Liver biopsy interpretation in chronic hepatitis

Liver biopsy reports are very variable in their terminology. In this article, frequently used terms and 2 common scoring systems are described.     

The pregnant applicant: normal alterations in physiologic parameters and testing

Pregnancy affects virtually every organ system, and "baseline" normal laboratory test levels change throughout gestation.     

Innovation at the speed of information

Conventional project-management tools--PERT charts and Gantt charts, for example--were created to help manage sequences of discrete tasks that make up large construction projects. Yet these tools don't capture clearly the back-and-forth of information that takes place in innovative processes, such as product development. Conventional tools are designed to answer the question, "What other tasks must be completed before I begin this one?" But product development planners, especially in high-tech businesses, need tools that answer a very different question: "What information do I need from other tasks before I can complete this one?" The author describes the Design Structure Matrix (DSM), a project management tool that focuses on representing the information flows of a project rather than its work flows. He explains how the DSM works and how to use it to make development processes more efficient. A project DSM can show which information exchanges involve design iteration and how well a process anticipates the need for rework. In addition, the author suggests four ways to improve a company's information flows: rearranging the sequence of tasks, reconsidering the organization of tasks, reducing the number of information exchanges, and managing unplannable work. By stripping away the mystery around information exchange during innovation, the DSM can give managers far more control over their most risky and expensive projects.     

Doppler echocardiographic changes found in diastolic dysfunction

Diastolic dysfunction may be associated with increased morbidity and mortality. In this article, an overview of the pathophysiology of diastolic dysfunction is discussed and the findings of Doppler echocardiography used to aid in its diagnosis are reviewed.     

AIDS is your business

If your company operates in a developing country, AIDS is your business. While Africa has received the most attention, AIDS is also spreading swiftly in other parts of the world. Russia and Ukraine had the fastest-growing epidemics last year, and many experts believe China and India will suffer the next tidal wave of infection. Why should executives be concerned about AIDS? Because it is destroying the twin rationales of globalization strategy-cheap labor and fast-growing markets--in countries where people are heavily affected by the epidemic. Fortunately, investments in programs that prevent infection and provide treatment for employees who have HIV/AIDS are profitable for many businesses--that is, they lead to savings that outweigh the programs' costs. Due to the long latency period between HIV infection and the onset of AIDS symptoms, a company is not likely to see any of the costs of HIV/AIDS until five to ten years after an employee is infected. But executives can calculate the present value of epidemic-related costs by using the discount rate to weigh each cost according to its expected timing. That allows companies to think about expenses on HIV/AIDS prevention and treatment programs as investments rather than merely as costs. The authors found that the annual cost of AIDS to six corporations in South Africa and Botswana ranged from 0.4% to 5.9% of the wage bill. All six companies would have earned positive returns on their investments if they had provided employees with free treatment for HIV/AIDS in the form of highly active antiretroviral therapy (HAART), according to the mathematical model the authors used. The annual reduction in the AIDS "tax" would have been as much as 40.4%. The authors' conclusion? Fighting AIDS not only helps those infected; it also makes good business sense.     

In search of global leaders

For all the talk about global organizations and executives, there's no definitive answer to the question of what we really mean by "global." A presence in multiple countries? Cultural adaptability? A multilingual top team? We asked four CEOs and the head of an international recruiting agency--HSBC's Stephen Green, Schering-Plough's Fred Hassan, GE's Jeffrey-lmmelt, Flextronics's Michael Marks, and Egon Zehnder's Daniel Meiland--to tell us what they think. They share some common ground. They all agree, for example, that the shift from a local to a global marketplace is irreversible and gaining momentum. "We're losing sight of the reality of globalization. But we should pay attention, because national barriers are quickly coming down", Daniel Meiland says. "If you look ahead five or ten years, the people with the top jobs in large corporations ... will be those who have lived in several cultures and who can converse in at least two languages." But the CEOs also disagree on many issues--on the importance of overseas assignments, for instance, and on the degree to which you need to adhere to local cultural norms. Some believe strongly that the global leader should, as a prerequisite to the job, live and work in other countries. As Stephen Green put it, "If you look at the executives currently running [HSBC's] largest businesses, all of them have worked in more than one, and nearly all in more than two, major country markets." Others downplay the importance of overseas assignments. "Putting people in foreign settings doesn't automatically imbue new attitudes, and it is attitudes rather than experiences that make a culture global," says Fred Hassan. The executives' essays capture views that are as diverse and multidimensional as the companies they lead.     

Cocaine revisited

Insurance companies often test applicants for the presence of cocaine. Because a positive test may automatically preclude further consideration, such cases often never reach the medical director. The negative impact of cocaine use on insurability is reviewed.