Pharmaceutical company influences on medication prescribing and their potential impact on quality use of medicines

Background Pharmaceuticals are big business, reporting strong market growth year after year. The ‘gatekeepers’ of this market are prescribers of medicines, who are the major target of pharmaceutical companies, utilizing direct and indirect influences. Methods This paper draws on previous research investigating pharmaceutical company prescribing influences to develop a qualitative model demonstrating the synergism between commercial influences on prescribing. The generic model was used to explore a realistic but hypothetical scenario to ascertain the applicability of the model. Results and Discussion A generic influence model was developed. The model was readily able to be adapted to reflect a realistic practice scenario. Conclusion Prescriber awareness of the linkages between various seemingly separate marketing techniques could potentially improve medicines usage in an evidence-based practice paradigm.

Interaction of metal salts with cytoskeletal motor protein systems

Interactions of chemicals with the microtubular network of cells may lead to genotoxicity. Micronuclei (MN) might be caused by interaction of metals with tubulin and/or kinesin. The genotoxic effects of inorganic lead and mercury salts were studied using the MN assay and the CREST analysis in V79 Chinese hamster fibroblasts. Effects on the functional activity of motor protein systems were examined by measurement of tubulin assembly and kinesin-driven motility. Lead and mercury salts induced MN dose-dependently. The no-effect-concentration for MN induction was 1.1 μM PbCl2, 0.05 μM Pb(OAc)2 and 0.01 μM HgCl2. The in vitro results obtained for PbCl2 correspond to reported MN induction in workers occupationally exposed to lead, starting at 1.2 μM Hg(II) (Vaglenov et al., 2001, Environ. Health Perspect. 109, 295-298). The CREST Analysis indicate aneugenic effects of Pb(II) and aneugenic and additionally clastogenic effects of Hg(II). Lead (chloride, acetate, and nitrate) and mercury (chloride and nitrate) interfered dose-dependently with tubulin assembly in vitro. The no-effect-concentration for lead salts in this assay was 10 μM. Inhibition of tubulin assembly by mercury started at 2 μM. The gliding velocity of microtubules along immobilised kinesin molecules was affected by 25 μM Pb(NO3)2 and 0.1 μM HgCl2 in a dose-dependent manner. Our data support the hypothesis that lead and mercury genotoxicity may result, at least in part, via disturbance of chromosome segregation via interaction with cytoskeletal proteins.

Incorporating human-factors in car-following models : a review of recent developments and research needs

Over the past decades there has been a considerable development in the modeling of car-following (CF) behavior as a result of research undertaken by both traffic engineers and traffic psychologists. While traffic engineers seek to understand the behavior of a traffic stream, traffic psychologists seek to describe the human abilities and errors involved in the driving process. This paper provides a comprehensive review of these two research streams. It is necessary to consider human-factors in {CF} modeling for a more realistic representation of {CF} behavior in complex driving situations (for example, in traffic breakdowns, crash-prone situations, and adverse weather conditions) to improve traffic safety and to better understand widely-reported puzzling traffic flow phenomena, such as capacity drop, stop-and-go oscillations, and traffic hysteresis. While there are some excellent reviews of {CF} models available in the literature, none of these specifically focuses on the human factors in these models. This paper addresses this gap by reviewing the available literature with a specific focus on the latest advances in car-following models from both the engineering and human behavior points of view. In so doing, it analyses the benefits and limitations of various models and highlights future research needs in the area.

Design, manufacturing and maintenance of sugar milling equipment : observations from the 2008 ISSCT Engineering Workshop

An International Society of Sugar Cane Technologists (ISSCT) Engineering Workshop was held in Piracicaba, Brazil from 30 June to 4 July 2008. The theme of the workshop was Design, manufacturing and maintenance of sugar mill equipment. The workshop consisted of a series of technical sessions and site visits. The Brazilian sugar industry is growing rapidly. The growth has occurred as the result of the sugar industry’s position as a key provider of renewable energy in the form of ethanol and, more recently, electricity. The increased focus on electricity is seeing investment in high pressure (100 bar) boilers, cane cleaning plants that allow an increased biomass supply from trash and digesters that produce biogas from dunder. It is clear that the Brazilian sugar industry has a well defined place in the country’s future. The ISSCT workshop provided a good opportunity to gain information from equipment suppliers and discuss new technology that may have application in Australia. The new technologies of interest included IMCO sintered carbide shredder hammer tips, Fives Cail MillMax mills, planetary mill gearboxes, Bosch Projects chainless diffusers, Fives Cail Zuka centrifugals and Vaperma Siftek membrane systems.

Design, manufacturing and maintenance of sugar mill equipment

The ISSCT Engineering Workshop 2008 in Brazil was well attended with 62 participants including 39 overseas visitors from 15 countries. The workshop addressed the theme Design, manufacturing and maintenance of sugar mill equipment. From the technical sessions, the following conclusions were drawn: • Several speakers articulated a shared vision of the future of the Brazilian sugar industry. This shared vision gives considerable confidence that the vision can become a reality. • There is an increased focus on energy products. As a result, the reduction of factory energy consumption in order to maximise the energy available for products is also a focus. • New equipment and products are being developed with reduced power consumption, lower capital and maintenance costs, and better performance. • Methods presented for reducing maintenance costs included the use of a maintenance management system, condition monitoring and material selection. The workshop was held in conjunction with Piracicaba’s annual SIMTEC exhibition for the sugar and alcohol industries that provides a forum for technical presentations and discussion, and showcases products and services from manufacturers and service providers. In return for holding the workshop in conjunction with SIMTEC, SIMTEC provided sponsorship for the workshop, including paying travel and accommodation costs for two invited speakers, and organisation for the workshop. The ISSCT and SIMTEC technical programs were arranged so that their technical sessions did not clash, and the ISSCT program was extended a day to provide an opportunity for ISSCT participants to attend the SIMTEC exhibition. Informal feedback from workshop participants suggested that the arrangement between ISSCT and SIMTEC worked well. Site visits to two manufacturing facilities and two sugar mills were arranged as part of the workshop.

Bikeshare: Barriers, facilitators and impacts on car use

This thesis examined the factors contributing to bikeshare participation in Brisbane and Melbourne, and opportunities for increasing bikeshare usage. The degree to which bikeshare impacts on car use was also quantified. The findings of this program of research have implications for existing as well as planned bikeshare programs, both in Australia and abroad.

The emergent imperatives from a design-led innovation engagement within the mining industry

This research seeks a better and more detailed understanding of the processes of implementing design-led innovation in the mining equipment technology services (METS) sector, in a context where the traditional approach to manufacturing is being challenged. This longitudinal research specifically investigated the barriers to design-led innovation and opportunities that developed throughout this research, to understand how the organisation and culture of a METS company evolved, in order to progress towards design-led change. The significance of these findings is shown in the combined implementation of design imperatives leading towards design-led change at all business levels of an organisational structure.

The driving visual field and a history of motor vehicle collision involvement in older drivers: A population-based examination

Purpose We designed a visual field test focused on the field utilized while driving to examine associations between field impairment and motor vehicle collision involvement in 2,000 drivers ≥70 years old. Methods The "driving visual field test" involved measuring light sensitivity for 20 targets in each eye, extending 15° superiorly, 30° inferiorly, 60° temporally and 30° nasally. The target locations were selected on the basis that they fell within the field region utilized when viewing through the windshield of a vehicle or viewing the dashboard while driving. Monocular fields were combined into a binocular field based on the more sensitive point from each eye. Severe impairment in the overall field or a region was defined as average sensitivity in the lowest quartile of sensitivity. At-fault collision involvement for five years prior to enrollment was obtained from state records. Poisson regression was used to calculate crude and adjusted rate ratios examining the association between field impairment and at-fault collision involvement. Results Drivers with severe binocular field impairment in the overall driving visual field had a 40% increased rate of at-fault collision involvement (RR 1.40, 95%CI 1.07-1.83). Impairment in the lower and left fields was associated with elevated collision rates (RR 1.40 95%CI 1.07-1.82 and RR 1.49, 95%CI 1.15-1.92, respectively), whereas impairment in the upper and right field regions was not. Conclusions Results suggest that older drivers with severe impairment in the lower or left region of the driving visual field are more likely to have a history of at-fault collision involvement.

Identifying product families using data mining techniques in manufacturing paradigm

Identifying product families has been considered as an effective way to accommodate the increasing product varieties across the diverse market niches. In this paper, we propose a novel framework to identifying product families by using a similarity measure for a common product design data BOM (Bill of Materials) based on data mining techniques such as frequent mining and clus-tering. For calculating the similarity between BOMs, a novel Extended Augmented Adjacency Matrix (EAAM) representation is introduced that consists of information not only of the content and topology but also of the fre-quent structural dependency among the various parts of a product design. These EAAM representations of BOMs are compared to calculate the similarity between products and used as a clustering input to group the product fami-lies. When applied on a real-life manufacturing data, the proposed framework outperforms a current baseline that uses orthogonal Procrustes for grouping product families.

Managing climate change ‘by the numbers’ in a UK energy company

This paper examines how ideas and practices of accounting come together in turning the abstract concept of climate change into a new non-financial performance measure in a large energy company in the UK. It develops the notion of ‘governmental management’ to explain how the firm’s carbon dioxide emissions were transformed into a new organisational object that could be made quantifiable, measureable and ultimately manageable because of the modern power of accounting in tying disciplinary subjectivities and objectivities together whilst operating simultaneously at the level of individual and the organisation. Examining these interrelations highlights the constitutive nature of accounting in creating not just new categories for accounting’s attention, but in turn new organisational knowledge and knowledge experts in the making up accounting for climate change. Significantly, it appears these new knowledge experts are no longer accountants: which may help explain accounting’s evolution into evermore spheres of influence as we increasingly choose to manage our world ‘by the numbers’.

Roundabout design and cycling safety

Roundabouts reduce the frequency and severity of motor vehicle crashes and therefore the number installed has increased dramatically in the last 20 years in many countries. However, the safety impacts of roundabouts for bicycle riders are a source of concern, with many studies reporting lower injury reductions for cyclists than car occupants. This paper summarises the results of a project undertaken to provide guidance on how cyclist safety could be improved at existing roundabouts in Queensland, Australia, where cyclist crashes have been increasing and legislation gives motor vehicles priority over cyclists and pedestrians at roundabouts. The review of international roundabout design guidelines identified two schools of design: tangential roundabouts (common in English-speaking countries, including Australia), which focus on minimising delay to motor vehicles, and radial roundabouts (common in continental Europe), which focus on speed reduction and safety. While it might be expected that radial roundabouts would be safer for cyclists, there have been no studies to confirm this view. Most guidelines expect cyclists to act as vehicle traffic in single-lane, typically low-speed, roundabouts. Some jurisdictions do not permit cyclists to travel on multi-lane roundabouts, and recommend segregated bicycle facilities because of their lowest crash risk for cyclists. Given that most bicycle-vehicle crashes at roundabouts involve an entering vehicle and a circulating cyclist, the greatest challenges appear to be reducing the speed of motor vehicles on the approach/entry to roundabouts and other ways of maximizing the likelihood that cyclists will be seen. Lower entry speeds are likely to underpin the greater safety of compact roundabouts for cyclists and, conversely, the higher than expected crash rates at two-lane roundabouts. European research discourages the use of bike lanes in roundabouts which position cyclists at the edge of the road and contributes to cyclists being less likely to be noticed by drivers.