Advanced Manufacturing Technology: A Strategic Solution To Production Problem

Advanced Manufacturing Technology (AMT) is revolutionizing the way products are manufactured especially in what are termed world-class manufactured especially in what are termed world-class manufacturers (WCM). AMT is a general expression encompassing Automated production technology, Computer Assisted Design and Manufacturing (CAD/CAM), Flexible Manufacturing Systems (FMS), robotics, Total Quality Control (TQC), advances in production management including materials requirement and manufacturing resources planning systems(MRP), Just-in-Time (JIT) Systems and so on. It has been argued by a number of academics, consultants and industrialists that traditional management accounting systems and performance measures are inappropriate and misleading for firm using AMT. This view is supported by Kaplan (1996) when he said that “traditional management accounting produces?… simple the wrong measures. They move the company in the wrong direction, reward managers for damaging the business and provide no incentive for improvement. The best we can do is to switch them off, just stop doing them!” Keywords: Advanced manufacturing, Total quality control, and Management accounting

Patterns and Predictors of First-Line Antiretroviral Therapy Modification in HIV-1-Infected Adults in a Large Urban Outpatient Cohort in Nigeria

Objective: We described the magnitude, type, and factors associated with first-line antiretroviral therapy (ART) modification in HIV-1-infected adults on ART in Jos, Nigeria. Method: Data on 6309 patients initiated on first-line ART between January 2004 and December 2006 were analyzed retrospectively. Factors predictive of modification to initial ART were assessed by chi-square and multivariable logistic regression analysis. Results: Overall, 5212 (83%) included patients incurred a modification (73.3% drug substitution and 9.7% drug switch) to their initial first-line ARV regimen during a median (interquartile range) follow-up period of 7 (3-8) years. Drug substitutions of zidovudine (ZDV) were less likely than of tenofovir (TDF; adjusted odd ratio [AOR] 0.6; 95% confidence interval [CI]: 0.51-0.71), and Drug substitutions of efavirenz (EFV) were more likely than of nevirapine (NVP)-containing (AOR 1.82; 95% CI: 1.42-2.33) regimens. Predictors of switch to second-line regimen include older age (AOR 2.05; 95% CI: 1.68-2.51), CD4 count ≤100 cells/mm 3 (AOR 1.89; 95% CI: 1.49-2.37), EFV compared to NVP (AOR 1.38; 95% CI: 1.02-1.88), and drug toxicity (AOR 1.90; 95% CI: 1.48-2.43). Conclusion: Modification to initial ART was common in this study. Further evaluation of the contribution of guideline changes on regimen modification and treatment outcomes is recommended