An evaluation of quinolone prescribing in a group of acute hospitals:Development of an objective measure of usage

Objectives: To develop an objective measure to enable hospital Trusts to compare their use of antibiotics. Design: Self-completion, postal questionnaire with telephone follow up. Sample: 4 hospital trusts in the English Midlands. Results: The survey showed that it was possible to collect data concerning the number of Defined Daily Doses (DDD's) of quinolone antibiotic dispensed per Finished Consultant Episode (FCE) in each Trust.. In the 4 trusts studied the mean DDD/FCE was 0.197 (range 0.117 to 0.258). This indicates that based on a typical course length of 5 days, 3.9% of patient episodes resulted in the prescription of a quinolone antibiotic. Antibiotic prescribing control measures in each Trust were found to be comparable. Conclusion: The measure will enable Trusts to objectively compare their usage of quinolone antibiotics and use this information to carry out clinical audit should differences be recorded. This is likely to be applicable to other groups of antibiotics.

An evaluation of thermal plasmas in pyrometallurgy

The development of reliable, high powered plasma generators has resulted in many plasma processes being proposed as alternatives to existing pyrometallurgical technologies. This work evaluates the advantages and disadvantages of plasma systems by reviewing plasma generators, their integration with reactors and the process economics. Many plasma systems were shown to be technically and economically superior to existing technologies, but some of the plasma system advantages quoted in the literature were found to be impractical because of other system constraints. Process applications were limited by the power inputs available from plasma generators compared to AC electric furnaces. A series of trials were conducted where chromite and steelplant baghouse dusts were smelted in the Tetronics' 2.0 MW transferred arc/open bath reactor to confirm the operating characteristics of the plasma system and its economics. Chromite smelting was technical superior to submerged arc furnace technology, but the economics were unfavourable because of the limited power available from the water-cooled plasma torch and the high electrical energy consumption. A DC graphite electrode plasma furnace using preheated and prereduced chromite concentrates will compete economically with the submerged arc furnace. Ni, Cr and Mo were economically recovered from high alloy content steelplant dusts for recycling. Five Electric Arc Furnace dusts were smelted to produce a non-toxic residue and recover the contained zinc to an enriched zinc oxide product for recycling. It should be possible to condense the zinc vapour directly in a zinc splash condenser to increase the value of the product. Because of the limited power available from plasma generators, plasma processes will be most suitable for treating high and medium value materials such as Au, Pt, Mo, Ni, Ti, V, Cr etc at small production rates, heating metals in tundishes and ladles and remelting superalloy scrap. The treatment of environmentally hazardous waste materials is a particularly interesting application because of the additional financial incentives. Non-transferred arc plasma generators will be used for air and gas preheating in blast furnaces to reduce metallurgical coke consumptions.

An analysis of fatal accidents in agriculture in Great Britain

The number of fatal accidents in the agricultural, horticultural and forestry industry in Great Britain has declined from an annual rate of about 135 in the 1960's to its current level of about 50. Changes to the size and makeup of the population at risk mean that there has been no real improvement in fatal injury incidence rates for farmers. The Health and Safety Executives' (HSE) current system of accident investigation, recording, and analysis is directed primarily at identifying fault, allocating blame, and punishing wrongdoers. Relatively little information is recorded about the personal and organisational factors that contributed to, or failed to prevent accidents. To develop effective preventive strategies, it is important to establish whether errors by the victims and others, occur at the skills, rules, or knowledge level of functioning: are violations of some rule or procedure; or stem from failures to correctly appraise, or control a hazard. A modified version of the Hale and Glendon accident causation model was used to study 230 fatal accidents. Inspectors' original reports were examined and expert judgement applied to identify and categorise the errors committed by each of the parties involved. The highest proportion of errors that led directly to accidents occurred whilst the victims were operating at the knowledge level. The mix and proportion of errors varied considerably between different classes of victim and kind of accident. Different preventive strategies will be needed to address the problem areas identified.

The use of expert manpower in health and safety in France

The thesis examines the system of occupational health and safety in France. It analyses the use of expert manpower in the field with a view to establishing the possibility of a profession in health and safety. An input-output model is developed to bring together the necessary elements of prevention of accidents and occupational diseases. The role of institutions concerned with health and safety is analysed with reference to this model. The research establishes the need for a health and safety specialist role. The recognition and status of this role are found to be subject to other criteria including the acceptance by institutions of such a specialist role. The model is also used to define the role of this specialist as expected by the various institutions intervening in the field.

Immuno-potentiating activity of surfactant vesicles in DNA and subunit vaccination

Enhanced immune responses for DNA and subunit vaccines potentiated by surfactant vesicle based delivery systems outlined in the present study, provides proof of principle for the beneficial aspects of vesicle mediated vaccination. The dehydration-rehydration technique was used to entrap plasmid DNA or subunit antigens into lipid-based (liposomes) or non-ionic surfactant-based (niosomes) dehydration-rehydration vesicles (DRV). Using this procedure, it was shown that both these types of antigens can be effectively entrapped in DRV liposomes and DRV niosomes. The vesicle size of DRV niosomes was shown to be twice the diameter (~2µm) of that of their liposome counterparts. Incorporation of cryoprotectants such as sucrose in the DRV procedure resulted in reduced vesicle sizes while retaining high DNA incorporation efficiency (~95%). Transfection studies in COS 7 cells demonstrated that the choice of cationic lipid, the helper lipid, and the method of preparation, all influenced transfection efficiency indicating a strong interdependency of these factors. This phenomenon has been further reinforced when 1,2-dioleoyl-sn-glycero-3-phosphoethanolamine (DOPE): cholesteryl 3b- [N-(N’ ,N’ -dimethylaminoethane)-carbamoyl] cholesterol (DC-Chol)/DNA complexes were supplemented with non-ionic surfactants. Morphological analysis of these complexes using transmission electron microscopy and environmental scanning electron microscopy (ESEM) revealed the presence of heterogeneous structures which may be essential for an efficient transfection in addition to the fusogenic properties of DOPE. In vivo evaluation of these DNA incorporated vesicle systems in BALB/c mice showed weak antibody and cell-mediated immune (CMI) responses. Subsequent mock challenge with hepatitis B antigen demonstrated that, 1-monopalmitoyl glycerol (MP) based DRV, is a more promising DNA vaccine adjuvant. Studying these DRV systems as adjuvants for the Hepatitis B subunit antigen (HBsAg) revealed a balanced antibody/CMI response profile on the basis of the HBsAg specific antibody and cytokine responses which were higher than unadjuvated antigen. The effect of addition of MP, cholesterol and trehalose 6,6’-dibehenate (TDB) on the stability and immuno-efficacy of dimethyldioctadecylammonium bromide (DDA) vesicles was investigated. Differential scanning calorimetry showed a reduction in transition temperature of DDA vesicles by ~12°C when incorporated with surfactants. ESEM of MP based DRV system indicated an increased vesicle stability upon incorporation of antigen. Adjuvant activity of these systems tested in C57BL/6j mice against three subunit antigens i.e., mycobacterial fusion protein- Ag85B-ESAT-6, and two malarial antigens - merozoite surface protein-1, (MSP1), and glutamate rich protein, (GLURP) revealed that while MP and DDA based systems induced comparable antibody responses, DDA based systems induced powerful CMI responses.

An examination of organisational issues in third sector organisations which undertake nonviolent direct action

This thesis is an examination of organisational issues faced by Third Sector organisations which undertake nonviolent direct action. A case study methodology is employed and data gathered from four organisations: Earth First!; genetiX Snowball; Greenpeace; and Trident Ploughshares. The argument commences with a review of the literature which shows that little is known of the organising of nonviolent direct action. Operational definitions of 'organisation' and 'nonviolent direct action' are drawn from the literature. 'Organisation' is conceptualised using new institutionalism. 'Nonviolent direct action' is conceptualised using new social movement theory. These concepts inform the case study methodology in the choice of case, the organisations selected and the data gathering tools. Most data were gathered by semi-structured interview and participant observation. The research findings result from theory-building arising from thick descriptions of the case in the four organisations. The findings suggest that nonviolent direct action is qualitatively different from terrorism or violence. Although there is much diversity in philosophies of nonviolence, the practice of nonviolent direct action has much in common across the four organisations. The argument is that nonviolent direct action is an institution. The findings also suggest that new institutionalism is a fruitful approach to studies of these organisations. Along with nonviolent direct action, three other institutions are identified: 'rules'; consensus decision-making; and 'affinity groups'. An unanticipated finding is how the four organisations are instances of innovation. Tentative theory is developed which brings together the seemingly incompatible concepts of institutions and innovation. The theory suggests preconditions and then stages in the development of new organisational forms in new social movements: innovation. The three pre-conditions are: the existence of an institutional field; an 'institution-broker' with access to different domains; and a shared 'problem' to resolve. The three stages are: unlocking existing knowledge and practice; bridging different domains of practice or different fields to add, develop or translocate those practices; and establishing those practices within their new combinations or novel locations. Participants are able to move into and between these new organisational forms because they consist of familiar and habitual institutional behaviour.

An investigation of production workers' performance variations and the potential impact of attitudes

In most manufacturing systems the contribution of human labour remains a vital element that affects overall performance and output. Workers’ individual performance is known to be a product of personal attitudes towards work. However, in current system design processes, worker performance variability is assumed to be largely insignificant and the potential impact of worker attitudes is ignored. This paper describes a field study that investigated the extent to which workers’ production task cycle times vary and the degree to which such variations are associated with attitude differences. Results show that worker performance varies significantly, much more than is assumed by contemporary manufacturing system designers and that this appears to be due to production task characteristics. The findings of this research and their implications are discussed.

An examination of moderator effects in the four-stage loyalty model

Oliver’s 1997 four-stage loyalty model proposes that loyalty consists of belief, affect, intention, and action. Although this loyalty model has recently been subject to empirical examination, the issue of moderator variables has been largely neglected. This article fills that void by analyzing the moderating effects of selected personal and situational characteristics, using a sample of 888 customers of a large do-it-yourself retailer. The results of multi-group causal analysis suggest that these moderators exert an influence on the development of the different stages of the loyalty sequence. Specifically, age, income, education and expertise, price orientation, critical incident recovery, and loyalty card membership are found to be important moderators of the links in the four-stage loyalty model. Limitations of the study are outlined, and implications for both research and managerial practice are discussed.

An analysis of food demand in Peru:implications for food-feed competition

In their policy proposals on how best to stimulate economic growth, economists have been increasingly emphasizing free markets. It is, however, possible that free-market-led economic growth can lead to increased income inequity which can further increase poverty. One of the more interesting but thus far insufficiently explored mechanisms for the latter is food–feed competition. Using Peruvian Living Standard Survey (PLSS) data for 1985–86 and 1990, the paper examines the demand patterns of households and concludes that the empirical evidence is in agreement with the hypotheses underlying the theory of food–feed competition.

An exploration of predatory behaviour in cyberspace:towards a typology of cyberstalkers

Over the last few years governments, law enforcement agencies, and the media have noted increases of online harassment. Although there has been a great deal of research into 'offline stalking', at this moment in time there has been no formal research that attempts to classify cyberstalkers. This study aimed to identify a classification of cyberstalkers by interviewing victims. Twenty-four participants were interviewed and their responses logged on a 76-item Cyberstalking Incident Checklist. A typology of cyberstalkers was developed.

An application of linear programming in the pottery industry

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An evaluation of human performance in a risk environment

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All change? Managers' experience of organizational change in theory and practice

Purpose - This paper aims to examine the usefulness of organizational change theory for management practice. Design/methodology/approach - The authors present an exploratory, empirical study of managers who were taught organizational change theory as part of a postgraduate degree. Building on the study findings, they analyse managers' subsequent experiences of organizational change; of how they use change theory in practice and the impact on their practice of their earlier formal study. Findings - The paper finds that the complexities of managing change in practice reflect distinctive organizational environments and cultures. The skills and knowledge which managers found most useful were those that enabled them to "make sense" of the organizational change they subsequently experienced. The main impact of their earlier studies was to prompt informative, discursive and reflective approaches to change management. Practical implications - The paper discusses the implications for future teaching of organizational change and the development of organizational change theory. Originality/value - The qualitative findings of the study add to, and help to explain, earlier research findings on the questions of how managers' experience change, how they use organizational change theory and its impact on their practice. © Emerald Group Publishing Limited.

Oxidiative lipidomics coming of age:advances in analysis of oxidized phospholipids in physiology and pathology

Significance: Oxidized phospholipids are now well-recognized as markers of biological oxidative stress and bioactive molecules with both pro-inflammatory and anti-inflammatory effects. While analytical methods continue to be developed for studies of generic lipid oxidation, mass spectrometry (MS) has underpinned the advances in knowledge of specific oxidized phospholipids by allowing their identification and characterization, and is responsible for the expansion of oxidative lipidomics. Recent Advances: Studies of oxidized phospholipids in biological samples, both from animal models and clinical samples, have been facilitated by the recent improvements in MS, especially targeted routines that depend on the fragmentation pattern of the parent molecular ion and improved resolution and mass accuracy. MS can be used to identify selectively individual compounds or groups of compounds with common features, which greatly improves the sensitivity and specificity of detection. Application of these methods have enabled important advances in understanding the mechanisms of inflammatory diseases such as atherosclerosis, steatohepatitis, leprosy and cystic fibrosis, and offer potential for developing biomarkers of molecular aspects of the diseases. Critical Issues and Future Directions: The future in this field will depend on development of improved MS technologies, such as ion mobility, novel enrichment methods and databases and software for data analysis, owing to the very large amount of data generated in these experiments. Imaging of oxidized phospholipids in tissue MS is an additional exciting direction emerging that can be expected to advance understanding of physiology and disease.