Diabetic gastroparesis: Therapeutic options

Gastroparesis is a condition characterized by delayed gastric emptying and the most common known underlying cause is diabetes mellitus. Symptoms include nausea, vomiting, abdominal fullness, and early satiety, which impact to varying degrees on the patient’s quality of life. Symptoms and deficits do not necessarily relate to each other, hence despite significant abnormalities in gastric emptying, some individuals have only minimal symptoms and, conversely, severe symptoms do not always relate to measures of gastric emptying. Prokinetic agents such as metoclopramide, domperidone, and erythromycin enhance gastric motility and have remained the mainstay of treatment for several decades, despite unwanted side effects and numerous drug interactions. Mechanical therapies such as endoscopic pyloric botulinum toxin injection, gastric electrical stimulation, and gastrostomy or jejunostomy are used in intractable diabetic gastroparesis (DG), refractory to prokinetic therapies. Mitemcinal and TZP-101 are novel investigational motilin receptor and ghrelin agonists, respectively, and show promise in the treatment of DG. The aim of this review is to provide an update on prokinetic and mechanical therapies in the treatment of DG

Entrepreneurship as a process : toward harmonizing multiple perspectives

Are there any common denominators within the diversity of entrepreneurship literature that may serve as foundations for understanding the entrepreneurial process in a systematic and comprehensive way that is useful to both scholars and practitioners? The objective of this paper was to discover about the entrepreneurial process what, if anything, is both generic (all processes that are “entrepreneurial” do this) and distinct (only entrepreneurial processes do this). Our approach was to evaluate published models of entrepreneurial process to discover what scholars have argued about what entrepreneurs do and how they do it (the processes they use) and to seek out any key commonalities that scholars claim are associated with the phenomenon. Unfortunately for the field, the investigation demonstrates that, as at the time of our investigation, the 32 extant models of entrepreneurial process are highly fragmented in their claims and emphases and are insufficient for establishing an infrastructure upon which to synthesize an understanding of entrepreneurial process that is both generic and distinct. Insights gained in the study lead to suggestions for future research and theory development of which the most urgent is the need to develop a single harmonized model of entrepreneurial process capable of embracing the best of what is on offer and adding new theoretical arguments in areas where practice shows that they are lacking

Models and representation

The problem of representation has generated a sizable literature, which has been growing fast in particular over the last decade. The aim of this chapter is to review this body of work and assess the strengths and weaknesses of the different proposals