SGLT inhibitors in management of diabetes

The two main sodium-glucose cotransporters (SGLTs), SGLT1 and SGLT2, provide new therapeutic targets to reduce hyperglycaemia in patients with diabetes. SGLT1 enables the small intestine to absorb glucose and contributes to the reabsorption of glucose filtered by the kidney. SGLT2 is responsible for reabsorption of most of the glucose filtered by the kidney. Inhibitors with varying specificities for these transporters (eg, dapagliflozin, canagliflozin, and empagliflozin) can slow the rate of intestinal glucose absorption and increase the renal elimination of glucose into the urine. Results of randomised clinical trials have shown the blood glucose-lowering efficacy of SGLT inhibitors in type 2 diabetes when administered as monotherapy or in addition to other glucose-lowering therapies including insulin. Increased renal glucose elimination also assists weight loss and could help to reduce blood pressure. Effective SGLT2 inhibition needs adequate glomerular filtration and might increase risk of urinary tract and genital infection, and excessive inhibition of SGLT1 can cause gastro-intestinal symptoms. However, the insulin-independent mechanism of action of SGLT inhibitors seems to offer durable glucose-lowering efficacy with low risk of clinically significant hypoglycaemia at any stage in the natural history of type 2 diabetes. SGLT inhibition might also be considered in conjunction with insulin therapy in type 1 diabetes. © 2013 Elsevier Ltd.

The silence of the archives:business history, Postcolonialism and archival ethnography

History as a discipline has been accused of being a-theoretical. Business historians working at business schools, however, need to better explicate their historical methodology, not theory, in order to communicate the value of archival research to social scientists, and to train future doctoral students outside history departments. This paper seeks to outline an important aspect of historical methodology, which is data collection from archives. In this area, postcolonialism and archival ethnography have made significant methodological contributions not just for non-Western history, as it has emphasized the importance of considering how archives were created, and how one can legitimately use them despite their limitations. I argue that these approaches offer new insights into the particularities of researching business archives.

Research strategies for organizational history:a dialogue between historical theory and organization theory

If history matters for organization theory, then we need greater reflexivity regarding the epistemological problem of representing the past; otherwise, history might be seen as merely a repository of ready-made data. To facilitate this reflexivity, we set out three epistemological dualisms derived from historical theory to explain the relationship between history and organization theory: (1) in the dualism of explanation, historians are preoccupied with narrative construction, whereas organization theorists subordinate narrative to analysis; (2) in the dualism of evidence, historians use verifiable documentary sources, whereas organization theorists prefer constructed data; and (3) in the dualism of temporality, historians construct their own periodization, whereas organization theorists treat time as constant for chronology. These three dualisms underpin our explication of four alternative research strategies for organizational history: corporate history, consisting of a holistic, objectivist narrative of a corporate entity; analytically structured history, narrating theoretically conceptualized structures and events; serial history, using replicable techniques to analyze repeatable facts; and ethnographic history, reading documentary sources "against the grain." Ultimately, we argue that our epistemological dualisms will enable organization theorists to justify their theoretical stance in relation to a range of strategies in organizational history, including narratives constructed from documentary sources found in organizational archives. Copyright of the Academy of Management, all rights reserved.

Making memories available:a framework for preserving rural heritage through community knowledge management (cKM)

While most of the research in Knowledge Management (KM) has focused on business communities, there is a breadth of potential applications of KM theory and practice to wider society. This paper explores the potential of KM for rural communities, specifically for those that want to preserve their social history and collective memories (what we call heritage) to enrich the lives of others. In KM terms, this is a task of accumulating and recording knowledge (using KM techniques such as story-telling and communities of practice) to enable its retention for future use (by interested people perhaps through KM systems). We report a case study of Cardrona, a valley of approximately 120 people in New Zealand's South Island. Realising that time would erode knowledge of their community a small, motivated group of residents initiated a KM programme to create a legacy for a wider community including younger generations, tourists and scholars. This paper applies KM principles to rural communities that want to harness their collective knowledge for wider societal gain, and develops a community-based framework to inform such initiatives. As a result, we call for a wider conceptualisation of KM to include motives for managing knowledge beyond business performance to accommodate community (cKM). © 2010 Operational Research Society.

Management of dry eye in UK pharmacies

Purpose - To investigate the ability of pharmacy staff in the United Kingdom (UK) to diagnose and treat dry eye. Methods - A mystery shopper technique to simulate a patient with presumed dry eye was used in 50 pharmacy practices in major towns and cities across the UK. Pharmacies were unaware of their involvement in the study. With the exception of a predetermined opening statement to initiate the consultation, no further information was volunteered. Questions asked, diagnoses given, management strategy advised and staff type was recorded immediately after the consultation. Results - The mean number of questions was 4.5 (SD 1.7; range 1–10). The most common question was the duration of symptoms (56%) and the least common was whether the patient had a history of headaches (2%). All pharmacy staff gave a diagnosis, but the majority were incorrect (58%), with only 42% correctly identifying dry eye. Treatment was advised by 92% of pharmacy staff, with the remaining 8% advising referral directly to the patient's GP or optometrist. Dry eye treatments involved topical ocular lubrication via eye drops (90%) and lipid based sprays (10%). However, only 10% gave administration advice, 10% gave dosage advice, 9% asked about contact lens wear, and none offered follow up although 15% also advised GP or optometrist referral. Conclusions - There is a need for improved ophthalmological training amongst pharmacists and pharmacy staff and establishment of cross referral relationships between pharmacies and optometry practices.

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.

Advanced data driven visualisation for geo-spatial data

Most current 3D landscape visualisation systems either use bespoke hardware solutions, or offer a limited amount of interaction and detail when used in realtime mode. We are developing a modular, data driven 3D visualisation system that can be readily customised to specific requirements. By utilising the latest software engineering methods and bringing a dynamic data driven approach to geo-spatial data visualisation we will deliver an unparalleled level of customisation in near-photo realistic, realtime 3D landscape visualisation. In this paper we show the system framework and describe how this employs data driven techniques. In particular we discuss how data driven approaches are applied to the spatiotemporal management aspect of the application framework, and describe the advantages these convey. © Springer-Verlag Berlin Heidelberg 2006.

What is the Future of Strategic Management?

The history of planning and creating strategies has a past of over half a century. Throughout this lifetime period we have witnessed both the evolution of theory and practice. The MBA study books in the last-third of the 20th century have with predilection exhibited this very process as a complex of monetary centered budget planning, forecast-based planning, strategic planning and strategic management. There might be a controversy existing about the naming, characteristics and timing of these different sections but there is an accordance that the changes that we have taken place in the last decade as a whole without a doubt can be derived from these very changes in the business environment or in some outstanding cases (like 9/11) they can be acknowledged as the ability of corporate foreseeing and the ability to adapt to the vision of the future. The main purposes of the research is to provide a summarized picture about the changing process of this procedure during last decades as far as the planning and creating strategies are concerned and also their milestones and periods. Try to explore and systemize the very aspects of these changes. The happenings of the first decade of the new millennium are outstandingly interesting if we consider their real effect on the theory and practice of strategic management. Let us remember the euphoria around the year 2000, the predictions of „new technologies”, „new economy”, „new organization” and „new leadership”. We have implied before on the destruction of the twin towers of the World Trade Center which meant a new era, a new quality of international terrorism and its consequences (Afghanistan, Iraq). But the „product” of this decade is the strategic aim that companies focus on, which is the social responsibility regarding the unavoidance of the effects of climate change on the long run. During the research the big question has risen concerning how did the science of strategic management do as far as the predictions of the global monetary and economic crisis are concerned? And also its solutions this very science has to offer in order to handle and get over the crisis. Does it conclude from the answers given to the questions that a change in paradigms are necessary, a new quality is needed or may be we have come to a new crossroad of the development process that will take over strategic management? (...)

Historical Artifact: Management Organization

Chart illustrates the College of Medicine's organizational structure.

The use of presidential executive orders to control the management and administration of the federal government

As long as governmental institutions have existed, efforts have been undertaken to reform them. This research examines a particular strategy, coercive controls, exercised through a particular instrument, executive orders, by a singular reformer, the president of the United States. The presidents studied-- Johnson, Nixon, Ford, Carter, Reagan, Bush, and Clinton--are those whose campaigns for office were characterized to varying degrees as against Washington bureaucracy and for executive reform. Executive order issuance is assessed through an examination of key factors for each president including political party affiliation, levels of political capital, and legislative experience. A classification typology is used to identify the topical dimensions and levels of coerciveness. The portrayal of the federal government is analyzed through examination of public, media, and presidential attention. The results show that executive orders are significant management tools for the president. Executive orders also represent an important component of the transition plans for incoming administrations. The findings indicate that overall, while executive orders have not increased in the aggregate, they are more intrusive and significant. When the factors of political party affiliation, political capital, and legislative experience are examined, it reveals a strong relationship between executive orders and previous executive experience, specifically presidents who served as a state governor prior to winning national election as president. Presidents Carter, Reagan, and Clinton (all former governors) have the highest percent of executive orders focusing on the federal bureaucracy. Additionally, the highest percent of forceful orders were issued by former governors (41.0%) as compared to their presidential counterparts who have not served as governors (19.9%). Secondly, political party affiliation is an important, but not significant, predictor for the use of executive orders. Thirdly, management strategies that provide the president with the greatest level of autonomy--executive orders--redefine the concept of presidential power and autonomous action. Interviews of elite government officials and political observers support the idea that executive orders can provide the president with a successful management strategy, requiring less expenditure of political resources, less risk to political capital, and a way of achieving objectives without depending on an unresponsive Congress. ^

College of Medicine Management Organization

Charts illustrating the organizational structure of the College of Medicine.

Prolegomenon to a History of Travel

The author attempts to provide a definition of travel by comparing it with the instinctive migration of animals and birds and viewing its changes over time. As a study of motion voluntarily undertaken, a history of travel can contribute to a better understanding of human beings