Factors influencing Hong Kong Chinese patients' decision-making in seeking early treatment for acute myocardial infarction

The purpose of this study was to identify, through in-depth interview, factors that influenced 27 Hong Kong Chinese patients' decision-making in seeking early treatment for acute myocardial infarction (AMI). The median delay time from the onset of symptoms to arrival at the hospital was 15.6 hours for men and 53.7 hours for women. Three major categories emerged from the data: (a) becoming aware of the threat, (b) maintaining a sense of normality, and (c) struggling to mobilize resources. A variety of decisions were made by patients from the onset of chest Pain to seeking help. These decisions were heavily influenced by healthcare factors (access to emergency medical service (EMS) and treatment), personal factors (cognitive interpretations of symptoms), sociocultural factors (family situation, cultural beliefs, and practices), and coping strategies. (c) 2006 Wiley Periodicals, Inc.

Isolation, characterization and discovery of new alleles of sHsp genes in durum wheat (Triticum durum Desf.)

Gli organismi vegetali mostrano una notevole capacità di adattamento alle condizioni di stress e lo studio delle componenti molecolari alla base dell'adattamento in colture cerealicole di interesse alimentare, come il frumento, è di particolare interesse per lo studio di varietà che consentano una buona produzione con basso input anche in condizioni ambientali non ottimali. L'esposizione delle colture cerealicole a stress termico durante determinate fasi del ciclo vitale influisce negativamente sulla resa e sulla qualità, a questo fine è necessario chiarire le basi genetiche e molecolari della termotolleranza per identificare geni e alleli vantaggiosi da impiegare in programmi di incrocio volti al miglioramento genetico. Numerosi studi dimostrano il coinvolgimento delle sHSP a localizzazione cloroplastica (in frumento sHSP26) nel meccanismo di acquisizione della termotolleranza e la loro interazione con diverse componenti del fotosistema II (PSII) che determinerebbe un’azione protettiva in condizioni di stress termico e altri tipi di stress. Lo scopo del progetto è quello di caratterizzare in frumento duro nuove varianti alleliche correlate alla tolleranza a stress termico mediate l'utilizzo del TILLING (Target Induced Local Lesion In Genome), un approccio di genetica inversa che prevede la mutagenesi e l'identificazione delle mutazioni indotte in siti di interesse. Durante la tesi sono state isolate e caratterizzate 3 sequenze geniche complete per smallHsp26 denominate TdHsp26-A1; TdHsp26-A2; TdHsp26-B1 e un putativo pseudogene denominato TdHsp26-A3. I geni isolati sono stati usati come target in analisi di TILLING in due popolazioni di frumento duro mutagenizzate con EMS (EtilMetanoSulfonato). Nel nostro studio sono stati impiegati due differenti approcci di TILLING: un approccio di TILLING classico mediante screening con High Resolution Melting (HRM) e un approccio innovativo che sfrutta un database di TILLING recentemente sviluppato. La popolazione di mutanti cv. Kronos è stata analizzata per la presenza di mutazioni in tutti e tre i geni individuati mediante ricerca online nel database di TILLING, il quale sfrutta la tecnica dell’exome capture sulla popolazione di TILLING seguito da sequenziamento ad alta processività. Attraverso questa tecnica sono state individuate, nella popolazione mutagenizzata di frumento duro cv. Kronos, 36 linee recanti mutazioni missenso. Contemporaneamente lo screening con HRM, effettuato su 960 genotipi della libreria di TILLING di frumento duro cv. Cham1 ha consentito di individuare mutazioni in una regione di 211bp di interesse funzionale del gene TdHsp26-B1, tra le quali 3 linee mutanti recanti mutazioni missenso in omozigosi. Alcune mutazioni missenso individuate sui due geni TdHsp26-A1 e TdHsp26-B1 sono state confermate in vivo nelle piante delle rispettive linee mutanti generando marcatori codominanti KASP (Kompetitive Allele Specific PCR) con cui è stato possibile verificare anche il grado di zigosità di tali mutazioni. Al fine di ridurre il numero di mutazioni non desiderate nelle linee risultate più interessanti, è stato eseguito il re-incrocio dei mutanti con i relativi parentali wild type ed inoltre sono stati generati alcuni doppi mutanti che consentiranno di comprendere meglio i meccanismi molecolari presieduti da questa classe genica. Gli individui F1 degli incroci sono stati poi genotipizzati con i medesimi marcatori KASP specifici per la mutazione di interesse per verificare la buona riuscita dell’incrocio. Questo approccio ha permesso di individuare ed implementare risorse genetiche utili ad intraprendere studi funzionali relativi al ruolo di smallHSP plastidiche implicate nella acquisizione di termotolleranza in frumento duro e di generare marcatori potenzialmente utili in futuri programmi di breeding.

A propaganda de medicamentos de venda livre: um estudo do discurso e das questões éticas

A pesquisa identifica as características do discurso da propaganda de medicamentos de venda livre, analisando a relação entre o seu conteúdo, as questões éticas e as normas legais que orientam a comercialização desses medicamentos. O corpus de análise é constituído de 31 peças publicitárias de mídia impressa, de merchandising em pontos de venda PDVs, em campanhas de divulgação/comercialização de medicamentos de venda livre por um laboratório nacional EMS Sigma Pharma, e um multinacional Aventis Pharma. A metodologia de investigação é a Análise do Discurso subjacente às mensagens veiculadas nas peças de PDV, tendo como orientação os pressupostos dos teóricos de linha francesa, além dos fundamentos da propaganda e a legislação que a rege bem como os direitos do consumidor. A investigação mostra que a propaganda de medicamentos de venda livre, com seus argumentos altamente persuasivos a fim de seduzir o consumidor, não evidencia uma preocupação responsável com o consumidor e trata os medicamentos como quaisquer outros produtos, restringindo-se ao cumprimento das determinações legais em seus aspectos mínimos. Os princípios éticos e os valores sociais são ignorados, na maioria das peças, o que vale dizer que os emissores pecam por omissão na construção de seu discurso.

Effect of age related macular degeneration on the Eger macular stressometer photostress recovery time

Aim: To assess the repeatability of Eger macular stressometer (EMS) measures of photostress recovery and determine their association with other measures of visual function. Methods: EMS photostress recovery time was measured in 90 patients with bilateral exudative age related macular degeneration (AMD), 19 with bilateral atrophic AMD and 47 with both forms of the condition (mean age 79 (SD 13) years). Measurements were made on two occasions separated by 1 year. Intrasession repeatability was assessed by repeating the measures after a 10 minute recovery period at the first visit. Distance visual acuity was measured with a logMAR chart, near visual acuity with a MNRead chart at 25 cm, contrast sensitivity with a Pelli-Robson chart, and the presence of central visual disturbance assessed with an Amsler grid. A questionnaire was used to assess self reported difficulties with glare recovery. Results: The average EMS recovery time was 11.0 (SD 8.9) seconds, decreasing by 1.6 (5.2) seconds on repeated measurement (p<0.05). EMS photostress recovery was not correlated with visual function measures or subjective difficulties with lights (p>0.05). EMS photostress recovery time did not predict those whose vision decreased over the following year compared with those among whom it remained stable. Conclusions: The EMS test is not a useful tool in determining the severity or progression of AMD.

Reliability, normative data, and the effect of age-related macular disease on the Eger Macular Stressometer photostress recovery time

Purpose: To assess repeatability and reproducibility, to determine normative data, and to investigate the effect of age-related macular disease, compared with normals, on photostress recovery time measured using the Eger Macular Stressometer (EMS). Method: The study population comprised 49 healthy eyes of 49 participants. Four EMS measurements were taken in two sessions separated by 1 h by two practitioners, with reversal of order in the second session. EMS readings were also taken from 17 age-related maculopathy (ARM), and 12 age-related macular degeneration (AMD), affected eyes. Results: EMS readings are repeatable to within ± 7 s. There is a statistically significant difference between controls and ARM affected eyes (t = 2.169, p = 0.045), and AMD affected eyes (t = 2.817, p = 0.016). The EMS is highly specific, and demonstrates sensitivity of 29% for ARM, and 50% for AMD. Conclusions: The EMS may be a useful screening test for ARM, however, direct illumination of the macula of greater intensity and longer duration may yield less variable results. © 2004 The College of Optometrists.

Managing the impact on biodiversity of supply chain companies

Industrial development has had a major role in creating the situation where bio-diverse materials and services essential for sustaining business are under threat. A key contributory factor to biodiversity decline comes from the cumulative impacts of extended supply chain business operations. In order to contribute to stopping this decline, the industrial world needs to form a better understanding of the way it utilizes the business and biodiversity agenda in its wider operations. This thesis investigates the perceptions and attitudes to biodiversity from government, society and a wide cross-section of industry. The research includes the extent of corporate attention to and use of environmental business tools and guidelines in reporting on biodiversity issues. A case study of three companies from different industrial sectors is undertaken to observe procurement and related environmental management of their supply chains. The use of accredited and non-accredited environmental management systems (EMS) are analysed as frameworks for introducing biodiversity aspects into supply chain management. The outcome is a methodology, which can be used either as a bespoke in-house biodiversity management system or within an accredited ISO 14001 EMS, for incorporating the assessment and management of the potential risks and opportunities involving environmental impacts on biodiversity of supply chain companies.

The effect of nutritional supplementation on visual function

The aim of this research was to determine the effect of a lutein-based nutritional supplemented on measures of visual function in normal and ARMD-affected eyes. Thirty participants were recruited to the ARMD cohort (aged between 55 and 82 years, mean ± SD: 69.2 ± 7.8) and 46 were recruited into the normal cohort (aged between 22 and 73 years, mean ± SD: 50.0 ± 15.9). Outcome measures were distance (DVA) and near (NVA) visual acuity, contrast sensitivity (CS), photostress recovery time measured with the Eger Macular Stressometer (EMS), central visual function assessed with the Macular Mapping test (MMT), and fundus photography. Reliability studies were carried out for the EMS and the MMT. A change of 14 s is required to indicate a clinically significant change in EMS time, and a change of 14 MMT points is required to indicate a clinically significant change in MMT score. Sample sizes were sufficient for the trial to have 80% power to detect a significant clinical effect at the 5% significance level for all outcome measures in the normal cohort, and for CS in the ARMD cohort. The study demonstrated that a nutritional supplement containing 6mg lutein, 750 mg vitamin A, 250 mg vitamin C, 34 mg vitamin E, 10 mg zinc, and 0.5 mg copper had no effect on the outcome measures over nine or 18 months in normal or ARMD affected participants. The finding that nine months of antioxidant supplementation, in this case, has no significant effect on CS in ARMD-affected participants adds to the literature, and contrasts with previous RCTs, the AREDS and the LAST. This project has added to the debate about the use of nutritional supplementation prior to the onset of ARMD.

Optimizing rate algorithms in wireless networks

Since wireless network optimisations can be typically designed and evaluated independently of one another under the assumption that they can be applied jointly or independently. In this paper, we have analysis some rate algorithms in wireless networks. Since wireless networks have different standards in IEEE with peculiar features, data rate is one of those important parameters that wireless networks depend on for performances. The optimisation of this network is dependent on the behaviour of a particular rate algorithm in a network scenario. We have considered some first and second generation's rate algorithm, and it is all about selecting an appropriate data rate that any available wireless network can utilise for transmission in order to achieve a good performance. We have designed and analysis a wireless network and results obtained for some rate algorithms, like ONOE and AARF.

A management tool for developing the relationships between large purchasing organisations and small ethnic minority suppliers

Purpose: The purpose of this paper is to scrutinise the characteristics of the relationship between large purchasing organisations (LPOs) and ethnic minority suppliers (EMSs) engaging with supplier diversity programmes and provide an assessment and developmental framework for such organisations. Design/methodology/approach: Having considered an array of purchaser-supplier relationship frameworks in relevant streams of literature, the paper draws on Lamming et al.'s framework to advance a tool for assessing and developing the relationship between LPOs and EMSs. Findings: The submitted relationship assessment and development framework brings in sharp focus the characteristics of the relationship between LPO and EMS, providing a systematic way to examine the inter-organisational context within which EMS development takes place. Research limitations/implications: The framework submitted could signpost future research in this field, which should take a longitudinal, processual approach. This is necessary to provide opportunities to examine the dynamics underlying the development of potent LPO-EMS relationships in a variety of settings, including negative instances. Practical implications: The paper has implications for corporate policy making and practice in this arena. Assessing the potency of LPOs-EMSs relationships by applying the proffered tool can help both parties engage with supplier diversity, to develop fruitful relationships that enhance their competitiveness. Social implications: The latter can have social implications, as EMSs often operate in and employ people from disadvantaged communities. Originality/value: The framework advanced in this article constitutes a novel tool that highlights the areas in which LPOs and EMSs should channel their efforts, in order to develop a potent relationship between them, which underpins the development of EMSs' supply capabilities. © Emerald Group Publishing Limited.

A new inventory model for aircraft spares

A special inventory problem is presented: aircraft spares that are repaired and returned to spares, called rotable inventory. Rotable inventory is not consumed so does not change in the medium term, but is rotated through operational, maintenance and stock phases. The objective for inventory performance is fleet Service Level (SL), which effects aircraft dispatch performance. A model is proposed where the fleet SL drives combined stock levels such that cost is optimized. By holding greater numbers of lower-cost items and holding lower levels of more expensive items, it is possible to achieve substantial cost savings while maintaining performance. This approach is shown to be an advance over the current literature and is tested with case data, with conclusive results.

The Complex Unified Evolutionary Approach to the Creation of the Multilevel Distributed Control System of a Gas-transport Company

The objects of a large-scale gas-transport company (GTC) suggest a complex unified evolutionary approach, which covers basic building concepts, up-to-date technologies, models, methods and means that are used in the phases of design, adoption, maintenance and development of the multilevel automated distributed control systems (ADCS).. As a single methodological basis of the suggested approach three basic Concepts, which contain the basic methodological principles and conceptual provisions on the creation of distributed control systems, were worked out: systems of the lower level (ACS of the technological processes based on up-to-date SCADA), of the middle level (ACS of the operative-dispatch production control based on MES-systems) and of the high level (business process control on the basis of complex automated systems ERP).

Интегрированный Моделирующий Комплекс Поддержки Принятия Решений в Комплексной Корпоративной Системе Управления Магистральной Газотранспортной Сетью

The approach to construction, structuring class of tasks, technology of the use and stages of modernization systems support of decision-making in composition the operative-dispatch control computer-based system by the gas-transport system of Ukraine is considered.

Performance evaluation of adaptive context aware rate selection algorithm (ACARS) for road safety applications in vehicular network

One of the major drawbacks for mobile nodes in wireless networks is power management. Our goal is to evaluate the performance power control scheme to be used to reduce network congestion, improve quality of service and collision avoidance in vehicular network and road safety application. Some of the importance of power control (PC) are improving spatial reuse, and increasing network capacity in mobile wireless communications. In this simulation we have evaluated the performance of existing rate algorithms compared with context Aware Rate selection algorithm (ACARS) and also seen the performance of ACARS and how it can be applied to road safety, improve network control and power management. Result shows that ACARS is able to minimize the total transmit power in the presence of propagation processes and mobility of vehicles, by adapting to the fast varying channels conditions with the Path loss exponent values that was used for that environment which is shown in the network simulation parameter. Our results have shown that ACARS is a very robust algorithm which performs very well with the effect of propagation processes that is prone to every transmitted signal in mobile networks. © 2013 IEEE.

Impact of electric vehicles on GB electricity demand and associated benefits for system control

This paper investigates the impact that electric vehicle uptake will have on the national electricity demand of Great Britain. Data from the National Travel Survey, and the Coventry and Birmingham Low Emissions Demonstration (CABLED) are used to model an electrical demand profile in a future scenario of significant electric vehicle market penetration. These two methods allow comparison of how conventional cars are currently used, and the resulting electrical demand with simple substitution of energy source, with data showing how electric vehicles are actually being used at present. The report finds that electric vehicles are unlikely to significantly impact electricity demand in GB. The paper also aims to determine whether electric vehicles have the potential to provide ancillary services to the grid operator, and if so, the capacity for such services that would be available. Demand side management, frequency response and Short term Operating Reserve (STOR) are the services considered. The report finds that electric cars are unlikely to provide enough moveable demand peak shedding to be worthwhile. However, it is found that controlling vehicle charging would provide sufficient power control to viably act as frequency response for dispatch by the transmission system operator. This paper concludes that electric vehicles have technical potential to aid management of the transmission network without adding a significant demand burden. © 2013 IEEE.

Human resource management in emerging markets:an introduction

The shifting of global economic power from mature, established markets to emerging markets (EMs) is a fundamental feature of the new realities in the global political economy. Due to a combination of reasons (such as scarcity of reliable information on management systems of EMs, the growing contribution of human resource management (HRM) towards organisational performance, amongst others), the understanding about the dynamics of management of HRM in the EMs context and the need for proactive efforts by key stakeholders (e.g., multinational and local firms, policy makers and institutions such as trade unions) to develop appropriate HRM practice and policy for EMs has now become more critical than ever. It is more so given the phenomenal significance of the EMs predicted for the future of the global economy. For example, Antoine van Agtmael predicts that: in about 25 years the combined gross national product (GNP) of emergent markets will overtake that of currently mature economies causing a major shift in the centre of gravity of the global economy away from the developed to emerging economies. (van Agtmael 2007: 10–11) Despite the present (late 2013 and early 2014) slowdown in the contribution of EMs towards the global industrial growth (e.g., Das, 2013; Reuters, 2014), EMs are predicted to produce 70 per cent of world GDP growth and a further ten years later, their equity market capitalisation is expected to reach US$ 80 trillion, 1.2 times more than the developed world (see Goldman Sachs, 2010).