Many ways to Rome: Exogenous and endogenous pathways to environmental and social performance

It is often taken for granted that corporate social responsibility (CSR) will bring about social benefits and environmental improvements. Yet there is little empirical evidence of outcomes of CSR initiatives for the natural environment or the wider society as studies have focused on the influence of CSR on financial performance rather than its societal outcomes. This study begins addressing this gap in the literature by empirically studying the environmental and social performance of CSR in 19 European companies. We analyse which configurations of institutional constraints and organizational CSR practices influence environmental and social performance. Based on this analysis, we identify two pathways that can lead to high environmental and social performance and we scrutinize configurations that lead to low performance. The exogenous pathway is characterized by the use of externally certified management tools and certificates and a high importance of external rating schemes. This pathway seems typical for large publicly listed firms. The endogenous pathway, in turn, includes firms that are characterized by internally developed means of conducting CSR

Baltic Ecological Recycling Agriculture and Society (BERAS project) - a case of Juva milk system

The aim of the study was to determine the potential, impact and prerequisites of localization and enhanced recycling in a rural food system, illustrated by the case of Juva milk. An interdisciplinary scenario based on the increase of local, organic milk to 50 % of milk comsumption was created and the sustainability was compared, on the basis of the statistics and data collected from the actors, with the present milk system

Accurate Dielectric Response of Solids: Combining the Bethe-Salpeter Equation with the Random Phase Approximation

The Bethe-Salpeter equation (BSE) can provide an accurate description of low-energy optical spectra of insulating crystals - even when excitonic effects are important. However, due to high computational costs it is only possible to include a few bands in the BSE Hamiltonian. As a consequence, the dielectric screening given by the real part of the dielectric function can be significantly underestimated by the BSE. Here we show that universally accurate optical response functions can be obtained by combining a four-point BSE-like equation for the irreducible polarisability with a two-point Dyson equation which includes the higher-lying transitions within the random phase approximation (RPA). The new method is referred to as BSE+. It has a computational cost comparable to the BSE but a much faster convergence with respect to the size of the electron-hole basis. We use the method to calculate refractive indices and electron energy loss spectra for a test set of semiconductors and insulators. In all cases the BSE+ yields excellent agreement with experimental data across a wide frequency range and outperforms both BSE and RPA.Comment: 6 pages, 4 figure

Closed ended structured questionnaire in fast track familiarization of nurses to conduct telephone follow-up after open carpal tunnel release

Background: Open carpal tunnel release (OCTR) due to chronic carpal tunnel syndrome (CTS) is the most common procedure in hand surgery. CTS is often bilateral. A follow-up is required to detect any complications and confirm successful recovery before contralateral procedure is booked. Objectives: The purpose of this study is to evaluate a closed ended questionnaire to assist nurses when starting routine follow-up telephone interviews after carpal tunnel surgery. Methods: In our hospital routine follow-up phone calls to the patients 3 months after OCTR were allocated to nurse practitioners instead of surgeons. Once the practice was started a structured face validated closed ended questionnaire was used to collect data from a total of 61 consecutive patients. Results: Nurse practitioners performed the follow-up independently in 97 % (59/61) of the cases. Ten per cent (6/61) of the patients were assigned further appointments to a surgeon and one patient was referred to an occupational therapist. 2 patients contacted the hospital after the telephone interview because of minor complaints. Patient charts were reviewed 18 months after the phone calls. No missed complications were detected. Conclusions: We conclude that a structured closed ended questionnaire is useful assist in fast track familiarization of nurse practitioners for the follow-up contact after OCTR.</p

Patient's dissatisfaction with the public and private laboratory services in conducting HIV related testing in Tanzania

<p>Abstract</p> <p>Background</p> <p>Patient's satisfaction with both private and public laboratory services is important for the improvement of the health care delivery in any country.</p> <p>Methods</p> <p>A cross-sectional survey was conducted in 24 randomly selected health facilities with laboratories that are conducting HIV related testing, in Mainland Tanzania. The study assessed patient's satisfaction with the laboratory services where by a total of 295 patients were interviewed.</p> <p>Results</p> <p>Of data analyzed for a varying totals from 224 to 294 patients, the percentage of dissatisfaction with both public and private laboratory services, ranged from 4.3% to 34.8%, with most of variables being more than 15%. Patients who sought private laboratory services were less dissatisfied with the cleanness (3/72, 4.2%) and the privacy (10/72, 13.9%) than those sought public laboratory service for the same services of cleanness (41/222, 18.5%) and privacy (61/222, 27.5%), and proportional differences were statistically significant (X²= 8.7, p = 0.003 and X²= 5.5, p = 0.01, respectively). Patients with higher education were more likely to be dissatisfied with privacy (OR = 1.8, 95% CI: 1.1–3.1) and waiting time (OR = 2.5, 95% CI: 1.5 – 4.2) in both private and public facilities. Patients with secondary education were more likely to be dissatisfied with the waiting time (OR = 5.2; 95%CI: 2.2–12.2) and result notification (OR = 5.1 95%CI (2.2–12.2) than those with lower education.</p> <p>Conclusion</p> <p>About 15.0% to 34.8% of patients were not satisfied with waiting time, privacy, results notification cleanness and timely instructions. Patients visited private facilities were less dissatisfied with cleanness and privacy of laboratory services than those visited public facilities. Patients with higher education were more likely to be dissatisfied with privacy and waiting time in both private and public facilities.</p

Ultra-Early Differential Diagnosis of Acute Cerebral Ischemia and Hemorrhagic Stroke by Measuring the Prehospital Release Rate of GFAP

BACKGROUND: Plasma glial fibrillary acidic protein (GFAP) and tau are promising markers for differentiating acute cerebral ischemia (ACI) and hemorrhagic stroke (HS), but their prehospital dynamics and usefulness are unknown. METHODS: We performed ultra-sensitivite single-molecule array (Simoa((R))) measurements of plasma GFAP and total tau in a stroke code patient cohort with cardinal stroke symptoms [National Institutes of Health Stroke Scale (NIHSS) >= 3]. Sequential sampling included 2 ultra-early samples, and a follow-up sample on the next morning. RESULTS: We included 272 cases (203 ACI, 60 HS, and 9 stroke mimics). Median (IQR) last-known-well to sampling time was 53 (35-90) minutes for initial prehospital samples, 90 (67-130) minutes for secondary acute samples, and 21 (16-24) hours for next morning samples. Plasma GFAP was significantly higher in patients with HS than ACI (P410pg/mL, or prehospital GFAP 90-410pg/mL together with GFAP release >0.6pg/mL/minute) enabled ruling out HS with high certainty (NPV 98.4%) in 68% of patients with ACI (sensitivity for HS 96.6%, specificity 68%, PPV 50%). CONCLUSIONS: In comparison to single-point measurement, monitoring the prehospital GFAP release rate improves ultra-early differentiation of stroke subtypes. With serial measurement GFAP has potential to improve future prehospital stroke diagnostics.Peer reviewe