There have long been calls from industry for guidance in implementing strategies for sustainable development. The Circular Economy represents the most recent attempt to conceptualize the integration of economic activity and environmental wellbeing in a sustainable way. This set of ideas has been adopted by China as the basis of their economic development (included in both the 11 th and the 12 th 'Five Year Plan'), escalating the concept in minds of western policymakers and NGOs. This paper traces the conceptualisations and origins of the Circular Economy, tracing its meanings and exploring its antecedents in economics and ecology, and discusses how the Circular Economy has been operationalised in business and policy. The paper finds that while the Circular Economy places emphasis on the redesign of processes and cycling of materials, which may contribute to more sustainable business models, it also encapsulates tensions and limitations. These include an absence of the social dimension inherent in sustainable development that limits its ethical dimensions, and some unintended consequences. This leads us to propose a revised definition of the Circular Economy as "an economic model wherein planning, resourcing, procurement, production and reprocessing are designed and managed, as both process and output, to maximize ecosystem functioning and human well-being".

Using a sample of 84 Fortune 500 food and oil companies, observed over the period 1967 to 1981, this paper tests a number of hypotheses relating top management group composition to firm performance. Specifically, it was expected that homogeneous top management groups would interact more efficiently and therefore be preferable when competition is intense, but that heterogeneous groups would facilitate adaptation and therefore be preferable under conditions of environmental change. Partial support for these hypotheses was found; however, the pattern of results also highlights the numerous difficulties in untangling and identifying the determinants of firm performance.

Purpose -The purpose of the paper is to explore whether there is any relationship(s) between social and environmental disclosure and the financial market performance of the UK's largest companies. Design/methodology/approach -Two data sets were used in the study. The CSEAR database of UK companies provided the social and environmental disclosure component. The second data were the stock market returns earned by the largest UK companies as listed by The Times 1,000. A series of statistical tests was performed to examine whether any relationship could be detected in either the cross sectional or longitudinal data over a period of ten years. Findings -No direct relationship between share returns and disclosure was found. Neither had such a relationship been expected, in keeping with the prior literature. However, the longitudinal data revealed a convincing relationship between consistently high(low) returns and the predilection to high(low) disclosure. There is no single convincing theoretical explanation as to why this might be. Originality/value -This paper demonstrates the importance of examining a range of hypotheses on longitudinal data when other research suggests that any relationships are unlikely to be unstable year on year. More significantly, this paper is motivated not by a concern to understand better how investors' already-high returns may be bettered, but rather to explore how the alleged potential of financial markets to contribute to social responsibility and sustainability might be engaged.

Sleep apnoea is a common disorder that is usually diagnosed through expensive studies conducted in sleep laboratories. Sleep apnoea is accompanied by a characteristic cyclic variation in heart rate or other changes in the waveform of the electrocardiogram (ECG). If sleep apnoea could be diagnosed using only the ECG, it could be possible to diagnose sleep apnoea automatically and inexpensively from ECG recordings acquired in the patient's home. This study had two parts. The first was to assess the ability of an overnight ECG recording to distinguish between patients with and without apnoea. The second was to assess whether the ECG could detect apnoea during each minute of the recording. An expert, who used additional physiological signals, assessed each of the recordings for apnoea. Research groups were invited to access data via the world-wide web and submit algorithm results to an international challenge linked to a conference. A training set of 35 recordings was made available for algorithm development, and results from a test set of 35 different recordings were made available for independent scoring. Thirteen algorithms were compared. The best algorithms made use of frequency-domain features to estimate changes in heart rate and the effect of respiration on the ECG waveform. Four of these algorithms achieved perfect scores of 100% in the first part of the study, and two achieved an accuracy of over 90% in the second part of the study.

Summary and conclusionsThe immediate heart-rate response to standing was measured in 22 normal controls and 25 patients with diabetes, 15 of whom had autonomic neuropathy. The response in the controls and patients without autonomic neuropathy was characteristic and consistent, with tachycardia maximal at around the 15th beat and relative bradycardia maximal at around the 30th beat. The diabetics with autonomic neuropathy, however, showed a flat response. In three controls the response was abolished with intravenous atropine but not with propranolol, showing that it is mediated through the vagus.

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Background: There are no studies of autonomic function comparing Alzheimer's disease (AD), vascular dementia (VAD), dementia with Lewy bodies (DLB) and Parkinson's disease dementia (PDD). Aims: To assess cardiovascular autonomic function in 39 patients with AD, 30 with VAD, 30 with DLB, 40 with PDD and 38 elderly controls by Ewing's battery of autonomic function tests and power spectral analysis of heart rate variability. To determine the prevalence of orthostatic hypotension and autonomic neuropathies by Ewing's classification. Results: There were significant differences in severity of cardiovascular autonomic dysfunction between the four types of dementia. PDD and DLB had considerable dysfunction. VAD showed limited evidence of autonomic dysfunction and in AD, apart from orthostatic hypotension, autonomic functions were relatively unimpaired. PDD showed consistent impairment of both parasympathetic and sympathetic function tests in comparison with controls (all p,0.001) and AD (all p,0.03). DLB showed impairment of parasympathetic function (all p,0.05) and one of the sympathetic tests in comparison with controls (orthostasis; p = 0.02). PDD had significantly more impairment than DLB in some autonomic parameters (Valsalva ratio: p = 0.024; response to isometric exercise: p = 0.002). Patients with VAD showed impairment in two parasympathetic tests (orthostasis: p = 0.02; Valsalva ratio: p = 0.08) and one sympathetic test (orthostasis: p = 0.04). These results were in contrast with AD patients who only showed impairment in one sympathetic response (orthostasis: p = 0.004). The prevalence of orthostatic hypotension and autonomic neuropathies was higher in all dementias than in controls (all p,0.05). Conclusion: Autonomic dysfunction occurs in all common dementias but is especially prominent in PDD with important treatment implications.

Atrial fibrillation (AF) is the most common arrhythmia encountered in clinical practice. Neither the natural history of AF nor its response to therapy is sufficiently predictable by clinical and echocardiographic parameters. The purpose of this article is to describe technical aspects of novel electrocardiogram (ECG) analysis techniques and to present research and clinical applications of these methods for characterization of both the fibrillatory process and the ventricular response during AF. Atrial fibrillatory frequency (or rate) can reliably be assessed from the surface ECG using digital signal processing (extraction of atrial signals and spectral analysis). This measurement shows large inter-individual variability and correlates well with intra-atrial cycle length, a parameter which appears to have primary importance in AF maintenance and response to therapy. AF with a low fibrillatory rate is more likely to terminate spontaneously and responds better to antiarrhythmic drugs or cardioversion, whereas high-rate AF is more often persistent and refractory to therapy. Ventricular responses during AF can be characterized by a variety of methods, which include analysis of heart rate variability, RR-interval histograms, Lorenz plots, and non-linear dynamics. These methods have all shown a certain degree of usefulness, either in scientific explorations of atrioventricular (AV) nodal function or in selected clinical questions such as predicting response to drugs, cardioversion, or AV nodal modification. The role of the autonomic nervous system for AF sustenance and termination, as well as for ventricular rate responses, can be explored by different ECG analysis methods. In conclusion, non-invasive characterization of atrial fibrillatory activity and ventricular response can be performed from the surface ECG in AF patients. Different signal processing techniques have been suggested for identification of underlying AF pathomechanisms and prediction of therapy efficacy.