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Harvard's Michael Porter has proposed the value chain as a tool for identifying ways to create more customer value.3 According to this model, every firm is a synthesis of activities performed to design, produce, market, deliver, and support its product. The value chain identifies nine strategically relevant activitiesfive primary and four support activitiesthat create value and cost in a specific business. The primary activities are (1) inbound logistics, or bringing materials into the business; (2) operations, or converting materials into final products; (3) outbound logistics, or shipping out final products; (4) marketing, which includes sales; and (5) service. Specialized departments handle the support activities(1) procurement, (2) technology development, (3) human resource management, and (4) firm infrastructure. (Infrastructure covers the costs of general management, planning, finance, accounting, legal, and government affairs.) The firm's task is to examine its costs and performance in each value-creating activity and look for ways to improve it. Managers should estimate competitors' costs and performances as benchmarks against which to compare their own. And they should go further and study the "best of class" practices of the world's best companies. We can identify best-practice companies by consulting customers, suppliers, distributors, financial analysts, trade associations, and magazines to see whom they rate as doing the best job. Even the best companies can benchmark, against other industries if necessary, to improve their performance. To support its corporate goal to be more innovative, GE has benchmarked against P&G as well as developing its own best practices

Question 21 I would like to know when and where antidepressants are used, because I am confused with selective serotonin re-uptake inhibitors (SSRIs), monoamine oxidase inhibitors (MAOIs) and tricyclics. Question 22 You have written that the serotonin syndrome results from sudden discontinuation of selective serotonin re-uptake inhibitors (SSRIs) with a short half-life, whereas other books I have read say that serotonin syndrome results from an overdose of SSRI or from combination with monoamine oxidase inhibitors (MAOIs) or serotonin agonists. Please clarify. Question 23 What is the safest antipsychotic and antidepressant to give during pregnancy? Question 24 How frequently should patients receiving chronic lithium therapy be evaluated for thyroid and renal function? Question 25 Is lithium generally associated with bone demineralization, especially in children? Question 26 Is lithium recommended in childhood bipolar affective disorder? Question 27 Is buspirone as effective as serotonin re-uptake inhibitors (SSRIs) in the treatment of a generalised anxiety disorder? Question 28 Can diethylpropion be used to treat children with attention deficit hyperactivity disorder (ADHD)? If so, what is the recommended dose and at what age can it safely be administered? Question 29 Can khat (norpseudoephedrine) be given to children with attention deficit hyperactivity disorder and, if so, from what age? Question 30 Are selective serotonin re-uptake inhibitors (SSRIs) and venlafaxin effective in the treatment of attention deficit hyperactivity disorder (ADHD)? How efficient are they in comparison with imipramine?