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Richard Steele

Publications and source records attributed to Richard Steele.

8 recordsLinked to original sources
PubMed2006

Anaphylaxis management: the essential role of adrenaline (epinephrine) auto-injectors. Should PHARMAC fund them in New Zealand?

Anaphylaxis is an important life-threatening medical emergency. There is extensive evidence supporting the early use of intramuscular adrenaline for first medical responders and for self-initiated treatment, in at-risk individuals. Major patient groups identified as at ongoing risk are children and adults with severe food allergy, patients with venom allergy who have not been desensitised, and those with idiopathic anaphylaxis. Individual anaphylactic events are largely unpredictable. The most effective and safe route of administration for adrenaline is intramuscular, but it is difficult for patients and carers to achieve accurate and timely self-administration using an ampoule, needle, and syringe. The adrenaline auto-injector device which is available in New Zealand (the EpiPen) is not funded by PHARMAC, and thus only available to patients and families who are able to afford the purchase cost. It is difficult to understand the continued unwillingness of PHARMAC to fund an adrenaline auto-injector device to at-risk individuals, given the large body of information supporting its efficacy and use. The Australian model, where authorisation from a relevant specialist is required, could be used.

Adrenergic beta-Agonists↗
PubMed2006

Stop making plans; start making decisions.

Many executives have grown skeptical of strategic planning. Is it any wonder? Despite all the time and energy that go into it, strategic planning most often acts as a barrier to good decision making and does little to influence strategy. Strategic planning fails because of two factors: It typically occurs annually, and it focuses on individual business units. As such, the process is completely at odds with the way executives actually make important strategy decisions, which are neither constrained by the calendar nor defined by unit boundaries. Thus, according to a survey of 156 large companies, senior executives often make strategic decisions outside the planning process, in an ad hoc fashion and without rigorous analysis or productive debate. But companies can fix the process if they attack its root problems. A few forward-looking firms have thrown out their calendar-driven, business-unit-focused planning procedures and replaced them with continuous, issues-focused decision making. In doing so, they rely on several basic principles: They separate, but integrate, decision making and plan making. They focus on a few key themes. And they structure strategy reviews to produce real decisions. When companies change the timing and focus of strategic planning, they also change the nature of senior management's discussions about strategy--from "review and approve" to "debate and decide," in which top executives actively think through every major decision and its implications for the company's performance and value. The authors have found that these companies make more than twice as many important strategic decisions per year as companies that follow the traditional planning model.

Commerce↗
PubMed2006

Angry fat.

Explore the source record for details and available documents.

Adipocytes↗
PubMed2004

A multi-centre evaluation of the intra-assay and inter-assay variation of commercial and in-house anti-cardiolipin antibody assays.

AIMS: To assess the intra-assay (intra-run) and inter-assay (inter-run) variation of commercial and in-house IgG and IgM anti-cardiolipin antibody (aCL) assays/kits, and to determine an appropriate maximum value for inclusion in consensus guidelines. METHODS: Frozen aliquots of two patient specimens and one commercial control were sent to nine laboratories for the evaluation of eight commercial kits and one in-house assay. Intra-assay and inter-assay evaluations were performed with all three samples for IgG aCL, and one patient specimen for IgM aCL. RESULTS: The IgG and IgM aCL values varied considerably between the nine assays/kits. The majority of assays/kits demonstrated less than 20% intra-assay and inter-assay variation, with lower intra-assay and inter-assay variation observed with the commercial control. Single calibrator assays were not consistently associated with higher inter-assay variation than multi-point calibrator assays. CONCLUSIONS: An inter-assay coefficient of variation of 20% was determined to be an appropriate maximum value for inclusion in the Australasian aCL Working Party consensus guidelines. Improved standardisation between different assay/kits is still required.

Antibodies, Anticardiolipin↗
PubMed2004

Anti-cardiolipin antibody testing and reporting practices among laboratories participating in a large external Quality Assurance Program.

AIMS: To investigate differences in anti-cardiolipin antibody (aCL) testing and reporting practices among diagnostic laboratories participating in the RCPA Quality Assurance Program (QAP) Immunology Program. METHODS: A survey was sent to all 58 laboratories enrolled for aCL testing in the RCPA QAP Program requesting the following information: (1). manufacturer/type of assay; (2). isotype tested; (3). use of calibrators and controls; (4). whether calibrators, control and patient specimens were performed in singles or duplicates; (5). whether results were reported semi-quantitatively and/or numerically; (6). values used to define negative/positive and semi-quantitative cut-offs and how they were determined; and (7). whether interpretative comments were provided and their content. RESULTS: Thirty-two surveys (55%) were received. Significant differences were present particularly in the following areas: (1). whether IgM isotype aCL testing was performed routinely or only on specific request; (2). whether controls/calibrators/specimens were tested in singles or duplicates; (3). whether results were reported numerically and/or semi-quantitatively; (4). the values used to define negative/positive and semi-quantitative range cut-offs; and (5). whether interpretative comments were provided and their content. CONCLUSIONS: These differences in testing and reporting practices are likely to contribute to the variation in aCL results reported by different laboratories, particularly among those using the same assay.

Antibodies, Anticardiolipin↗
PubMedDate not supplied

Turning great strategy into great performance.

Despite the enormous time and energy that goes into strategy development, many companies have little to show for their efforts. Indeed, research by the consultancy Marakon Associates suggests that companies on average deliver only 63% of the financial performance their strategies promise. In this article, Michael Mankins and Richard Steele of Marakon present the findings of this research. They draw on their experience with high-performing companies like Barclays, Cisco, Dow Chemical, 3M, and Roche to establish some basic rules for setting and delivering strategy: Keep it simple, make it concrete. Avoid long, drawn-out descriptions of lofty goals and instead stick to clear language describing what your company will and won't do. Debate assumptions, not forecasts. Create cross-functional teams drawn from strategy, marketing, and finance to ensure the assumptions underlying your long-term plans reflect both the real economics of your company's markets and its actual performance relative to competitors. Use a rigorous analytic framework. Ensure that the dialogue between the corporate center and the business units about market trends and assumptions is conducted within a rigorous framework, such as that of "profit pools". Discuss resource deployments early. Create more realistic forecasts and more executable plans by discussing up front the level and timing of critical deployments. Clearly identify priorities. Prioritize tactics so that employees have a clear sense of where to direct their efforts. Continuously monitor performance. Track resource deployment and results against plan, using continuous feedback to reset assumptions and reallocate resources. Reward and develop execution capabilities. Motivate and develop staff. Following these rules strictly can help narrow the strategy-to-performance gap.

Benchmarking↗