Optimisation Methods in Sustainable Manufacturing

Sustainable manufacturing is driven by the insight that the focus on the economic dimension in current businesses and lifestyles has to be broadened to cover all three pillars of sustainability: economic development, social development, and environmental protection

Avoiding Treatment Interruptions: What Role Do Australian Community Pharmacists Play?

OBJECTIVE: To explore the reported practice of Australian community pharmacists when dealing with medication supply requests in absence of a valid prescription. METHODS: Self-administered questionnaire was posted to 1490 randomly selected community pharmacies across all Australian states and territories. This sample was estimated to be a 20% of all Australian community pharmacies. RESULTS: Three hundred eighty five pharmacists participated in the study (response rate achieved was 27.9% (there were 111 undelivered questionnaires). Respondents indicated that they were more likely to provide medications to regular customers without a valid prescription compared to non-regular customers (p<0.0001). However, supply was also influenced by the type of prescription and the medication requested. In the case of type of prescription (Standard, Authority or Private) this relates to the complexity/probability of obtaining a valid prescription from the prescriber at a later date (i.e. supply with an anticipated prescription). Decisions to supply and/or not supply related to medication type were more complex. For some cases, including medication with potential for abuse, the practice and/or the method of supply varied significantly according to age and gender of the pharmacist, and pharmacy location (p<0.05). CONCLUSIONS: Although being a regular customer does not guarantee a supply, results of this study reinforce the importance for patients having a regular pharmacy, where pharmacists were more likely to continue medication supply in cases of patients presenting without a valid prescription. We would suggest, more flexible legislation should be implemented to allow pharmacists to continue supplying of medication when obtaining a prescription is not practical

The role of sex in the pathophysiology of pulmonary hypertension

Pulmonary arterial hypertension (PAH) is a progressive disease characterised by increased pulmonary vascular resistance and pulmonary artery remodelling as result of increased vascular tone and vascular cell proliferation, respectively. Eventually, this leads to right heart failure. Heritable PAH is caused by a mutation in the bone morphogenetic protein receptor-II (BMPR-II). Female susceptibility to PAH has been known for some time, and most recent figures show a female-to-male ratio of 4:1. Variations in the female sex hormone estrogen and estrogen metabolism modify FPAH risk, and penetrance of the disease in BMPR-II mutation carriers is increased in females. Several lines of evidence point towards estrogen being pathogenic in the pulmonary circulation, and thus increasing the risk of females developing PAH. Recent studies have also suggested that estrogen metabolism may be crucial in the development and progression of PAH with studies indicating that downstream metabolites such as 16α-hydroxyestrone are upregulated in several forms of experimental pulmonary hypertension (PH) and can cause pulmonary artery smooth muscle cell proliferation and subsequent vascular remodelling. Conversely, other estrogen metabolites such as 2-methoxyestradiol have been shown to be protective in the context of PAH. Estrogen may also upregulate the signalling pathways of other key mediators of PAH such as serotonin

Resource-based strategies and problem structuring : using resource maps to manage resource systems

Design/methodology/approach - Draws on the literature in discussing the difficulties of strategic decision making regarding resources through uncertainty, differences in stakeholder perspectives, interest conflicts and differences between main actors' mental models. Introduces resource mapping as a problem structuring method to overcome this. Illustrates the concept by an exercise concerning two UK commercial radio broadcasting industry firms (Scottish Radio Holdings; GWR plc). Analyses CEO comments 1998-2000, and employs MBA students to compare their own analyses against. Findings - Differentiates concepts difficult to represent as asset stocks, and determines resources/factors giving competitive advantage. Maps these using system dynamics flow symbols with added causal relationships determined from CEO statement analyses. Explicates how the displayed resource map for each firm, and tabled concepts (with agreement factor by MBA students and importance rating) visualizes the firms' intended strategies. Finds student/author agreement levels are generally ~60%. Research limitations/implications - None stated. Practical implications - States the technique resolves problem structuring and decision making through its participatory nature. Originality/value - Illustrates use of resource maps to determine what are believed to be a firm's most important asset stocks for driving forward business performance, by discussing maps of the system of resources (asset stocks) for two UK commercial radio firms

Competitive dynamics in pharmaceutical markets : a case study in the chronic cardiac disease market

A modelling project involved system dynamics simulation of chronic cardiac disease in Bulgaria, examining the dynamic behaviour of a cardiac drug molecule in the market. The system dynamics model was calibrated using market data sourced from the Bulgarian National Health Care Fund, the Bulgarian Generic Pharmaceutical Association and a market research firm. The main results of the study showed that the timing of access to market was a critical driver in reducing prices and providing wider, as well as more affordable, access for patients to medicinal therapy. Our findings indicate that healthcare authorities may obtain savings while, at the same time, they may provide conditions for more patients to be treated depending on the timing of access to market of new generic drugs