Genomic medicine: genetic variation and its impact on the future of health care

Advances in genome technology and other fruits of the Human Genome Project are playing a growing role in the delivery of health care. With the development of new technologies and opportunities for large-scale analysis of the genome, transcriptome, proteome and metabolome, the genome sciences are poised to have a profound impact on clinical medicine. Cancer prognostics will be among the first major test cases for a genomic medicine paradigm, given that all cancer is caused by genomic instability, and microarrays allow assessment of patients' entire expressed genomes. Analysis of breast cancer patients' expression patterns can already be highly correlated with recurrence risks. By integrating clinical data with gene expression profiles, imaging, metabolomic profiles and proteomic data, the prospect for developing truly individualized care becomes ever more real. Notwithstanding these promises, daunting challenges remain for genomic medicine. Success will require planning robust prospective trials, analysing health care economic and outcome data, assuaging insurance and privacy concerns, developing health delivery models that are commercially viable and scaling up to meet the needs of the whole population

Business practices in social enterprises

Purpose: To report the findings of a European Social Fund (ESF) financed study into the investigation and development of business practices and managerial skills in the social enterprises sector. Design/methodology/approach – The qualitative and grounded research investigation was conducted using interviews with owner/managers of 15 social enterprises in Greater Manchester and Lancashire, UK, and aimed to develop a strategic understanding of social enterprise business practices and issues and to develop baseline information to develop a management tool based on the balanced scorecard (BS) of Kaplan and Norton (1996). Develops a definition of social enterprise and presents a brief background of the post-war development of the social enterprises sector, its recent growth and increasing competition for resources. Findings – The results indicated that social enterprises adopt varying practices, face many issues and, while many are beginning to make themselves more accountable in terms of their social value, there was little evidence to suggest that social enterprises were measuring their social impact beyond providing data that was sought by funders. Reveals that the social enterprise managers implied that the next step was to become more proactive in recording and marketing their social values and that developing social value indicators is the next challenge, while evidence suggests that tools developed for social enterprises need to be informal, non-generic and based on experiential learning. Originality/value – Reveals key concepts that will form the framework for a modified BS