long-period gratings. Following modification, devices in single-mode fiber are shown to be capable of sensing the magnitude and direction of bending in one plane by producing blue and red wavelength shifts depending upon the orientation of the bend. The resulting curvature sensitivities were -1.62 and +3.82 nm&middotm. Devices have also been produced using an elliptical core fiber to study the effects of the cladding modification on the two polarization eigenstates. A cladding modification applied on the fast axis of the fiber is shown to affect the light in the fast axis much more significantly than the light in the orthogonal state; this behavior may ultimately lead to a sensor capable of detecting the direction of bending in two dimensions for applications in shape sensing.

A study of thermodynamic characteristics and predictive computer modelling of an air to water heat pump system

A study on heat pump thermodynamic characteristics has been made in the laboratory on a specially designed and instrumented air to water heat pump system. The design, using refrigerant R12, was based on the requirement to produce domestic hot water at a temperature of about 50 °C and was assembled in the laboratory. All the experimental data were fed to a microcomputer and stored on disk automatically from appropriate transducers via amplifier and 16 channel analogue to digital converters. The measurements taken were R12 pressures and temperatures, water and R12 mass flow rates, air speed, fan and compressor input powers, water and air inlet and outlet temperatures, wet and dry bulb temperatures. The time interval between the observations could be varied. The results showed, as expected, that the COP was higher at higher air inlet temperatures and at lower hot water output temperatures. The optimum air speed was found to be at a speed when the fan input power was about 4% of the condenser heat output. It was also found that the hot water can be produced at a temperature higher than the appropriate R12 condensing temperature corresponding to condensing pressure. This was achieved by condenser design to take advantage of discharge superheat and by further heating the water using heat recovery from the compressor. Of the input power to the compressor, typically about 85% was transferred to the refrigerant, 50 % by the compression work and 35% due to the heating of the refrigerant by the cylinder wall, and the remaining 15% (of the input power) was rejected to the cooling medium. The evaporator effectiveness was found to be about 75% and sensitive to the air speed. Using the data collected, a steady state computer model was developed. For given input conditions s air inlet temperature, air speed, the degree of suction superheat , water inlet and outlet temperatures; the model is capable of predicting the refrigerant cycle, compressor efficiency, evaporator effectiveness, condenser water flow rate and system Cop.

Analysis of organisational climate to improve the adequacy of primary health care in the State of Kuwait

This study covers two areas of contribution to the knowledge, firstly it tried to investigate rigourously the relationships of a number of factors believed that they may affect the climate perception, classified into three types to arrive to prove a hypothesis of the important role that qualification and personal factors play in shaping the climate perception, this is in contrast with situational factors. Secondly, the study tries to recluster the items of a wide-range applied scale for the measurement of climate named HAY in order to overcome the cross-cultural differences between the Kuwaiti and the American society, and to achieve a modified dimensions of climate for a civil service organisation in Kuwait. Furthermore, the study attempts to carry out a diagnostic test for the climate of the Ministry of Public Health in Kuwait, aiming to diagnose the perceived characteristics of the MoPH organisation, and suggests a number of areas to be given attention if an improvement is to be introduced. The study used extensively the statistical and the computer facilities to make the analysis more representing the field data, on the other hand this study is characterised by the very highly responsive rate of the main survey which would affect the findings reliability. Three main field studies are included, the first one was to conduct the main questionnaire where the second was to measure the "should be" climate by the experts of MoPH using the DELPHI technique, and the third was to conduct an extensive meeting with the very top management team in MoPH. Results of the first stage were subject to CLUSTER analysis for the reconstruction of the HAY tool, whereas comparative analysis was carried on between the results of the second and third stages on one side, the first from the other.

Fundamental characteristics of space-charge waves in photorefractive sillenite crystals

We investigate experimentally the fundamental characteristics of space-charge waves excited in a photorefractive crystal of Bi12SiO20. Features such as their transient rise and decay as well as their steady-state frequency response are investigated. Based on this, we find the dependence of the space-charge waves' quality factor on spatial frequency and electric-field biasing. The experimental findings are compared with the linear space-charge wave theory developed previously by Sturman et al. [J. Opt. Sec. Am. B 10, 1919 (1993)].

An examination of the calcium and strontium site distribution in bioactive glasses through isomorphic neutron diffraction, X-ray diffraction, EXAFS and multinuclear solid state NMR.

Strontium has been substituted for calcium in the glass series (SiO2)49.46(Na2O)26.38(P2O5)1.07(CaO)23.08x(SrO)x (where x = 0, 11.54, 23.08) to elucidate their underlying atomic-scale structural characteristics as a basis for understanding features related to the bioactivity. These bioactive glasses have been investigated using isomorphic neutron and X-ray diffraction, Sr K-edge EXAFS and solid state 17O, 23Na, 29Si, 31P and 43Ca magic-angle-spinning (MAS) NMR. An effective isomorphic substitution first-order difference function has been applied to the neutron diffraction data, confirming that Ca and Sr behave in a similar manner within the glass network, with residual differences attributed to solely the variation in ionic radius between the two species. The diffraction data provides the first direct experimental evidence of split Ca–O nearest-neighbour correlations in these melt quench bioactive glasses, together with an analogous splitting of the Sr–O correlations; the correlations are attributed to the metal ions correlated either to bridging or to non-bridging oxygen atoms. Triple quantum (3Q) 43Ca MAS NMR corroborates the split Ca–O correlations. Successful simplification of the 2 < r (A) < 3 region via the difference method has also revealed two distinct Na environments. These environments are attributed to sodium correlated either to bridging or to nonbridging oxygen atoms. Complementary multinuclear MAS NMR, Sr K-edge EXAFS and X-ray diffraction data supports the structural model presented. The structural sites present will be intimately related to their release properties in physiological fluids such as plasma and saliva, and hence the bioactivity of the material. Detailed structural knowledge is therefore a prerequisite for optimising material design.

End-to-end versus hop-by-hop state refresh in soft state signaling protocols

The concept of soft state (i.e., the state that will expire unless been refreshed) has been widely used in the design of network signaling protocols. The approaches of refreshing state in multi-hop networks can be classified to end-to-end (E2E) and hop-by-hop (HbH) refreshes. In this article we propose an effective Markov chain based analytical model for both E2E and HbH refresh approaches. Simulations verify the analytical models, which can be used to study the impacts of link characteristics on the performance (e.g., state synchronization and message overhead), as a guide on configuration and optimization of soft state signaling protocols. © 2009 IEEE.

Ownership characteristics and access to finance:evidence from a survey of large privatised companies in Hungary and Poland

We examine financial constraints and forms of finance used for investment, by analysing survey data on 157 large privatised companies in Hungary and Poland for the period 1998 - 2000. The Bayesian analysis using Gibbs sampling is carried out to obtain inferences about the sample companies' access to finance from a model for categorical outcome. By applying alternative measures of financial constraints we find that foreign companies, companies that are part of domestic industrial groups and enterprises with concentrated ownership are all less constrained in their access to finance. Moreover, we identify alternative modes of finance since different corporate control and past performance characteristics influence the sample firms' choice of finance source. In particular, while being industry-specific, the access to domestic credit is positively associated with company size and past profitability. Industrial group members tend to favour bond issues as well as sells-offs of assets as appropriate types of finance for their investment programmes. Preferences for raising finance in the form of equity are associated with share concentration in a non-monotonic way, being most prevalent in those companies where the dominant owner holds 25%-49% of shares. Close links with a leading bank not only increase the possibility of bond issues but also appear to facilitate access to non-banking sources of funds, in particular, to finance supplied by industrial partners. Finally, reliance on state finance is less likely for the companies whose profiles resemble the case of unconstrained finance, namely, for companies with foreign partners, companies that are part of domestic industrial groups and companies with a strategic investor. Model implications also include that the use of state funds is less likely for Polish than for Hungarian companies.

Bending characteristics of fiber long-period gratings with cladding index modified by femtosecond laser

A femtosecond laser has been used to asymmetrically modify the cladding of fiber containing long-period gratings. Following modification, devices in single-mode fiber are shown to be capable of sensing the magnitude and direction of bending in one plane by producing blue and red wavelength shifts depending upon the orientation of the bend. The resulting curvature sensitivities were -1.62 and +3.82 nm·m. Devices have also been produced using an elliptical core fiber to study the effects of the cladding modification on the two polarization eigenstates. A cladding modification applied on the fast axis of the fiber is shown to affect the light in the fast axis much more significantly than the light in the orthogonal state; this behavior may ultimately lead to a sensor capable of detecting the direction of bending in two dimensions for applications in shape sensing. © 2006 IEEE.

Conversion of a chirped Gaussian pulse to a soliton or a bound multisoliton state in quasi-lossless and lossy optical fiber spans

The formation of single-soliton or bound-multisoliton states from a single linearly chirped Gaussian pulse in quasi-lossless and lossy fiber spans is examined. The conversion of an input-chirped pulse into soliton states is carried out by virtue of the so-called direct Zakharov-Shabat spectral problem, the solution of which allows one to single out the radiative (dispersive) and soliton constituents of the beam and determine the parameters of the emerging bound state(s). We describe here how the emerging pulse characteristics (the number of bound solitons, the relative soliton power) depend on the input pulse chirp and amplitude. © 2007 Optical Society of America.

BRACHYURY confers cancer stem cell characteristics on colorectal cancer cells

Cancer stem cells (CSCs) are initiating cells in colorectal cancer (CRC). Colorectal tumours undergo epithelial to mesenchymal transition (EMT)-like processes at the invasive front, enabling invasion and metastasis, and recent studies have linked this process to the acquisition of stem cell-like properties. It is of fundamental importance to understand the molecular events leading to the establishment of cancer initiating cells and how these mechanisms relate to cellular transitions during tumourigenesis. We use an in vitro system to recapitulate changes in CRC cells at the invasive front (mesenchymal-like cells) and central mass (epithelial-like cells) of tumours. We show that the mesoderm inducer BRACHYURY is expressed in a subpopulation of CRC cells that resemble invasive front mesenchymal-like cells, where it acts to impose characteristics of CSCs in a fully reversible manner, suggesting reversible formation and modulation of such cells. BRACHYURY, itself regulated by the oncogene β-catenin, influences NANOG and other 'stemness' markers including a panel of markers defining CRC-CSC whose presence has been linked to poor patient prognosis. Similar regulation of NANOG through BRACHYURY was observed in other cells lines, suggesting this might be a pathway common to cancer cells undergoing mesenchymal transition. We suggest that BRACHYURY may regulate NANOG in mesenchymal-like CRC cells to impose a 'plastic-state', allowing competence of cells to respond to signals prompting invasion or metastasis. Copyright © 2011 UICC.