6 research outputs found

    Implementing supply chain visibility to promote fisheries sustainability

    Get PDF
    Operationalising good practices and better management of marine resources were pursued, in a retailer exploratory case, by following a triple bottom line approach to fine tuning corporate responsibility. Recommendations towards sustainable operations were made, as regards: developing voluntary self-certification towards eco-labelling based on third party; using IT, as a transparency promoter and so, as a leverage for traceability, collaboration and trust across the chain of custody; designing customised policies to deal with different consumer profiles and so, assuring their loyalty by adjusting consumer campaigns; educating consumers as seafood demand regulators. Improvements in Greenpeace evaluation were documented, profit increase was expected.info:eu-repo/semantics/publishedVersio

    Differences in Nevirapine Biotransformation as a Factor for its Sex-Dependent Dimorphic Profile of Adverse Drug Reactions

    Get PDF
    OBJECTIVES: Nevirapine is widely used for the treatment of HIV-1 infection; however, its chronic use has been associated with severe liver and skin toxicity. Women are at increased risk for these toxic events, but the reasons for the sex-related differences are unclear. Disparities in the biotransformation of nevirapine and the generation of toxic metabolites between men and women might be the underlying cause. The present work aimed to explore sex differences in nevirapine biotransformation as a potential factor in nevirapine-induced toxicity. METHODS: All included subjects were adults who had been receiving 400 mg of nevirapine once daily for at least 1 month. Blood samples were collected and the levels of nevirapine and its phase I metabolites were quantified by HPLC. Anthropometric and clinical data, and nevirapine metabolite profiles, were assessed for sex-related differences. RESULTS: A total of 52 patients were included (63% were men). Body weight was lower in women (P = 0.028) and female sex was associated with higher alkaline phosphatase (P = 0.036) and lactate dehydrogenase (P = 0.037) levels. The plasma concentrations of nevirapine (P = 0.030) and the metabolite 3-hydroxy-nevirapine (P = 0.035), as well as the proportions of the metabolites 12-hydroxy-nevirapine (P = 0.037) and 3-hydroxy-nevirapine (P = 0.001), were higher in women, when adjusted for body weight. CONCLUSIONS: There was a sex-dependent variation in nevirapine biotransformation, particularly in the generation of the 12-hydroxy-nevirapine and 3-hydroxy-nevirapine metabolites. These data are consistent with the sex-dependent formation of toxic reactive metabolites, which may contribute to the sex-dependent dimorphic profile of nevirapine toxicity

    Medical Practice under Managed Care: Cost-control Mechanisms and Impact on Quality of Service

    No full text
    The paper investigates the US experience of Managed Care. It describes the cost controlling measures and the new modes of payment that were implemented along with managed Care. Using theory and field surveys, it reviews how these measures have affected physician practices. The paper also investigates their impact on the quality of health services. Copyright Springer Science + Business Media, Inc. 2005HMO, Managed Care, patient, US, physician payment,
    corecore