From raw materials to customers: Supply chain management in the service industry

No company can operate without a supply chain. recent years have seen change in the way many companies manage their supply chains - holistically rather than as a series of separate pieces. Manufacturers have taken the lead in improving supply chain management, but now the fast-growing service industry is adopting these principles. A study in the health care area illustrates fast-growing service industry is adopting these principles. A study in the health care area illustrates how service businesses can benefit from the decreased lead times, faster product development, higher quality, and reduced costs that can accompany successful supply chain management

An examination of the attitudes and policies of Andrew Jackson concerning the American Indian

This study will focus on the development of Andrew Jackson\u27s attitude toward the American Indian and the effect of these attitudes on the shaping of official United states policy toward the Indians. Jackson was born and raised on the frontier. There his prejudices were acquired and his personality was formed. Chapter I deals with Jackson\u27s early life as a young frontiersman, politician and Indian-fighter. His championing of the rights of the westerner, his attitudes toward the Indian and his love for the martial spirit led him into the Tennessee militia and the United States Army during the Indian wars. The military period of Jackson\u27s life also is covered in Chapter I. Chapter II discusses the problems arising from the contact between the American colonist and the Indian as the white frontier pressed against and into Indian land. Jackson agreed with the general political justification for expansion: that the frontier must be advanced to provide security for settlements and farms. The average frontiersman would add that expansion also brought land into the hands of those who were meant to use it. Though acquisition of additional land was usually a result rather than a cause of war, few would deny that getting it by conquest was more desirable than buying it. With the cry for removal reaching a crescendo, the advocates found their champion in Andrew Jackson. He would implement the final solution to the Indian problem. Chapter III deals with the Indian removal policy and with Jackson\u27s administration of removals, the dominant Indian feature of his presidency. The policy is described in detail, and the various attempts to justify it are considered. An important part of the removal story involves the relationship between the federal government and the states, the subject of Chapter IV. Jackson believed in the basic rights of states and had no desire to increase the power of the national government at their expense. In the controversy over Indian lands, he felt that the states had jurisdiction. This attitude the stage for this refusal to come to the aid of the Indians, in spite of treaty obligations to them. Chapter IV also covers the reaction to the removal policy by the public and by the Indians. Jackson\u27s tendency to contradict himself is much in evidence in his Indian attitudes and policies. Chapter V attempts to show that he was a pragmatist. He was willing to do whatever was necessary to accomplish his ends, even if it meant completely reversing a principle that he had previously taken great pains to defend. In Chapter VI, conclusions are drawn on the effects of Jackson\u27s Indian attitudes on the people of his own day and on generations that followed. Finally, an attempt is made to explain why Jackson felt and acted as he did in his relationships with the Indians. This section also deals with the charge that he was a racist and that he held the Indian in contempt as an inferior human being. Since the study is concerned primarily with Jackson\u27s attitudes, the principal sources consulted were his letters and speeches. Published collections of Jackson\u27s works proved especially valuable. Particularly helpful were Correspondence of Andrew Jackson, volumes I, II, and III, edited by John S. Bassett and J. F. Jameson and A Compilation of the Messages and Papers of the Presidents, volumes II and III, edited by James D. Richardson. To record the response to Jackson\u27s Indian policies, contemporary newspapers were consulted, especially the New York Evening Post. Secondary sources were examined for detail and description rather than for analysis

The impact of clinical pharmacy services on the low-density lipoprotein goal attainment with lipid lowering therapies.

Chung, Jennifer Siu Toye."June 2008."Thesis (M.Phil.)--Chinese University of Hong Kong, 2008.Includes bibliographical references (leaves 145-157).Abstracts in English and Chinese, some text in appendix also in Chinese.Abstract of Thesis in English --- p.iAbstract of Thesis in Chinese --- p.iiiAcknowledgments --- p.vList of Tables --- p.xiList of Figures --- p.xiiiList of Abbreviations --- p.xivList of Publications and Presentations related to Thesis --- p.xviContributions related to Thesis --- p.xviiChapter Chapter 1 --- Introduction --- p.1Chapter 1.1 --- Introduction of the Thesis --- p.1Chapter 1.2 --- Review on Coronary Heart Disease --- p.3Chapter 1.2.1 --- Definition of Coronary Heart Disease --- p.3Chapter 1.2.2 --- Risk factors for the development of Coronary Heart Disease --- p.3Chapter 1.2.3 --- Worldwide Figures for Coronary Heart Disease --- p.9Chapter 1.2.4 --- Coronary Heart Disease in Asia Pacific --- p.10Chapter 1.2.5 --- Coronary Heart Disease in Hong Kong --- p.11Chapter 1.3 --- Dyslipidaemia --- p.14Chapter 1.3.1 --- Lipid Transport and Lipoprotein Metabolism --- p.14Chapter 1.3.2 --- Definition and Classification of Dyslipidaemia --- p.16Chapter 1.3.3 --- Coronary Heart Disease and Dyslipidaemia --- p.17Chapter 1.3.4 --- Lifestyle Modifications for the Management of Dyslipidaemia --- p.19Chapter 1.3.4.1 --- Dietary Measures --- p.20Chapter 1.3.4.2 --- Cigarette Smoking --- p.23Chapter 1.3.4.3 --- Physical Activity --- p.24Chapter 1.3.4.4 --- Weight Control --- p.25Chapter 1.3.5 --- Lipid-lowering Drug Therapy for Dyslipidaemia --- p.29Chapter 1.3.5.1 --- Statins --- p.31Chapter 1.3.5.2 --- Bile Acid Sequestrants --- p.35Chapter 1.3.5.3 --- Fibrates --- p.36Chapter 1.3.5.4 --- Ezetimibe --- p.37Chapter 1.3.5.5 --- Nicotinic Acid Group --- p.38Chapter 1.4 --- International Guidelines for Dyslipidaemic Management --- p.39Chapter 1.4.1 --- National Service Framework for Coronary Heart Disease (UK) --- p.39Chapter 1.4.1.1 --- National Service Framework Lipid-lowering Goals --- p.40Chapter 1.4.1.2 --- The Joint British Societies' Guidelines --- p.41Chapter 1.4.1.3 --- Achievement of the NSF Lipid Profile Targets --- p.42Chapter 1.4.2 --- National Cholesterol Education Program (United States) --- p.43Chapter 1.4.2.1 --- The Third Report of the National Cholesterol Education Program --- p.43Chapter 1.4.2.2 --- Review of Clinical Trials --- p.43Chapter 1.4.2.3 --- Low-Density Lipoprotein Cholesterol Goal Targets --- p.46Chapter 1.4.2.4 --- Compliance with the NCEP ATP III Guidelines --- p.48Chapter 1.4.3 --- Dyslipidaemic Guidelines for Study --- p.51Chapter 1.5 --- Clinical Pharmacy Services --- p.52Chapter 1.5.1 --- The Healthcare System in Hong Kong --- p.52Chapter 1.5.2 --- Clinical Pharmacy Services in Hong Kong --- p.54Chapter 1.5.3 --- Examples of successful Clinical Pharmacy Services --- p.55Chapter 1.5.3.1 --- Hypertension Clinic --- p.55Chapter 1.5.3.2 --- Diabetes Mellitus Clinic --- p.56Chapter 1.5.3.3 --- Smoking Cessation Clinic --- p.57Chapter 1.5.3.4 --- Anticoagulation Clinic --- p.57Chapter 1.5.3.5 --- Haematology-oncology Clinic --- p.57Chapter 1.5.4 --- Pharmacist-managed Lipid Clinics --- p.58Chapter 1.6 --- Objective & General Aims of the Study --- p.60Chapter 1.6.1 --- Objectives --- p.60Chapter 1.6.2 --- Study Hypothesis --- p.60Chapter 1.6.3 --- General Aims of the Study --- p.60Chapter Chapter 2 --- Methodology of Study --- p.62Chapter 2.1 --- Background Setting --- p.62Chapter 2.2 --- Subject Selection and Recruitment --- p.62Chapter 2.3 --- Intervention and Control Groups --- p.63Chapter 2.4 --- Validation of Survey --- p.67Chapter 2.5 --- Data Collection --- p.67Chapter 2.6 --- Outcome Measures --- p.68Chapter 2.6.1 --- Lipid value changes --- p.68Chapter 2.6.2 --- Compliance rate with medications --- p.68Chapter 2.6.3 --- Patient satisfaction survey assessment --- p.69Chapter 2.6.4 --- Time spent and Cost of clinical pharmacist --- p.69Chapter 2.7 --- Statistical Analysis --- p.70Chapter 2.7.1 --- Sample Size Calculation --- p.70Chapter 2.7.2 --- Methods of Statistical Analysis --- p.71Chapter Chapter 3 --- Results of Study --- p.72Chapter 3.1 --- Recruitment Details --- p.72Chapter 3.2 --- Demographic Characteristics of Patients --- p.73Chapter 3.3 --- Drug Therapy of Patients during Study Period --- p.75Chapter 3.4 --- LDL-C Lowering Potency of Statin Doses Prescribed --- p.80Chapter 3.5 --- Coronary Heart Disease Risk Category of Patients --- p.84Chapter 3.6 --- Lipid Profile Changes --- p.85Chapter 3.7 --- NCEP ATP III LDL-C Goal Attainment --- p.87Chapter 3.8 --- Relationship between Patient Characteristics and LDL-C Goal Attainment --- p.91Chapter 3.9 --- Compliance with Medications --- p.94Chapter 3.10 --- Pharmacist Intervention --- p.98Chapter 3.10.1 --- Range of Pharmacist Intervention --- p.98Chapter 3.10.2 --- Time spent by Pharmacist --- p.100Chapter 3.10.2.1 --- Time spent on Documentation --- p.100Chapter 3.10.2.2 --- Time spent on Direct Communication with Patients --- p.101Chapter 3.10.3 --- Cost of Clinical Pharmacy Service at the Lipid Clinic --- p.102Chapter 3.10.3.1 --- Cost of Pharmacist Involvement --- p.102Chapter 3.10.3.2 --- Potential Healthcare Cost Saving --- p.103Chapter 3.11 --- Clinical Pharmacy Service Satisfaction Survey --- p.105Chapter 3.11.1 --- Validation of Survey --- p.105Chapter 3.11.2 --- Questionnaire Survey for Intervention and Control Groups --- p.107Chapter 3.11.3 --- Physician Questionnaire Survey on Clinical Pharmacy Service --- p.110Chapter Chapter 4 --- Discussion --- p.111Chapter 4.1 --- Clinical Outcomes of Study --- p.111Chapter 4.1.1 --- Changes in Lipid Parameters --- p.111Chapter 4.1.2 --- Reduction in CHD risk --- p.113Chapter 4.1.3 --- Attainment in NCEP ATP III LDL-C goals --- p.114Chapter 4.1.4 --- Predictors for LDL-C Goal Attainment --- p.117Chapter 4.2 --- Drug-related Problems --- p.119Chapter 4.2.1 --- Statin Dosing and LDL-C Lowering Potency --- p.119Chapter 4.2.2 --- Adherence to Drug Therapy --- p.121Chapter 4.2.3 --- Polypharmacy --- p.126Chapter 4.2.4 --- Adverse Drug Events and Drug Interactions --- p.129Chapter 4.2.5 --- Patient Busy Lifestyle --- p.131Chapter 4.3 --- Role of Clinical Pharmacist --- p.133Chapter 4.3.1 --- Role of Pharmacist --- p.133Chapter 4.3.2 --- Multidisciplinary Team --- p.135Chapter 4.3.3 --- Healthcare Cost Saving --- p.137Chapter 4.4 --- Limitations of Study --- p.139Chapter 4.5 --- Further Study --- p.142Chapter Chapter 5 --- Conclusion --- p.144Chapter 5.1 --- Conclusion of Study --- p.144Bibliography --- p.145Appendices --- p.158Appendix I Data collection form --- p.158Appendix II Information sheet on study protocol to patient --- p.160Appendix III Patient consent form for study --- p.164Appendix IV Framingham risk scoring system for male --- p.165Appendix V Framingham risk scoring system for female --- p.166Appendix VI Patient educational leaflet --- p.167Appendix VII Physician-pharmacist communication sheet --- p.169Appendix VIII Telephone checklist --- p.170Appendix IX Questionnaire survey provided to Intervention Group --- p.172Appendix X Questionnaire survey provided to Control Group --- p.174Appendix XI Questionnaire survey provided to Physicians --- p.17

Accelerator physics - in the wake of success

Particle accelerators tend to be large and expensive. But an alternative technology, which could result in more compact, cheaper machines, is proving its viability for the acceleration of subatomic particles

Measurement of the diffractive cross-section in deep inelastic scattering

Diffractive scattering of $\gamma^* p \to X + N$, where $N$ is either a proton or a nucleonic system with $M_N~<~4$~GeV has been measured in deep inelastic scattering (DIS) at HERA. The cross section was determined by a novel method as a function of the $\gamma^* p$ c.m. energy $W$ between 60 and 245~GeV and of the mass $M_X$ of the system $X$ up to 15~GeV at average $Q^2$ values of 14 and 31~GeV$^2$. The diffractive cross section $d\sigma^{diff} /dM_X$ is, within errors, found to rise linearly with $W$. Parameterizing the $W$ dependence by the form d\sigma^{diff}/dM_X \propto (W^2)^{(2\overline{\mbox{\alpha_{_{I\hspace{-0.2em}P}}}} -2)} the DIS data yield for the pomeron trajectory \overline{\mbox{\alpha_{_{I\hspace{-0.2em}P}}}} = 1.23 \pm 0.02(stat) \pm 0.04 (syst) averaged over $t$ in the measured kinematic range assuming the longitudinal photon contribution to be zero. This value for the pomeron trajectory is substantially larger than \overline{\mbox{\alpha_{_{I\hspace{-0.2em}P}}}} extracted from soft interactions. The value of \overline{\mbox{\alpha_{_{I\hspace{-0.2em}P}}}} measured in this analysis suggests that a substantial part of the diffractive DIS cross section originates from processes which can be described by perturbative QCD. From the measured diffractive cross sections the diffractive structure function of the proton F^{D(3)}_2(\beta,Q^2, \mbox{x_{_{I\hspace{-0.2em}P}}}) has been determined, where $\beta$ is the momentum fraction of the struck quark in the pomeron. The form F^{D(3)}_2 = constant \cdot (1/ \mbox{x_{_{I\hspace{-0.2em}P}}})^a gives a good fit to the data in all $\beta$ and $Q^2$ intervals with $a = 1.46 \pm 0.04 (stat) \pmComment: 45 pages, including 16 figure