Achieving Business Continuity through Succession Planning among Small & Medium Enterprises in the Food and Beverage Industry

Succession planning plays a key role in ensuring the long-term continuity of a business. Evidence has shown that only a very small percentage of family-owned businesses continue to the third generation and succession planning is not given sufficient weight in such businesses. As research has shown that a poor (or poorly executed) plan for succession can seriously destabilize a business, it is imperative that more is done to ensure that such businesses are aware of the need for succession planning and the factors they have to consider in doing so. Employing a narrative analysis as a research design, this paper aims to explore the views and concerns of family owned small and medium sized food and beverage enterprises in planning for their long term future, with added weight on their plans for succession of their businesses. This paper aims to create more awareness of the challenges faced by these business owners in planning for the succession of their businesses

A Self-Sustainable and Micro-Second Time Synchronized Multi-Node Wireless System for Aerodynamic Monitoring on Wind Turbines

Wind energy generation plays a vital role in transitioning from fossil fuel-based energy sources and in alleviating the impacts of global warming. However, global wind energy coverage still needs to rise, while requiring a significant step up in conversion efficiency: monitoring wind flow and operational parameters of wind turbines is an essential prerequisite for coverage and conversion efficiency optimization. This paper presents a low-power, self-sustainable, and time-synchronised system for aerodynamic and acoustic measurements on operating wind turbines. It includes 40 high-accuracy barometers, 10 microphones, 5 differential pressure sensors, and implements a coarse time synchronisation on top of a Bluetooth Low Energy 5.1 protocol tuned for long-range communications. Moreover, we field-assessed the node capability to collect precise and accurate aerodynamic data with a multi-node setup. Outdoor experimental tests revealed that the system can acquire heterogeneous data with a time synchronisation error below 100 mu s and sustain a data rate of 600 kbps over 400 m with up to 5 sensor nodes, enough to fully instrument a wind turbine. The proposed method does not add any traffic overhead on the Bluetooth Low Energy 5.1 protocol, fully relying only on connection events and withstands transmission discontinuity often present in long range wireless communications

Collaboration between Hospital and Community Pharmacists to Improve Medication Management from Hospital to Home

Objective: The objective of this study is to determine if a model for patient-centered care that integrates medication management between hospital and community pharmacists is feasible and can improve medication adherence. Design: This was a randomized, non-blinded, interventional study of 69 patients discharged from a hospital to home. Process measures include the number and type of medication-related discrepancies or problems identified, patient willingness to participate, the quality and quantity of interactions with community pharmacists, hospital readmissions, and medication adherence. Setting: A 214-bed acute care hospital in Northeastern Pennsylvania and seventeen regional community pharmacies. Patients: Enrolled patients were hospitalized with a primary or secondary diagnosis of heart failure or COPD, had a planned discharge to home, and agreed to speak to one of seventeen community pharmacists within the study network (i.e., a network community pharmacist) following hospital discharge. Intervention: Information about a comprehensive medication review completed by the hospital pharmacist was communicated with the network community pharmacist to assist with providing medication therapy management following hospital discharge. Results: Of 180 patients eligible for the study, 111 declined to participate. Many patients were reluctant to talk to an additional pharmacist, however if the patient’s pharmacist was already within the network of 17 pharmacies, they usually agreed to participate. The study enrolled 35 patients in the intervention group and 34 in the control group. An average of 6 medication-related problems per patient were communicated to the patient’s network community pharmacist after discharge. In the treatment group, 44% of patients had at least one conversation with the network community pharmacist following hospital discharge. There was no difference in post-discharge adherence between the groups (Proportion of Days Covered 0.76 treatment group vs. 0.73 control group, p=0.69), but there was a reduction in hospital readmissions (43% treatment group vs. 62% control group). Conclusion: The feasibility of this model can be improved by integrating medication management with the patient’s existing community pharmacist, rather than an additional network community pharmacist. While there was no difference in medication adherence, collaboration between the hospital and community pharmacists can potentially reduce hospital readmissions, improve medication safety, and facilitate medication therapy management across care transitions. Conflict of Interest "We declare no conflicts of interest or financial interests that the authors or members of their immediate families have in any product or service discussed in the manuscript, including grants (pending or received), employment, gifts, stock holdings or options, honoraria, consultancies, expert testimony, patents and royalties".   Type: Original Researc

Viral Sepsis in Children

Sepsis in children is typically presumed to be bacterial in origin until proven otherwise, but frequently bacterial cultures ultimately return negative. Although viruses may be important causative agents of culture-negative sepsis worldwide, the incidence, disease burden and mortality of viral-induced sepsis is poorly elucidated. Consideration of viral sepsis is critical as its recognition carries implications on appropriate use of antibacterial agents, infection control measures, and, in some cases, specific, time-sensitive antiviral therapies. This review outlines our current understanding of viral sepsis in children and addresses its epidemiology and pathophysiology, including pathogen-host interaction during active infection. Clinical manifestation, diagnostic testing, and management options unique to viral infections will be outlined

Contemporary Trainee Knowledge of Autism: How Prepared Are Our Future Providers?

Background: Over the last several decades, the prevalence of Autism Spectrum Disorder (ASD) has continued to increase, creating a unique challenge for general physicians who are likely to encounter these patients in their practice. The primary aim of this cross-sectional study design was to identify potential knowledge gaps that were present among medical students and pediatric trainees (interns, residents, and fellows) particularly during the management of a sick child with ASD.Methods: A 23-question online survey was developed and distributed to medical students and pediatric trainees at a tertiary children's hospital affiliated with a medical school.Results: Medical students and pediatric trainees reported a low general knowledge of ASD and were unfamiliar with sensory issues that are often present in these children. Increased discomfort and insufficient didactic and clinical training for providing care to children with ASD during an acute illness were also identified. Both medical students and trainees reported the need for increased education and training, preferentially via patient interaction and small group-based learning. We found that as education/training levels increased, participants perceived increased comfort, and knowledge in managing an ill child with ASD.Conclusions: A perceived knowledge gap and discomfort is present amongst medical students and pediatric trainees on the management of children with ASD. Across all education levels, awareness for sensory dysregulation in ASD children is low. Education programs using direct patient interaction and small group learning were the preferred training modalities to learn how to provide optimal care for children with ASD

Lon et al. Malaria Journal 2014, 13:96

Blackwater fever in an uncomplicated Plasmodium falciparum patient treated with dihydroartemisinin-piperaquin

Accuracy of PARTwear inertial sensor and Optojump optical measurement system for measuring ground contact time during running

The aim of this study was to validate the detection of ground contact time (GCT) during running in two differently working systems: a small inertial measurement sensor, PARTwear (PW), worn on the shoe laces, and the optical measurement system, Optojump (OJ), placed on the track. Twelve well-trained subjects performed 12 runs each on an indoor track at speeds ranging from 3.0 - 9.0 m[middle dot]s-1. GCT of one step per run (total 144) was simultaneously obtained by the PW, the OJ, and a high- speed video camera (HSC), whereby the latter served as reference system. The sampling rate was 1,000 Hz for all methods. Compared to the HSC, the PW and the OJ systems underestimated GCT by -1.3 +/-6.1% and -16.5 +/-6.7% (p- values < .05), respectively. The intraclass correlation coefficients between PW and HSC and between OJ and HSC were .984 and .853 (p-values < .001), respectively. Despite the constant systematic underestimation of GCT, analyses indicated that PW successfully recorded GCT over a wide range of speeds. However, results showed only moderate validity for the OJ system, with increasing errors when speed decreased. In conclusion, the PW proved to be a highly useful and valid application, and its use can be recommended not only for laboratory settings but also for field applications. In contrast, data on GCT obtained by OJ during running must be treated with caution, specifically when running speed changes or when comparisons are made with GCT data collected by other measurement systems

Early Elevation of Matrix Metalloproteinase-8 and -9 in Pediatric ARDS Is Associated with an Increased Risk of Prolonged Mechanical Ventilation

BACKGROUND: Matrix metalloproteinases (MMP) -8 and -9 may play key roles in the modulation of neutrophilic lung inflammation seen in pediatric Acute Respiratory Distress Syndrome (ARDS). We aimed to perform a comprehensive analysis of MMP-8 and MMP-9 activity in tracheal aspirates of pediatric ARDS patients compared with non-ARDS controls, testing whether increased MMP-8 and -9 activities were associated with clinical outcomes. METHODS: Tracheal aspirates were collected from 33 pediatric ARDS patients and 21 non-ARDS controls at 48 hours of intubation, and serially for those who remained intubated greater than five days. MMPs, tissue inhibitor of metalloproteinases (TIMPs), human neutrophil elastase (HNE) and myeloperoxidase (MPO) activity were measured by ELISA, and correlated with clinical indicators of disease severity such as PRISM (Pediatric Risk of Mortality) scores, oxygen index (OI), multi-organ system failure (MOSF) and clinical outcome measures including length of intubation, ventilator-free days (VFDs) and mortality in the Pediatric Intensive Care Unit (PICU). RESULTS: Active MMP-9 was elevated early in pediatric ARDS subjects compared to non-ARDS controls. Higher MMP-8 and active MMP-9 levels at 48 hours correlated with a longer course of mechanical ventilation (r = 0.41, p = 0.018 and r = 0.75, p<0.001; respectively) and fewer number of VFDs (r = -0.43, p = 0.013 and r = -0.76, p<0.001; respectively), independent of age, gender and severity of illness. Patients with the highest number of ventilator days had the highest levels of active MMP-9. MMP-9 and to a lesser extent MMP-8 activities in tracheal aspirates from ARDS subjects were sensitive to blockade by small molecule inhibitors. CONCLUSIONS: Higher MMP-8 and active MMP-9 levels at 48 hours of disease onset are associated with a longer duration of mechanical ventilation and fewer ventilator-free days among pediatric patients with ARDS. Together, these results identify early biomarkers predictive of disease course and potential therapeutic targets for this life threatening disease