GP prescribing of nicotine replacement and bupropion to aid smoking cessation in England and Wales

Aims Prescribing nicotine replacement therapy (NRT) or bupropion for smoking cessation is of considerable importance to public health but little is known about prescribing practices. This paper examines general practitioners' (GPs') prescribing patterns in Britain where these drugs are reimbursed. The results have implications for other health-care systems considering introducing reimbursement.Design, participants and setting Postal survey conducted in 2002 of a random sample of 1088 GPs in England and Wales, of whom 642 (59%) responded.Measures Number of requests GPs reported having received from patients for NRT and bupropion over the past month, the number of prescriptions they reported issuing and ratings of attitudes to these medications.Findings GPs reported receiving an average of 4.3 requests for NRT and 1.9 for bupropion in the previous month. They reported issuing 3.5 prescriptions for NRT and 1.2 for bupropion. Almost all GPs accepted that NRT (95%) and bupropion (97%) should be reimbursable on National Health Service (NHS) prescription. However, a significant minority of those who received requests for prescriptions did not issue any (81% for NRT and 26% for bupropion). This was related to whether they thought these products should be available on NHS prescription for both NRT and bupropion (OR = 0.66, P < 0.05), which in turn was related to beliefs about whether smokers should have to pay for treatment themselves, the cost-effectiveness of NRT/bupropion and the low priority they would give NRT/bupropion in the drug budget. For bupropion, concern about side-effects independently predicted not prescribing [odds ratio (OR) = 1.46, P < 0.03].Conclusion In the British health-care system, which has a well-established system for technology assessment and professionally endorsed guidelines, a significant minority of GPs decline all patient requests for stop-smoking medicines

The fabrication and test of a dual spin gas bearing reaction wheel

The design and fabrication of a dual spin gas bearing reaction wheel are discussed. Numerical analyses, data, and conclusions from performance tests are reported. The unique feature of the reaction wheel is the dual gas bearing concept in which two sets of self-acting hydrodynamic bearing are used to obtain stictionless operation and low noise around zero speed and to accommodate the momentum range from plus 6.8 N-m-s to minus 6.8 N-m-s with the potential for long life inherent in gas bearings

Profits and balance sheet developments at U.S. commercial banks in 1996

U.S. commercial banks had another very good year in 1996. Profits posted strong growth, preserving the high levels of return on equity and return on assets that have prevailed over the past four years. Helping to boost profits were continued strong growth of interest-earning assets, a slight widening of the net interest margin, significant gains in noninterest income, and continued containment of noninterest expenses. Return on assets edged up despite a slight increase in provisioning for loan and lease losses relative to assets. Delinquency and charge-off rates stayed low for business loans but climbed throughout the year for consumer loans.Bank assets ; Banks and banking

Exploring the role of U.K. Government policy in developing the university entrepreneurial finance ecosystem for Cleantech

Vast sums of public money are invested into universities globally as anchor institutions and knowledge bases providing seedbed resources for research and development (R&D) and entrepreneurship. Focusing on university science and technology (S&T) research we examine two UK case studies of government support from the ‘Innovation Knowledge Centre’ (IKC) program to translate research into industry innovation for public good. Although IKCs are not tasked to address Climate Change, the two case studies demonstrate tremendous potential for Cleantech development. An exploratory entrepreneurial finance (‘entfin’) ecosystem theoretical lens contextualizes the catalytic roles of universities and public funding to support industry at the base of the innovation finance escalator. We thus develop university-industry ecosystems literature, addressing the gap in nurturing university entfin for climate change. Our qualitative case study methodology includes literature review and 51 key informant interviews with: policymakers; university research leaders, technology transfer officers, specialist research to industry innovation ‘translation’ staff, SME beneficiaries, trade bodies; and early-stage private finance providers. We reveal nuances in different emerging innovation sectors – notably their degree of maturity, locality and outcome horizons for achieving impact, drawing attention to the key roles of universities and financing and their interactions within their entfin ecosystems. We demonstrate the need for government long horizon, deep pocket, investment and integrated university entfin policy mix, alongside more open, inclusive, ecosystem development between different actors

Investigating the relationship between formal time management practices and business performance of UK SMEs

Objectives This research aims to investigate the relationship that exists between time management practices and business performance. Prior Work Terziovski’s (2009) research into formal and informal SME management practices concluded that formal structure and innovation strategy are the key drivers for innovation leading to high performance. This builds on previous work (Patel, 2005; Prakash and Gupta, 2008) arguing that formal structures add clarity to employees’ roles, leading to greater employee commitment and overall organizational effectiveness. Others, such as Fiegenbaum and Karnani (1991), Appiah-Adu and Singh (1998), Narayanan (2001) and Qian and Li (2003) argue that SMEs are competitive because of flexible organisational structure and centralised decision making which supports informality. Hence a theoretical tension exists between formality and informality in SMEs. Approach An online management questionnaire was e-mailed to 10,000 UK employer SMEs, evenly stratified across the manufacturing, distribution and business services sectors, in October 2014, yielding 757 usable responses. The questionnaire contained three sections: business and management characteristics, operational efficiencies and time management efficiencies, based on Kaplan and Norton’s (1992) balanced scorecard approach. Addressing the fundamental hypothesis that “Formal time management practice (TMP) is positively associated with improved business performance”, five associated hypotheses relating time to TMP and business performance were tested to explore their interrelation, controlling for business and management characteristics, using binary logit regression analysis. Results Adoption of formal time management systems is significantly associated with business size (<.001). There is a positive correlation between formal time management systems and employment growth and future sales turnover. Micro businesses are less likely to use formal time management practices (only 74% adopted software for this) when compared with businesses of other sizes (95% adoption rate). Moreover micro businesses that did adopt a formal time management system have a negative association with business growth thus highlighting the lack of suitability for micro businesses. Above average business efficiency is a significant factor that is strongly associated with future business growth (<0.001); projected employment growth (<0.05); projected sales growth (<0.05) and adopting Cloud technologies (<0.01) is positively associated with above industry average efficiency. Implications The findings of the research are timely as it contributes to the productivity puzzle which is a major concern for the UK economy. The findings indicate that organisations with formal time management systems and latest technologies like Cloud computing enjoy higher efficiency levels highlighting the need for driving digitisations amongst SMEs. Value The findings support the need for formality in SME business practices, suggesting a key area for business support, alongside the need for further research to understand the relationship between TME and competitive advantage

Annex 1 IKC and Stakeholder Topic Guide Summary

This document depicts the topic guide that was developed for undertaking interviews with various Innovation and Knowledge Centre stakeholders based in the UK

How much improvement in mental health can be expected when people stop smoking? Findings from a national survey

Background and aims: There is evidence that mental health improves when smokers stop. This study aimed to assess in a nationally representative sample how far anxiety and depression in long-term ex-smokers can be expected eventually to reach levels found in those who have never smoked. Methods: Data from the Smoking Toolkit Study (STS) were used. The STS involves monthly household surveys of representative samples of the adult population of England. Anxiety and depression were compared using an item from the EQ5-D in respondents aged 40+ years where were either current smokers, never smokers, or had stopped for at least a year, adjusting statistically for age, gender and social grade. Results: The prevalence of anxiety or depression was 10.0% (95% CI 9.1-10.9) in never smokers, 18.3% (95% CI 16.0-20.6) in current smokers, and 11.3% (95% CI 9.6-13.0) in long-term ex-smokers. After adjusting for age, sex and social grade, long-term ex-smokers were similar to never smokers (OR=1.15, 95% CI=0.94-1.41). Current smokers had higher prevalence than never smokers (OR=1.69, 95% CI=1.39-2.04) and ex-smokers (OR=1.47, 95% CI=1.15-1.86). Conclusions: Prevalence of anxiety and depression in long-term ex-smokers appears to be similar to what is found in never smokers

The absolute photometry of the zodiacal light

Absolute photometry of zodiacal ligh