Thundermist Health Center: Extending Pharmaceutical Services To Underserved Patients

This paper describes a not-for-profit healthcare providers strategy to provide its economically disadvantaged patients with access to low cost pharmaceuticals. Initially, an in-house pharmacy was established, supported by a satellite distribution system using a telepharmacy solution to extend medications to its patients at remote sites. New federal legislation which provided access to low cost insurance through Medicare Part D to many of the providers disadvantaged patients, along with state licensing requirements forced the healthcare provider to reassess the economics of its pharmaceutical distribution system and seek other alternatives. Among the alternatives the healthcare provider considered was partnering with for-profit pharmaceutical companies in order to reach their patients

Maintaining Relationships With Supply Chain Partners: A Case Study

This case study describes efforts of a market leader in the communication infrastructure industry to assess the relationships they have developed with their global supply chain partners.  Changes in the industry have resulted in geographic shifts of existing and potential supply chain suppliers and customers.  In an effort to determine if commitment to customer service has resulted in increased customer satisfaction and loyalty, research was conducted to assess their performance.  The results of this research were compared to previous research to determine if their service program has successfully differentiated them from their competitors

Segmental Duplication Implicated in the Genesis of Inversion 2Rj of Anopheles gambiae

The malaria vector Anopheles gambiae maintains high levels of inversion polymorphism that facilitate its exploitation of diverse ecological settings across tropical Africa. Molecular characterization of inversion breakpoints is a first step toward understanding the processes that generate and maintain inversions. Here we focused on inversion 2Rj because of its association with the assortatively mating Bamako chromosomal form of An. gambiae, whose distinctive breeding sites are rock pools beside the Niger River in Mali and Guinea. Sequence and computational analysis of 2Rj revealed the same 14.6 kb insertion between both breakpoints, which occurred near but not within predicted genes. Each insertion consists of 5.3 kb terminal inverted repeat arms separated by a 4 kb spacer. The insertions lack coding capacity, and are comprised of degraded remnants of repetitive sequences including class I and II transposable elements. Because of their large size and patchwork composition, and as no other instances of these insertions were identified in the An. gambiae genome, they do not appear to be transposable elements. The 14.6 kb modules inserted at both 2Rj breakpoint junctions represent low copy repeats (LCRs, also called segmental duplications) that are strongly implicated in the recent (∼0.4Ne generations) origin of 2Rj. The LCRs contribute to further genome instability, as demonstrated by an imprecise excision event at the proximal breakpoint of 2Rj in field isolates