Sample records for multinational design evaluation

  1. Managing Human Resources in a Multinational Context

    ERIC Educational Resources Information Center

    Sumetzberger, Walter

    2005-01-01

    Purpose: To develop more sensitivity for different patterns of human resource management in multinational companies. Design/methodology/approach: Systemic approach; the concepts and models are based on the evaluation of consulting projects in the field of human resource management. Findings: A concept of four typical varieties of human resource…

  2. A mission design for International Manned Mars Mission - From the 1991 International Space University (ISU) Design Project

    NASA Technical Reports Server (NTRS)

    Mendell, Wendell W.

    1991-01-01

    The International Space University (ISU) conducted a study of an international program to support human exploration of Mars as its annual Design Project activity during its 1991 summer session in Toulouse, France. Although an ISU Design Project strives to produce an in-depth analysis during the intense 10-week summer session, the International Mars Mission (IMM) project was conducted in a manner designed to provide a learning experience for young professionals working in an unusual multidisciplinary and multinational environment. The breadth of the IMM study exceeds that of most Mars mission studies of the past, encompassing political organization for long-term commitment, multinational management structure, cost analysis, mission architecture, vehicle configuration, crew health, life support, Mars surface infrastructure, mission operations, technology evaluation, risk assessment, scientific planning, exploration, communication networks, and Martian resource utilization. The IMM Final Report has particular value for those seeking insight into the choices made by a multinational group working in an apolitical environment on the problems of international cooperation in space.

  3. The Effects of Organization Design on Media Richness in Multinational Enterprises.

    ERIC Educational Resources Information Center

    Whitfield, J. Michael; And Others

    1996-01-01

    Examines effects of two organizational design parameters, divisionalization and centralization, on the media richness choices of Chief Executive Officers (CEOs) of multinational enterprises in obtaining information from foreign subsidiaries on strategic issues. Samples 86 US multinationals; finds formal divisional structure affects CEOs' use of…

  4. Evaluating the Investment Benefit of Multinational Enterprises' International Projects Based on Risk Adjustment: Evidence from China

    ERIC Educational Resources Information Center

    Chen, Chong

    2016-01-01

    This study examines the international risks faced by multinational enterprises to understand their impact on the evaluation of investment projects. Moreover, it establishes a 'three-dimensional' theoretical framework of risk identification to analyse the composition of international risk indicators of multinational enterprises based on the theory…

  5. A European perspective--the European clinical research infrastructures network.

    PubMed

    Demotes-Mainard, J; Kubiak, C

    2011-11-01

    Evaluating research outcomes requires multinational cooperation in clinical research for optimization of treatment strategies and comparative effectiveness research, leading to evidence-based practice and healthcare cost containment. The European Clinical Research Infrastructures Network (ECRIN) is a distributed ESFRI (European Strategy Forum on Research Infrastructures) roadmap pan-European infrastructure designed to support multinational clinical research, making Europe a single area for clinical studies, taking advantage of its population size to access patients, and unlocking latent scientific potential. Servicing multinational trials started during its preparatory phase, and ECRIN will now apply for an ERIC (European Research Infrastructures Consortium) status by 2011. By creating a single area for clinical research in Europe, this achievement will contribute to the implementation of the Europe flagship initiative 2020 'Innovation Union', whose objectives include defragmentation of the research and education capacity, tackling the major societal challenges starting with the area of healthy ageing, and removing barriers to bring ideas to the market.

  6. Multinational Activities of Major U.S. Automotive Producers : Volume 3. Research, Development, and Engineering Abroad

    DOT National Transportation Integrated Search

    1978-09-01

    This is Volume III of the report on the multinational activities of the four major U.S. automotive producers. The primary objective of Volume III is to evaluate the RD&E activities performed abroad by the U.S. automotive multinationals in order to de...

  7. Economic Evaluation alongside Multinational Studies: A Systematic Review of Empirical Studies

    PubMed Central

    Oppong, Raymond; Jowett, Sue; Roberts, Tracy E.

    2015-01-01

    Purpose of the study This study seeks to explore methods for conducting economic evaluations alongside multinational trials by conducting a systematic review of the methods used in practice and the challenges that are typically faced by the researchers who conducted the economic evaluations. Methods A review was conducted for the period 2002 to 2012, with potentially relevant articles identified by searching the Medline, Embase and NHS EED databases. Studies were included if they were full economic evaluations conducted alongside a multinational trial. Results A total of 44 studies out of a possible 2667 met the inclusion criteria. Methods used for the analyses varied between studies, indicating a lack of consensus on how economic evaluation alongside multinational studies should be carried out. The most common challenge appeared to be related to addressing differences between countries, which potentially hinders the generalisability and transferability of results. Other challenges reported included inadequate sample sizes and choosing cost-effectiveness thresholds. Conclusions It is recommended that additional guidelines be developed to aid researchers in this area and that these be based on an understanding of the challenges associated with multinational trials and the strengths and limitations of alternative approaches. Guidelines should focus on ensuring that results will aid decision makers in their individual countries. PMID:26121465

  8. Five Themes Impacting Collaboration in a Joint Interagency Multinational Public Operational Context (Les cinq Facteurs Influencant la Collaboration en Contexte Operationnel Interarmees, Interorganisationnel, Multinational et Public)

    DTIC Science & Technology

    2011-03-01

    cited by the Director of Land Concepts and Designs as an important enabler for the Army of Tomorrow operating concept of adaptive dispersed operations...2010). La partie 1.3 porte sur l’influence du pouvoir sur la collaboration. Étant donné l’ampleur des FC comparativement à celle de la plupart des...Multinational Public (JIMP) operating environment, the capacity to be "JIMP-capable" is now cited by the Director of Land Concepts and Designs as an important

  9. Evaluating Organizational Change at a Multinational Transportation Corporation: Method and Reflections

    ERIC Educational Resources Information Center

    Plakhotnik, Maria S.

    2016-01-01

    The purpose of this perspective on practice is to share my experience conducting an organizational change evaluation using qualitative methodology at a multinational transportation company Global Logistics. I provide a detailed description of the three phase approach to data analysis and my reflections on the process.

  10. Standardized Evaluation for Multi-National Development Programs.

    ERIC Educational Resources Information Center

    Farrell, W. Timothy

    This paper takes the position that standardized evaluation formats and procedures for multi-national development programs are not only desirable but possible in diverse settings. The key is the localization of standard systems, which involves not only the technical manipulation of items and scales, but also the contextual interpretation of…

  11. Multinational Quality Assurance

    ERIC Educational Resources Information Center

    Kinser, Kevin

    2011-01-01

    Multinational colleges and universities pose numerous challenges to the traditional models of quality assurance that are designed to validate domestic higher education. When institutions cross international borders, at least two quality assurance protocols are involved. To guard against fraud and abuse, quality assurance in the host country is…

  12. Evaluating Knowledge, Attitudinal, and Behavioral Change Effects from a Multinational HIV/AIDS Education Program for Youth

    ERIC Educational Resources Information Center

    Hardre, Patricia L.; Garcia, Fe; Apamo, Peter; Mutheu, Lucy; Ndege, Monica; Bois, Iderle

    2010-01-01

    This project tracked the mid-term evaluation processes, practices, and products of a multinational program to reduce at-risk behaviors for HIV/AIDS among children in Kenya, Tanzania, and Haiti. It focused on participant and community perceptions; program effectiveness in promoting abstinence and monogamy decisions; and factors supporting ongoing…

  13. Leadership styles of nurse managers in a multinational environment.

    PubMed

    Suliman, Wafika A

    2009-01-01

    This is a descriptive study conducted at a multinational working environment, where 1500 nurses representing 52 nationalities are employed. The study aimed at exploring the predominant leadership style of nurse managers through self-evaluation and staff nurses' evaluation and the impact of working in a multinational environment on their intention to stay or quit. The value lies in its focus on leadership styles in an environment where national diversity among managers, staff, and patients is very challenging. The study included 31 nurse managers and 118 staff nurses using Bass and Avolio's (1995) Multifactor Leadership Questionnaire. The results showed that nurse managers and staff nurses reported transformational leadership as predominant with significant difference in favor of nurse managers. Participants' nationality and intention to stay or quit affected their perception of transformational leadership as a predominant style. The implications highlight the need for senior nursing management to set effective retention strategies for transformational nurse managers who work at multinational environments.

  14. Using English as the Common Corporate Language in a German Multinational

    ERIC Educational Resources Information Center

    Swift, Jonathan S.; Wallace, James

    2011-01-01

    Purpose: This study aims to examine a German multinational that uses English as the common corporate language (CCL) for internal communications with its international subsidiaries/agencies. It examines use of English within the workplace, and problems/opportunities it presents to those who use it. Design/methodology: The questionnaire was piloted…

  15. Knowledge Sharing in an American Multinational Company Based in Malaysia

    ERIC Educational Resources Information Center

    Ling, Chen Wai; Sandhu, Manjit S.; Jain, Kamal Kishore

    2009-01-01

    Purpose: This paper seeks to examine the views of executives working in an American based multinational company (MNC) about knowledge sharing, barriers to knowledge sharing, and strategies to promote knowledge sharing. Design/methodology/approach: This study was carried out in phases. In the first phase, a topology of organizational mechanisms for…

  16. A multinational Mars mission for the International Space University

    NASA Technical Reports Server (NTRS)

    Mendell, Wendell W.

    1992-01-01

    The International Space University's 1991 design project activity has yielded a report on the organization and implementation of a multinational program for manned exploration of Mars; the organization encompasses a political as well as a technical component. This International Manned Mission employs an artificial-gravity spacecraft with nuclear-electric propulsion for interplanetary transfer. An unmanned cargo mission precedes the piloted flights to increase the mass deliverable to Mars, as well as to serve as a testbed for interplanetary vehicle design.

  17. Current Status of Diversity Initiatives in Selected Multinational Corporations.

    ERIC Educational Resources Information Center

    Wentling, Rose Mary; Palma-Rivas, Nilda

    2000-01-01

    Interviews with eight diversity managers in multinational corporations revealed a variety of domestic and international diversity initiatives, especially in leadership and management. Formal and informal methods were used to plan them. Business unit managers were responsible for implementation. Evaluation was difficult and time consuming. (SK)

  18. Human Resource Development Practices, Managers and Multinational Enterprises in Australia: Thinking Globally, Acting Locally

    ERIC Educational Resources Information Center

    Sablok, Gitika; Stanton, Pauline; Bartram, Timothy; Burgess, John; Boyle, Brendan

    2017-01-01

    Purpose: The purpose of this paper is to examine the HRD practices of multinational enterprises (MNEs) operating in Australia to understand the value that MNEs place on investment in their human capital, particularly managerial talent. Design/methodology/approach: Drawing on a representative sample of 211 MNEs operating in Australia, this paper…

  19. Multinational Activities of Major U.S. Automotive Producers : Volume 5. Diffusion of Production and Sales Operations Abroad.

    DOT National Transportation Integrated Search

    1978-09-01

    This is Volume V on the multi-national activities of the major U.S. automotive producers. The purpose of this Volume is to evaluate the foreign manufacturing and sales activities of the General Motors Corporation, Ford Motor Company, and Chrysler Cor...

  20. GLOBAL CHANGE RESEARCH NEWS #10: MULTIAGENCY, MULTINATIONAL GLOBAL CHANGE RESEARCH EFFORT IN THE UPPER SAN PEDRO BASIN

    EPA Science Inventory

    This edition reports on a multiagency, multinational global-change research effort that seeks to evaluate the consequences of natural and human-induced changes in semi-arid environments. The Semi-Arid Land-Surface-Atmosphere Program ("SALSA") is focused on the environmentally sen...

  1. A Content Analysis of Multinationals' Web Communication Strategies: Cross-Cultural Research Framework and Pre-Testing.

    ERIC Educational Resources Information Center

    Okazaki, Shintaro; Alonso Rivas, Javier

    2002-01-01

    Discussion of research methodology for evaluating the degree of standardization in multinational corporations' online communication strategies across differing cultures focuses on a research framework for cross-cultural comparison of corporate Web pages, applying traditional advertising content study techniques. Describes pre-tests that examined…

  2. Application status and its affecting factors of double standard for multinational corporations in Korea.

    PubMed

    Ki, Myung; Choi, Jaewook; Lee, Juneyoung; Park, Heechan; Yoon, Seokjoon; Kim, Namhoon; Heo, Jungyeon

    2004-02-01

    We intended to evaluate the double standard status and to identify factors of determining double standard criteria in multinational corporations of Korea, and specifically those in the occupational health and safety area. A postal questionnaire had been sent, between August 2002 and September 2002, to multinational corporations in Korea. A double standard company was defined as those who answered in more than one item as adopting a different standard among the five items regarding double standard identification. By comparing double standard companies with equivalent standard companies, determinants for double standards were then identified using logistic regression analysis. Of multinational corporations, 45.1% had adopted a double standard. Based on the question naire's scale level, the factor of 'characteristic and size of multinational corporation' was found to have the most potent impact on increasing double standard risk. On the variable level, factors of 'number of affiliated companies' and 'existence of an auditing system with the parent company' showed a strong negative impact on double standard risk. Our study suggests that a distinctive approach is needed to manage the occupational safety and health for multinational corporations. This approach should be focused on the specific level of a corporation, not on a country level.

  3. Cross-Cultural Adjustment Process of Expatriate Families in a Multinational Organization: A Family System Theory Perspective

    ERIC Educational Resources Information Center

    Rosenbusch, Katherine

    2010-01-01

    The purpose of this survey based study was to examine whether the characteristics (i.e., flexibility and cohesion) of expatriate families in a multinational corporation as measured by the Family Adaptability and Cohesion Evaluation Scale can predict cross-cultural adjustment of the expatriate (individual level of analysis) and his/her family…

  4. Conducting multinational, cross-cultural research in the functional gastrointestinal disorders: issues and recommendations. A Rome Foundation working team report.

    PubMed

    Sperber, A D; Gwee, K A; Hungin, A P; Corazziari, E; Fukudo, S; Gerson, C; Ghoshal, U C; Kang, J-Y; Levy, R L; Schmulson, M; Dumitrascu, D; Gerson, M-J; Chen, M; Myung, S-J; Quigley, E M M; Whorwell, P J; Zarzar, K; Whitehead, W E

    2014-11-01

    Cross-cultural, multinational research can advance the field of functional gastrointestinal disorders (FGIDs). Cross-cultural comparative research can make a significant contribution in areas such as epidemiology, genetics, psychosocial modulators, symptom reporting and interpretation, extra-intestinal co-morbidity, diagnosis and treatment, determinants of disease severity, health care utilisation, and health-related quality of life, all issues that can be affected by geographical region, culture, ethnicity and race. To identify methodological challenges for cross-cultural, multinational research, and suggest possible solutions. This report, which summarises the full report of a working team established by the Rome Foundation that is available on the Internet, reflects an effort by an international committee of FGID clinicians and researchers. It is based on comprehensive literature reviews and expert opinion. Cross-cultural, multinational research is important and feasible, but has barriers to successful implementation. This report contains recommendations for future research relating to study design, subject recruitment, availability of appropriate study instruments, translation and validation of study instruments, documenting confounders, statistical analyses and reporting of results. Advances in study design and methodology, as well as cross-cultural research competence, have not matched technological advancements. The development of multinational research networks and cross-cultural research collaboration is still in its early stages. This report is intended to be aspirational rather than prescriptive, so we present recommendations, not guidelines. We aim to raise awareness of these issues and to pose higher standards, but not to discourage investigators from doing what is feasible in any particular setting. © 2014 John Wiley & Sons Ltd.

  5. Thermal and ghost reflection modeling for a 180-deg. field-of-view long-wave infrared lens

    NASA Astrophysics Data System (ADS)

    Shi, Weimin; Couture, Michael E.

    2001-03-01

    Optics 1, Inc. has successfully designed and developed a 180 degree(s) field of view long wave infrared lens for USAF/AFRL under SBIR phase I and II funded projects in support of the multi-national Programmable Integrated Ordinance Suite (PIOS) program. In this paper, a procedure is presented on how to evaluate image degradation caused by asymmetric aerodynamic dome heating. In addition, a thermal gradient model is proposed to evaluate degradation caused by axial temperature gradient throughout the entire PIOS lens. Finally, a ghost reflection analysis is demonstrated with non-sequential model.

  6. The Cooperative Landscape of Multinational Clinical Trials

    PubMed Central

    Hsiehchen, David; Espinoza, Magdalena; Hsieh, Antony

    2015-01-01

    The scale and nature of cooperative efforts spanning geopolitical borders in clinical research have not been elucidated to date. In a cross-sectional study of 110,428 interventional trials registered in Clinicaltrials.gov, we characterized the evolution, trial demographics, and network properties of multinational clinical research. We reveal that the relative growth of international collaboratives has remained stagnant in the last two decades, although clinical trials have evolved to become much larger in scale. Multinational clinical trials are also characterized by higher patient enrollments, industry funding, and specific clinical disciplines including oncology and infectious disease. Network analyses demonstrate temporal shifts in collaboration patterns between countries and world regions, with developing nations now collaborating more within themselves, although Europe remains the dominant contributor to multinational clinical trials worldwide. Performances in network centrality measures also highlight the differential contribution of nations in the global research network. A city-level clinical trial network analysis further demonstrates how collaborative ties decline with physical distance. This study clarifies evolving themes and highlights potential growth mechanisms and barriers in multinational clinical trials, which may be useful in evaluating the role of national and local policies in organizing transborder efforts in clinical endeavors. PMID:26103155

  7. Registry of Hypogonadism in Men (RHYME): design of a multi-national longitudinal, observational registry of exogenous testosterone use in hypogonadal men.

    PubMed

    Rosen, Raymond C; Wu, Frederick C W; Behre, Hermann M; Roehrborn, Claus G; Schröder, Fritz H; Siami, Flora S; Martha, Julia F; Finn, Joseph D; Araujo, Andre B

    2013-03-01

    Despite the prevalence of hypogonadism (HG) and widespread use of testosterone therapy, little is known about the safety/effectiveness of long-term testosterone use. The Registry of Hypogonadism in Men (RHYME) is a multi-national patient registry assessing prostate health and other outcomes associated with testosterone treatment in men. Observational patient disease registry. RHYME is a non-interventional disease registry with longitudinal data collection on a large sample (N = 999) of well-characterized, hypogonadal men aged 18 years or older. The Registry will prospectively evaluate male patients diagnosed with HG, who have not previously been treated with testosterone therapy. Key design features include: (1) broad inclusion/exclusion criteria, (2) standardized central laboratory hormone assays, (3) independent adjudication of prostate biopsies and mortalities, (4) standard of care treatment, (5) comprehensive medical record and questionnaire data at six months and annually post-enrollment and (6) adequate statistical power for assessing prostate endpoints at 36 months. A total of 25 clinical sites in six European countries (Germany, Italy, the Netherlands, Spain, Sweden and the United Kingdom) have completed recruitment for the study. Recruitment was initiated in May 2009, and completed in December 2011. Data collection is ongoing with a minimum of two years of follow-up on all patients.

  8. Mapping R&D within Multinational Networks: Evidence from the Electronics Industry

    NASA Astrophysics Data System (ADS)

    Urze, Paula; Manatos, Maria João

    Based on the final results of the R&D.COM - Local R&D COMpetencies within Global Value Chains project, this paper aims at mapping the trajectories of delocalised R&D units within a multinational’s global strategy and designing the knowledge flows within the global value chain. This analysis was performed using typologies proposed in the theoretical framework, which help us to have an overview of the network. The methodology is grounded on one extended case study that involves a local R&D unit (Portugal), a foreign R&D unit (Netherlands) and the headquarters (Norway) - developed on a multinational from the electronics industry. This case is an example of a multinational company where R&D is developed mainly in the headquarters but it is also delocalised to some subsidiaries with a certain level of autonomy.

  9. Multiple Learning Tracks: For Training Multinational Managers

    ERIC Educational Resources Information Center

    Harvey, Michael G.; Kerin, Roger A.

    1977-01-01

    The problem of identifying and training college students to be effective multinational marketing managers is investigated in three parts: (1) Identification of multinational manager attributes, (2) selection of multinational managers, and (3) multiple "track" training programs. (TA)

  10. Why Design History? A Multi-National Perspective on the State and Purpose of the Field

    ERIC Educational Resources Information Center

    Huppatz, DJ; Lees-Maffei, Grace

    2013-01-01

    This article asks: what is the significance of design history within higher education? It reviews the practice and purpose of design history, in the education of historically aware and critically engaged designers, as an emerging independent discipline, and in terms of what the subject has to offer allied fields such as history, sociology,…

  11. A survey of national and multi-national registries and cohort studies in juvenile idiopathic arthritis: challenges and opportunities.

    PubMed

    Beukelman, Timothy; Anink, Janneke; Berntson, Lillemor; Duffy, Ciaran; Ellis, Justine A; Glerup, Mia; Guzman, Jaime; Horneff, Gerd; Kearsley-Fleet, Lianne; Klein, Ariane; Klotsche, Jens; Magnusson, Bo; Minden, Kirsten; Munro, Jane E; Niewerth, Martina; Nordal, Ellen; Ruperto, Nicolino; Santos, Maria Jose; Schanberg, Laura E; Thomson, Wendy; van Suijlekom-Smit, Lisette; Wulffraat, Nico; Hyrich, Kimme

    2017-04-19

    To characterize the existing national and multi-national registries and cohort studies in juvenile idiopathic arthritis (JIA) and identify differences as well as areas of potential future collaboration. We surveyed investigators from North America, Europe, and Australia about existing JIA cohort studies and registries. We excluded cross-sectional studies. We captured information about study design, duration, location, inclusion criteria, data elements and collection methods. We received survey results from 18 studies, including 11 national and 7 multi-national studies representing 37 countries in total. Study designs included inception cohorts, prevalent disease cohorts, and new treatment cohorts (several of which contribute to pharmacosurveillance activities). Despite numerous differences, the data elements collected across the studies was quite similar, with most studies collecting at least 5 of the 6 American College of Rheumatology core set variables and the data needed to calculate the 3-variable clinical juvenile disease activity score. Most studies were collecting medication initiation and discontinuation dates and were attempting to capture serious adverse events. There is a wide-range of large, ongoing JIA registries and cohort studies around the world. Our survey results indicate significant potential for future collaborative work using data from different studies and both combined and comparative analyses.

  12. Methodology for clinical trials involving patients with cancer who have febrile neutropenia: updated guidelines of the Immunocompromised Host Society/Multinational Association for Supportive Care in Cancer, with emphasis on outpatient studies.

    PubMed

    Feld, Ronald; Paesmans, Marianne; Freifeld, Alison G; Klastersky, Jean; Pizzo, Philip A; Rolston, Kenneth V I; Rubenstein, Edward; Talcott, James A; Walsh, Thomas J

    2002-12-15

    Two multinational organizations, the Immunocompromised Host Society and the Multinational Association for Supportive Care in Cancer, have produced for investigators and regulatory bodies a set of guidelines on methodology for clinical trials involving patients with febrile neutropenia. The guidelines suggest that response (i.e., success of initial empirical antibiotic therapy without any modification) be determined at 72 h and again on day 5, and the reasons for modification should be stated. Blinding and stratification are to be encouraged, as should statistical consideration of trials specifically designed for showing equivalence. Patients enrolled in outpatient studies should be selected by use of a validated risk model, and patients should be carefully monitored after discharge from the hospital. Response and safety parameters should be recorded along with readmission rates. If studies use these guidelines, comparisons between studies will be simpler and will lead to further improvements in patient therapy.

  13. Exploring Employee Engagement from the Employee Perspective: Implications for HRD

    ERIC Educational Resources Information Center

    Shuck, M. Brad; Rocco, Tonette S.; Albornoz, Carlos A.

    2011-01-01

    Purpose: The purpose of this paper is to examine an employee's unique experience of being engaged in their work. Design/methodology/approach: Following Yin's case study design method, researchers collected documents, conducted semi-structured interviews and recorded observations at a large multinational service corporation ranked as one of the…

  14. Mipomersen sodium: first global approval.

    PubMed

    Hair, Philip; Cameron, Fiona; McKeage, Kate

    2013-04-01

    Mipomersen sodium (Kynamro™) (henceforth mipomersen) is a second-generation antisense oligonucleotide inhibitor of apolipoprotein B-100, which is the main structural component of atherogenic lipid particles. Mipomersen is administered via subcutaneous injection and is indicated as adjunctive treatment for homozygous familial hypercholesterolaemia (HoFH). The drug was developed by Isis Pharmaceuticals, which now collaborates with Genzyme Corporation for on-going development and product marketing. Multinational phase III trials of mipomersen as adjunctive therapy were completed in patients with HoFH, severe FH, heterozygous FH (HeFH) with coronary artery disease (CAD), and in those with hypercholesterolaemia at high risk of CAD. Mipomersen 200 mg once weekly has been approved in the USA as an adjunct to lipid-lowering medications and diet in HoFH patients and is undergoing regulatory review in the EU for the same indication. Genzyme is also conducting a multinational phase III, open-label extension study to evaluate long-term treatment in HoFH and HeFH patients, as well as a multinational trial to evaluate a three-times-per-week mipomersen regimen in patients with severe FH. This article summarises the milestones in the development of once-weekly, subcutaneous mipomersen leading to this first approval.

  15. Making metadata usable in a multi-national research setting.

    PubMed

    Ellul, Claire; Foord, Joanna; Mooney, John

    2013-11-01

    SECOA (Solutions for Environmental Contrasts in Coastal Areas) is a multi-national research project examining the effects of human mobility on urban settlements in fragile coastal environments. This paper describes the setting up of a SECOA metadata repository for non-specialist researchers such as environmental scientists and tourism experts. Conflicting usability requirements of two groups - metadata creators and metadata users - are identified along with associated limitations of current metadata standards. A description is given of a configurable metadata system designed to grow as the project evolves. This work is of relevance for similar projects such as INSPIRE. Copyright © 2012 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  16. Cultural Penetration in Latin America through Multinational Advertising Agencies.

    ERIC Educational Resources Information Center

    Del Toro, Wanda

    Few studies have addressed the issue of cultural penetration of Latin American countries by multinational corporations (MNCs) and multinational advertising agencies (MAAs). Whether they are considered multinational or transnational, MAAs have expanded as a form of international communication in the global market, forming the backbone of MNCs.…

  17. Pacific Ocean Fisheries Project. A Study of International Cooperation in Curriculum Design.

    ERIC Educational Resources Information Center

    Pottenger, Francis M., III

    Common educational curricula have been suggested to be advantageous in enhancing the stability of the community of nations. This paper describes a multinational curriculum design effort by four Pacific rim nations (Australia, Japan, New Zealand, and the United States) which has created a common curriculum program. This joint venture resulted in…

  18. An organizational model for an international Mars mission (From the 1991 International Space University (ISU) design project)

    NASA Technical Reports Server (NTRS)

    Stoffel, Wilhelm; Mendell, Wendell W.

    1991-01-01

    An international Mars mission aimed at designing a long term, multinational program for conducting scientific exploration of Mars and developing and/or validating technology enabling the eventual human settlement on the planet is discussed. Emphasis is placed on political and legal issues of the project.

  19. Proliferation resistance design of a plutonium cycle (Proliferation Resistance Engineering Program: PREP)

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Sorenson, R.J.; Roberts, F.P.; Clark, R.G.

    1979-01-19

    This document describes the proliferation resistance engineering concepts developed to counter the threat of proliferation of nuclear weapons in an International Fuel Service Center (IFSC). The basic elements of an International Fuel Service Center are described. Possible methods for resisting proliferation such as processing alternatives, close-coupling of facilities, process equipment layout, maintenance philosophy, process control, and process monitoring are discussed. Political and institutional issues in providing proliferation resistance for an International Fuel Service Center are analyzed. The conclusions drawn are (1) use-denial can provide time for international response in the event of a host nation takeover. Passive use-denial is moremore » acceptable than active use-denial, and acceptability of active-denial concepts is highly dependent on sovereignty, energy dependence and economic considerations; (2) multinational presence can enhance proliferation resistance; and (3) use-denial must be nonprejudicial with balanced interests for governments and/or private corporations being served. Comparisons between an IFSC as a national facility, an IFSC with minimum multinational effect, and an IFSC with maximum multinational effect show incremental design costs to be less than 2% of total cost of the baseline non-PRE concept facility. The total equipment acquisition cost increment is estimated to be less than 2% of total baseline facility costs. Personnel costs are estimated to increase by less than 10% due to maximum international presence. 46 figures, 9 tables.« less

  20. Institutional arrangements for the reduction of proliferation risks formulation, evaluation, and implementation of institutional concepts. Appendices

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Not Available

    The purpose of this supporting analysis is to provide a foundation for developing a model, an international or multinational institution capable of accomodating the back end of the fuel cycle, while meeting US nonproliferation goals. The analysis is based on a review of selected, defunct and extant institutions which, although not necessarily concerned with nonproliferation, have faced a trade-off between acceptability and effectiveness in meeting their objectives. Discussion of the various institutions is divided into three categories: international organizations, multinational consortia, and cartels or producer associations. Examples of international organizations include the International Seabed Authority, Intelsat, the United Nations andmore » the International Atomic Energy Agency (IAEA). The International Seabed Authority is discussed. Multinational consortia are organizations that have been developed primarily to meet common commercial objectives. Membership includes at least three member nations. Examples include the Scandinavian Airline System (SAS), URENCO, Unilever, Royal Dutch Shell, Eurochemic, Eurodif, Euratom, European Coal and Steel Community, and Serena. Cartels or producer associations are multinational agreements that restrict market forces; viz, production, market share, customers or prices. Examples include the Intergovernmental Council of Copper Exporting Countries (CIPEC), the Organization of Petroleum Exporting Countries (OPEC), and the Fifth International Tin Agreement (ITA), as well as agreements governing diamonds and uranium, bauxite and coffee. OPEC, CIPEC and ITA are discussed.« less

  1. Sharing the Burden: How Effective is a Multinational Force in the Contemporary Operational Environment

    DTIC Science & Technology

    2007-06-01

    multinational setting justifies a reassessment of the benefits and costs of multinational operations and that the solution may lie in a “modular...Nonetheless, Brown identifies benefits from multinational commitments, relevant to this study: legitimacy, burden sharing and access to the battlefield and...require more robust tools and would benefit if supplemented by alliance and cooperative partnerships. Nations “are increasingly disinclined to

  2. Multinational Activities of Major U.S. Automotive Producers : Volume 1. Summary.

    DOT National Transportation Integrated Search

    1978-09-01

    The multinational activities of General Motors, Ford, Chrysler, and American Motors are documented and analyzed. The study contains a compilation of data related to multinational operations; specifically it addresses research, development, engineerin...

  3. Functional Recovery Measures for Spinal Cord Injury: An Evidence-Based Review for Clinical Practice and Research

    PubMed Central

    Anderson, Kim; Aito, Sergio; Atkins, Michal; Biering-Sørensen, Fin; Charlifue, Susan; Curt, Armin; Ditunno, John; Glass, Clive; Marino, Ralph; Marshall, Ruth; Mulcahey, Mary Jane; Post, Marcel; Savic, Gordana; Scivoletto, Giorgio; Catz, Amiram

    2008-01-01

    Background/Objective: The end goal of clinical care and clinical research involving spinal cord injury (SCI) is to improve the overall ability of persons living with SCI to function on a daily basis. Neurologic recovery does not always translate into functional recovery. Thus, sensitive outcome measures designed to assess functional status relevant to SCI are important to develop. Method: Evaluation of currently available SCI functional outcome measures by a multinational work group. Results: The 4 measures that fit the prespecified inclusion criteria were the Modified Barthel Index (MBI), the Functional Independence Measure (FIM), the Quadriplegia Index of Function (QIF), and the Spinal Cord Independence Measure (SCIM). The MBI and the QIF were found to have minimal evidence for validity, whereas the FIM and the SCIM were found to be reliable and valid. The MBI has little clinical utility for use in the SCI population. Likewise, the FIM applies mainly when measuring burden of care, which is not necessarily a reflection of functional recovery. The QIF is useful for measuring functional recovery but only in a subpopulation of people with SCI, and substantial validity data are still required. The SCIM is the only functional recovery outcome measure designed specifically for SCI. Conclusions: The multinational work group recommends that the latest version of the SCIM (SCIM III) continue to be refined and validated and subsequently implemented worldwide as the primary functional recovery outcome measure for SCI. The QIF may continue to be developed and validated for use as a supplemental tool for the nonambulatory tetraplegic population. PMID:18581660

  4. Monitoring and Evaluation of African Women in Agricultural Research and Development (AWARD): An Exemplar of Managing for Impact in Development Evaluation

    ERIC Educational Resources Information Center

    Brandon, Paul R.; Smith, Nick L.; Ofir, Zenda; Noordeloos, Marco

    2014-01-01

    In this Exemplars case, the fifth and final under the direction of the current coeditors, the authors present a reflective account of an ongoing, complex, multiyear, multinational monitoring and evaluation (M&E) system conducted for African Women in Agricultural Research and Development (AWARD), an international development program. The…

  5. Dependency, democracy, and infant mortality: a quantitative, cross-national analysis of less developed countries.

    PubMed

    Shandra, John M; Nobles, Jenna; London, Bruce; Williamson, John B

    2004-07-01

    This study presents quantitative, sociological models designed to account for cross-national variation in infant mortality rates. We consider variables linked to four different theoretical perspectives: the economic modernization, social modernization, political modernization, and dependency perspectives. The study is based on a panel regression analysis of a sample of 59 developing countries. Our preliminary analysis based on additive models replicates prior studies to the extent that we find that indicators linked to economic and social modernization have beneficial effects on infant mortality. We also find support for hypotheses derived from the dependency perspective suggesting that multinational corporate penetration fosters higher levels of infant mortality. Subsequent analysis incorporating interaction effects suggest that the level of political democracy conditions the effects of dependency relationships based upon exports, investments from multinational corporations, and international lending institutions. Transnational economic linkages associated with exports, multinational corporations, and international lending institutions adversely affect infant mortality more strongly at lower levels of democracy than at higher levels of democracy: intranational, political factors interact with the international, economic forces to affect infant mortality. We conclude with some brief policy recommendations and suggestions for the direction of future research.

  6. [ECRIN (European clinical research infrastructures network), a pan-European infrastructure for clinical research].

    PubMed

    Demotes-Mainard, Jacques

    2010-12-01

    Clinical research plays a key role both in the development of innovative health products and in the optimisation of medical strategies, leading to evidence-based practice and healthcare cost containment. ECRIN is a distributed ESFRI-roadmap pan-European infrastructure designed to support multinational clinical research, making Europe a single area for clinical studies, taking advantage of its population size to access patients, and unlocking latent scientific providing services to multinational. Servicing of multinational trials started during the preparatory phase, and ECRIN has applied for ERIC status in 2011. In parallel, ECRIN has also proposed an FP7 integrating activity project to further develop, upgrade and expand the ECRIN infrastructure built up during the past FP6 and FP7 projects, facilitating an efficient organization of clinical research in Europe, with ECRIN developing generic tools and providing generic services for multinational studies, and supporting the construction of pan-European disease-oriented networks that will in turn act as ECRIN users. This organization will improve Europe's attractiveness for industry trials, boost its scientific competitiveness, and result in better healthcare for European citizens. The three medical areas supported in this project (rare diseases, medical devices, and nutrition) will serve as pilots for other biomedical research fields. By creating a single area for clinical research in Europe, this structure will contribute to the implementation of the Europe flagship initiative 2020 'Innovation Union', whose objectives include defragmentation of research and educational capacities, tackling the major societal challenges (starting with healthy aging), and removing barriers to bringing ideas to the market.

  7. Learning at Transition for New and Experienced Staff

    ERIC Educational Resources Information Center

    Milligan, Colin; Margaryan, Anoush; Littlejohn, Allison

    2013-01-01

    Purpose: This study aims to improve the understanding of the learning and development that occurs during initial and subsequent role transitions within knowledge intensive workplaces. Design/methodology/approach: Semi-structured interviews were conducted with 19 knowledge workers in a multinational company and the learning experiences of new…

  8. Consulting-Research Froblems with German and American Multinational Firms.

    ERIC Educational Resources Information Center

    Hildebrandt, Herbert W.

    International researchers need to be aware of international problems and multinational managerial codes when they work with worldwide organizations. This paper develops the premise that consulting with German multinational companies is more complex than consulting with or researching for American firms. Discussion focuses on the following three…

  9. More Than We Bargained For: The Impact of Consumer Culture in Southeast Asia.

    ERIC Educational Resources Information Center

    Frith, Katherine T.

    Advertising by multinational corporations in Southeast Asia is generating a growing resistance to its perceived role in creating a "consumer culture" damaging to indigenous values systems. Critics of advertising in Southeast Asia argue that when multinational advertisers or their multinational advertising agencies move into this foreign…

  10. Design and Analysis of Cognitive Interviews for Comparative Multinational Testing

    PubMed Central

    Fitzgerald, Rory; Padilla, José-Luis; Willson, Stephanie; Widdop, Sally; Caspar, Rachel; Dimov, Martin; Gray, Michelle; Nunes, Cátia; Prüfer, Peter; Schöbi, Nicole; Schoua-Glusberg, Alisú

    2011-01-01

    This article summarizes the work of the Comparative Cognitive Testing Workgroup, an international coalition of survey methodologists interested in developing an evidence-based methodology for examining the comparability of survey questions within cross-cultural or multinational contexts. To meet this objective, it was necessary to ensure that the cognitive interviewing (CI) method itself did not introduce method bias. Therefore, the workgroup first identified specific characteristics inherent in CI methodology that could undermine the comparability of CI evidence. The group then developed and implemented a protocol addressing those issues. In total, 135 cognitive interviews were conducted by participating countries. Through the process, the group identified various interpretive patterns resulting from sociocultural and language-related differences among countries as well as other patterns of error that would impede comparability of survey data. PMID:29081719

  11. Unseen and Unheard? Women Managers and Organizational Learning

    ERIC Educational Resources Information Center

    Martin, Lynn M.; Lord, Gemma; Warren-Smith, Izzy

    2018-01-01

    Purpose: This paper aims to use (in)visibility as a lens to understand the lived experience of six women managers in the headquarters of a large multinational organization in the UK to identify how "gender" is expressed in the context of organizational learning. Design/methodology/approach: The researchers take a phenomenological…

  12. "Think Differently, Get Creative": Producing Precarity in India's Corporate Theater Culture Industry

    ERIC Educational Resources Information Center

    Saddler, Sarah

    2017-01-01

    In India's rapidly developing global cities, large multinational corporations implement theater-based corporate training programs that are designed to inspire employees to be more dynamic, aspirational, and self-motivated at work. Offering a performance ethnography of a week-long "Theatre in Excellence" program hosted in Bangalore…

  13. Multinational Corporations, Democracy and Child Mortality: A Quantitative, Cross-National Analysis of Developing Countries

    ERIC Educational Resources Information Center

    Shandra, John M.; Nobles, Jenna E.; London, Bruce; Williamson, John B.

    2005-01-01

    This study presents quantitative, sociological models designed to account for cross-national variation in child mortality. We consider variables linked to five different theoretical perspectives that include the economic modernization, social modernization, political modernization, ecological-evolutionary, and dependency perspectives. The study is…

  14. Teaching Methodologies and Course Contents in International Finance.

    ERIC Educational Resources Information Center

    Garg, Ramesh C.

    A guide to designing a course in international finance and multinational corporations is presented. It offers a rationale for such a course, discusses its primary goals, suggests two possible course orientations (professional or theoretical) and desirable or necessary prerequisites, and recommends specific course content areas and subareas. Types…

  15. Casco Bay Partnership for Workplace Education. Final Performance Report.

    ERIC Educational Resources Information Center

    University of Southern Maine, Gorham.

    The Casco Bay Partnership includes the University of Southern Maine (USM) and seven businesses in greater Portland, Maine, that range from large multinational corporations to small, family-owned businesses. During a 3-year project funded by a National Workplace Literacy Program grant, the partnership designed and delivered workplace basic skills…

  16. A multinational report of technical factors on stereotactic body radiotherapy for oligometastases.

    PubMed

    Redmond, Kristin J; Lo, Simon S; Dagan, Roi; Poon, Ian; Foote, Matthew C; Erler, Darby; Lee, Young; Lohr, Frank; Biswas, Tithi; Ricardi, Umberto; Sahgal, Arjun

    2017-05-01

    Oligometastatic cancer is being increasingly managed with aggressive local therapy using stereotactic body radiation therapy (SBRT). However, few guidelines exist. We summarize the results of an international survey reviewing technical factors for extracranial SBRT for oligometastatic disease to guide safe management. Seven high-volume centers contributed. Levels of agreement were categorized as strong (6-7 common responses), moderate (4-5), low (2-3) or no agreement. We present the results of a multi-national and multi-institutional survey of technical factors of SBRT for extracranial oligometastases. Key methods including target delineation, prescription doses, normal tissue constraints, imaging and set-up for safe implementation and practice of SBRT for oligometastasis have been identified. This manuscript will serve as a foundation for future clinical evaluations.

  17. The World Economy and Multinational Corporations: An Activity Program for Grades 9 through 12.

    ERIC Educational Resources Information Center

    Caterpillar Tractor Co., Peoria, IL.

    This booklet for secondary students contains background information and activities about the multinational corporation (MNC). The major goal of the booklet is to impart an understanding of the economic concepts underlying the world economy and the activities of multinational business enterprises. The world economy, the exchange of goods and…

  18. On the topological structure of multinationals network

    NASA Astrophysics Data System (ADS)

    Joyez, Charlie

    2017-05-01

    This paper uses a weighted network analysis to examine the structure of multinationals' implantation countries network. Based on French firm-level dataset of multinational enterprises (MNEs) the network analysis provides information on each country position in the network and in internationalization strategies of French MNEs through connectivity preferences among the nodes. The paper also details network-wide features and their recent evolution toward a more decentralized structure. While much has been said on international trade network, this paper shows that multinational firms' studies would also benefit from network analysis, notably by investigating the sensitivity of the network construction to firm heterogeneity.

  19. Recalibrating Baseline Evidence in Burundi, Malawi, Senegal and Uganda: Exploring the Potential of Multi-Site, National-Level Stakeholder Engagement in Participatory Evaluation

    ERIC Educational Resources Information Center

    Edge, Karen; Marphatia, Akanksha A.

    2015-01-01

    This paper details our collaborative work on the Improving Learning Outcomes in Primary Schools (ILOPS) project in Burundi, Malawi, Uganda and Senegal. ILOPS set out to establish an innovative template for multi-stakeholder, multinational participatory evaluation (PE) and examine the fundamental roles, relationships and evidence that underpin the…

  20. Current Status of Diversity Initiatives in Selected Multinational Corporations. Diversity in the Workforce Series Report #3.

    ERIC Educational Resources Information Center

    Wentling, Rose Mary; Palma-Rivas, Nilda

    The current status of diversity initiatives in eight U.S.-based multinational corporations was examined through a process involving semistructured interviews of diversity managers and analysis of their annual reports for fiscal 1996 and related documents. The 8 corporations were randomly selected from the 30 multinational corporations in Illinois.…

  1. Role of the multinational corporations in Nigeria's development

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Okonkwo, P.A.

    1978-01-01

    A dominant characteristic of the decades immediately following World War II is the evolution of the multinational corporation. This evolution necessitated a change in the perspective of the international companies. The survival of the multinational corporations depended on its world profit perspective. Initially, the European countries provided the American multinational with world trade avenues while the European multinationals established subsidiaries in Africa. Recently, both the American and the European subsidiares have become interested in Nigeria because of its prospect as a potential market in Africa. The major objective of the research is to inquire about executive judgements and decision criteriamore » for marketing mix considerations and decisions. Also because of the uniqueness of Nigeria from the Western World in terms of its socio-cultural, legal, economic and political environments,executive decision criteria in the area of manufacturing was also investigated.« less

  2. Cost-effectiveness analysis using data from multinational trials: The use of bivariate hierarchical modelling

    PubMed Central

    Manca, Andrea; Lambert, Paul C; Sculpher, Mark; Rice, Nigel

    2008-01-01

    Healthcare cost-effectiveness analysis (CEA) often uses individual patient data (IPD) from multinational randomised controlled trials. Although designed to account for between-patient sampling variability in the clinical and economic data, standard analytical approaches to CEA ignore the presence of between-location variability in the study results. This is a restrictive limitation given that countries often differ in factors that could affect the results of CEAs, such as the availability of healthcare resources, their unit costs, clinical practice, and patient case-mix. We advocate the use of Bayesian bivariate hierarchical modelling to analyse multinational cost-effectiveness data. This analytical framework explicitly recognises that patient-level costs and outcomes are nested within countries. Using real life data, we illustrate how the proposed methods can be applied to obtain (a) more appropriate estimates of overall cost-effectiveness and associated measure of sampling uncertainty compared to standard CEA; and (b) country-specific cost-effectiveness estimates which can be used to assess the between-location variability of the study results, while controlling for differences in country-specific and patient-specific characteristics. It is demonstrated that results from standard CEA using IPD from multinational trials display a large degree of variability across the 17 countries included in the analysis, producing potentially misleading results. In contrast, ‘shrinkage estimates’ obtained from the modelling approach proposed here facilitate the appropriate quantification of country-specific cost-effectiveness estimates, while weighting the results based on the level of information available within each country. We suggest that the methods presented here represent a general framework for the analysis of economic data collected from different locations. PMID:17641141

  3. Contemporary management of acute coronary syndromes: does the practice match the evidence? The global registry of acute coronary events (GRACE).

    PubMed

    Carruthers, K F; Dabbous, O H; Flather, M D; Starkey, I; Jacob, A; Macleod, D; Fox, K A A

    2005-03-01

    To determine to what extent evidence based guidelines are followed in the management of acute coronary syndromes (ACS) in the UK, elsewhere in Europe, and multinationally, and what the outcomes are. Multinational, prospective, observational registry (GRACE, global registry of acute coronary events) with six months' follow up. Patients presenting to a cluster of hospitals. The study was designed to collect data representative of the full spectrum of ACS in specific geographic populations. Patients admitted with a working diagnosis of unstable angina or suspected myocardial infarction (MI). Death during hospitalisation and at six months' follow up (adjusted for baseline risks). In ST elevation MI, reperfusion was applied more often in the UK (71%) than in Europe (65%) and multinationally (59%) (p < 0.01). However, this was almost entirely by lytic treatment, in contrast with elsewhere (primary percutaneous coronary intervention 1%, 29%, 16%, respectively). Statins were applied more frequently in the UK for all classes of patients with ACS (p < 0.0001). In contrast there was lower use of revascularisation procedures in non-ST MI (20% v 37% v 28%, respectively) and glycoprotein IIb/IIIa antagonists (6% v 25% v 26%, respectively). In-hospital death rates, adjusted for baseline risk, were not significantly different but six month death rates were higher in the UK for ST elevation MI (7.2% UK, 4.3% Europe, 5.3% multinationally; p < 0.0001) and non-ST elevation MI (7.5%, 6.2%, and 6.7%, respectively; p = 0.012, UK v Europe). Current management of ACS in the UK more closely follows the recommendations of the National Service Framework than British or European guidelines. Differences in practice may account for the observed higher event rates in the UK after hospital discharge.

  4. Basic Research in Human Factors

    DTIC Science & Technology

    1990-07-01

    settings as military organizations, voluntary organizations, multinational corporations, 15 diplamatic corps, governmnt agencies, and couples managing a...developrent, the analysis suggests both problem and possible solutions. It also derives some general conclusions regarding the design and management ...organize and manage information spontaneasly in order to develop techniques which will help them do so more effectively. Attitudes toards and

  5. Managerial Selection Decisions in Multinational Corporations: Teaching International Business Using Problem-Based Learning

    ERIC Educational Resources Information Center

    Zisk, Daniel S.; Owyar-Hosseini, Marion M.; DuBose, Philip B.

    2015-01-01

    Companies face many challenges as they staff managerial positions in overseas operations, including decisions on whether to staff using expatriates, host-country nationals, or third-country nationals. We developed an exercise--designed to help students understand the differences between these three groups of employees--that requires students to…

  6. Economists & Higher Learning in the Nineteenth Century.

    ERIC Educational Resources Information Center

    Barber, William J., Ed.

    As part of a multi-nation research project on the institutionalization of political economy in European, Japanese, and North American universities, the 14 essays in this volume explore the roots of academic economics in the United States during the 19th century. The organization of the essays is designed to show the catalytic role economists…

  7. Predictors of Learner Satisfaction and Transfer of Learning in a Corporate Online Education Program

    ERIC Educational Resources Information Center

    Gunawardena, Charlotte N.; Linder-VanBerschot, Jennifer A.; LaPointe, Deborah K.; Rao, Lalita

    2010-01-01

    This study explores factors that predict learner satisfaction and transfer of learning in an online educational program at a multinational corporation, established to improve organizational learning by providing training in technical skills. A mixed-methods design was used, selecting both quantitative methods (utilizing survey research) and…

  8. Culturally-Based Adaptive Learning and Concept Analytics to Guide Educational Website Content Integration

    ERIC Educational Resources Information Center

    Reiners, Torsten; Dreher, Heinz

    2009-01-01

    In modern learning environments, the lecturer or educational designer is often confronted with multi-national student cohorts, requiring special consideration regarding language, cultural norms and taboos, religion, and ethics. Through a somewhat provocative example we demonstrate that taking such factors into account can be essential to avoid…

  9. Developing Geospatial Intelligence Stewardship for Multinational Operations

    DTIC Science & Technology

    2010-06-11

    and chaired by the NGA’s It is important to note that the GEOINT data stream requires the largest bandwidth for full motion video , hyper-spectral...platforms, as in the phrase “Predator Porn .” Yet, what should be used could be called an ISR-operational design, in an end-ways-means approach...

  10. Reflexive Deliberation in International Research Collaboration: Minimising Risk and Maximising Opportunity

    ERIC Educational Resources Information Center

    Brew, Angela; Boud, David; Lucas, Lisa; Crawford, Karin

    2013-01-01

    International research collaboration raises questions about how groups from different national and institutional contexts can work together for common ends. This paper uses issues that have arisen in carrying out the first stage of an international research project to discuss a framework designed to map different kinds of multi-national research…

  11. Promoting Protean Career through Employability Culture and Mentoring: Career Strategies as Moderator

    ERIC Educational Resources Information Center

    Wong, Siew Chin; Mohd Rasdi, Roziah; Abu Samah, Bahaman; Abdul Wahat, Nor Wahiza

    2017-01-01

    Purpose: The purpose of this paper is to examine the effects of organizational-related variables and the moderating role of career strategies on protean career among employees. Design/methodology/approach: Research data are gathered from a sample of 306 employees in 18 electrical and electronics multinational corporations (MNCs) in Malaysia.…

  12. L'identificazione etnico-linguistica in comunita infantili plurinazionali (Ethnolinguistic Identification in a Multinational Children's Community).

    ERIC Educational Resources Information Center

    Franchi, Annalisa

    1988-01-01

    Analyzes the results of a study undertaken in Switzerland, which was designed to determine the degree of integration of non-Italian children in Italian-language nursery schools in the German part of Switzerland. Attempts to synthesize the ethnic and lingusitic elements of the study are made. (CFM)

  13. Repatriation of Expatriate Employees, Knowledge Transfer, and Organizational Learning: What Do We Know?

    ERIC Educational Resources Information Center

    Nery-Kjerfve, Tania; McLean, Gary N.

    2012-01-01

    Purpose: The purpose of this paper is to present a review of the topic of repatriation and the potential benefits of the use of repatriated employees to enhance global knowledge and organizational learning in multinational corporations. Design/methodology/approach: The paper provides an integrative literature review of articles published on…

  14. Local Nordic tobacco interests collaborated with multinational companies to maintain a united front and undermine tobacco control policies.

    PubMed

    Hiilamo, Heikki; Glantz, Stanton A

    2013-03-01

    To analyse how local tobacco companies in the Nordic countries, individually and through National Manufacturers' Associations, cooperated with British American Tobacco and Philip Morris in denying the health hazards of smoking and undermining tobacco control. Analysis of tobacco control policies in the Nordic countries and tobacco industry documents. Nordic countries were early adopters of tobacco control policies. The multinational tobacco companies recognised this fact and mobilised to oppose these policies, in part because of fear that they would set unfavourable precedents. Since at least 1972, the Nordic tobacco companies were well informed about and willing to participate in the multinational companies activities to obscure the health dangers of smoking and secondhand smoke and to oppose tobacco control policies. Cooperation between multinational companies, Nordic national manufacturer associations and local companies ensured a united front on smoking and health issues in the Nordic area that was consistent with the positions that the multinational companies were taking. This cooperation delayed smoke-free laws and undermined other tobacco control measures. Local tobacco companies worked with multinational companies to undermine tobacco control in distant and small Nordic markets because of concern that pioneering policies initiated in Nordic countries would spread to bigger market areas. Claims by the local Nordic companies that they were not actively involved with the multinationals are not supported by the facts. These results also demonstrate that the industry appreciates the global importance of both positive and negative public health precedents in tobacco control.

  15. The Contribution of Command and Control to Unity of Effort

    DTIC Science & Technology

    2002-09-01

    Engineering and Evaluation Centre University of South Australia Mawson Lakes, South Australia Author contact: 6 Frank Street St Morris SA 5068... Mawson Lakes, South Australia, , 8. PERFORMING ORGANIZATION REPORT NUMBER 9. SPONSORING/MONITORING AGENCY NAME(S) AND ADDRESS(ES) 10. SPONSOR/MONITOR’S...Noel Sproles PhD Systems Engineering and Evaluation Centre University of South Australia Mawson Lakes, South Australia While joint and multi-national

  16. The Army in Multinational Operations

    DTIC Science & Technology

    2010-05-01

    multinational commanders may be faced with nations refusing to perform assigned tasks. The term “national red card” using a soccer simile has been coined...106. What is the multinational plan for recovery of critical aviation equipment, facilities, and resources? Constraints and Freedom of Action 5-107...quantity, and timeliness) suitable for likely combat search and rescue as well as recovery of encircled forces? Operations and Planning 20 May

  17. Crosscultural Issues in the Process of Sending U.S. Employees of Multinational Corporations for Overseas Service: Theoretical Considerations with Practical Implications.

    ERIC Educational Resources Information Center

    Griffis, Betty Ann

    Defining the multinational as a producing enterprise motivated by profit and owning or controlling facilities in more than one country, this paper analyzes the process employed by United States multinationals in sending parent country nationals abroad for service in a subsidiary. It first examines the process in its fullest form by citing…

  18. Rationale and trial design of Bardoxolone Methyl Evaluation in Patients with Chronic Kidney Disease and Type 2 Diabetes: the Occurrence of Renal Events (BEACON).

    PubMed

    de Zeeuw, Dick; Akizawa, Tadao; Agarwal, Rajiv; Audhya, Paul; Bakris, George L; Chin, Melanie; Krauth, Melissa; Lambers Heerspink, Hiddo J; Meyer, Colin J; McMurray, John J; Parving, Hans-Henrik; Pergola, Pablo E; Remuzzi, Giuseppe; Toto, Robert D; Vaziri, Nosratola D; Wanner, Christoph; Warnock, David G; Wittes, Janet; Chertow, Glenn M

    2013-01-01

    Chronic kidney disease (CKD) associated with type 2 diabetes mellitus constitutes a global epidemic complicated by considerable renal and cardiovascular morbidity and mortality, despite the provision of inhibitors of the renin-angiotensin-aldosterone system (RAAS). Bardoxolone methyl, a synthetic triterpenoid that reduces oxidative stress and inflammation through Nrf2 activation and inhibition of NF-κB was previously shown to increase estimated glomerular filtration rate (eGFR) in patients with CKD associated with type 2 diabetes mellitus. To date, no antioxidant or anti-inflammatory therapy has proved successful at slowing the progression of CKD. Herein, we describe the design of Bardoxolone Methyl Evaluation in Patients with Chronic Kidney Disease and Type 2 Diabetes: the Occurrence of Renal Events (BEACON) trial, a multinational, multicenter, double-blind, randomized, placebo-controlled Phase 3 trial designed to determine whether long-term administration of bardoxolone methyl (on a background of standard therapy, including RAAS inhibitors) safely reduces renal and cardiac morbidity and mortality. The primary composite endpoint is time-to-first occurrence of either end-stage renal disease or cardiovascular death. Secondary endpoints include the change in eGFR and time to occurrence of cardiovascular events. BEACON will be the first event-driven trial to evaluate the effect of an oral antioxidant and anti-inflammatory drug in advanced CKD. Copyright © 2013 S. Karger AG, Basel.

  19. When in Rome? The Effects of Spokesperson Ethnicity on Audience Evaluation of Crisis Communication.

    ERIC Educational Resources Information Center

    Arpan, Laura M.

    2002-01-01

    Examines the effects of using organizational spokespersons of ethnic backgrounds similar to or different from possible stakeholders of a multinational organization. Finds that the degree to which undergraduate students identified with his or her own ethnic group affected spokesperson similarity ratings. Discusses implications for multinational…

  20. Issues of Global and Local Norm Use in Assessments of Motivation

    ERIC Educational Resources Information Center

    Kabacoff, Robert I.

    2008-01-01

    With the growth of globalization, organizations are facing an increased challenge to manage talent, improve employee engagement, develop effective teams, create succession pipelines, and increase organizational effectiveness in multinational settings. Given the need to evaluate and compare individuals from more than one country using standardized…

  1. USE OF RADIOPHONIC TEACHING IN FUNDAMENTAL EDUCATION.

    ERIC Educational Resources Information Center

    RHOADS, WILLIAM G.; AND OTHERS

    A PILOT STUDY WAS CONDUCTED IN EL SALVADOR AND HONDURAS TO TEST THE FEASIBILITY OF MULTINATIONAL EVALUATION OF THE RADIOPHONIC SCHOOL SYSTEM IN LATIN AMERICA. RADIO SCHOOL PROGRAMS WERE EXAMINED IN TERMS OF THEIR EFFECT ON PARTICIPANT ACHIEVEMENT, SATISFACTION, AND APPLICATION OF ACQUIRED SKILLS AND KNOWLEDGE. ATTITUDINAL, SOCIAL, AND CULTURAL…

  2. Cultural Variation in Antismoking Video Ads between the United States, Taiwan, and China

    ERIC Educational Resources Information Center

    Wong, Tzu-Jung; King, Jessica L.; Pomeranz, Jamie L.

    2016-01-01

    Antitobacco advertisement components, including types of messages and advertising appeals, have not been evaluated among multinational groups. This study identified and compared the content of antismoking video ads across three countries. We reviewed 86 antismoking video advertisements for the following information: severity of the consequences of…

  3. Clinical trial allocation in multinational pharmaceutical companies - a qualitative study on influential factors.

    PubMed

    Dombernowsky, Tilde; Haedersdal, Merete; Lassen, Ulrik; Thomsen, Simon F

    2017-06-01

    Clinical trial allocation in multinational pharmaceutical companies includes country selection and site selection. With emphasis on site selection, the overall aim of this study was to examine which factors pharmaceutical companies value most when allocating clinical trials. The specific aims were (1) to identify key decision makers during country and site selection, respectively, (2) to evaluate by which parameters subsidiaries are primarily assessed by headquarters with regard to conducting clinical trials, and (3) to evaluate which site-related qualities companies value most when selecting trial sites. Eleven semistructured interviews were conducted among employees engaged in trial allocation at 11 pharmaceutical companies. The interviews were analyzed by deductive content analysis, which included coding of data to a categorization matrix containing categories of site-related qualities. The results suggest that headquarters and regional departments are key decision makers during country selection, whereas subsidiaries decide on site selection. Study participants argued that headquarters primarily value timely patient recruitment and quality of data when assessing subsidiaries. The site-related qualities most commonly emphasized during interviews were study population availability, timely patient recruitment, resources at the site, and site personnel's interest and commitment. Costs of running the trials were described as less important. Site personnel experience in conducting trials was described as valuable but not imperative. In conclusion, multinational pharmaceutical companies consider recruitment-related factors as crucial when allocating clinical trials. Quality of data and site personnel's interest and commitment are also essential, whereas costs seem less important. While valued, site personnel experience in conducting clinical trials is not imperative.

  4. CREATION OF A MODEL TO PREDICT SURVIVAL IN PATIENTS WITH REFRACTORY COELIAC DISEASE USING A MULTINATIONAL REGISTRY

    PubMed Central

    Rubio-Tapia, Alberto; Malamut, Georgia; Verbeek, Wieke H.M.; van Wanrooij, Roy L.J.; Leffler, Daniel A.; Niveloni, Sonia I.; Arguelles-Grande, Carolina; Lahr, Brian D.; Zinsmeister, Alan R.; Murray, Joseph A.; Kelly, Ciaran P.; Bai, Julio C.; Green, Peter H.; Daum, Severin; Mulder, Chris J.J.; Cellier, Christophe

    2016-01-01

    Background Refractory coeliac disease is a severe complication of coeliac disease with heterogeneous outcome. Aim To create a prognostic model to estimate survival of patients with refractory coeliac disease. Methods We evaluated predictors of 5-year mortality using Cox proportional hazards regression on subjects from a multinational registry. Bootstrap re-sampling was used to internally validate the individual factors and overall model performance. The mean of the estimated regression coefficients from 400 bootstrap models was used to derive a risk score for 5-year mortality. Results The multinational cohort was composed of 232 patients diagnosed with refractory coeliac disease across 7 centers (range of 11–63 cases per center). The median age was 53 years and 150 (64%) were women. A total of 51 subjects died during 5-year follow-up (cumulative 5-year all-cause mortality = 30%). From a multiple variable Cox proportional hazards model, the following variables were significantly associated with 5-year mortality: age at refractory coeliac disease diagnosis (per 20 year increase, hazard ratio = 2.21; 95% confidence interval: 1.38, 3.55), abnormal intraepithelial lymphocytes (hazard ratio = 2.85; 95% confidence interval: 1.22, 6.62), and albumin (per 0.5 unit increase, hazard ratio = 0.72; 95% confidence interval: 0.61, 0.85). A simple weighted 3-factor risk score was created to estimate 5-year survival. Conclusions Using data from a multinational registry and previously-reported risk factors, we create a prognostic model to predict 5-year mortality among patients with refractory coeliac disease. This new model may help clinicians to guide treatment and follow-up. PMID:27485029

  5. Mind the Gap! A Multilevel Analysis of Factors Related to Variation in Published Cost-Effectiveness Estimates within and between Countries.

    PubMed

    Boehler, Christian E H; Lord, Joanne

    2016-01-01

    Published cost-effectiveness estimates can vary considerably, both within and between countries. Despite extensive discussion, little is known empirically about factors relating to these variations. To use multilevel statistical modeling to integrate cost-effectiveness estimates from published economic evaluations to investigate potential causes of variation. Cost-effectiveness studies of statins for cardiovascular disease prevention were identified by systematic review. Estimates of incremental costs and effects were extracted from reported base case, sensitivity, and subgroup analyses, with estimates grouped in studies and in countries. Three bivariate models were developed: a cross-classified model to accommodate data from multinational studies, a hierarchical model with multinational data allocated to a single category at country level, and a hierarchical model excluding multinational data. Covariates at different levels were drawn from a long list of factors suggested in the literature. We found 67 studies reporting 2094 cost-effectiveness estimates relating to 23 countries (6 studies reporting for more than 1 country). Data and study-level covariates included patient characteristics, intervention and comparator cost, and some study methods (e.g., discount rates and time horizon). After adjusting for these factors, the proportion of variation attributable to countries was negligible in the cross-classified model but moderate in the hierarchical models (14%-19% of total variance). Country-level variables that improved the fit of the hierarchical models included measures of income and health care finance, health care resources, and population risks. Our analysis suggested that variability in published cost-effectiveness estimates is related more to differences in study methods than to differences in national context. Multinational studies were associated with much lower country-level variation than single-country studies. These findings are for a single clinical question and may be atypical. © The Author(s) 2015.

  6. Creation of a model to predict survival in patients with refractory coeliac disease using a multinational registry.

    PubMed

    Rubio-Tapia, A; Malamut, G; Verbeek, W H M; van Wanrooij, R L J; Leffler, D A; Niveloni, S I; Arguelles-Grande, C; Lahr, B D; Zinsmeister, A R; Murray, J A; Kelly, C P; Bai, J C; Green, P H; Daum, S; Mulder, C J J; Cellier, C

    2016-10-01

    Refractory coeliac disease is a severe complication of coeliac disease with heterogeneous outcome. To create a prognostic model to estimate survival of patients with refractory coeliac disease. We evaluated predictors of 5-year mortality using Cox proportional hazards regression on subjects from a multinational registry. Bootstrap resampling was used to internally validate the individual factors and overall model performance. The mean of the estimated regression coefficients from 400 bootstrap models was used to derive a risk score for 5-year mortality. The multinational cohort was composed of 232 patients diagnosed with refractory coeliac disease across seven centres (range of 11-63 cases per centre). The median age was 53 years and 150 (64%) were women. A total of 51 subjects died during a 5-year follow-up (cumulative 5-year all-cause mortality = 30%). From a multiple variable Cox proportional hazards model, the following variables were significantly associated with 5-year mortality: age at refractory coeliac disease diagnosis (per 20 year increase, hazard ratio = 2.21; 95% confidence interval, CI: 1.38-3.55), abnormal intraepithelial lymphocytes (hazard ratio = 2.85; 95% CI: 1.22-6.62), and albumin (per 0.5 unit increase, hazard ratio = 0.72; 95% CI: 0.61-0.85). A simple weighted three-factor risk score was created to estimate 5-year survival. Using data from a multinational registry and previously reported risk factors, we create a prognostic model to predict 5-year mortality among patients with refractory coeliac disease. This new model may help clinicians to guide treatment and follow-up. © 2016 John Wiley & Sons Ltd.

  7. Gaming Sea-based Multinational HA/DR Operations at PACOM Amphibious Leaders Symposium 2016

    DTIC Science & Technology

    2016-11-01

    DISTRIBUTION STATEMENT A. Approved for public release: distribution unlimited. Gaming Sea-based Multinational HA/DR Operations...Marine Corps photo by Cpl. Wesley Timm. Approved by: November 2016 Dr. E.D. McGrady Director, Integration and Gaming Advanced Technology and...TYPE Final2 3. DATES COVERED (From - To) 4. TITLE AND SUBTITLE Gaming Seabased Multinational HA/DR Operations at PACOM 5a. CONTRACT NUMBER N00014-16

  8. Stilwell’s North Burma campaign: a case study in multinational mission command

    DTIC Science & Technology

    2017-05-25

    history of providing multinational leadership , publications from the Army Press and Combat Studies Institute have not explored the use of the mission...the campaign. His leadership aided the US effort to reestablish its ground line of communication with its Chinese Nationalist allies. Stilwell’s...history of providing multinational leadership , publications from the Army Press and Combat Studies Institute have not explored the use of the mission

  9. Local Nordic tobacco interests collaborated with multinational companies to maintain a united front and undermine tobacco control policies

    PubMed Central

    Hiilamo, Heikki; Glantz, Stanton A

    2012-01-01

    Objective To analyse how local tobacco companies in the Nordic countries, individually and through National Manufacturers’ Associations, cooperated with British American Tobacco and Philip Morris in denying the health hazards of smoking and undermining tobacco control. Methods Analysis of tobacco control policies in the Nordic countries and tobacco industry documents. Results Nordic countries were early adopters of tobacco control policies. The multinational tobacco companies recognised this fact and mobilised to oppose these policies, in part because of fear that they would set unfavourable precedents. Since at least 1972, the Nordic tobacco companies were well informed about and willing to participate in the multinational companies activities to obscure the health dangers of smoking and secondhand smoke and to oppose tobacco control policies. Cooperation between multinational companies, Nordic national manufacturer associations and local companies ensured a united front on smoking and health issues in the Nordic area that was consistent with the positions that the multinational companies were taking. This cooperation delayed smoke-free laws and undermined other tobacco control measures. Conclusions Local tobacco companies worked with multinational companies to undermine tobacco control in distant and small Nordic markets because of concern that pioneering policies initiated in Nordic countries would spread to bigger market areas. Claims by the local Nordic companies that they were not actively involved with the multinationals are not supported by the facts. These results also demonstrate that the industry appreciates the global importance of both positive and negative public health precedents in tobacco control. PMID:22199013

  10. Measuring Organizational Learning Capability in Indian Managers and Establishing Firm Performance Linkage: An Empirical Analysis

    ERIC Educational Resources Information Center

    Bhatnagar, Jyotsna

    2006-01-01

    Purpose: The purpose of this research is to measure Organizational Learning Capability (OLC) perception in the managers of public, private and multinational organizations and establish the link between OLC and firm performance. Design/methodology/approach: The data were collected from a sample of 612 managers randomly drawn from Indian industry,…

  11. Quantifying Attitude to Chemistry in Students at the University of the South Pacific

    ERIC Educational Resources Information Center

    Brown, S. J.; Sharma, B. N.; Wakeling, L.; Naiker, M.; Chandra, S.; Gopalan, R. D.; Bilimoria, V. B.

    2014-01-01

    The attitude towards the study of chemistry for new entrant chemistry students from a multi-national, regional, tertiary educational institution in the South Pacific was investigated using a purpose-designed diagnostic instrument. The Attitude toward the Study of Chemistry Inventory (ASCI) was used to quantify attitude in a cohort of first year…

  12. Introduction to Political Risk Analysis. Learning Packages in the Policy Sciences, PS-24.

    ERIC Educational Resources Information Center

    Coplin, William D.; O'Leary, Michael K.

    This package introduces college students to the kind of analysis that multinational corporations undertake to assess risks to their business operations due to political and economic conditions. Designed to be completed in 3 weeks, the four exercises enable students to (1) identify the major sources of political risk; (2) determine what social,…

  13. Contact sensitizers in commercial hair dye products sold in Thailand.

    PubMed

    Boonchai, Waranya; Bunyavaree, Monthathip; Winayanuwattikun, Waranaree; Kasemsarn, Pranee

    2016-04-01

    Hair dyes are known to contain potent contact allergens for which sensitization rates have increased over the last decade. To examine the type and frequency of potent contact sensitizers labelled on hair dyes sold in metropolitan Bangkok, Thailand. During the 2013-2014 study period, labelled ingredient information from home use and professional hair dye products was collected. Two hundred and fifty-two hair dye products were evaluated. One hundred and forty-nine products from 48 brands were domestically produced in Thailand, and 103 products were from 23 multinational brands produced in countries other than Thailand. Two hundred and fourteen of 252 (84.9%) hair dye products were found to contain strong skin sensitizers, with 118 (46.8%) being found in domestically produced products, and 96 (38.1%) being found in multinational brand products. Thirty-eight hair dye products (15.1%) were free of potent skin sensitizers. The number of domestically produced products (31, 20.8%) that were free of potent skin sensitizers was significantly higher (p = 0.002) than the number of multinational brand products (7, 6.8%). p-Phenylenediamine was the most prevalent potent sensitizer found among domestically produced hair dyes available on the market. Our findings indicate regional differences in hair dye allergen exposure. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  14. Intimate partner violence in Europe: design and methods of a multinational study.

    PubMed

    Costa, Diogo; Soares, Joaquim J F; Lindert, Jutta; Hatzidimitriadou, Eleni; Karlsso, Andreas; Sundin, Örjan; Toth, Olga; Ioannidi-Kapolou, Ellisabeth; Degomme, Olivier; Cervilla, Jorge; Barros, Henrique

    2013-01-01

    To describe the design, methods, procedures and characteristics of the population involved in a study designed to compare Intimate Partner Violence (IPV) in eight European countries. Women and men aged 18-65, living in Ghent-Belgium (n = 245), Stuttgart-Germany (n = 546), Athens-Greece (n = 548), Budapest-Hungary (n = 604), Porto-Portugal (n = 635), Granada-Spain (n = 138), Östersund-Sweden (n = 592), London-United Kingdom (n = 571), were sampled and administered a common questionnaire. Chi-square goodness of fit and five-age strata population fractions ratios for sex and education were computed to evaluate samples' representativeness. Differences in the age distributions were found among women from Sweden and Portugal and among men from Belgium, Hungary, Portugal and Sweden. Over-recruitment of more educated respondents was noted in all sites. The use of a common research protocol with the same structured questionnaire is likely to provide accurate estimates of the general population IPV frequency, despite limitations in probabilistic sampling and restrictions in methods of administration. Copyright © 2012 SESPAS. Published by Elsevier Espana. All rights reserved.

  15. Perinatal health services organization for preterm births: a multinational comparison.

    PubMed

    Kelly, L E; Shah, P S; Håkansson, S; Kusuda, S; Adams, M; Lee, S K; Sjörs, G; Vento, M; Rusconi, F; Lehtonen, L; Reichman, B; Darlow, B A; Lui, K; Feliciano, L S; Gagliardi, L; Bassler, D; Modi, N

    2017-07-01

    To explore population characteristics, organization of health services and comparability of available information for very low birth weight or very preterm neonates born before 32 weeks' gestation in 11 high-income countries contributing data to the International Network for Evaluating Outcomes of Neonates (iNeo). We obtained population characteristics from public domain sources, conducted a survey of organization of maternal and neonatal health services and evaluated the comparability of data contributed to the iNeo collaboration from Australia, Canada, Finland, Israel, Italy, Japan, New Zealand, Spain, Sweden, Switzerland and UK. All countries have nationally funded maternal/neonatal health care with >90% of women receiving prenatal care. Preterm birth rate, maternal age, and neonatal and infant mortality rates were relatively similar across countries. Most (50 to >95%) between-hospital transports of neonates born at non-tertiary units were conducted by designated transport teams; 72% (8/11 countries) had designated transfer and 63% (7/11 countries) mandate the presence of a physician. The capacity of 'step-down' units varied between countries, with capacity for respiratory care available in <10% to >75% of units. Heterogeneity in data collection processes for benchmarking and quality improvement activities were identified. Comparability of healthcare outcomes for very preterm low birth weight neonates between countries requires an evaluation of differences in population coverage, healthcare services and meta-data.

  16. Coalition Logistics - The Multinational Force and Observers Model

    DTIC Science & Technology

    1986-05-19

    MISSION The mission of the MFO, as specified by the protocol , is to supervise implemeutation of the peace treaty and to employ its best efforts to prevent ...result, a protocol was -- negotiated, calling for a multinational military force and civilian- ---- observer unit to serve in the Sinai--outside the...auspices of the United Nations.2 In this way, the protocol of 3 August 1981 created the Multinational Force and Observers and directed Lhat it be

  17. Multinational corporations and culture in Liberia

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Bonaparte, T.H.

    1979-07-01

    The proportion of multinational corporations (MCs) in a developing country (DC) has little to do with the degree of corruption of local culture that takes place. Rather, policy decisions taken by governments of DCs determine whether or not multinationals have a positive or negative impact, according to the author's research in Liberia among foreign managers, African supervisors, and Liberian workers. Even though Liberia has an open door policy toward MCs, very little violence has been done to Liberian culture. The reason is two-fold: 1) multinationals have maintained tight enclaves and have generally refused to integrate their values, managerial and otherwise,more » with those of the Liberian society; and 2) Liberian government officials have done little to generate Liberian interest in the business field or to force multinationals to play a more participative role in the society. The result has been growth without development, in the sense that the country's growth rate has increased over the years, but the Liberian people remain very much underdeveloped. A change of policy could bring about continued growth with development and without cultural disintegration.« less

  18. Multinational Activities of Major U.S. Automotive Producers : Volume 4. A Preliminary Evaluation of Technology Innovation and Transfer

    DOT National Transportation Integrated Search

    1978-09-01

    While the major focus of the present study, as reflected in Volume II, III, and V, has been upon the overseas activities of the four U.S. automobile manufacturers, a supplementary concern has been to develop insights into the flows or transfers of te...

  19. Nuclear ribosomal internal transcribed spacer (ITS) region as a universal DNA barcode marker for Fungi

    USDA-ARS?s Scientific Manuscript database

    Six DNA regions were evaluated in a multi-national, multi-laboratory consortium as potential DNA barcodes for Fungi, the second largest kingdom of eukaryotic life. The region of the mitochondrial cytochrome c oxidase subunit 1 used as the animal barcode was excluded as a potential marker, because it...

  20. Joint Operations. Change 1

    DTIC Science & Technology

    2008-02-13

    procedures not ratified by the United States, commanders should evaluate and follow the multinational command’s doctrine and procedures, where applicable... human intelligence sources to be effective and implementation of appropriate force protection measures regardless of the operational...intelligence requirements needed to support the anticipated operation. Human intelligence often may provide the most useful source of information. Even

  1. A Qualitative Study of Managerial Coaching: How Critical Reflection and Experiential Learning Are Facilitated within a Multi-National Pharmaceutical Company

    ERIC Educational Resources Information Center

    Herrera, Tony Isaac

    2010-01-01

    This qualitative case study was designed to explore whether and how a sample of domestic and international managers use two key adult education concepts--critical reflection and experiential learning--to influence changes in individual employees whom they coach. The study is based on the primary assumption that although managers do not…

  2. KSC-2012-1853

    NASA Image and Video Library

    2012-02-17

    International Cooperation: NASA international cooperation provides opportunities for utilization of space by NASA partners worldwide. Cooperative programs allow each participating country to contribute its special talents and facilities to a common goal. International cooperation is a cornerstone of NASA’s space program today with multi-national crews living and working aboard the International Space Station. Poster designed by Kennedy Space Center Graphics Department/Greg Lee. Credit: NASA

  3. Proceedings of the Eastern Michigan University Conference on Languages for Business and the Professions (4th, Dearborn, MI, May 2-4, 1985).

    ERIC Educational Resources Information Center

    Voght, Geoffrey M., Comp.

    The proceedings of this conference include 56 papers on program design, classroom techniques, and ideas for second language instruction for business and the professions. The papers are presented in eight groups: (1) "International Business: The Language and Culture Connection," which includes papers on multinational business, marketing,…

  4. Making markets work for clean water.

    PubMed

    Carpenter, G

    2003-01-01

    Part of the solution to close the gap to meet the UN Millennium safe water goal lies in the domestic consumer marketplace. Multinational corporations must design products for low income consumers to deliver clean water at a household level. The future of business is linked to improving the lives of developing country consumers and to the improved economic status of those consumers.

  5. Design and analysis issues for economic analysis alongside clinical trials.

    PubMed

    Marshall, Deborah A; Hux, Margaret

    2009-07-01

    Clinical trials can offer a valuable and efficient opportunity to collect the health resource use and outcomes data for economic evaluation. However, economic and clinical studies differ fundamentally in the question they seek to answer. The design and analysis of trial-based cost-effectiveness studies require special consideration, which are reviewed in this article. Traditional randomized controlled trials, using an experimental design with a controlled protocol, are designed to measure safety and efficacy for product registration. Cost-effectiveness analysis seeks to measure effectiveness in the context of routine clinical practice, and requires collection of health care resources to allow estimation of cost over an equal timeframe for each treatment alternative. In assessing suitability of a trial for economic data collection, the comparator treatment and other protocol factors need to reflect current clinical practice and the trial follow-up must be sufficiently long to capture important costs and effects. The broadest available population and a measure of effectiveness reflecting important benefits for patients are preferred for economic analyses. Special analytical issues include dealing with missing and censored cost data, assessing uncertainty of the incremental cost-effectiveness ratio, and accounting for the underlying heterogeneity in patient subgroups. Careful consideration also needs to be given to data from multinational studies since practice patterns can differ across countries. Although clinical trials can be an efficient opportunity to collect data for economic evaluation, careful consideration of the suitability of the study design, and appropriate analytical methods must be applied to obtain rigorous results.

  6. 32 CFR 268.9 - Discussion of terms.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ..., excepting branches or agencies thereof located in the United States. (3) Any branch, subsidiary, or allied... organization of a multinational or regional character with headquarters abroad. (6) Any official multinational...

  7. Unsafe sexual behaviour in domestic and foreign migrant male workers in multinational workplaces in Jordan: occupational-based and behavioural assessment survey

    PubMed Central

    Al Rifai, Rami; Nakamura, Keiko; Seino, Kaoruko; Kizuki, Masashi; Morita, Ayako

    2015-01-01

    Objectives To examine the prevalence of unsafe sexual behaviour, sexually transmitted infection (STI)-related knowledge, health and work-related conditions, and correlates of practising unsafe sex among domestic and foreign male workers in multinational workplaces in Jordan. Design Cross-sectional behavioural assessment survey. Setting Multinational workplaces in Jordan. Participants 230 Jordanian and 480 foreign male workers aged ≥18 years who had worked in a Qualified Industrial Zone (QIZ) for 12 months or more. Outcomes The primary outcome was the prevalence of practising unsafe sex. ‘Unsafe sex’ was defined as sex with a non-regular sexual partner with inconsistent condom usage. Results Overall, 74.3% of workers reported lifetime sexual experience. The proportion of lifetime unsafe sex was similar among domestic (31.8%) and foreign (35.6%) workers. Of those, 59.2% of domestic and 68.1% of foreign workers started practising unsafe sex after joining the QIZ. Rates of lifetime unsafe sex were significantly higher among those who had their sexual debut after joining the QIZ in domestic (aOR, 2.2, 95% CI 1.1 to 4.4) and foreign workers (aOR, 2.4, 95% CI 1.4 to 4.1). Among the domestic workers, being 18–24 years old (aOR, 4.9), unmarried (aOR, 4.8), working in the QIZ for 5–8 years (aOR, 5.0), sometimes/frequently shopped with foreign workers (aOR, 2.1) or were current/ex-alcohol drinkers (aORs, 3.4) were independently significantly associated with higher odds of practising unsafe sex. Conclusions A significant proportion of domestic and foreign male workers had been practising unsafe sex. The findings indicated that not only foreigners but also domestic male workers associating with foreign workers are at high risk of unsafe sex. Tailored interventions to promote safer sex in multinational workplaces in Jordan are needed. PMID:26068511

  8. Multilevel models for estimating incremental net benefits in multinational studies.

    PubMed

    Grieve, Richard; Nixon, Richard; Thompson, Simon G; Cairns, John

    2007-08-01

    Multilevel models (MLMs) have been recommended for estimating incremental net benefits (INBs) in multicentre cost-effectiveness analysis (CEA). However, these models have assumed that the INBs are exchangeable and that there is a common variance across all centres. This paper examines the plausibility of these assumptions by comparing various MLMs for estimating the mean INB in a multinational CEA. The results showed that the MLMs that assumed the INBs were exchangeable and had a common variance led to incorrect inferences. The MLMs that included covariates to allow for systematic differences across the centres, and estimated different variances in each centre, made more plausible assumptions, fitted the data better and led to more appropriate inferences. We conclude that the validity of assumptions underlying MLMs used in CEA need to be critically evaluated before reliable conclusions can be drawn. Copyright 2006 John Wiley & Sons, Ltd.

  9. Relationship Between Patients' Perceptions of Care Quality and Health Care Errors in 11 Countries: A Secondary Data Analysis.

    PubMed

    Hincapie, Ana L; Slack, Marion; Malone, Daniel C; MacKinnon, Neil J; Warholak, Terri L

    2016-01-01

    Patients may be the most reliable reporters of some aspects of the health care process; their perspectives should be considered when pursuing changes to improve patient safety. The authors evaluated the association between patients' perceived health care quality and self-reported medical, medication, and laboratory errors in a multinational sample. The analysis was conducted using the 2010 Commonwealth Fund International Health Policy Survey, a multinational consumer survey conducted in 11 countries. Quality of care was measured by a multifaceted construct developed using Rasch techniques. After adjusting for potentially important confounding variables, an increase in respondents' perceptions of care coordination decreased the odds of self-reporting medical errors, medication errors, and laboratory errors (P < .001). As health care stakeholders continue to search for initiatives that improve care experiences and outcomes, this study's results emphasize the importance of guaranteeing integrated care.

  10. Oral disease in adults treated with hemodialysis: prevalence, predictors, and association with mortality and adverse cardiovascular events: the rationale and design of the ORAL Diseases in hemodialysis (ORAL-D) study, a prospective, multinational, longitudinal, observational, cohort study.

    PubMed

    Strippoli, Giovanni F M; Palmer, Suetonia C; Ruospo, Marinella; Natale, Patrizia; Saglimbene, Valeria; Craig, Jonathan C; Pellegrini, Fabio; Petruzzi, Massimo; De Benedittis, Michele; Ford, Pauline; Johnson, David W; Celia, Eduardo; Gelfman, Ruben; Leal, Miguel R; Torok, Marietta; Stroumza, Paul; Bednarek-Skublewska, Anna; Dulawa, Jan; Frantzen, Luc; Ferrari, Juan Nin; del Castillo, Domingo; Hegbrant, Jorgen; Wollheim, Charlotta; Gargano, Letitzia

    2013-04-19

    People with end-stage kidney disease treated with dialysis experience high rates of premature death that are at least 30-fold that of the general population, and have markedly impaired quality of life. Despite this, interventions that lower risk factors for mortality (including antiplatelet agents, epoetins, lipid lowering, vitamin D compounds, or dialysis dose) have not been shown to improve clinical outcomes for this population. Although mortality outcomes may be improving overall, additional modifiable determinants of health in people treated with dialysis need to be identified and evaluated. Oral disease is highly prevalent in the general population and represents a potential and preventable cause of poor health in dialysis patients. Oral disease may be increased in patients treated with dialysis due to their lower uptake of public dental services, as well as increased malnutrition and inflammation, although available exploratory data are limited by small sample sizes and few studies evaluating links between oral health and clinical outcomes for this group, including mortality and cardiovascular disease. Recent data suggest periodontitis may be associated with mortality in dialysis patients and well-designed, larger studies are now required. The ORAL Diseases in hemodialysis (ORAL-D) study is a multinational, prospective (minimum follow-up 12 months) study. Participants comprise consecutive adults treated with long-term in-center hemodialysis. Between July 2010 and February 2012, we recruited 4500 dialysis patients from randomly selected outpatient dialysis clinics in Europe within a collaborative network of dialysis clinics administered by a dialysis provider, Diaverum, in Europe (France, Hungary, Italy, Poland, Portugal, and Spain) and South America (Argentina). At baseline, dental surgeons with training in periodontology systematically assessed the prevalence and characteristics of oral disease (dental, periodontal, mucosal, and salivary) in all participants. Oral hygiene habits and thirst were evaluated using self-administered questionnaires. Data for hospitalizations and mortality (total and cause-specific) according to baseline oral health status will be collected once a year until 2022. This large study will estimate the prevalence, characteristics and correlations of oral disease and clinical outcomes (mortality and hospitalization) in adults treated with dialysis. We will further evaluate any association between periodontitis and risk of premature death in dialysis patients that has been suggested by existing research. The results from this study should provide powerful new data to guide strategies for future interventional studies for preventative and curative oral disease strategies in adults who have end-stage kidney disease.

  11. Pirfenidone for idiopathic pulmonary fibrosis: analysis of pooled data from three multinational phase 3 trials.

    PubMed

    Noble, Paul W; Albera, Carlo; Bradford, Williamson Z; Costabel, Ulrich; du Bois, Roland M; Fagan, Elizabeth A; Fishman, Robert S; Glaspole, Ian; Glassberg, Marilyn K; Lancaster, Lisa; Lederer, David J; Leff, Jonathan A; Nathan, Steven D; Pereira, Carlos A; Swigris, Jeffrey J; Valeyre, Dominique; King, Talmadge E

    2016-01-01

    Pirfenidone is an antifibrotic agent that has been evaluated in three multinational phase 3 trials in patients with idiopathic pulmonary fibrosis (IPF). We analysed pooled data from the multinational trials to obtain the most precise estimates of the magnitude of treatment effect on measures of disease progression.All patients randomised to pirfenidone 2403 mg·day(-1) or placebo in the CAPACITY or ASCEND studies were included in the analysis. Pooled analyses of outcomes at 1 year were based on the pre-specified end-points and analytic methods described in the ASCEND study protocol.A total of 1247 patients were included in the analysis. At 1 year, pirfenidone reduced the proportion of patients with a ≥10% decline in per cent predicted forced vital capacity or death by 43.8% (95% CI 29.3-55.4%) and increased the proportion of patients with no decline by 59.3% (95% CI 29.0-96.8%). A treatment benefit was also observed for progression-free survival, 6-min walk distance and dyspnoea. Gastrointestinal and skin-related adverse events were more common in the pirfenidone group, but rarely led to discontinuation.Analysis of data from three phase 3 trials demonstrated that treatment with pirfenidone for 1 year resulted in clinically meaningful reductions in disease progression in patients with IPF. Copyright ©ERS 2016.

  12. Pirfenidone for idiopathic pulmonary fibrosis: analysis of pooled data from three multinational phase 3 trials

    PubMed Central

    Albera, Carlo; Bradford, Williamson Z.; Costabel, Ulrich; du Bois, Roland M.; Fagan, Elizabeth A.; Fishman, Robert S.; Glaspole, Ian; Glassberg, Marilyn K.; Lancaster, Lisa; Lederer, David J.; Leff, Jonathan A.; Nathan, Steven D.; Pereira, Carlos A.; Swigris, Jeffrey J.; Valeyre, Dominique; King, Talmadge E.

    2016-01-01

    Pirfenidone is an antifibrotic agent that has been evaluated in three multinational phase 3 trials in patients with idiopathic pulmonary fibrosis (IPF). We analysed pooled data from the multinational trials to obtain the most precise estimates of the magnitude of treatment effect on measures of disease progression. All patients randomised to pirfenidone 2403 mg·day−1 or placebo in the CAPACITY or ASCEND studies were included in the analysis. Pooled analyses of outcomes at 1 year were based on the pre-specified end-points and analytic methods described in the ASCEND study protocol. A total of 1247 patients were included in the analysis. At 1 year, pirfenidone reduced the proportion of patients with a ≥10% decline in per cent predicted forced vital capacity or death by 43.8% (95% CI 29.3–55.4%) and increased the proportion of patients with no decline by 59.3% (95% CI 29.0–96.8%). A treatment benefit was also observed for progression-free survival, 6-min walk distance and dyspnoea. Gastrointestinal and skin-related adverse events were more common in the pirfenidone group, but rarely led to discontinuation. Analysis of data from three phase 3 trials demonstrated that treatment with pirfenidone for 1 year resulted in clinically meaningful reductions in disease progression in patients with IPF. PMID:26647432

  13. Vocational Education in Developing Countries. A Review of Studies and Project Experience. Education Division Documents No. 34.

    ERIC Educational Resources Information Center

    Hultin, Mats

    This paper looks at the position taken in available literature and evaluation reports of multinational and bilateral agencies in regard to vocational education in developing countries. Section 1 provides background on such topics as links between education and development, support of vocational education, diversified secondary education, foreign…

  14. Moving out of Their Comfort Zones: Enhancing Teaching Practice in Transnational Education

    ERIC Educational Resources Information Center

    Lamers, Antonia M.; Admiraal, Wilfried F.

    2018-01-01

    This paper investigates the development of teaching practice of the multinational staff delivering UK programmes in a higher education institution in Oman hosting these programmes. It presents a tool to evaluate the teaching practice, and points to those elements of an academic development framework that were found to be most useful in supporting…

  15. Multinational Experiment 7: Protecting Access to Space

    DTIC Science & Technology

    2013-07-08

    access to space cost to the design, engineering , production and operation of the spacecraft. They also have an impact on spacecraft mass, thermal...station and provide engineering support to receive data in the agreed format. Step 5 – Implementing interoperability. Once a framework has been...procedures or using alternative means (for example, high-altitude airships ). A7. The results support the view that better mitigation approaches need to

  16. The case for a multinational Mars Surveyor Program

    NASA Astrophysics Data System (ADS)

    Rea, D. G.; Carr, M. H.; Craig, M. K.

    1989-10-01

    A coordinated multinational Mars Surveyor Program involving a series of robotic missions is proposed in order to select worthwhile human landing sites for discoveries, for safe operations, and for testing and proving technologies for making human flight to Mars possible. Some characteristics motivating exploration of the planet are briefly discussed, including the possibility of life, geological features, and meteorological conditions. The necessity for preliminary exploration of Mars by robots prior to human exploration is discussed, and the rationale behind a multinational approach for a Mars Surveyor Program is presented.

  17. Diagnosis of inflammatory bowel disease in Asia: the results of a multinational web-based survey in the 2(nd) Asian Organization for Crohn's and Colitis (AOCC) meeting in Seoul.

    PubMed

    Kim, Eun Soo; Chen, Minhu; Lee, Jun; Lee, Chang-Kyun; Kim, You Sun

    2016-07-01

    As the number of Asian patients with inflammatory bowel disease (IBD) has increased recently, there is a growing need to improve IBD care in this region. This study is aimed at determining how Asian countries are currently dealing with their IBD patients in terms of diagnosis. A questionnaire was designed by the organizing committee of Asian Organization for Crohn's and Colitis, for a multinational web-based survey conducted between March 2014 and May 2014. A total of 353 Asian medical doctors treating IBD patients responded to the survey (114 in China, 88 in Japan, 116 in Korea, and 35 in other Asian countries). Most of the respondents were gastroenterologists working in an academic teaching hospital. While most of the doctors from China, Japan, and Korea use their own national guidelines for IBD diagnosis, those from other Asian countries most commonly adopt the European Crohn's Colitis Organisation's guideline. Japanese doctors seldom adopt the Montreal classification for IBD. The most commonly used activity scoring system for ulcerative colitis is the Mayo score in all countries except China, whereas that for Crohn's disease (CD) is the Crohn's Disease Activity Index. The most available tool for small-bowel evaluation in CD patients differs across countries. Many physicians administer empirical anti-tuberculous medications before the diagnosis of CD. The results of this survey demonstrate that Asian medical doctors have different diagnostic approaches for IBD. This knowledge would be important in establishing guidelines for improving the care of IBD patients in this region.

  18. Multinationals' Political Activities on Climate Change

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Kolk, A.; Pinkse, J.

    2007-06-15

    This article explores the international dimensions of multinationals' corporate political activities, focusing on an international issue - climate change - being implemented differently in a range of countries. Analyzing data from Financial Times Global 500 firms, it examines the influence on types and process of multinationals' political strategies, reckoning with institutional contexts and issue saliency. Findings show that the type of political activities can be characterized as an information strategy to influence policy makers toward market-based solutions, not so much withholding action on emission reduction. Moreover, multinationals pursue self-regulation, targeting a broad range of political actors. The process of politicalmore » strategy is mostly one of collective action. International differences particularly surface in the type of political actors aimed at, with U.S. and Australian firms focusing more on non-government actors (voluntary programs) than European and Japanese firms. Influencing home-country (not host-country) governments is the main component of international political strategy on climate change.« less

  19. Marketing Norm Perception Among Medical Representatives in Indian Pharmaceutical Industry

    PubMed Central

    Nagashekhara, Molugulu; Agil, Syed Omar Syed; Ramasamy, Ravindran

    2012-01-01

    Study of marketing norm perception among medical representatives is an under-portrayed component that deserves further perusal in the pharmaceutical industry. The purpose of this study is to find out the perception of marketing norms among medical representatives. The research design is quantitative and cross sectional study with medical representatives as unit of analysis. Data is collected from medical representatives (n=300) using a simple random and cluster sampling using a structured questionnaire. Results indicate that there is no difference in the perception of marketing norms among male and female medical representatives. But there is a difference in opinion among domestic and multinational company’s medical representatives. Educational back ground of medical representatives also shows the difference in opinion among medical representatives. Degree holders and multinational company medical representatives have high perception of marketing norms compare to their counterparts. The researchers strongly believe that mandatory training on marketing norms is beneficial in decision making process during the dilemmas in the sales field. PMID:24826035

  20. Factors affecting breastfeeding practices among working women in Pakistan.

    PubMed

    Soomro, J A; Shaikh, Z N; Bijarani, S A; Saheer, T B

    2017-02-01

    In urban areas of Pakistan, women's return to work after giving birth has frequently been found to be a main contributor to the early termination of breastfeeding. This study aimed to assess workplace breastfeeding support provided to working mothers in Pakistan. In a cross-sectional survey in 2014, mothers and employers from a representative sample of 297 workplaces were interviewed using a pre-tested questionnaire. Mothers from 36 (12.1%) sites reported receiving breastfeeding breaks, and 86% of the mothers had received 3 months paid maternity leave. Provision of a lighter job and information about breastfeeding options on return to work were reported from 15% and 5% of the workplaces, respectively. Only two sites had designated breastfeeding corners. Significantly different results were found between types of employer (government or private) and type of organization (national or multinational) with regard to breastfeeding breaks, breastfeeding corners, lighter jobs and paid maternity leave. Public and multinational companies were slightly better than private and national ones in providing breastfeeding facilities.

  1. Mind the Gap! A Multilevel Analysis of Factors Related to Variation in Published Cost-Effectiveness Estimates within and between Countries

    PubMed Central

    Boehler, Christian E. H.; Lord, Joanne

    2016-01-01

    Background. Published cost-effectiveness estimates can vary considerably, both within and between countries. Despite extensive discussion, little is known empirically about factors relating to these variations. Objectives. To use multilevel statistical modeling to integrate cost-effectiveness estimates from published economic evaluations to investigate potential causes of variation. Methods. Cost-effectiveness studies of statins for cardiovascular disease prevention were identified by systematic review. Estimates of incremental costs and effects were extracted from reported base case, sensitivity, and subgroup analyses, with estimates grouped in studies and in countries. Three bivariate models were developed: a cross-classified model to accommodate data from multinational studies, a hierarchical model with multinational data allocated to a single category at country level, and a hierarchical model excluding multinational data. Covariates at different levels were drawn from a long list of factors suggested in the literature. Results. We found 67 studies reporting 2094 cost-effectiveness estimates relating to 23 countries (6 studies reporting for more than 1 country). Data and study-level covariates included patient characteristics, intervention and comparator cost, and some study methods (e.g., discount rates and time horizon). After adjusting for these factors, the proportion of variation attributable to countries was negligible in the cross-classified model but moderate in the hierarchical models (14%−19% of total variance). Country-level variables that improved the fit of the hierarchical models included measures of income and health care finance, health care resources, and population risks. Conclusions. Our analysis suggested that variability in published cost-effectiveness estimates is related more to differences in study methods than to differences in national context. Multinational studies were associated with much lower country-level variation than single-country studies. These findings are for a single clinical question and may be atypical. PMID:25878194

  2. Probability of Finding Marrow Unrelated Donor (MUD) for an Indian patient in a Multi-national Human Leukocyte Antigen (HLA) Registry.

    PubMed

    Tiwari, Aseem K; Bhati-Kushwaha, Himakshi; Kukreja, Pooja; Mishra, Vikash C; Tyagi, Neetu; Sharma, Ashish; Raina, Vimarsh

    2015-06-01

    With an increase in the number of transplants happening globally, hematopoietic stem cells (HSC) transplantation from matched unrelated donor (MUD) has begun. The increasing trend of MUD transplants across countries has been largely facilitated with the conspicuous growth of volunteer HSC donor noted in the last decade i.e. 8 million HSC donors in 2002 to more than 22 million in 2013 registered in 71 member registries of the Bone Marrow Donor Worldwide (BMDW). Some populations of the world are still very poorly represented in these registries. Since, the chances of successful engraftment and disease free survival are directly proportional to the HLA compatibility between the recipient and the prospective donor, the diversity of the HLA system at the antigenic and allelic level and the heterogeneity of HLA data of the registered donors has a bearing on the probability of finding a volunteer unrelated HSC donor for patients from such populations. In the present study 126 patients were identified suffering from hematological diseases requiring MUD transplant. Their HLA typing was performed and search was done using BMDW database. The search results for these Indian patients in the multinational registry as well as in the Indian Registries were analyzed using mean, range, standard deviation and finally evaluated in terms of probability for finding matched donor (MUD). Total Asian population is only 11 % in the BMDW making it difficult to find a MUD for an Asian patient. The current study supports this, experimentally; revealing that the probability of finding an allele match for an Indian patient in the multinational Human Leukocyte Antigen (HLA) registries is 16 % and a dismal 0.008 % in the Indian registries (donors in Indian registries is just 33,678 as compared to 22.5 million in BMDW). This greatly, emphasizes on enhancing the number of Indian donors in Indian and multi-national registries.

  3. Business Communication Consulting and Research in Multinational Companies.

    ERIC Educational Resources Information Center

    Hildebrandt, Herbert W.

    1978-01-01

    Describes three issues involved in communication research and consulting for multinational companies, particularly those in Germany: qualifications for doing international consulting and research, problems of American scholar-researchers in those firms, and suggestions for dealing with those issues. (JMF)

  4. Culture and International Management: A Review.

    ERIC Educational Resources Information Center

    Miroshnik, Victoria

    2002-01-01

    A literature review explored the effectiveness of cross-cultural managements of multinational companies. The effect of national culture on organizational culture was analyzed and ways in which multinational companies can adopt the national differences were suggested. (Contains 42 references.) (JOW)

  5. CRM System Implementation in a Multinational Enterprise

    NASA Astrophysics Data System (ADS)

    Mishra, Alok; Mishra, Deepti

    The concept of customer relationship management (CRM) resonates with managers in today's competitive economy. As more and more organizations realize the significance of becoming customer-centric in today's competitive era, they embrace CRM as a core business strategy. CRM an integration of information technology and relationship marketing provides the infrastructure that facilitates long-term relationship building with customers at an enterprise-wide level. Successful CRM implementation is a complex, expensive and rarely technical projects. This paper presents the successful implementation of CRM in a multinational organization. This study will facilitate in understanding transition, constraints and implementation of CRM in multinational enterprises.

  6. Information Design for Synchronization and Co-ordination of Modern, Complex, Multi-National Operations

    DTIC Science & Technology

    2011-06-01

    are collection biases in operation, either independently of or driven specifically by the original hypothesis). Information incest • . Stripping...out data duplicates does not necessarily mean that information incest has been prevented, if insufficient context comes back to strip out the real... incest and procedural gaps) will require the mechanisms to be found in the ‘quasi-complex’. The Liaison Officer in a conventional military

  7. South Korean anthropometric data and survey methodology: 'Size Korea' project.

    PubMed

    Kim, Jung Yong; You, Jae Woo; Kim, Mi Sook

    2017-11-01

    Considering the many emerging markets in East Asia, access to contemporary anthropometric data for this region is important for designers and manufacturers seeking to produce the best fitting products and living environments for consumers. The purpose of this paper is to describe Korean anthropometric data collection and survey techniques for those who are interested in ethnic characteristics, conducting surveys, and formulating ergonomic product designs for South Korean and, more broadly, East Asian populations. The Size Korea survey was conducted in 2003-2004 and 2010. A total of 14,200 civilians aged 0-90 years participated in the survey, with 119 body and weight dimensions measured in 2004. Twenty new dimensions from Inbody measurement were added in 2010 and the data were continuously updated. We referred to ISO 7250, 8559 and 15535 to ensure validity and reliability. Fifty major body dimensions, including weight, are summarised in this paper, and 34 of these dimensions can be compared with 11 multinational data already reported  in other publications. Practitioner Summary: This paper presents the up-to-date anthropometric database of East Asian physical characteristics and survey methodology. These data satisfy the ISO standards and comprise 50 physical dimensions including weight. Thirty-four dimensions of these can be directly compared with available multinational data.

  8. Integrating electronic healthcare records of armed forces personnel: Developing a framework for evaluating health outcomes in England, Scotland and Wales.

    PubMed

    Leightley, Daniel; Chui, Zoe; Jones, Margaret; Landau, Sabine; McCrone, Paul; Hayes, Richard D; Wessely, Simon; Fear, Nicola T; Goodwin, Laura

    2018-05-01

    Electronic Healthcare Records (EHRs) are created to capture summaries of care and contact made to healthcare services. EHRs offer a means to analyse admissions to hospitals for epidemiological research. In the United Kingdom (UK), England, Scotland and Wales maintain separate data stores, which are administered and managed exclusively by devolved Government. This independence results in harmonisation challenges, not least lack of uniformity, making it difficult to evaluate care, diagnoses and treatment across the UK. To overcome this lack of uniformity, it is important to develop methods to integrate EHRs to provide a multi-nation dataset of health. To develop and describe a method which integrates the EHRs of Armed Forces personnel in England, Scotland and Wales based on variable commonality to produce a multi-nation dataset of secondary health care. An Armed Forces cohort was used to extract and integrate three EHR datasets, using commonality as the linkage point. This was achieved by evaluating and combining variables which shared the same characteristics. EHRs representing Accident and Emergency (A&E), Admitted Patient Care (APC) and Outpatient care were combined to create a patient-level history spanning three nations. Patient-level EHRs were examined to ascertain admission differences, common diagnoses and record completeness. A total of 6,336 Armed Forces personnel were matched, of which 5,460 personnel had 7,510 A&E visits, 9,316 APC episodes and 45,005 Outpatient appointments. We observed full completeness for diagnoses in APC, whereas Outpatient admissions were sparsely coded; with 88% of diagnoses coded as "Unknown/unspecified cause of morbidity". In addition, A&E records were sporadically coded; we found five coding systems for identifying reason for admission. At present, EHRs are designed to monitor the cost of treatment, enable administrative oversight, and are not currently suited to epidemiological research. However, only small changes may be needed to take advantage of what should be a highly cost-effective means of delivering important research for the benefit of the NHS. Copyright © 2018 The Author(s). Published by Elsevier B.V. All rights reserved.

  9. Communication Effectiveness in Multinational Organizations: Developing Universal Intercultural Skills.

    ERIC Educational Resources Information Center

    Baird, John W.; Stull, James B.

    The increase in size and number of multinational corporations requires programs for training their personnel in intercultural communication emphasizing development of skills necessary for cultural adaptation and a "universal" perspective. Currently, intercultural training is either nonexistent or emphasizes mastery of language with…

  10. Multinational Activities of Major U.S. Automotive Producers : Volume 2. Data on Foreign Facilities and Operations.

    DOT National Transportation Integrated Search

    1978-09-01

    The objective of Volume II is to present data gathered from several sources, public and private, on three aspects of multinational involvement for General Motors Corporation, Ford Motor Company, Chrysler Corporation, and American Motors Corporation. ...

  11. Using multilevel models for assessing the variability of multinational resource use and cost data.

    PubMed

    Grieve, Richard; Nixon, Richard; Thompson, Simon G; Normand, Charles

    2005-02-01

    Multinational economic evaluations often calculate a single measure of cost-effectiveness using cost data pooled across several countries. To assess the validity of pooling international cost data the reasons for cost variation across countries need to be assessed. Previously, ordinary least-squares (OLS) regression models have been used to identify factors associated with variability in resource use and total costs. However, multilevel models (MLMs), which accommodate the hierarchical structure of the data, may be more appropriate. This paper compares these different techniques using a multinational dataset comprising case-mix, resource use and cost data on 1300 stroke admissions from 13 centres in 11 European countries. OLS and MLMs were used to estimate the effect of patient and centre-level covariates on the total length of hospital stay (LOS) and total cost. MLMs with normal and gamma distributions for the data within centres were compared. The results from the OLS model showed that both patient and centre-level covariates were associated with LOS and total cost. The estimates from the MLMs showed that none of the centre-level characteristics were associated with LOS, and the level of spending on health was the centre-level variable most highly associated with total cost. We conclude that using OLS models for assessing international variation can lead to incorrect inferences, and that MLMs are more appropriate for assessing why resource use and costs vary across centres. Copyright (c) 2004 John Wiley & Sons, Ltd.

  12. Resource costing for multinational neurologic clinical trials: methods and results.

    PubMed

    Schulman, K; Burke, J; Drummond, M; Davies, L; Carlsson, P; Gruger, J; Harris, A; Lucioni, C; Gisbert, R; Llana, T; Tom, E; Bloom, B; Willke, R; Glick, H

    1998-11-01

    We present the results of a multinational resource costing study for a prospective economic evaluation of a new medical technology for treatment of subarachnoid hemorrhage within a clinical trial. The study describes a framework for the collection and analysis of international resource cost data that can contribute to a consistent and accurate intercountry estimation of cost. Of the 15 countries that participated in the clinical trial, we collected cost information in the following seven: Australia, France, Germany, the UK, Italy, Spain, and Sweden. The collection of cost data in these countries was structured through the use of worksheets to provide accurate and efficient cost reporting. We converted total average costs to average variable costs and then aggregated the data to develop study unit costs. When unit costs were unavailable, we developed an index table, based on a market-basket approach, to estimate unit costs. To estimate the cost of a given procedure, the market-basket estimation process required that cost information be available for at least one country. When cost information was unavailable in all countries for a given procedure, we estimated costs using a method based on physician-work and practice-expense resource-based relative value units. Finally, we converted study unit costs to a common currency using purchasing power parity measures. Through this costing exercise we developed a set of unit costs for patient services and per diem hospital services. We conclude by discussing the implications of our costing exercise and suggest guidelines to facilitate more effective multinational costing exercises.

  13. Small Nations in Multinational Operations and Armenian Perspectives

    DTIC Science & Technology

    2014-12-12

    National Security Powers: Are the Checks in Balance?” In U.S. Army War College Guide to National Security Issues, Volume II: National Security Policy and...SMALL NATIONS IN MULTINATIONAL OPERATIONS AND ARMENIAN PERSPECTIVES A thesis presented to the Faculty of the U.S. Army

  14. Multinationals, state-owned corporations, and the transformation of imperialism: a Brazilian case study

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Evans, P.

    1977-10-01

    The Brazilian petrochemical industry is used as a case study in cooperation of state-owned and multinational corporations in bringing capitalism into the Third World. The petrochemical industry was chosen because it entails enormous transfers of capital investment and technology and the development of internal industrialization. Active participation by the host state, while it modifies the capitalization process, also is seen to provide a mutually beneficial partnership. A chronological account is given of the process by which Brazil evolved a system for encouraging multinationals to bring basic industries while participating directly in production. Multinationals have found that state-owned corporations do notmore » destroy capitalism, while the state-owned corporations have adapted to a profit orientation. A new ruling class has emerged in the process to provide technical and managerial skills. A disappointing social record developed at the same time and indicates the capitalization process was not able to provide the expected social benefits. (DCK)« less

  15. Breast-feeding: the role of multinational corporations in Latin America.

    PubMed

    Bader, M B

    1976-01-01

    The decline in birthrates in the developed countries of the world has forced multinational corporations engaged in the production of infant formula to seek out new markets in the developing countries, where burgeoning population rates potentially guarantee the long-term profitability of these corporations. This development, ostensibly benign and nutritionally advantageous to infants in developing countries, has serious public health consequences, due to the high relative cost of purchased formula and the paucity of hygienic facilities essential to the sterile preparation of bottle formula. This paper delineates in detail economic and contraceptive advantages of breast-feeding, and examines the role of health personnel and multinational advertising techniques which have catalyzed the decline in breast-feeding. In addition, the paper focuses on the question of cultural imperialism and current efforts to regulate the multinational firms through both United Nations groups and stock-holders' suits. Finally, some suggestions are made concerning ameliorative public policy approaches to the breast-feeding controversy.

  16. Methods for evaluating temporal trends in noise exposure

    PubMed Central

    Neitzel, RL; Galusha, D; Dixon-Ernst, C; Rabinowitz, PM

    2014-01-01

    Objective Hearing conservation programs have been mandatory in many US industries since 1983. Since then, three program elements (audiometric testing, hearing protection, and training) have been the focus of much research. By comparison, little has been done on noise exposure evaluation. Design and study sample Utilizing a large dataset (>10,000 measurements over 20 years) from eight facilities operated by a multinational aluminum manufacturing company, we evaluated several approaches to assessing temporal trends in Time Weighted Average (TWA) exposures and the fraction of measurements exceeding 85 dBA by facility, by exposure group within facility, and by individual worker within facility. Results Overall, exposures declined across locations over the study period. Several facilities demonstrated substantial reductions in exposure, and the results of mean noise levels and exceedance fractions generally showed good agreement. The results of analyses at the individual level diverged with analyses by facility and exposure group within facility, suggesting that individual-level analyses, while challenging, may provide important information not available from coarser levels of analysis. Conclusions Validated metrics are needed to allow for assessment of temporal trends in noise exposure. Such metrics will improve our ability to characterize, in a standardized manner, efforts to reduce noise-induced hearing loss. PMID:24564696

  17. Using Internet Resources in Teaching Financial Reporting and Analysis of Multinational Enterprises.

    ERIC Educational Resources Information Center

    Agami, Abdel M.

    2003-01-01

    Provides some sources of corporate financial information on the Internet and illustrates how to use these resources in teaching international business and, more specifically, financial reporting and analysis of multinational enterprises. Points out some of the advantages and limitations of these resources. (EV)

  18. Intercultural Communication Problems in Japanese Multinationals.

    ERIC Educational Resources Information Center

    Nishiyama, Kazuo

    Many large Japanese-owned multinational corporations have established successful subsidiaries in the United States, but distinct ethnic and cultural differences have caused communication problems between Japanese managers and American laborers and business people. Many top executives of the Japanese subsidiaries are sent to the United States on a…

  19. Koinonia: The Requirements and Vision for an Unclassified Information-Sharing System

    DTIC Science & Technology

    2013-06-01

    of an effort to share information with multinational partners in Multinational Planning Augmentation Team (MPAT) ( Tempest Express Fact Sheet 2011... Tempest fact sheet. Global Security.org. May 7, 2011. Accessed May 3, 2013. http://www.globalsecurity.org/military/ops/ tempest -express.htm U.S

  20. Language (Medical Terminology) Assistance to Multinational Partners in Coalition Operations

    DTIC Science & Technology

    2012-02-01

    also without us being conscious that we are learning” [19], i.e. facilitate life-long learning as a part of other activities related to business or...research a proof of concept experiment, qualitative study, statistical evaluation Due to the varieties of the MALL studies as described above and quick...learning research agenda for active, experiential learning: Four case studies. Australasian Journal of Educational Technology, http

  1. Reliability (internal consistency) of the job content questionnaire on job stress among office workers of a multinational company in Kuala Lumpur.

    PubMed

    Maizura, Husna; Masilamani, Retneswari; Aris, Tahir

    2009-04-01

    This small, cross-sectional study assessed the reliability of 3 scales from the Job Content Questionnaire (JCQ)-decision latitude, psychological job demand, and social support-in a group of office workers in a multinational company in Kuala Lumpur. A universal sample of 30 white-collar workers from a department of the company self-administered the English version of the JCQ comprising 21 core items selected from the full recommended version of 49 items on-site. Reliability (internal consistency) was evaluated using Cronbach's alpha coefficients for each scale. Corrected item-total correlation was presented for each and every item. Cronbach's alpha coefficients were acceptable for decision latitude (.76) and social support (.79) but slightly lower for psychological job demand (.64). Values for all item-total correlations for all 3 scales were greater than .3. In conclusion, this study suggests that the JCQ is a reliable scale for assessing job stress in this group of workers.

  2. Staffing UK University Campuses Overseas: Lessons from MNE Practice

    ERIC Educational Resources Information Center

    Salt, John; Wood, Peter

    2014-01-01

    This article suggests that as their internal labor markets become more multinational in scope, UK universities may acquire similar staffing characteristics to commercial multinational enterprises (MNEs). Comparing evidence from four UK universities with several surveys of MNEs it concludes that, although there are broad similarities in the…

  3. The Role of Language in National and Multinational Enterprises in Taiwan.

    ERIC Educational Resources Information Center

    Du-Babcock, Bertha; Babcock, Richard D.

    Communication patterns and language use in four national and multinational companies operating in Taiwan illustrate the potential for communication problems when more than one language is in use. The companies include Texas Instruments, Kaohsiung Monomer Company, Ltd., Bank of America, and Cheng-Yia International Corporation. In the four…

  4. An Assessment of E-Training Effectiveness in Multinational Companies in Malaysia

    ERIC Educational Resources Information Center

    Ramayah, Thurasamy; Ahmad, Noor Hazlina; Hong, Tan Say

    2012-01-01

    E-training has developed into a revolutionary way of learning in Malaysian organizations due to rapid growth in information technology infrastructure. The present study endeavors to determine the critical factors that influence e-training effectiveness in multinational companies (MNCs) in Malaysia. By integrating Technology Acceptance Model (TAM),…

  5. The Role of Culture on Knowledge Transfer: The Case of the Multinational Corporation

    ERIC Educational Resources Information Center

    Lucas, Leyland M.

    2006-01-01

    Purpose: This paper aims to look at the issue of culture's role in knowledge transfer within multinational corporations (MNCs). Studies of MNCs have hinted at the importance of culture to the performance of subsidiaries. Using Hofstede's cultural dimensions of power distance, individualism/collectivism, uncertainty avoidance, and…

  6. Multinational Corporate Penetration, Industrialism, Region, and Social Security Expenditures: A Cross-National Analysis.

    ERIC Educational Resources Information Center

    Clark, Roger; Filinson, Rachel

    1991-01-01

    Examined determinants of spending on social security programs, using data from 75 nations representative of core, semiperipheral, and peripheral nations. Industrialization variables had strong effects in models involving all nations, as did multinational corporate penetration in extraction, particularly when region was controlled; such penetration…

  7. Multinational Scanning: A Study of the Information Sources Utilized by Headquarters Executives in Multinational Companies

    ERIC Educational Resources Information Center

    Keegan, Warren J.

    1974-01-01

    Findings reveal the great importance of human sources of information and sources outside the organization. Divisional boundaries, functional specialization, and level were all found to act as significant barriers to information flows, and thus as limitations to organizational effectiveness. (Author/WM)

  8. The Management of Training in Multinational Corporations: Comparative Case Studies.

    ERIC Educational Resources Information Center

    Noble, Charles

    1997-01-01

    Case studies of British and Australian multinational corporations in the food and drink industry investigated how training and development are managed. Competency-based education and industry boards are important elements in both countries. Lack of a training culture in the industry and little innovation in training were observed. (SK)

  9. A Comparative Perspective of Intercultural Sensitivity between College Students and Multinational Employees in China

    ERIC Educational Resources Information Center

    Peng, Shi-Yong

    2006-01-01

    Using the Intercultural Sensitivity Scale formulated by G. M. Chen and Starosta, the intercultural sensitivity of English major students, non-English major students, and multinational employees in China were investigated. In this study, intercultural sensitivity was defined as consisting of interaction engagement, interaction confidence, respect…

  10. Intraorganizational Career Advancement and Voluntary Turnover in a Multinational Bank in Taiwan

    ERIC Educational Resources Information Center

    Zhao, Wei; Zhou, Xueguang

    2008-01-01

    Purpose: This study aims to investigate how various aspects of intraorganizational career advancement--current career attainments, recent pace of upward mobility, and future prospect of career advancement--affect voluntary turnover, drawing empirical evidence from a multinational corporation (MNC) in Taiwan's cultural and labor market environment.…

  11. Assessment of a Multinational Online Faculty Development Program on Online Teaching: Reflections of Candidate E-Tutors

    ERIC Educational Resources Information Center

    Adnan, Muge; Kalelioglu, Filiz; Gulbahar, Yasemin

    2017-01-01

    Teaching online requires different skills, roles and competencies for online instructors compared to teaching in traditional learning environments. Universities should offer ongoing support in various forms to help academic staff through their online journey. This paper provides insights into a multinational faculty development program for…

  12. Developing Managerial Talent: Exploring the Link between Management Talent and Perceived Performance in Multinational Corporations (MNCs)

    ERIC Educational Resources Information Center

    Sheehan, Maura

    2012-01-01

    Purpose: To examine the association between talent management (TM) and perceived subsidiary performance. Focus is given to the development of one key talent group--line managers--in subsidiaries of multinational corporations (MNCs). Specifically, the paper examines: whether there is a positive relationship between Management Development (MD) and…

  13. Measuring the Value of Succession Planning and Management: A Qualitative Study of Multinational Companies

    ERIC Educational Resources Information Center

    Kim, Yeonsoo

    2010-01-01

    This article proposes a model for planning and operating an effective succession planning and management (SP&M) program and measuring its value. The nature of the research is exploratory, following a qualitative approach using in-depth interviews. Representatives of multinational companies interviewed for this study revealed that succession…

  14. The Status of International Business Communication Training in the 100 Largest Multinational United States Corporations.

    ERIC Educational Resources Information Center

    Zimpfer, Forest; Underwood, Robert

    The 100 largest multinational U.S. corporations were surveyed concerning business communication training provided for personnel assigned to overseas posts. The survey requested information on the existence and content of such formal training programs and the qualifications of their training directors. Results drawn from the 43 usable responses…

  15. Pre-Interaction Management in Multinational Companies in Central Europe

    ERIC Educational Resources Information Center

    Nekvapil, Jiri; Sherman, Tamah

    2009-01-01

    This article is devoted to the linguistic, communicative and sociocultural situation in branches of multinational companies located in the Czech Republic and Hungary. There are typically several languages used in these branches. In addition to the local languages, there are the languages of the parent companies--most commonly English or German,…

  16. Confucius Institutes: Distributed Leadership and Knowledge Sharing in a Worldwide Network

    ERIC Educational Resources Information Center

    Li, Hsi Chang; Mirmirani, Sam; Ilacqua, Joseph A.

    2009-01-01

    Purpose: The purpose of this paper is to focus on Confucius Institutes and assess the applicability of theories of leadership and knowledge sharing to multinational organizations and worldwide networks. Growth of multinational trade and decrease in international tension have facilitated the globalization of both profit-seeking and non-profit…

  17. National Bibliography in a Multi-National State as Accomplished in the USSR.

    ERIC Educational Resources Information Center

    Vesirova, L. A.

    Soviet national bibliographies register all types of publications printed in the Soviet Union regardless of the language in which they were published. These bibliographies are known as state bibliographies. This report dwells on the characteristics of the organization of a state bibliographic system in a multi-national socialistic state. The…

  18. Safety and Health in Multinational Enterprises: What Have We Learnt?

    ERIC Educational Resources Information Center

    Romero, Ana Teresa

    1993-01-01

    Analyzes the practices of multinationals in the sphere of occupational safety and health and poses the question of safety and health and industrial risks in terms of environmental problems. Indicates that the future of safety and health may hinge on the adaptation and implementation of recommendations of International Labour Organisation members.…

  19. Developing Collaboratively an International School Special Needs Plan for Multicultural, Multilingual, and Multinational Secondary Students.

    ERIC Educational Resources Information Center

    Jonietz, Patricia L.

    The International School of Brussels (Belgium) developed a program of Curriculum-Based Assessment (CBA) to increase support for "at risk" multicultural, multilingual, and multinational students. The at-risk population included three groups: those who passed standardized English as a Foreign Language tests but were not literate enough for…

  20. “A question of balance”: addressing the public health impacts of multinational enterprises in the OECD Guidelines for Multinational Enterprises

    PubMed Central

    Yang, Joshua S.; McDaniel, Patricia A.; Malone, Ruth E.

    2012-01-01

    Background The global community is beginning to address non-communicable diseases, but how to increase the accountability of multinational enterprises (MNEs) for the health impacts of their products and practices remains unclear. We examine the Organization for Economic Cooperation and Development’s (OECD) efforts to do so through voluntary MNE guidelines. Methods We developed a historical case study of how the OECD Guidelines for Multinational Enterprises were developed and revised from 1973–2000 through an analysis of publicly available archived OECD and tobacco industry documents. Results The first edition of the Guidelines was a purely economic instrument. Outside pressures and a desire to ward off more stringent regulatory efforts resulted in the addition over time of guidelines related to the environment, consumer interests, sustainable development, and human rights. Conclusion Despite their voluntary nature, the Guidelines can play a role in efforts to help balance the interests of MNEs and public health by providing a starting point for efforts to create binding provisions addressing MNEs’ contributions to disease burden or disease reduction. PMID:23046298

  1. Risk factors for acute generalized exanthematous pustulosis (AGEP)-results of a multinational case-control study (EuroSCAR).

    PubMed

    Sidoroff, A; Dunant, A; Viboud, C; Halevy, S; Bavinck, J N Bouwes; Naldi, L; Mockenhaupt, M; Fagot, J-P; Roujeau, J-C

    2007-11-01

    Acute generalized exanthematous pustulosis (AGEP) is a disease characterized by the rapid occurrence of many sterile, nonfollicular pustules usually arising on an oedematous erythema often accompanied by leucocytosis and fever. It is usually attributed to drugs. To evaluate the risk for different drugs of causing AGEP. A multinational case-control study (EuroSCAR) conducted to evaluate the risk for different drugs of causing severe cutaneous adverse reactions; the study included 97 validated community cases of AGEP and 1009 controls. Results Strongly associated drugs, i.e. drugs with a lower bound of the 95% confidence interval (CI) of the odds ratio (OR) > 5 were pristinamycin (CI 26-infinity), ampicillin/amoxicillin (CI 10-infinity), quinolones (CI 8.5-infinity), (hydroxy)chloroquine (CI 8-infinity), anti-infective sulphonamides (CI 7.1-infinity), terbinafine (CI 7.1-infinity) and diltiazem (CI 5.0-infinity). No significant risk was found for infections and a personal or family history of psoriasis (CI 0.7-2.2). Medications associated with AGEP differ from those associated with Stevens-Johnson syndrome or toxic epidermal necrolysis. Different timing patterns from drug intake to reaction onset were observed for different drugs. Infections, although possible triggers, played no prominent role in causing AGEP and there was no evidence that AGEP is a variant of pustular psoriasis.

  2. Major multinational food and beverage companies and informal sector contributions to global food consumption: implications for nutrition policy.

    PubMed

    Alexander, Eleanore; Yach, Derek; Mensah, George A

    2011-08-01

    In recent years, 10 major multinational food and beverage companies have worked together within the International Food and Beverage Alliance (IFBA) to increase their commitments to public health. Current IFBA commitments include initiatives to improve the nutrition quality of products and how these products are advertised to children. The impact and magnitude of IFBA member contributions to the total market share of packaged foods and beverages consumed remain incompletely understood, however. In order to evaluate this impact, we examined packaged food and soft drink company shares provided by Euromonitor, an international independent market analysis company. Packaged foods include baby food, bakery, canned/preserved food, chilled/processed food, confectionery, dairy, dried processed food, frozen processed food, ice cream, meal replacement, noodles, oils and fats, pasta, ready meals, sauces, dressings and condiments, snack bars, soup, spreads, and sweet and savoury snacks. Soft drinks include carbonates, packaged fruit/vegetable juice, bottled water, functional drinks, concentrates, ready-to-drink tea, ready-to-drink coffee and Asian specialty drinks. We calculated the market shares for IFBA companies, globally and within nine countries--the US, China, India, Egypt, South Africa, Brazil, Mexico, Turkey and the UK. Worldwide, the top ten packaged food companies account for 15.2% of sales, with each individual company contributing less than 3.3%. The top ten soft drink companies account for 52.3% of sales worldwide; Coca-Cola and PepsiCo lead with 25.9% and 11.5% of sales, respectively. Although the top ten soft drink companies account for half of global sales, the top ten packaged food companies account for only a small proportion of market share with most individual companies contributing less than 3.3% each. Major multinational companies need to be joined by the myriad of small- and medium-sized enterprises in developing and implementing programs to improve the health of the public, globally. Without full participation of these companies, the impact of commitments made by IFBA members and other major multinational food and beverage companies will remain limited.

  3. Major multinational food and beverage companies and informal sector contributions to global food consumption: implications for nutrition policy

    PubMed Central

    2011-01-01

    Background In recent years, 10 major multinational food and beverage companies have worked together within the International Food and Beverage Alliance (IFBA) to increase their commitments to public health. Current IFBA commitments include initiatives to improve the nutrition quality of products and how these products are advertised to children. The impact and magnitude of IFBA member contributions to the total market share of packaged foods and beverages consumed remain incompletely understood, however. Methods In order to evaluate this impact, we examined packaged food and soft drink company shares provided by Euromonitor, an international independent market analysis company. Packaged foods include baby food, bakery, canned/preserved food, chilled/processed food, confectionery, dairy, dried processed food, frozen processed food, ice cream, meal replacement, noodles, oils and fats, pasta, ready meals, sauces, dressings and condiments, snack bars, soup, spreads, and sweet and savoury snacks. Soft drinks include carbonates, packaged fruit/vegetable juice, bottled water, functional drinks, concentrates, ready-to-drink tea, ready-to-drink coffee and Asian specialty drinks. We calculated the market shares for IFBA companies, globally and within nine countries--the US, China, India, Egypt, South Africa, Brazil, Mexico, Turkey and the UK. Results Worldwide, the top ten packaged food companies account for 15.2% of sales, with each individual company contributing less than 3.3%. The top ten soft drink companies account for 52.3% of sales worldwide; Coca-Cola and PepsiCo lead with 25.9% and 11.5% of sales, respectively. Conclusions Although the top ten soft drink companies account for half of global sales, the top ten packaged food companies account for only a small proportion of market share with most individual companies contributing less than 3.3% each. Major multinational companies need to be joined by the myriad of small- and medium-sized enterprises in developing and implementing programs to improve the health of the public, globally. Without full participation of these companies, the impact of commitments made by IFBA members and other major multinational food and beverage companies will remain limited. PMID:21806827

  4. Multinational medical support to operations: challenges, benefits and recommendations for the future.

    PubMed

    Cordell, R F

    2012-03-01

    This paper considers the strategic aspects of medical support to military operations as delivered through multi-national collaboration. The military medical services are in essence a people organisation; the purpose of the organisation is primarily to support the people engaged in military operations, and also the people providing healthcare to them. Increasingly, supporting the latter also includes preparation for the ethical dilemmas that they will face. Providing health advice and healthcare on operations is now usually undertaken on a multinational basis, in order to generate sufficient medical capacity to meet the requirement with assets of the appropriate (and NATO mandated) capability. This will be an enduring feature, particularly in light of increasing costs of providing high quality healthcare and the operational and logistic challenges of delivering this capability in adverse environments, and in the context of medical personnel being a limited resource. The key to overcoming the challenges, often the result of the "people issues" such as cultural differences, is to recognise the value that the inherent diversity of multinational healthcare provision brings. The benefit is realised through sharing best practice, and the lessons from challenges met, as well as through burden sharing, and to understand that challenges are most commonly the result of misunderstandings, such as those inherent in language differences. The advice for those bringing a multinational team together includes considering the implications of culture (noting differences in national and military perspectives, and in medical processes such as clinical governance), to ensure effective communication, and to utilise feedback to confirm understanding. It is important not to prejudge or denigrate others. Share information and knowledge, provide positive reinforcement when things go well, and recognise that there will inevitably be challenges and use these as an opportunity to learn. Above all, the personal touch builds a culture within the multinational team that transcends national culture; celebrating success breeds success and thus optimal outcome for patients.

  5. An Expert Elicitation of the Proliferation Resistance of Using Small Modular Reactors (SMR) for the Expansion of Civilian Nuclear Systems.

    PubMed

    Siegel, Jonas; Gilmore, Elisabeth A; Gallagher, Nancy; Fetter, Steve

    2018-02-01

    To facilitate the use of nuclear energy globally, small modular reactors (SMRs) may represent a viable alternative or complement to large reactor designs. One potential benefit is that SMRs could allow for more proliferation resistant designs, manufacturing arrangements, and fuel-cycle practices at widespread deployment. However, there is limited work evaluating the proliferation resistance of SMRs, and existing proliferation assessment approaches are not well suited for these novel arrangements. Here, we conduct an expert elicitation of the relative proliferation resistance of scenarios for future nuclear energy deployment driven by Generation III+ light-water reactors, fast reactors, or SMRs. Specifically, we construct the scenarios to investigate relevant technical and institutional features that are postulated to enhance the proliferation resistance of SMRs. The experts do not consistently judge the scenario with SMRs to have greater overall proliferation resistance than scenarios that rely on conventional nuclear energy generation options. Further, the experts disagreed on whether incorporating a long-lifetime sealed core into an SMR design would strengthen or weaken proliferation resistance. However, regardless of the type of reactor, the experts judged that proliferation resistance would be enhanced by improving international safeguards and operating several multinational fuel-cycle facilities rather than supporting many more national facilities. © 2017 Society for Risk Analysis.

  6. Medication use in pregnancy: a cross-sectional, multinational web-based study

    PubMed Central

    Lupattelli, A; Spigset, O; Twigg, M J; Zagorodnikova, K; Mårdby, A C; Moretti, M E; Drozd, M; Panchaud, A; Hämeen-Anttila, K; Rieutord, A; Gjergja Juraski, R; Odalovic, M; Kennedy, D; Rudolf, G; Juch, H; Passier, A; Björnsdóttir, I; Nordeng, H

    2014-01-01

    Objectives Intercountry comparability between studies on medication use in pregnancy is difficult due to dissimilarities in study design and methodology. This study aimed to examine patterns and factors associated with medications use in pregnancy from a multinational perspective, with emphasis on type of medication utilised and indication for use. Design Cross-sectional, web-based study performed within the period from 1 October 2011 to 29 February 2012. Uniform collection of drug utilisation data was performed via an anonymous online questionnaire. Setting Multinational study in Europe (Western, Northern and Eastern), North and South America and Australia. Participants Pregnant women and new mothers with children less than 1 year of age. Primary and secondary outcome measures Prevalence of and factors associated with medication use for acute/short-term illnesses, chronic/long-term disorders and over-the-counter (OTC) medication use. Results The study population included 9459 women, of which 81.2% reported use of at least one medication (prescribed or OTC) during pregnancy. Overall, OTC medication use occurred in 66.9% of the pregnancies, whereas 68.4% and 17% of women reported use of at least one medication for treatment of acute/short-term illnesses and chronic/long-term disorders, respectively. The extent of self-reported medicated illnesses and types of medication used by indication varied across regions, especially in relation to urinary tract infections, depression or OTC nasal sprays. Women with higher age or lower educational level, housewives or women with an unplanned pregnancy were those most often reporting use of medication for chronic/long-term disorders. Immigrant women in Western (adjusted OR (aOR): 0.55, 95% CI 0.34 to 0.87) and Northern Europe (aOR: 0.50, 95% CI 0.31 to 0.83) were less likely to report use of medication for chronic/long-term disorders during pregnancy than non-immigrants. Conclusions In this study, the majority of women in Europe, North America, South America and Australia used at least one medication during pregnancy. There was a substantial inter-region variability in the types of medication used. PMID:24534260

  7. Continuous Linguistic Rhetorical Education as a Means of Optimizing Language Policy in Russian Multinational Regions

    ERIC Educational Resources Information Center

    Vorozhbitova, Alexandra A.; Konovalova, Galina M.; Ogneva, Tatiana N.; Chekulaeva, Natalia Y.

    2017-01-01

    Drawing on the function of Russian as a state language the paper proposes a concept of continuous linguistic rhetorical (LR) education perceived as a means of optimizing language policy in Russian multinational regions. LR education as an innovative pedagogical system shapes a learner's readiness for self-projection as a strong linguistic…

  8. The Multilingual Reality of the Multinational Workplace: Language Policy and Language Use

    ERIC Educational Resources Information Center

    Angouri, Jo

    2013-01-01

    In the multinational corporation (MNC) context the crossing of linguistic boundaries and the fast-paced change of linguistic ecologies due to market trends and new business activities is the rule rather than the exception. Accordingly, the aim of this paper is to discuss language policy and language practice in one consortium of three…

  9. Army Engineers in a Joint and Multinational Environment

    DTIC Science & Technology

    2008-05-22

    operatio 0 in a maneuver battalion in national ns. The battalion also lacked...construction management section (CMS) to fulfill these requirements and provide operatio mission guidance for the multinational units. The CMS, led by a lieuten...also deleting from the inventory the engineer group headquarters, relying 115 Andrew Feickert, “U.S. Army’s Modular Redesign: Issues for Congress

  10. The International Collaboration for Autism Registry Epidemiology (iCARE): Multinational Registry-Based Investigations of Autism Risk Factors and Trends

    ERIC Educational Resources Information Center

    Schendel, Diana E.; Bresnahan, Michaeline; Carter, Kim W.; Francis, Richard W.; Gissler, Mika; Grønborg, Therese K.; Gross, Raz; Gunnes, Nina; Hornig, Mady; Hultman, Christina M.; Langridge, Amanda; Lauritsen, Marlene B.; Leonard, Helen; Parner, Erik T.; Reichenberg, Abraham; Sandin, Sven; Sourander, Andre; Stoltenberg, Camilla; Suominen, Auli; Surén, Pål; Susser, Ezra

    2013-01-01

    The International Collaboration for Autism Registry Epidemiology (iCARE) is the first multinational research consortium (Australia, Denmark, Finland, Israel, Norway, Sweden, USA) to promote research in autism geographical and temporal heterogeneity, phenotype, family and life course patterns, and etiology. iCARE devised solutions to challenges in…

  11. Critical Success Factors: How One Multinational Company Develops Global E-Learning

    ERIC Educational Resources Information Center

    Nathan, Edward Pavel

    2011-01-01

    This research study examined how a multinational company determined what the critical success factors (CSFs) were for developing global e-learning. The study analyzed how these CSFs were grouped together to make their management more efficient. There were 21 participants in the study who were key stakeholders from the United States, Europe, Latin…

  12. "Hej Seppo, Could You Pls Comment on This!"--Internal Email Communication in Lingua Franca English in a Multinational Company

    ERIC Educational Resources Information Center

    Kankaanranta, Anne

    2006-01-01

    Recent turbulence in the corporate world resulting from cross-border mergers and acquisitions and advances in communication technology has meant major changes for internal communication in multinational companies. For example, in Finnish-Swedish mergers the common corporate language is increasingly English even though Swedish has traditionally…

  13. Critical Success Factors: How One Multinational Company Develops Global E-Learning

    ERIC Educational Resources Information Center

    Nathan, Edward Pavel

    2009-01-01

    This research study examined how a multinational company determined what the critical success factors (CSFs) were for developing global e-learning. The study analyzed how these CSFs were grouped together in order to make their management more efficient. There were 21 participants in the study who were key stakeholders and came from one of four…

  14. A Survey of Current and Future Perceived Multi-National Corporation Manufacturing Training Needs in Tianjin, (T.E.D.A.) China.

    ERIC Educational Resources Information Center

    Hickey, Will

    2001-01-01

    Describes a study that surveyed current and perceived future employer-provided training practices among multinational corporations manufacturing companies in the Tianjin Economic Development Area (T.E.D.A.) of China. Highlights include labor market; human resources management in China; workforce productivity; and return on investment. (Author/LRW)

  15. Scorched earth: will environmental risks in China overwhelm its opportunities?

    PubMed

    Economy, Elizabeth; Lieberthal, Kenneth

    2007-06-01

    Of all the risks of doing business in China, the greatest is the threat posed by environmental degradation. And yet it's barely discussed in corporate boardrooms. This is a serious mistake. Multinationals may be more concerned with intellectual property rights violations, corruption, and potential political instability, but the Chinese government, NGOs, and the Chinese press have been focused squarely on the country's energy shortages, soil erosion, lack of water, and pollution problems, which are so severe they might constrain GDP growth. What's more, the Chinese expect the international community to take the lead in environmental protection. If that doesn't happen, multinationals face clear risks to their operations, their workers' health, and their reputations. In factoring environmental issues into their China strategies, foreign firms need to be both defensive, taking steps to reduce harm, and proactive, investing in environmental protection efforts. Coca-Cola, for example, installed state-of-the-art bottling plants in China that operate with no net loss of water resources. Mattel increased the safety of its Barbie-manufacturing process to protect workers' health. With its efforts to reduce greenhouse gas emissions, GE is shrinking its environmental footprint in China; more proactively, GE is working closely with the Chinese government and scientists to develop clean coal, water purification, and water reuse technologies. In considering the value of such efforts, companies can not only factor in reduced risk but also increased opportunity, as they use innovations designed for the Chinese market in the rest of the world. The bottom line: How well multinationals address environmental issues in China will affect their fortunes in one of the most important economies in the world.

  16. Trainees' self-evaluation of their development as psychotherapists: An Italian contribution to an international collaborative study on psychotherapy training.

    PubMed

    Messina, Irene; Gelo, Omar C G; Sambin, Marco; Bianco, Francesca; Mosconi, Andrea; Fenelli, Antonio; Curto, Marcello; Gullo, Salvo; Orlinsky, David

    2018-03-01

    This study presents a pilot contribution to the new collaborative, multinational study of psychotherapy trainee development that was undertaken by the Society for Psychotherapy Research Interest Section on Therapist Training and Development (see Orlinsky, Strauss, Rønnestad, et al., ). Although the main project is longitudinal in design, this preliminary study investigated cross-sectional differences between trainees in different years of training and explored the influence of core training experiences-including supervision and personal therapy-on their perceived development as therapists. Using the trainee current-progress report that was designed for the Society for Psychotherapy Research Interest Section on Therapist Training and Development project, 90 trainees at 4 different 4-year training programs in Italy provided self-evaluations of their development and of their therapeutic work experiences. Perceived development included overall change, progress, deterioration, overcoming past limitations, and realization of potential as a therapist. Therapeutic work experiences were assessed using scales of healing and stressful involvement (Orlinsky & Rønnestad, ). Year in training and support in supervision predicted perceived development and healing involvement, whereas experiencing criticism in supervision was associated with stressful involvement. Having had personal therapy, and especially ratings of benefit from personal therapy, was also associated with perceived development and healing involvement. Results are discussed with regard of their implications for psychotherapy training. Copyright © 2017 John Wiley & Sons, Ltd.

  17. A Model for the Evaluation of Offsets in International Arms Transfers.

    DTIC Science & Technology

    1982-01-01

    8tefan a. Robock and Kenneth Sizmonds, International Business and Multinational Entergrises (Wamewood, Illinois: Richard D. Irwin, Inc., 1973)., pp. 70-73...individual voter is socialized into his political attitudes, not, as Sir Ivor Jennings suggested, on casting his first vote, nor at the moment of birth...N.J.: Prentice-Hall, 1974. Branson , William H. Macroeconomic Theory and Policy. New York: Harper and Row Publishers, 1972. Carlton, David and Carlo

  18. The Second Annual International Space University Alumni Conference

    NASA Technical Reports Server (NTRS)

    Johnson, Les (Compiler); Robinson, Paul A. (Compiler)

    1994-01-01

    The papers presented at the conference reflect the multidisciplinary nature of the International Space University (ISU) and its alumni. The first papers presented hold special relevance to the design projects, and cover such topics as lunar-based astronomical instrumentation, solar lunar power generation, habitation on the moon, and the legal issues governing multinational astronauts conducting research in space. The next set of papers cover various technical issues such as project success assessment, satellite networks and space station dynamics, thus reflecting the diverse backgrounds of the ISU alumni.

  19. High Velocity Jet Noise Source Location and Reduction. Task 3 - Experimental Investigation of Suppression Principles. Volume I. Suppressor Concepts Optimization

    DTIC Science & Technology

    1978-12-01

    multinational corporation in the 1960’s placed extreme emphasis on the need for effective and efficient noise suppression devices. Phase I of work...through model and engine testing applicable to an afterburning turbojet engine. Suppressor designs were based primarily on empirical methods. Phase II...using "ray" acoustics. This method is in contrast to the purely empirical method which consists of the curve -fitting of normalized data. In order to

  20. Towards evidence-based medicine in specific grass pollen immunotherapy.

    PubMed

    Calderon, M; Mösges, R; Hellmich, M; Demoly, P

    2010-04-01

    When initiating grass pollen immunotherapy for seasonal allergic rhinoconjunctivitis, specialist physicians in many European countries must choose between modalities of differing pharmaceutical and regulatory status. We applied an evidence-based medicine (EBM) approach to commercially available subcutaneous and sublingual Gramineae grass pollen immunotherapies (SCIT and SLIT) by evaluating study design, populations, pollen seasons, treatment doses and durations, efficacy, quality of life, safety and compliance. After searching MEDLINE, Embase and the Cochrane Library up until January 2009, we identified 33 randomized, double-blind, placebo-controlled trials (including seven paediatric trials) with a total of 440 specific immunotherapy (SIT)-treated subjects in seven trials (0 paediatric) for SCIT with natural pollen extracts, 168 in three trials (0 paediatric) for SCIT with allergoids, 906 in 16 trials (five paediatric) for natural extract SLIT drops, 41 in two trials (one paediatric) for allergoid SLIT tablets and 1605 in five trials (two paediatric) for natural extract SLIT tablets. Trial design and quality varied significantly within and between SIT modalities. The multinational, rigorous trials of natural extract SLIT tablets correspond to a high level of evidence in adult and paediatric populations. The limited amount of published data on allergoids prevented us from judging the level of evidence for this modality.

  1. L-SAT - Europe's large satellite for the eighties

    NASA Astrophysics Data System (ADS)

    Biggs, P. D.; Blonstein, J. L.

    1980-09-01

    The ESA market evaluation of telecommunications over the next 20 years suggests needs that range from thin-route rural telephony to multi-national videoconferencing and direct TV broadcast, with EUTELSAT's forecasts of ECS traffic indicating saturation by 1987. L-SAT, with as many as 50 transponders with a total capacity of 90,000 half-circuits, has a capacity of five times greater than that of the ECS-sized spacecraft and will be capable of covering those needs to the end of the century. As a result of the market surveys and of the subsequent technical requirement considerations, the L-SAT 1 first-flight model will be designed to meet the 2300 kg in transfer orbit case, but a design-for-growth approach for all subsystems will also be specified. L-SAT 1, to be launched in 1984, will provide high-density communications for business services in 14/12 GHz and direct broadcast TV in 17/12 GHz with fixed and steerable antennas. Four kW of power are to be provided in sunlight and one kW in eclipse. Details on launch vehicle (Ariane/Shuttle), liquid boost motor selection, array configuration, and the three-axis stabilization system are given.

  2. Multinational corporations and health care in the United States and Latin America: strategies, actions, and effects.

    PubMed

    Jasso-Aguilar, Rebeca; Waitzkin, Howard; Landwehr, Angela

    2004-01-01

    In this article we analyze the corporate dominance of health care in the United States and the dynamics that have motivated the international expansion of multinational health care corporations, especially to Latin America. We identify the strategies, actions, and effects of multinational corporations in health care delivery and public health policies. Our methods have included systematic bibliographical research and in-depth interviews in the United States, Mexico, and Brazil. Influenced by public policy makers in the United States, such organizations as the World Bank, International Monetary Fund, and World Trade Organization have advocated policies that encourage reduction and privatization of health care and public health services previously provided in the public sector. Multinational managed care organizations have entered managed care markets in several Latin American countries at the same time as they were withdrawing from managed care activities in Medicaid and Medicare within the United States. Corporate strategies have culminated in a marked expansion of corporations' access to social security and related public sector funds for the support of privatized health services. International financial institutions and multinational corporations have influenced reforms that, while favorable to corporate interests, have worsened access to needed services and have strained the remaining public sector institutions. A theoretical approach to these problems emphasizes the falling rate of profit as an economic motivation of corporate actions, silent reform, and the subordination of polity to economy. Praxis to address these problems involves opposition to policies that enhance corporate interests while reducing public sector services, as well as alternative models that emphasize a strengthened public sector

  3. Multinational Corporations and Health Care in the United States and Latin America: Strategies, Actions, and Effects*

    PubMed Central

    JASSO-AGUILAR, REBECA; WAITZKIN, HOWARD; LANDWEHR, ANGELA

    2010-01-01

    In this article we analyze the corporate dominance of health care in the United States and the dynamics that have motivated the international expansion of multinational health care corporations, especially to Latin America. We identify the strategies, actions, and effects of multinational corporations in health care delivery and public health policies. Our methods have included systematic bibliographical research and in-depth interviews in the United States, Mexico, and Brazil. Influenced by public policy makers in the United States, such organizations as the World Bank, International Monetary Fund, and World Trade Organization have advocated policies that encourage reduction and privatization of health care and public health services previously provided in the public sector. Multinational managed care organizations have entered managed care markets in several Latin American countries at the same time as they were withdrawing from managed care activities in Medicaid and Medicare within the United States. Corporate strategies have culminated in a marked expansion of corporations’ access to social security and related public sector funds for the support of privatized health services. International financial institutions and multinational corporations have influenced reforms that, while favorable to corporate interests, have worsened access to needed services and have strained the remaining public sector institutions. A theoretical approach to these problems emphasizes the falling rate of profit as an economic motivation of corporate actions, silent reform, and the subordination of polity to economy. Praxis to address these problems involves opposition to policies that enhance corporate interests while reducing public sector services, as well as alternative models that emphasize a strengthened public sector. PMID:15779471

  4. Theater Logistics Management: A Case for a Joint Distribution Solution

    DTIC Science & Technology

    2008-03-15

    Multinational (JIIM) operations necessitate creating joint-multinational-based distribution management centers which effectively manage materiel...in the world. However, as the operation continued, the inherent weakness of the intra-theater logistical distribution management link became clear...compounded the distribution management problem. The common thread between each of the noted GAO failures is the lack of a defined joint, theater

  5. Multinational Corporations and British Labour: A Review of Attitudes and Responses.

    ERIC Educational Resources Information Center

    Gennard, John

    Multinational corporations operating in Great Britain, specifically American industry, are arousing fears on the part of British labor, which can be grouped into these categories: (1) a threat to the job security of union members, (2) a change in the balance of power at the collective bargaining table in favor of the employers, (3) a clash of…

  6. The P15--A Multinational Assessment Battery for Collecting Data on Health Indicators Relevant to Adults with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Perry, J.; Linehan, C.; Kerr, M.; Salvador-Carulla, L.; Zeilinger, E.; Weber, G.; Walsh, P.; Van Schrojenstein Lantman-De-Valk, H.; Haveman, M.; Azema, B.; Buono, S.; Cara, A. C.; Germanavicius, A.; Van Hove, G.; Maatta, T.; Berger, D. M.; Tossebro, J.

    2010-01-01

    Background: Health disparities between adults with intellectual disabilities (ID) and the general population have been well documented but, to date, no dedicated assessment battery for measuring health disparity has been available. This paper reports on the development and testing of a multinational assessment battery for collecting data on a…

  7. Learning Experiences of Nurses as Part of a European Union Project on Complementary Therapies: A Multinational Qualitative Study.

    PubMed

    Boz, İlkay; Özer, Zeynep; Teskereci, Gamze; Kavradim, Selma Turan

    The objectives of this study were to investigate learning experiences of the nurses who participated in transnational and multinational occupational training. A qualitative descriptive methodology was used. Data are clustered into 3 categories "occupational training," "complementary care," and "intercultural interaction." This research has revealed many insights into the transnational training of nurses.

  8. Factors in the Effective Transfer of Knowledge from Multinational Enterprises to Their Foreign Subsidiaries: A Mozambican Case Study

    ERIC Educational Resources Information Center

    Duarte Moleiro Martins, José

    2016-01-01

    The purpose of this article is to better understand the role of internal stakeholders in subsidiaries of multinational companies (MNCs) in order to offer potential insights into the cross-border transfer of knowledge from those companies' headquarters to their subsidiaries. The focus is upon subsidiaries in developing countries, here Mozambique.…

  9. The Invisible Blockade and the Covert War: U.S. Relations with Chile, 1970-1973

    DTIC Science & Technology

    1979-06-01

    U.S.- owned multinational corporations , pursued a course of action, publicly, economically and covertly, bent on discrediting, disrupting and dislodging...government, in concert with U.S.- .owned multinational corporations , pursued a course of action, publicly, economically and covertly, bent on...513 E. CONCLUSION -------------------------------------- 64 IV. COVERT GOVERNMENTAL AND CORPORATE PRESSURES-------- 67 A. ATTEMPTS TO KEEP

  10. Multinational corporations, the politics of the world economy, and their effects on women's health in the developing world: a review.

    PubMed

    Hippert, Christine

    2002-12-01

    Presently, globalization and the world economy maintain power relations that hamper the economic integrity and the political autonomy of the developing world. My paper addresses specific economic conditions that perpetuate poverty and poor health. I examine multinational corporations and their effects on women's health, particularly in Mexico and parts of Asia. The advent of multinational corporate business in Mexico, Malaysia, Philippines, India, and Indonesia has led to increased poverty and human rights abuses. Women bear the brunt of this because of specific international economic arrangements and their low social status, both locally and globally. As a result, their physical, mental, and emotional health is suffering. Solutions to these health problems have been proposed on multiple levels: international top-down approaches (i.e., employing international protectionist regulatory standards, exposing multinationals who infringe on their workers' human rights), as well as local grassroots organizational campaigns (i.e., conducting informational human rights workshops for factory workers). Ultimately, the answers lie in holding corporations accountable to their laborers while developing countries maintain their comparative advantage; this is the only way women's health will improve and the developing world can entice corporate investment.

  11. International taxation of multinational enterprises in developed countries

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Adams, J.D.R.; Whalley, J.

    1977-01-01

    The authors, specialists in law and economics, respectively, adopt an interdisciplinary approach to the international taxation of multinational corporations in developed countries, with particular emphasis on the EEC and the United States, integrating both legal and economic aspects of the subject. Since the international nature of the activities of multinational companies brings them within the scope of the domestic tax provisions of different countries, the authors outline the principles behind the domestic tax treatment of companies, and then assess the economic impact of this treatment. They subsequently examine the international taxation of multinationals, paying special attention to the OECD modelmore » treaty which seeks to remove the problem of international double taxation; reactions of governments to each other's fiscal policies are also examined, with special attention being paid to tax havens. Finally, they look at the EEC proposals for the harmonization of corporate tax systems within the Community and postulate how these proposals would operate if put into effect. There are numerous examples throughout the book of international taxation at work, and these together with the clear text provide a readily comprehensible account of a subject that can seem highly complicated to the uninitiated.« less

  12. Regulating chemical hazards in Japan, West Germany, France, the United Kingdom, and the European community: a comparative examination. Final report

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Coppock, R.

    This report is an outgrowth of a National Research Council program initiative to gain a cross-national perspective on the role scientific information has played in hazardous chemical regulation. Although this study is not meant to be evaluative, it is designed to help assess by comparison the decision-making and regulatory mechanisms in U.S. hazard assessment. The chapters on the individual countries are divided into three components: (1) relevant political and administrative traditions that influence expectations about and mechanisms of hazard regulation; (2) a compilation of the relevant statuatory instruments; and (3) the scope of the regulatory jurisdiction. The last category dividesmore » the laws into those which govern industrial plants, emmissions and discharges, worker protection, industrial substances, poisons, agricultural chemicals, food additives, and contaminants, consumer products, transport, chemical waste, and victim compensation. The study concludes with a discussion of ways in which such multinational perspectives might be used to strengthen the regulatory process of the U.S.« less

  13. Interprofessional Fellowship Training for Emerging Global Health Leaders in Africa to Improve HIV Prevention and Care: The Afya Bora Consortium

    PubMed Central

    Ousman, Kevin; Polomano, Rosemary C.; Seloilwe, Esther; Odero, Theresa; Tarimo, Edith; Mashalla, Yohana J.; Voss, Joachim G.; O’Malley, Gabrielle; Chapman, Susan A.; Gachuno, Onesmus; Manabe, Yukari; Nakanjako, Damalie; Sewankambo, Nelson; Urassa, David; Wasserheit, Judith N.; Wiebe, Douglas J.; Green, Wendy; Farquhar, Carey

    2016-01-01

    HIV continues to challenge health systems, especially in low- and middle-income countries in Sub-Saharan Africa. A qualified workforce of transformational leaders is required to strengthen health systems and introduce policy reforms to address the barriers to HIV testing, treatment, and other HIV services. The 1-year Afya Bora Consortium Fellowship in Global Health capitalizes on academic partnerships between African and U.S. universities to provide interprofessional leadership training through classroom, online, and service-oriented learning in 5 countries in Africa. This fellowship program prepares health professionals to design, implement, scale-up, evaluate, and lead health programs that are population-based and focused on prevention and control of HIV and other public health issues of greatest importance to African communities and health service settings. Afya Bora nurse fellows acquire leadership attributes and competencies that are continuously and systematically tested during the entire program. This multinational training platform promotes interprofessional networks and career opportunities for nurses. PMID:27086192

  14. Mass communication and cultural identity: the unresolved issue of national sovereignty and cultural autonomy in the wake of new communication technologies.

    PubMed

    Uche, L U

    1988-01-01

    The trend in modern mass communication appears to be toward the imposition of the cultural, economic, and political values of the societies with the most advanced communication and information technologies and media sources. The consequence of this reality is that the cultural values, national aspirations, economic needs, and political independence of developing countries are not taken into consideration. Thus, the national interests of African states make it imperative for them to carefully evaluate, assess, and examine the development of their present media structures and ownership patterns. If the mass media is privatized, their owners serve as mouthpieces for multinational corporations. This phenomenon can severely undermine African goals of self-sufficiency in food production and industrialization, political stability that guarantees territorial integrity, and preservation of the African culture. It is imperative that African governments do not allow big multinationals to take over the molding and control of public opinion. Although modern systems of communication are exceedingly expensive and sophisticated, ways must be found to make the media public utilities.

  15. Assuaging Nuclear Energy Risks: The Angarsk International Uranium Enrichment Center

    NASA Astrophysics Data System (ADS)

    Myers, Astasia

    2011-06-01

    The recent nuclear renaissance has motivated many countries, especially developing nations, to plan and build nuclear power reactors. However, domestic low enriched uranium demands may trigger nations to construct indigenous enrichment facilities, which could be redirected to fabricate high enriched uranium for nuclear weapons. The potential advantages of establishing multinational uranium enrichment sites are numerous including increased low enrichment uranium access with decreased nuclear proliferation risks. While multinational nuclear initiatives have been discussed, Russia is the first nation to actualize this concept with their Angarsk International Uranium Enrichment Center (IUEC). This paper provides an overview of the historical and modern context of the multinational nuclear fuel cycle as well as the evolution of Russia's IUEC, which exemplifies how international fuel cycle cooperation is an alternative to domestic facilities.

  16. Reducing Proliferation Rick Through Multinational Fuel Cycle Facilities

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Amanda Rynes

    2010-11-01

    With the prospect of rapid expansion of the nuclear energy industry and the ongoing concern over weapons proliferation, there is a growing need for a viable alternative to traditional nation-based fuel production facilities. While some in the international community remain apprehensive, the advantages of multinational fuel cycle facilities are becoming increasingly apparent, with states on both sides of the supply chain able to garner the security and financial benefits of such facilities. Proliferation risk is minimized by eliminating the need of states to establish indigenous fuel production capabilities and the concept's structure provides an additional internationally monitored barrier against themore » misuse or diversion of nuclear materials. This article gives a brief description of the arguments for and against the implementation of a complete multinational fuel cycle.« less

  17. IAI Capacity Building Activities in the Americas: Fostering Multinational and Multidisciplinary Research

    NASA Astrophysics Data System (ADS)

    Ohira, M. S.

    2007-05-01

    The IAI's Training and Education (T&E) activities are designed to encourage capacity building in the Americas and are developed within and in parallel with the IAI research programs in global environmental change (GEC). The IAI has various training priorities: (1) support for graduate students in the form of fellowships through research programs; (2) development of IAI Training Institutes in Interdisciplinary Sciences and Science-Policy Fora; and (3) support for technical workshops, scientific meetings, and seminars. It becomes increasingly evident that institutions such as IAI must provide training and support to policy and decision makers who deal with environmental issues. The IAI Training Institutes emphasize an exchange of information about the various scientific languages, needs, and methodologies of disciplines that study GEC. Particular attention is given to socio-economic impacts and ways in which nations can gain a better understanding of the complex mechanisms, degrees of change, causes, and consequences - and therefore, plan sound public and private policies to minimize problems and maximize opportunities. The IAI has also implemented a Training Institute Seed Grant (TISG) Program as an assessment activity of the Training Institutes to further encourage network building and multinational and multidisciplinary collaboration among its 19 member countries in the Americas. By fostering the development of such new multidisciplinary, multinational teams, the IAI ensures a future generation of professionals who will be engaged in IAI research programs and networks and will lead the integrated science programs in the next decades. Furthermore, IAI has organized Science-Policy Fora, which focus on the science- policy interface and ways to incorporate scientific information into policy and decision-making processes. Participants discussed what scientific information is available, what aspects need to be better understood, translation of scientific information for the nonscientific community, potential uses of technical information, and policy issues that should be incorporated into the scientific community's agenda. Participants are individuals from governmental agencies, national and international organizations, nongovernmental organizations (NGO), universities, and private companies. Various other T&E-based initiatives that contribute to the building of scientific capacity in the Americas are supported by the IAI. Workshops, seminars, conferences, and other venues encourage the exchange of information and data providing scientists and professionals in global change related fields many opportunities to interact and benefit from multinational, multidisciplinary collaborations.

  18. Education and training in pediatric robotic surgery: lessons learned from an inaugural multinational workshop.

    PubMed

    Cundy, Thomas P; Mayer, Erik K; Camps, Juan I; Olsen, Lars H; Pelizzo, Gloria; Yang, Guang-Zhong; Darzi, Ara; Najmaldin, Azad S

    2015-03-01

    The introduction of robotic surgery into clinical practice brings new and specific needs for education and training. Application to the pediatric setting comes with unique considerations, warranting dedicated training resources that are accessible. A pediatric robotic surgery workshop was convened to address initial education and training requirements. The event was designed to offer an exposure rich environment for delegates to familiarize and learn basic principles in a maximally efficient manner. Pre- and post-workshop survey responses were evaluated to reflect on the quality of the educational experience and scope for improvement. Feasibility and sustainability of such events was further evaluated by reviewing various challenges encountered. A total of 29 surgeons participated in the workshop, with 7 countries represented. The majority of delegates (94 %) indicated they were "very satisfied" with the overall program. Delegates almost unanimously expressed preference and satisfaction for hands-on content. Qualitative feedback favored a stepwise and modular workshop structure, transitioning from didactic teaching to progressively more advanced training. At the basic and intermediate level, this style of event is able to satisfy initial training and educational needs. Feasibility and sustainability of such events is highly dependent on infrastructure resources that have numerous barriers to accessibility.

  19. The Mission Partner Environment: Challenges To Multinational Information Sharing

    DTIC Science & Technology

    2016-02-15

    Harvey , Royal Air Force 15 February 2016 DISTRIBUTION A. Approved for public release: distribution unlimited. ii Disclaimer The views expressed...troops, with non-U.S. commanders in charge of vast areas of inhospitable geography . The enormous size and scope of this mission created incredibly...between people and organizations separated by wide geography is the requirement for a persistent and durable means for multinational communication and

  20. How China Could Affect the Future of U.S. Defense Corporations

    DTIC Science & Technology

    2010-12-01

    of Jonathan Galloway , who addressees among many things, the global implications of DMNCs by differentiating the driving mechanisms for these... Galloway , “The Military-Industrial Linkages of U.S.-Based Multinational Corporations,” International Studies Quarterly 16, no. 4, Multinational...individual percentages.56 Galloway states “it stands to reason that their managements will be interested in preserving the dynamic equilibrium between

  1. Implications for the U.S. of Anglo-French Defense Cooperation

    DTIC Science & Technology

    2012-04-30

    multinational European military development projects are viewed with scepticism in the UK, the Anglo- French arrangement could strengthen the prospects...multinational European military development projects are viewed with scepticism in the UK, the Anglo- French arrangement could strengthen the prospects for...programme. The UK also dropped out of the Horizon Common New Generation Frigate project , which included France and Italy (Antill, 2011). Continued

  2. The Promotion of Bottle Feeding by Multinational Corporations: How Advertising and the Health Professions Have Contributed. Cornell International Nutritioon Monograph Series, Number 2 (1975).

    ERIC Educational Resources Information Center

    Greiner, Ted; Latham, Michael C., Ed.

    This report investigates the ways bottle feeding of infants is promoted by multinational corporations. Data were obtained from the following: (1) a survey of available infant food advertising in newspapers and magazines from developing countries; (2) a study of some interrelationships between the health professions and infant food companies,…

  3. Abdominal Pain-Associated Functional Gastrointestinal Disorder Prevalence in Children and Adolescents with Celiac Disease on Gluten-Free Diet: A Multinational Study.

    PubMed

    Saps, Miguel; Sansotta, Naire; Bingham, Sean; Magazzu, Giuseppe; Grosso, Caterina; Romano, Simone; Pusatcioglu, Cenk; Guandalini, Stefano

    2017-03-01

    To test the hypothesis that children with celiac disease (CD) on gluten-free diet are at increased risk of abdominal pain (AP) associated-functional gastrointestinal disorders (FGIDs). This was a multinational cross-sectional study performed from 2014 to 2015. Patients 4-18 years of age with CD on gluten-free diet for longer than 6 months were recruited from pediatric CD clinics in US and Italy. Control groups included siblings of children with CD (with normal tissue transglutaminase levels) and unrelated controls. Subjects or parents completed the Questionnaire on Pediatric Gastrointestinal Symptoms-Rome III. Children (n = 289) were recruited (55% US, 45% Italy): 96 children with CD, 96 sibling controls, and 97 unrelated controls. Chronic AP was present in 30 (30.9%) subjects with CD, 22 (22.7%) sibling controls, and 21 (21.6%) unrelated controls (P = .26 patients with CD vs siblings; P = .18 patients with CD vs unrelated; P = .96 siblings vs unrelated). AP-FGIDs were present in 8 (8.2%) subjects with CD, 8 (8.2%) sibling controls, and 2 (2.1%) unrelated controls (P = 1.00 subjects with CD vs sibling controls; P = .06 subjects with CD vs unrelated controls; P = .06 sibling controls vs unrelated controls). This multinational study evaluated the prevalence of chronic abdominal pain and AP-FGIDs in the pediatric population with CD. We found that subjects with CD and controls have a similar prevalence of chronic AP and AP-FGIDs. This suggests that not all types of gastrointestinal inflammation result in AP-FGIDs in children. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Money Laundering in China: Why PACOM Should Place High Priority on this Issue

    DTIC Science & Technology

    2012-10-06

    Financial Action Task Force ( FATF ), a multi-national organization responsible for anti-money laundering (AML) regulation and enforcement standards...29, 2007, 7. www.fatf- gafi.org/media/ fatf /documents/reports/mer/MER%20China%20full.pdf Accessed on 12Sep12. 14 George W. Russell, “Dirty Money...Evaluation, 8 th Follow-up Report, Financial Action Task Force, February 17, 2012. www.fatf- gafi.org/media/ fatf /documents/reports/mer/Follow%20Up

  5. THE TEMPLATE FOR THE ACQUISITION OF THE NEXT MULTINATIONAL MULTI-ROLE FIGHTER

    DTIC Science & Technology

    2015-10-01

    creation of this unique teaming arrangement. Therefore, the conclusion of this report is that when each of the six individual countries purchased their...States in purchasing the F-16. 13 Figure 2: MNFP F-16 during MLU test and evaluation. 14 Because of the immediate successes to the program... bribes . In the end, this agreement was considered the ‘Deal of the Century’, not only for the benefits provided to participating militaries but also

  6. Building local research and development capacity for the prevention and cure of neglected diseases: the case of India.

    PubMed

    Kettler, H E; Modi, R

    2001-01-01

    This paper examines the proposal to build research and development (R&D) capabilities for dealing with neglected infectious and tropical diseases in countries where they are endemic, as a potentially cost- and time-effective way to fill the gap between the supply of and need for new medicines. With reference to the situation in India, we consider the competencies and incentives needed by companies so that their strategy can be shifted from reverse engineering of existing products to investment in R&D for new products. This requires complex reforms, of which the intellectual property rights agreement is only one. We also consider whether Indian companies capable of conducting research and development are likely to target neglected diseases. Patterns of patenting and of R&D, together with evidence from interviews we have conducted, suggest that Indian companies, like multinational corporations, are likely to target global diseases because of the prospect of much greater returns. Further studies are required on how Indian companies would respond to push and pull incentives originally designed to persuade multinational corporations to do more R&D on neglected diseases.

  7. Building local research and development capacity for the prevention and cure of neglected diseases: the case of India.

    PubMed Central

    Kettler, H. E.; Modi, R.

    2001-01-01

    This paper examines the proposal to build research and development (R&D) capabilities for dealing with neglected infectious and tropical diseases in countries where they are endemic, as a potentially cost- and time-effective way to fill the gap between the supply of and need for new medicines. With reference to the situation in India, we consider the competencies and incentives needed by companies so that their strategy can be shifted from reverse engineering of existing products to investment in R&D for new products. This requires complex reforms, of which the intellectual property rights agreement is only one. We also consider whether Indian companies capable of conducting research and development are likely to target neglected diseases. Patterns of patenting and of R&D, together with evidence from interviews we have conducted, suggest that Indian companies, like multinational corporations, are likely to target global diseases because of the prospect of much greater returns. Further studies are required on how Indian companies would respond to push and pull incentives originally designed to persuade multinational corporations to do more R&D on neglected diseases. PMID:11545331

  8. The end of corporate imperialism.

    PubMed

    Prahalad, C K; Lieberthal, Kenneth

    2003-08-01

    As they search for growth, multinational corporations will have no choice but to compete in the big emerging markets of China, India, Indonesia, and Brazil. But while it is still common to question how such corporations will change life in those markets, Western executives would be smart to turn the question around and ask how multinationals themselves will be transformed by these markets. To be successful, MNCs will have to rethink every element of their business models, the authors assert in this seminal HBR article from 1998. During the first wave of market entry in the 1980s, multinationals operated with what might be termed an imperialist mind-set, assuming that the emerging markets would merely be new markets for their old products. But this mind-set limited their success: What is truly big and emerging in countries like China and India is a new consumer base comprising hundreds of millions of people. To tap into this huge opportunity, MNCs need to ask themselves five basic questions: Who is in the emerging middle class in these countries? How do the distribution networks operate? What mix of local and global leadership do you need to foster business opportunities? Should you adopt a consistent strategy for all of your business units within one country? Should you take on local partners? The transformation that multinational corporations must undergo is not cosmetic--simply developing greater sensitivity to local cultures will not do the trick, the authors say. To compete in the big emerging markets, multinationals must reconfigure their resources, rethink their cost structures, redesign their product development processes, and challenge their assumptions about who their top-level managers should be.

  9. The International Collaboration for Autism Registry Epidemiology (iCARE): multinational registry-based investigations of autism risk factors and trends.

    PubMed

    Schendel, Diana E; Bresnahan, Michaeline; Carter, Kim W; Francis, Richard W; Gissler, Mika; Grønborg, Therese K; Gross, Raz; Gunnes, Nina; Hornig, Mady; Hultman, Christina M; Langridge, Amanda; Lauritsen, Marlene B; Leonard, Helen; Parner, Erik T; Reichenberg, Abraham; Sandin, Sven; Sourander, Andre; Stoltenberg, Camilla; Suominen, Auli; Surén, Pål; Susser, Ezra

    2013-11-01

    The International Collaboration for Autism Registry Epidemiology (iCARE) is the first multinational research consortium (Australia, Denmark, Finland, Israel, Norway, Sweden, USA) to promote research in autism geographical and temporal heterogeneity, phenotype, family and life course patterns, and etiology. iCARE devised solutions to challenges in multinational collaboration concerning data access security, confidentiality and management. Data are obtained by integrating existing national or state-wide, population-based, individual-level data systems and undergo rigorous harmonization and quality control processes. Analyses are performed using database federation via a computational infrastructure with a secure, web-based, interface. iCARE provides a unique, unprecedented resource in autism research that will significantly enhance the ability to detect environmental and genetic contributions to the causes and life course of autism.

  10. Decisive Action Training Environment at the Joint Multinational Readiness Center, Volume 3: Multinational Interoperability

    DTIC Science & Technology

    2016-09-01

    training in the decisive action training environment, with rotations routinely featuring several thousand participants from many nations and operating in...teams work with exercise participants before they arrive at the training center. The goal is to ensure all formations understand — and are able to...capabilities, location, and extensive experience working with NATO and partner countries, the JMTC is uniquely positioned to implement NATO training

  11. Competence and Human Resource Development in Multinational Companies in Three European Union Member States: A Comparative Analysis between Austria, the Netherlands and the United Kingdom. CEDEFOP Panorama Series.

    ERIC Educational Resources Information Center

    Markowitsch, Jorg; Kollinger, Iris; Warmerdam, John; Moerel, Hans; Konrad, John; Burell, Catherine; Guile, David

    A comparative analysis of human resources development and management in the subsidiaries of three multinational companies (Xerox, Glaxo Wellcome, and AXA Nordstern Colonia) was conducted in these three European Union (EU) member states: Austria, the United Kingdom, and the Netherlands. Case studies were used, focusing on competence needs and…

  12. Multinational Experiment 7. Protecting Access to Space: Presentation to Senior Leaders

    DTIC Science & Technology

    2013-07-08

    Multinational Experiment 7: Outcome 3: Space Access Briefing to SLS 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d...operations Consequence management Ship status during search & rescue Tele-medicine Broadband internet TV signal distribution Satellite radio Rural...military-usage • Significant economic & societal consequences Access to space at risk • Current approach unsustainable • Broad range of threats

  13. National Security Implications of Transnational Economic Activity

    DTIC Science & Technology

    1993-04-01

    ABSTRACT SECURITY CLASSIFICATION rUNCLASSIFIED/UNLIMITED El SAME AS RPT. O DTIC USERS Unclassified 22a. NAME OF RESPONSIBLE INDIVIDUAL 22b. TELEPHONE...Activity This paper discusses the impact of regional trading arrangements (RTA’s), multinational corporations (MNC’s), and transnational financial activity...multinational corporation investment and taxation. o The U.S. must strengthen its national economy in order to be a world class player in transnational

  14. Conducting a multicentre and multinational qualitative study on patient transitions.

    PubMed

    Johnson, Julie K; Barach, Paul; Vernooij-Dassen, Myrra

    2012-12-01

    A multicentre, multinational research study requires careful planning and coordination to accomplish the aims of the study and to ensure systematic and rigorous examination of all project methods and data collected. The aim of this paper is to describe the approach we used during the HANDOVER Project to develop a multicentre, multinational research project for studying transitions of patient care while creating a community of practice for the researchers. We highlight the process used to assure the quality of a multicentre qualitative study and to create a codebook for data analysis as examples of attending to the community of practice while conducting rigorous qualitative research. Essential elements for the success of this multinational, multilanguage research project included recruiting a strong research team, explicit planning for decision-making processes to be used throughout the project, acknowledging the differences among the study settings and planning the protocols to capitalise upon those differences. Although not commonly discussed in reports of large research projects, there is an underlying, concurrent stream of activities to develop a cohesive team that trusts and respects one another's skills and that engage independent researchers in a group process that contributes to achieving study goals. We discuss other lessons learned and offer recommendations for other teams planning multicentre research.

  15. Smart Grid Development: Multinational Demo Project Analysis

    NASA Astrophysics Data System (ADS)

    Oleinikova, I.; Mutule, A.; Obushevs, A.; Antoskovs, N.

    2016-12-01

    This paper analyses demand side management (DSM) projects and stakeholders' experience with the aim to develop, promote and adapt smart grid tehnologies in Latvia. The research aims at identifying possible system service posibilites, including demand response (DR) and determining the appropriate market design for such type of services to be implemented at the Baltic power system level, with the cooperation of distribution system operator (DSO) and transmission system operator (TSO). This paper is prepared as an extract from the global smart grid best practices, smart solutions and business models.

  16. Asia Pacific Economic Cooperation (APEC) and the 2008 Meetings in Lima, Peru

    DTIC Science & Technology

    2009-03-31

    major retailers and multinational corporations who source products from manufacturers and sourcing companies around the world. In turn, these companies...on orders from U.S., European, or Japanese retailers or brand name distributors to initiate the multinational manufacturing of the consumer products...describes a “patchwork of bilateral hub-and-spoke FTAs in a noodle bowl.” According to some experts, the growth of bilateral trade agreements (BTAs

  17. The Military Dimension of the Niger Delta Crisis: Increasing the Effectiveness of Security Forces Through Information Operations

    DTIC Science & Technology

    2010-06-11

    Torulagha makes strong accusations against the oil companies who he says barely conduct any environmental assessment before engaging in exploratory...residents widely regard the GoN as ―having collaborated with the multinational oil firms to alter the social and environmental stability of the area ...residents demanded resource control in the face of environmental degradation by multinational oil companies; and complaints of government marginalization

  18. Multinational Limited Objective Experiment II (MN LOE II)

    DTIC Science & Technology

    2003-06-01

    multinational ONA development to the international players for the first time. Vignette 4 promoted the systems-of-systems approach , the need to...as a result of ongoing famines and economic chaos. The new nation adopted the South Korean form of government and economic system. Concern of a...negative impact on the economy of the south , as they combined with the north, was well founded. Without a Korean “Marshall Plan” instituted by the

  19. Multinational corporate penetration, industrialism, region, and social security expenditures: a cross-national analysis.

    PubMed

    Clark, R; Filinson, R

    1991-01-01

    This study examines the determinants of spending on social security programs. We draw predictions from industrialism and dependency theories for the explanation of social security programs. The explanations are tested with data on seventy-five nations, representative of core, semipheripheral and peripheral nations. Industrialization variables such as the percentage of older adults and economic productivity have strong effects in models involving all nations, as does multinational corporate (MNC) penetration in extraction, particularly when region is controlled; such penetration is negatively associated with spending on social security. We then look at industrialism and dependency effects for peripheral and non-core nations alone. The effects of all industrialization variables, except economic productivity, appear insignificant for peripheral nations, while the effects of region and multinational corporate penetration in extractive and agricultural industries appears significant. Models involving all non-core nations (peripheral and semi-peripheral) look more like models for all nations than for peripheral nations alone.

  20. Lost in Translation? Challenges and Opportunities for Raising Health and Safety Awareness among a Multinational Workforce in the United Arab Emirates

    PubMed Central

    Cooling, Robert Fletcher; Aw, Tar-Ching

    2012-01-01

    The United Arab Emirates (UAE) has experienced tremendous economic and industrial growth in the petroleum, airline, maritime and construction sectors, especially since the discovery of oil reserves. Mass recruitment of low skilled or unskilled laborers from less-developed countries has been utilized to satisfy the manpower demands of these fast paced industrial developments. Such workforce recruitment has created an unusual populace demographic, with the total UAE population estimated at 8.3 million, composed of 950,000 Emiratis, with the remainder being multinational expatriate workers, with varying educational qualifications, work experience, religious beliefs, cultural practices, and native languages. These unique characteristics pose a challenge for health and safety professionals tasked with ensuring the UAE workforce adheres to specific occupational health and safety procedures. The paper discusses two case studies that employ a novel multimedia approach to raising health and safety awareness among a multinational workforce. PMID:23251846

  1. Acquisition of Armored Vehicles Purchased Through Contract W914NS-05-M-1189

    DTIC Science & Technology

    2005-10-21

    vehicles. Results. The Multi-National Security Transition Command – Iraq (MNSTC-I) purchased seven armored Mercedes - Benz vehicles that did not have...contractor to provide seven armored Mercedes - Benz vehicles. The vehicles were to be used by the Multi-National Security Transition Command (MNSTC-I) to...ability to provide the vehicles immediately. The contract called for the delivery of seven Mercedes - Benz sedans at a price of $135,000 per vehicle that

  2. Distribution Synergy in Multi-National Division-Baghdad during Operation Iraqi Freedom Rotation 07-09

    DTIC Science & Technology

    2011-06-10

    customer wait time (CWT) in Multi-National Division-Baghdad (MND- B ) from October 2007 to January 2008. A secondary objective was to determine what...LIMITATION OF ABSTRACT 18. NUMBER OF PAGES 19a. NAME OF RESPONSIBLE PERSON a. REPORT b . ABSTRACT c. THIS PAGE 19b. PHONE NUMBER (include...Division-Baghdad (MND- B ) from October 2007 to January 2008. A secondary objective was to determine what affect initiatives from operational and

  3. Providing Enterprise Information Services for Multinational Interoperability - The EIM Approach

    DTIC Science & Technology

    2005-06-01

    Federated Search • Document Processing and Archiving • Workflow processing References 1. Perspective on Multinational Information Sharing, Cheryl...layer, with a primary focus on the Application Layers. App Layer Focus Areas Enterprise Content Mgt, Workflow, Business Processes, Federated ... Search Integration Layer – EAI Components Nation 1 Nation 2 Nation 3 … Nation N Silo 1 Silo 2 Silo 3 S ilo N Silo 1 Silo 1 Silo 2 Silo 2 Silo 3 Silo 3 S

  4. Preparing General Purpose Forces in the United States and British Armies for Counterinsurgent Operations

    DTIC Science & Technology

    2010-12-10

    Operations In Iraq: Planning, Combat, And Occupation,” Thomas Ricks’ Fiasco, and reports by Army historian Major Isaiah Wilson, and former CENCTOM J-4...established Multi-National Forces-Iraq, and Lieutenant General Thomas Metz, commander of the Army’s III Corps, assumed the mantle of Multi-National Corps...Donald P. Wright and Colonel Timothy R. Reese or Thomas Ricks’ Fiasco among other books. 18Dr. Carter Malkasian, “Counterinsurgency in Iraq: May 2003

  5. IRS Could Better Protect U.S. Tax Interests in Determining the Income of Multinational Corporations.

    DTIC Science & Technology

    1981-09-30

    together by ties of common ownership and responsive to a common management strat- egy. 2/ Unlike a corporation which conducts business in only one...multinational corporate tax returns. The Assistant Commissi3ner carries out this responsibility through the IRS Examination Divi- sion and Office of...information return would not place an added burden on the corporations be- cause the corporations are currently providing similar data in response to

  6. Medication use in pregnancy: a cross-sectional, multinational web-based study.

    PubMed

    Lupattelli, A; Spigset, O; Twigg, M J; Zagorodnikova, K; Mårdby, A C; Moretti, M E; Drozd, M; Panchaud, A; Hämeen-Anttila, K; Rieutord, A; Gjergja Juraski, R; Odalovic, M; Kennedy, D; Rudolf, G; Juch, H; Passier, A; Björnsdóttir, I; Nordeng, H

    2014-02-17

    Intercountry comparability between studies on medication use in pregnancy is difficult due to dissimilarities in study design and methodology. This study aimed to examine patterns and factors associated with medications use in pregnancy from a multinational perspective, with emphasis on type of medication utilised and indication for use. Cross-sectional, web-based study performed within the period from 1 October 2011 to 29 February 2012. Uniform collection of drug utilisation data was performed via an anonymous online questionnaire. Multinational study in Europe (Western, Northern and Eastern), North and South America and Australia. Pregnant women and new mothers with children less than 1 year of age. Prevalence of and factors associated with medication use for acute/short-term illnesses, chronic/long-term disorders and over-the-counter (OTC) medication use. The study population included 9459 women, of which 81.2% reported use of at least one medication (prescribed or OTC) during pregnancy. Overall, OTC medication use occurred in 66.9% of the pregnancies, whereas 68.4% and 17% of women reported use of at least one medication for treatment of acute/short-term illnesses and chronic/long-term disorders, respectively. The extent of self-reported medicated illnesses and types of medication used by indication varied across regions, especially in relation to urinary tract infections, depression or OTC nasal sprays. Women with higher age or lower educational level, housewives or women with an unplanned pregnancy were those most often reporting use of medication for chronic/long-term disorders. Immigrant women in Western (adjusted OR (aOR): 0.55, 95% CI 0.34 to 0.87) and Northern Europe (aOR: 0.50, 95% CI 0.31 to 0.83) were less likely to report use of medication for chronic/long-term disorders during pregnancy than non-immigrants. In this study, the majority of women in Europe, North America, South America and Australia used at least one medication during pregnancy. There was a substantial inter-region variability in the types of medication used.

  7. A taxonomy of multinational ethical and methodological standards for clinical trials of therapeutic interventions

    PubMed Central

    Ashton, Carol M; Wray, Nelda P; Jarman, Anna F; Kolman, Jacob M; Wenner, Danielle M; Brody, Baruch A

    2013-01-01

    Background If trials of therapeutic interventions are to serve society’s interests, they must be of high methodological quality and must satisfy moral commitments to human subjects. The authors set out to develop a clinical-trials compendium in which standards for the ethical treatment of human subjects are integrated with standards for research methods. Methods The authors rank-ordered the world’s nations and chose the 31 with >700 active trials as of 24 July 2008. Governmental and other authoritative entities of the 31 countries were searched, and 1004 English-language documents containing ethical and/or methodological standards for clinical trials were identified. The authors extracted standards from 144 of those: 50 designated as ‘core’, 39 addressing trials of invasive procedures and a 5% sample (N=55) of the remainder. As the integrating framework for the standards we developed a coherent taxonomy encompassing all elements of a trial’s stages. Findings Review of the 144 documents yielded nearly 15 000 discrete standards. After duplicates were removed, 5903 substantive standards remained, distributed in the taxonomy as follows: initiation, 1401 standards, 8 divisions; design, 1869 standards, 16 divisions; conduct, 1473 standards, 8 divisions; analysing and reporting results, 997 standards, four divisions; and post-trial standards, 168 standards, 5 divisions. Conclusions The overwhelming number of source documents and standards uncovered in this study was not anticipated beforehand and confirms the extraordinary complexity of the clinical trials enterprise. This taxonomy of multinational ethical and methodological standards may help trialists and overseers improve the quality of clinical trials, particularly given the globalisation of clinical research. PMID:21429960

  8. A taxonomy of multinational ethical and methodological standards for clinical trials of therapeutic interventions.

    PubMed

    Ashton, Carol M; Wray, Nelda P; Jarman, Anna F; Kolman, Jacob M; Wenner, Danielle M; Brody, Baruch A

    2011-06-01

    If trials of therapeutic interventions are to serve society's interests, they must be of high methodological quality and must satisfy moral commitments to human subjects. The authors set out to develop a clinical-trials compendium in which standards for the ethical treatment of human subjects are integrated with standards for research methods. The authors rank-ordered the world's nations and chose the 31 with >700 active trials as of 24 July 2008. Governmental and other authoritative entities of the 31 countries were searched, and 1004 English-language documents containing ethical and/or methodological standards for clinical trials were identified. The authors extracted standards from 144 of those: 50 designated as 'core', 39 addressing trials of invasive procedures and a 5% sample (N=55) of the remainder. As the integrating framework for the standards we developed a coherent taxonomy encompassing all elements of a trial's stages. Review of the 144 documents yielded nearly 15 000 discrete standards. After duplicates were removed, 5903 substantive standards remained, distributed in the taxonomy as follows: initiation, 1401 standards, 8 divisions; design, 1869 standards, 16 divisions; conduct, 1473 standards, 8 divisions; analysing and reporting results, 997 standards, four divisions; and post-trial standards, 168 standards, 5 divisions. The overwhelming number of source documents and standards uncovered in this study was not anticipated beforehand and confirms the extraordinary complexity of the clinical trials enterprise. This taxonomy of multinational ethical and methodological standards may help trialists and overseers improve the quality of clinical trials, particularly given the globalisation of clinical research.

  9. A data dictionary approach to multilingual documentation and decision support for the diagnosis of acute abdominal pain. (COPERNICUS 555, an European concerted action).

    PubMed

    Ohmann, C; Eich, H P; Sippel, H

    1998-01-01

    This paper describes the design and development of a multilingual documentation and decision support system for the diagnosis of acute abdominal pain. The work was performed within a multi-national COPERNICUS European concerted action dealing with information technology for quality assurance in acute abdominal pain in Europe (EURO-AAP, 555). The software engineering was based on object-oriented analysis design and programming. The program cover three modules: a data dictionary, a documentation program and a knowledge based system. National versions of the software were provided and introduced into 16 centers from Central and Eastern Europe. A prospective data collection was performed in which 4020 patients were recruited. The software design has been proven to be very efficient and useful for the development of multilingual software.

  10. Space Technology Research Vehicle (STRV)-2 program

    NASA Astrophysics Data System (ADS)

    Shoemaker, James; Brooks, Paul; Korevaar, Eric J.; Arnold, Graham S.; Das, Alok; Stubstad, John; Hay, R. G.

    2000-11-01

    The STRV-2 program is the second in a series of three collaborative flight test programs between the U.S. Ballistic Missile Defense Organization (BMDO) and the United Kingdom (UK) Minstry of Defence (MoD). The STRV-2 Experiment Module contains five major experiments to provide proof-of-concept data on system design, data on the mid-earth orbit (MEO) space environment, and data on durability of materials and components operating in the MEO environment. The UK Defence Evaluation and Research Agency (DERA) has provided a mid- wavelength infrared (MWIF) imager to evaluate passive detection of aircraft from space. BMDO, in conjunction with the US Air Force Research Laboratory (AFRL) and the National Aeronautics and Space Administration (NASA), have provided experiments to evaluate use of adaptive structures for vibration suppression, to investigate the use of high bandwidth laser communications to transmit data from space to ground or airborne receivers, to study the durability of materials and components in the MEO space environment, and to measure radiation and micrometeoroid/debris fluence. These experiments are mounted on all- composite structure. This structure provides a significant reduction in weight and cost over comparable aluminum designs while maintaining the high stiffness required by optical payloads. In 1994, STRV-2 was manifested for launch by the DOD Space Test Program. STRV-2, the primary payload on the Tri-Service eXperiment (TSX)-5 spacecraft, was successfully launched on 7 June 2000 on a Pegasus XL from Vandenbery AFB, CA. The STRV-2 program, like the companion STRV-1 program, validates the viability of multi-national, multi-agency collaborations to provide cost effective acquisition of space test data. The experimental data to be obtained will reduce future satellite risk and provide guidelines for further system development.

  11. “Does Organizational Culture Influence the Ethical Behavior in the Pharmaceutical Industry?”

    PubMed Central

    Nagashekhara, Molugulu; Agil, Syed Omar Syed

    2011-01-01

    Study of ethical behavior among medical representatives in the profession is an under-portrayed component that deserves further perusal in the pharmaceutical industry. The purpose of this study is to find out the influence of organizational culture on ethical behavior of medical representatives. Medical representatives working for both domestic and multinational companies constitutes the sample (n=300). Data is collected using a simple random and cluster sampling through a structured questionnaire. The research design is hypothesis testing. It is a cross-sectional and correlational study, conducted under non-contrived settings. Chi-square tests were shows that there is an association between the organizational culture and ethical behavior of medical representatives. In addition, the strength of the association is measured which report to Cramer’s V of 63.1% and Phi Value of 2.749. Results indicate that multinational company medical reps are more ethical compared to domestic company medical representatives vast difference in both variance and in t test results. Through better organizational culture, pharmaceutical companies can create the most desirable behavior among their employees. Authors conclude that apart from organizational culture, the study of additional organizational, individual and external factors are imperative for better understanding of ethical behavior of medical representatives in the pharmaceutical industry in India. PMID:24826027

  12. "Does organizational culture influence the ethical behavior in the pharmaceutical industry?".

    PubMed

    Nagashekhara, Molugulu; Agil, Syed Omar Syed

    2011-12-01

    Study of ethical behavior among medical representatives in the profession is an under-portrayed component that deserves further perusal in the pharmaceutical industry. The purpose of this study is to find out the influence of organizational culture on ethical behavior of medical representatives. Medical representatives working for both domestic and multinational companies constitutes the sample (n=300). Data is collected using a simple random and cluster sampling through a structured questionnaire. The research design is hypothesis testing. It is a cross-sectional and correlational study, conducted under non-contrived settings. Chi-square tests were shows that there is an association between the organizational culture and ethical behavior of medical representatives. In addition, the strength of the association is measured which report to Cramer's V of 63.1% and Phi Value of 2.749. Results indicate that multinational company medical reps are more ethical compared to domestic company medical representatives vast difference in both variance and in t test results. Through better organizational culture, pharmaceutical companies can create the most desirable behavior among their employees. Authors conclude that apart from organizational culture, the study of additional organizational, individual and external factors are imperative for better understanding of ethical behavior of medical representatives in the pharmaceutical industry in India.

  13. Health and well-being factors associated with international business travel.

    PubMed

    Burkholder, Justin D; Joines, Ron; Cunningham-Hill, Mark; Xu, Baowei

    2010-01-01

    International travel by US business travelers is continuing to increase with the globalization of the economy. The objective of this study was to determine if the frequency and duration of international business travel is associated with differences in travelers' health and well-being. This study expands our limited knowledge of the impact of long-haul travel on healthy lifestyle choices and traveler's perceptions of their health and well-being. 12,942 unique health risk appraisal (HRA) records of US employees of a multinational corporation were analyzed according to self-reported (objective and subjective) travel history and lifestyle habits. Comparing 2,962 international travelers and 9,980 non-travelers, international business travel was significantly associated with a lower body mass index, lower blood pressure, excess alcohol consumption, sleep deprivation, and diminished confidence to keep up with the pace of work. This study demonstrated both positive and negative associations on the health risks and well-being of a large sample of US-based international business travelers from an US multinational company. This study identifies targeted areas for pretrip screening and counseling to proactively address potential negative effects of travel and may assist in the design of corporate travel health and employee assistance programs. © 2010 International Society of Travel Medicine.

  14. Health impact assessment in multinationals: A case study of the Royal Dutch/Shell Group

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Birley, Martin

    2005-10-15

    Health impact assessment is part of the risk management process of multinational corporations/companies. Sexually transmitted infections, including HIV/AIDS, and the 'paradox of plenty' are used as examples of the challenges they face. The 'business case' for impact assessment is explained. The policies, procedures, standards, and activities used by Shell to manage such risks are described. An approach to capacity building and competency development is presented that applies to both company staff and external contractors.

  15. Arctic Collaborative Environment: A New Multi-National Partnership for Arctic Science and Decision Support

    NASA Technical Reports Server (NTRS)

    Laymon, Charles A,; Kress, Martin P.; McCracken, Jeff E.; Spehn, Stephen L.; Tanner, Steve

    2011-01-01

    The Arctic Collaborative Environment (ACE) project is a new international partnership for information sharing to meet the challenges of addressing Arctic. The goal of ACE is to create an open source, web-based, multi-national monitoring, analysis, and visualization decision-support system for Arctic environmental assessment, management, and sustainability. This paper will describe the concept, system architecture, and data products that are being developed and disseminated among partners and independent users through remote access.

  16. Brands or generics: the dilemma of pharmaceutical marketing in a developing country.

    PubMed

    Quraeshi, Z A; Luqmani, M; Malhotra, N

    1983-01-01

    A significant issue in pharmaceutical marketing in many developing countries is whether drugs should be sold by generic or by brand names. In Pakistan, legislation prohibited the sale of brand name drugs in order to increase price competition, and strengthen the market position of indigenous manufacturers to compete against multinationals. However, the government's objectives were not achieved for reasons discussed in the article. The Pakistan case has implications for multinational firms and for other developing countries in similar situations.

  17. Military Airlift: DOD Plans to Participate in Multi-National Program to Exchange Air Services with European Nations

    DTIC Science & Technology

    2013-10-30

    Air Transport, Air-to-Air Refueling and Other Exchange of Services ( ATARES ) program.1 ATARES is a European program through which member nations use a... ATARES is managed by the Movement Coordination Centre Europe (MCCE), a multi-national organization established in July 2007 to coordinate and optimize...of ATARES but is seeking to join the program. DOD is a member of MCCE and pays a fee for this membership; there is no additional fee to become a

  18. Interprofessional Fellowship Training for Emerging Global Health Leaders in Africa to Improve HIV Prevention and Care: The Afya Bora Consortium.

    PubMed

    Ousman, Kevin; Polomano, Rosemary C; Seloilwe, Esther; Odero, Theresa; Tarimo, Edith; Mashalla, Yohana J; Voss, Joachim G; O'Malley, Gabrielle; Chapman, Susan A; Gachuno, Onesmus; Manabe, Yukari; Nakanjako, Damalie; Sewankambo, Nelson; Urassa, David; Wasserheit, Judith N; Wiebe, Douglas J; Green, Wendy; Farquhar, Carey

    2016-01-01

    HIV continues to challenge health systems, especially in low- and middle-income countries in Sub-Saharan Africa. A qualified workforce of transformational leaders is required to strengthen health systems and introduce policy reforms to address the barriers to HIV testing, treatment, and other HIV services. The 1-year Afya Bora Consortium Fellowship in Global Health capitalizes on academic partnerships between African and U.S. universities to provide interprofessional leadership training through classroom, online, and service-oriented learning in 5 countries in Africa. This fellowship program prepares health professionals to design, implement, scale-up, evaluate, and lead health programs that are population-based and focused on prevention and control of HIV and other public health issues of greatest importance to African communities and health service settings. Afya Bora nurse fellows acquire leadership attributes and competencies that are continuously and systematically tested during the entire program. This multinational training platform promotes interprofessional networks and career opportunities for nurses. Copyright © 2016 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

  19. Evaluating teams in extreme environments: from issues to answers.

    PubMed

    Bishop, Sheryl L

    2004-07-01

    The challenge to effectively evaluating teams in extreme environments necessarily involves a wide range of physiological, psychological, and psychosocial factors. The high reliance on technology, the growing frequency of multinational and multicultural teams, and the demand for longer duration missions all further compound the complexity of the problem. The primary goal is the insurance of human health and well-being with expectations that such priorities will naturally lead to improved chances for performance and mission success. This paper provides an overview of some of the most salient immediate challenges for selecting, training, and supporting teams in extreme environments, gives exemplars of research findings concerning these challenges, and discusses the need for future research.

  20. [Lean production and psychosocial risks: the case of a multinational merger in a metallurgical company in Brazil].

    PubMed

    Stenger, Eunice; Monteiro, Maria Inês; Sabino, Marcos Oliveira; Miquilin, Isabella de Oliveira Campos; Corrêa Filho, Heleno Rodrigues

    2014-08-01

    This study focused on the method known as "lean production" as a work-related psychosocial risk factor in a Brazilian multinational auto parts company after its merger with other multinational companies. The authors conducted a qualitative analysis of two time points: the first using on-site observation and key interviews with managers and workers during implementation of lean production in 1996; the second, 16 years later, comparing data from a document search in labor inspection records from the Ministry of Labor and Employment and legal proceedings initiated by the Office of the Public Prosecutor for Labor Affairs. The merger led to layoffs, replacements, and an increase in the workday. A class action suit was filed on grounds of aggravated working conditions. The new production model led to psychosocial risks that increased the need for workers' health precautions when changes in the production process introduced new and increased risks of physical and mental illnesses.

  1. Multinational corporations, nation-states and ocean resource management: the impact of the world's 200-mile economic zone on multinational and national development

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Gopalakrishnan, C.

    1979-07-01

    The extension of coastal state jurisdiction to 200-nautical miles - a fact of international law about to receive juridical status - would lead to a unique situation in the ownership of ocean resources, viz. 15 coastal states would receive among them approximately 42% of the world's 200-mile economic zone area. At least 8 of these countries are less-developed coastal states (LDCS) which lack the key factors, capital, technology, and managerial skill, necessary to tap these resources. As a result, the reliance of the LDCS on marine multinational corporations will markedly increase since a significant part of marine technology exists inmore » the private sector. Concurrently, a dramatic rise in the control of coastal states over MNCs engaged in ocean resource development will occur. Thus, under the new regime of ocean resource management, the relationship between MNCs and nation-states is likely to be one of constructive partnership in development, rather than one of conflict and discord.« less

  2. Family, Community, and Health System Considerations for Reducing the Burden of Pediatric Sickle Cell Disease in Uganda Through Newborn Screening

    PubMed Central

    Green, Nancy S.; Mathur, Sanyukta; Kiguli, Sarah; Makani, Julie; Fashakin, Victoria; LaRussa, Philip; Lyimo, Magdalena; Abrams, Elaine J.; Mulumba, Lukia; Mupere, Ezekiel

    2016-01-01

    Sickle cell disease (SCD) is associated with high mortality for children under 5 years of age in sub-Saharan Africa. Newborn sickle screening program and enhanced capacity for SCD treatment are under development to reduce disease burden in Uganda and elsewhere in the region. Based on an international stakeholder meeting and a family-directed conference on SCD in Kampala in 2015, and interviews with parents, multinational experts, and other key informants, we describe health care, community, and family perspectives in support of these initiatives. Key stakeholder meetings, discussions, and interviews were held to understand perspectives of public health and multinational leadership, patients and families, as well as national progress, resource needs, medical and social barriers to program success, and resources leveraged from HIV/AIDS. Partnering with program leadership, professionals, patients and families, multinational stakeholders, and leveraging resources from existing programs are needed for building successful programs in Uganda and elsewhere in sub-Saharan Africa. PMID:27336011

  3. Double standards: the multinational asbestos industry and asbestos-related disease in South Africa.

    PubMed

    McCulloch, Jock; Tweedale, Geoffrey

    2004-01-01

    This study documents and contrasts the development of knowledge about asbestos-related disease (ARD) in South Africa and the United Kingdom. It also contributes to the globalization debate by exploring corporate decision-making in a multinational industry. Between the 1930s and 1960s, the leading U.K. asbestos companies developed a sophisticated knowledge of ARD, though in South Africa, where the leading companies such as Turner & Newall and Cape Asbestos owned mines, there was little attempt to apply this knowledge. Asbestos mines (and their environments) in South Africa were uniquely dusty and ARD was rife. Social and political factors in South Africa, especially apartheid, allowed these companies to apply double standards, even after 1960 when the much more serious hazard of mesothelioma was identified. This shows the need for greater regulation of multinationals. Because of the lack of such regulation in the early 1960s, an opportunity was lost to prevent the current high morbidity and mortality of ARD both in South Africa and worldwide.

  4. Opportunities and Challenges of Multinational Pharmaceutical Enterprises in Transforming Pharmaceutical Market in China.

    PubMed

    Hu, Linfeng; Yu, Zhong; Yuan, Qingwen; Hu, Yuanjia; Ung, Carolina Oi Lam

    2018-01-01

    The surging costs of health care in China is highly related to the high expenses in pharmaceutical costs. Since the Government of China launched the health care reform in 2009, the issue of growing pharmaceutical expenditure continues to grasp policy makers' attention. Since 2015, an ongoing series of drug-related policies have been revised or developed, resulting in profound impact on the overall pharmaceutical market in China, and the dynamic is still evolving. As China has become the second largest pharmaceutical market in the world, any volatility in the Chinese pharmaceutical market may have great implications to multinational pharmaceutical markets that have had their products launched in China or plan to extend their business to the Chinese market. Based on a comprehensive analysis of the most recent health care reform policies in China, the objectives of this study were to identify the major opportunities appealed to and the challenges confronted by multinational pharmaceutical enterprises in the current Chinese pharmaceutical market.

  5. [Why multi-national clinical trials now?--Industry perspective].

    PubMed

    Miki, Satoshi

    2007-02-01

    Clinical trial environment in Japan has issues such as high clinical development cost, resource-intensive and time-consuming preparation for clinical trial conduct in each clinical site, long "White Space" and slow speed in pt.recruitment. As a result of the Guideline revision in Nov., 2005, overseas' Phase III data is now usable as pivotal data for NDA submissions. Therefore, acceleration of "hollowing out of clinical trails for registration in Japan has been the significant concern. Under such circumstances, the possible solution would be to participate in the Multi-National Clinical Trials." While other Asian countries, EU and the US have rich precedents and experiences in conducting Multi-National Clinical Trials, Japan was left alone and other Asian countries do not need any collaboration with Japan. It is proposed that Japan take initiative to set up the network such as "Asian Clinical Trial Group" and collaborate with other Asian countries from the beginning of early stage development. Eventually, Asia should become the third region to create clinical evidence, same as to EU and the US.

  6. Processes for Assessing Outcomes of Multi-national Missions (Processus d’evaluation des resultats de missions multinationales)

    DTIC Science & Technology

    2013-11-01

    la raison d’être du recueil des données relatives aux variables centrales afin de soutenir ces efforts dans...communs utilisés par les pays membres et un ensemble central d’indicateurs complétant les Mesures de Performance (MOP) et Mesures d’Efficacité (MOE...dénomination « STO », « RTO » ou « AGARD » selon le cas, suivi du numéro de série. Des informations analogues, telles que le titre est la date de

  7. Seven rules of international distribution.

    PubMed

    Arnold, D

    2000-01-01

    A multinational entering a new market in a developing country knows that on its own, it cannot master local business practices, meet regulatory requirements, hire and manage local personnel, and gain access to potential customers. So it partners with a local distributor. At first, sales take off, revenues grow, and the entry seems like a smart move. But when sales plateau, the corporation begins blaming the distributor for not investing sufficiently in business growth or expanding markets, and the distributor claims that it hasn't received enough support and that the corporation's expectations are too high. The key to solving such problems lies in recognizing that the phases are predictable and can be planned for. As a new business grows in an emerging market, its marketing strategy needs to evolve, and each sequential phase requires different skills, financial investments, and management resources. The author offers seven strategies to manage the multinational-distributor partnership. He discusses what to consider when choosing a distributor, how to structure the relationship between the two partners, what resources the multinational should commit, and what can be expected in return. He states that a successful distributor must risk investing in training, information services, and advertising and promotion in order to implement the company's marketing strategy and grow the business. Paying attention at the start of a partnership can result in a better working relationship between a multinational and a distributor, along with more consistent sales and growth for the corporation.

  8. Comparisons of hypertension-related costs from multinational clinical studies.

    PubMed

    Mullins, C Daniel; Sikirica, Mirko; Seneviratne, Viran; Ahn, Jeonghoon; Akhras, Kasem S

    2004-01-01

    This study identifies and compares the individual cost components of hospital and ambulatory services that manage the care of hypertensive patients in eight countries: the US, the UK, France, Spain, Germany, Italy, Canada and Australia. Hypertension-related costs are classified according to four major cardiovascular events: (i) acute myocardial infarction; (ii) congestive heart failure; (iii) stroke; and (iv) renal failure, which was subdivided into renal failure treated by dialysis and renal failure treated by kidney transplantation. To make cross-country costs comparisons, we used the DRG codes used in the US and DRG-like codes from each country. US cost information was obtained from hypertension data available from the literature and health economics researchers. For costs in other countries, we consulted with national health economics experts in each country, used analyses by the Research Triangle Institute, and performed Medline and international literature searches. When available, we obtained information from the countries' public and private nationally representative data sources. For cross-country currency adjustments, all currencies were converted using the Purchasing Power Parities from the Organisation for Economic Cooperation and Development, and then converted into inflation-adjusted year 2000 US dollars. There exists considerable variation in hypertension-related costs from multinational clinical studies. This study documents that costs are generally higher in the US than in other countries; however, this is not always true. In particular, costs of treating heart failure in France and the costs of renal failure without transplantation in Germany and the UK are relatively high. While analysing multinational hypertensive cost data, this study also addresses the impact of cross-country cost variations on cost analyses. During the last decade, drug-development researchers have drawn extensively upon multinational trials to resolve enrollment problems and drug-registration issues. At the same time, formulary decision-makers are increasingly demanding multinational cost-effectiveness analyses of the clinical differences found between drug-treatment regimens. Since these data are typically not captured by randomised clinical trials, standard cost estimates must be applied to the clinical trials' resource data, although such standardised calculations do not necessarily account for clinical and cost variations between countries. This paper serves as an instrument for identifying which national and event cost data are comparable for analysis as well as highlighting specific problem areas for cost data integration. Although the study focuses on hypertension-related costs, its results may provide insight for multinational cost comparisons of other diseases where similar hospitalisation costs may be analysed.

  9. Leveraging Quick Response Code Technology to Facilitate Simulation-Based Leaderboard Competition.

    PubMed

    Chang, Todd P; Doughty, Cara B; Mitchell, Diana; Rutledge, Chrystal; Auerbach, Marc A; Frisell, Karin; Jani, Priti; Kessler, David O; Wolfe, Heather; MacKinnon, Ralph J; Dewan, Maya; Pirie, Jonathan; Lemke, Daniel; Khattab, Mona; Tofil, Nancy; Nagamuthu, Chenthila; Walsh, Catharine M

    2018-02-01

    Leaderboards provide feedback on relative performance and a competitive atmosphere for both self-guided improvement and social comparison. Because simulation can provide substantial quantitative participant feedback, leaderboards can be used, not only locally but also in a multidepartment, multicenter fashion. Quick Response (QR) codes can be integrated to allow participants to access and upload data. We present the development, implementation, and initial evaluation of an online leaderboard employing principles of gamification using points, badges, and leaderboards designed to enhance competition among healthcare providers. This article details the fundamentals behind the development and implementation of a user-friendly, online, multinational leaderboard that employs principles of gamification to enhance competition and integrates a QR code system to promote both self-reporting of performance data and data integrity. An open-ended survey was administered to capture perceptions of leaderboard implementation. Conceptual step-by-step instructions detailing how to apply the QR code system to any leaderboard using simulated or real performance metrics are outlined using an illustrative example of a leaderboard that employed simulated cardiopulmonary resuscitation performance scores to compare participants across 17 hospitals in 4 countries for 16 months. The following three major descriptive categories that captured perceptions of leaderboard implementation emerged from initial evaluation data from 10 sites: (1) competition, (2) longevity, and (3) perceived deficits. A well-designed leaderboard should be user-friendly and encompass best practices in gamification principles while collecting and storing data for research analyses. Easy storage and export of data allow for longitudinal record keeping that can be leveraged both to track compliance and to enable social competition.

  10. Ownership strategies of multinational corporations: Towards designing effective global networks

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Raghunathan, S.P.

    1992-01-01

    The thesis of this research is that MNCs, attempting to implement different international strategies in response to several environmental factors, let their global networks evolve. The ownership structure of the network is therefore a function of the international strategy and environment of a firm. A particular strategy (configuration/coordination), given a certain environment, may be effective if associated with the appropriate structure. This study is based on a survey of 318 US manufacturing-sector MNCs using a questionnaire. The ownership structure of an MNC network was identified by studying the nature of ownership - method and form - of overseas subsidiaries. Usingmore » network theoretic methods, ownership structure was empirically related to international environment, strategy, and performance. Results of this study throw light on the design of global networks and enable a general theory of the design of MNCs to be eventually developed.« less

  11. Rebuilding Iraq: DoD and State Department Have Improved Oversight and Coordination of Private Security Contractors in Iraq, but Further Actions are Needed to Sustain Improvements

    DTIC Science & Technology

    2008-07-01

    MNC-I Multi-National Corps-Iraq MNF-I Multi-National Force-Iraq PSC private security contractor RSO Regional Security Office TOC tactical...maritime and territorial jurisdiction’ to include a housing complex leased by the U.S. military on a military base in Germany where a sexual assault...and monitored by RSO personnel in the RSO TOC . Motorcade vehicles are equipped with video cameras that record and document motorcade movements and

  12. Multinational outbreak of Salmonella Enteritidis infection during an international youth ice hockey competition in Riga, Latvia, preliminary report, March and April 2015.

    PubMed

    Pesola, A K; Parn, T; Huusko, S; Perevosčikovs, J; Ollgren, J; Salmenlinna, S; Lienemann, T; Gossner, C; Danielsson, N; Rimhanen-Finne, R

    2015-05-21

    A multinational outbreak of salmonellosis linked to the Riga Cup 2015 junior ice-hockey competition was detected by the Finnish health authorities in mid-April and immediately notified at the European Union level. This prompted an international outbreak investigation supported by the European Centre for Disease Prevention and Control. As of 8 May 2015, seven countries have reported 214 confirmed and suspected cases, among which 122 from Finland. The search for the source of the outbreak is ongoing.

  13. Technology, the evolution of the transnational corporation, and the nation-state: A speculative essay

    NASA Technical Reports Server (NTRS)

    Miller, A. S.

    1972-01-01

    This study deals with two exceedingly complex matters; first, the causal connection between technology and the rise of giant transnational or multinational corporations, and second, the impact that development is having on the political order called the nation-state. It is concluded that the multinational enterprise and the nation-state are the major participants in the planetary order; that the enterprise has a political role and the state has an economic role; and that they are conjoined ever increasingly into a system of global corporativism.

  14. A novel approach to rater training and certification in multinational trials.

    PubMed

    Jeglic, Elizabeth; Kobak, Kenneth A; Engelhardt, Nina; Williams, Janet B W; Lipsitz, Joshua D; Salvucci, Donna; Bryson, Heather; Bellew, Kevin

    2007-07-01

    Clinical trials are becoming increasingly international in scope. Global studies pose unique challenges in training and calibrating raters owing to language and cultural differences. Recent findings that poorly conducted interviews reduce study power, makes attention to raters' clinical skills critical. In this study, 109 raters from 14 countries went through a two-step certification process on the Hamilton Depression and Anxiety Rating Scales: (i) an online didactic tutorial on scoring conventions, and (ii) applied clinical training, consisting of small language-specific groups in which raters took turns interviewing patients while observed by an expert trainer, and observation and evaluation of individual interviews. Translators were used when native-language trainers were unavailable. Those who were unable to attend the startup meeting received the training individually via telephone. Results found a significant improvement in raters' knowledge of scoring conventions, with the mean number of correct answers on the 20-item test improving from 14.59 to 17.83, P<0.0001. In addition, raters' clinical skills improved significantly, with the mean score on the Rater Applied Performance Scale improving from their first to their second testing from 10.25 to 11.31, P=0.003. These results support the efficacy of this applied training model in improving raters' applied clinical skills in multinational trials.

  15. The MOBI-Kids Study Protocol: Challenges in Assessing Childhood and Adolescent Exposure to Electromagnetic Fields from Wireless Telecommunication Technologies and Possible Association with Brain Tumor Risk

    PubMed Central

    Sadetzki, Siegal; Langer, Chelsea Eastman; Bruchim, Revital; Kundi, Michael; Merletti, Franco; Vermeulen, Roel; Kromhout, Hans; Lee, Ae-Kyoung; Maslanyj, Myron; Sim, Malcolm R.; Taki, Masao; Wiart, Joe; Armstrong, Bruce; Milne, Elizabeth; Benke, Geza; Schattner, Rosa; Hutter, Hans-Peter; Woehrer, Adelheid; Krewski, Daniel; Mohipp, Charmaine; Momoli, Franco; Ritvo, Paul; Spinelli, John; Lacour, Brigitte; Delmas, Dominique; Remen, Thomas; Radon, Katja; Weinmann, Tobias; Klostermann, Swaantje; Heinrich, Sabine; Petridou, Eleni; Bouka, Evdoxia; Panagopoulou, Paraskevi; Dikshit, Rajesh; Nagrani, Rajini; Even-Nir, Hadas; Chetrit, Angela; Maule, Milena; Migliore, Enrica; Filippini, Graziella; Miligi, Lucia; Mattioli, Stefano; Yamaguchi, Naohito; Kojimahara, Noriko; Ha, Mina; Choi, Kyung-Hwa; Mannetje, Andrea ’t; Eng, Amanda; Woodward, Alistair; Carretero, Gema; Alguacil, Juan; Aragones, Nuria; Suare-Varela, Maria Morales; Goedhart, Geertje; Schouten-van Meeteren, A. Antoinette Y. N.; Reedijk, A. Ardine M. J.; Cardis, Elisabeth

    2014-01-01

    The rapid increase in mobile phone use in young people has generated concern about possible health effects of exposure to radiofrequency (RF) and extremely low frequency (ELF) electromagnetic fields (EMF). MOBI-Kids, a multinational case–control study, investigates the potential effects of childhood and adolescent exposure to EMF from mobile communications technologies on brain tumor risk in 14 countries. The study, which aims to include approximately 1,000 brain tumor cases aged 10–24 years and two individually matched controls for each case, follows a common protocol and builds upon the methodological experience of the INTERPHONE study. The design and conduct of a study on EMF exposure and brain tumor risk in young people in a large number of countries is complex and poses methodological challenges. This manuscript discusses the design of MOBI-Kids and describes the challenges and approaches chosen to address them, including: (1) the choice of controls operated for suspected appendicitis, to reduce potential selection bias related to low response rates among population controls; (2) investigating a young study population spanning a relatively wide age range; (3) conducting a large, multinational epidemiological study, while adhering to increasingly stricter ethics requirements; (4) investigating a rare and potentially fatal disease; and (5) assessing exposure to EMF from communication technologies. Our experience in thus far developing and implementing the study protocol indicates that MOBI-Kids is feasible and will generate results that will contribute to the understanding of potential brain tumor risks associated with use of mobile phones and other wireless communications technologies among young people. PMID:25295243

  16. The MOBI-Kids Study Protocol: Challenges in Assessing Childhood and Adolescent Exposure to Electromagnetic Fields from Wireless Telecommunication Technologies and Possible Association with Brain Tumor Risk.

    PubMed

    Sadetzki, Siegal; Langer, Chelsea Eastman; Bruchim, Revital; Kundi, Michael; Merletti, Franco; Vermeulen, Roel; Kromhout, Hans; Lee, Ae-Kyoung; Maslanyj, Myron; Sim, Malcolm R; Taki, Masao; Wiart, Joe; Armstrong, Bruce; Milne, Elizabeth; Benke, Geza; Schattner, Rosa; Hutter, Hans-Peter; Woehrer, Adelheid; Krewski, Daniel; Mohipp, Charmaine; Momoli, Franco; Ritvo, Paul; Spinelli, John; Lacour, Brigitte; Delmas, Dominique; Remen, Thomas; Radon, Katja; Weinmann, Tobias; Klostermann, Swaantje; Heinrich, Sabine; Petridou, Eleni; Bouka, Evdoxia; Panagopoulou, Paraskevi; Dikshit, Rajesh; Nagrani, Rajini; Even-Nir, Hadas; Chetrit, Angela; Maule, Milena; Migliore, Enrica; Filippini, Graziella; Miligi, Lucia; Mattioli, Stefano; Yamaguchi, Naohito; Kojimahara, Noriko; Ha, Mina; Choi, Kyung-Hwa; Mannetje, Andrea 't; Eng, Amanda; Woodward, Alistair; Carretero, Gema; Alguacil, Juan; Aragones, Nuria; Suare-Varela, Maria Morales; Goedhart, Geertje; Schouten-van Meeteren, A Antoinette Y N; Reedijk, A Ardine M J; Cardis, Elisabeth

    2014-01-01

    The rapid increase in mobile phone use in young people has generated concern about possible health effects of exposure to radiofrequency (RF) and extremely low frequency (ELF) electromagnetic fields (EMF). MOBI-Kids, a multinational case-control study, investigates the potential effects of childhood and adolescent exposure to EMF from mobile communications technologies on brain tumor risk in 14 countries. The study, which aims to include approximately 1,000 brain tumor cases aged 10-24 years and two individually matched controls for each case, follows a common protocol and builds upon the methodological experience of the INTERPHONE study. The design and conduct of a study on EMF exposure and brain tumor risk in young people in a large number of countries is complex and poses methodological challenges. This manuscript discusses the design of MOBI-Kids and describes the challenges and approaches chosen to address them, including: (1) the choice of controls operated for suspected appendicitis, to reduce potential selection bias related to low response rates among population controls; (2) investigating a young study population spanning a relatively wide age range; (3) conducting a large, multinational epidemiological study, while adhering to increasingly stricter ethics requirements; (4) investigating a rare and potentially fatal disease; and (5) assessing exposure to EMF from communication technologies. Our experience in thus far developing and implementing the study protocol indicates that MOBI-Kids is feasible and will generate results that will contribute to the understanding of potential brain tumor risks associated with use of mobile phones and other wireless communications technologies among young people.

  17. ECLAMC Study: prevalence patterns of hypospadias in South America: multi-national analysis over a 24-year period

    PubMed Central

    Fernández, Nicolás; Pérez, Jaime; Monterrey, Pedro; Poletta, Fernando A.; Bägli, Darius J.; Lorenzo, Armando J.; Zarante, Ignacio

    2017-01-01

    ABSTRACT Objective To evaluate prevalence trends of hypospadias in South-America it is essential to perform multicenter and multinational studies with the same methodology. Herein we present systematic data as part of an international multicenter initiative evaluating congenital malformations in South America over a 24-year period. Materials and Methods A nested case-control study was conducted using the Latin American Collaborative Study of Congenital Malformations (ECLAMC), between January 1989 and December 2012. Cases were stratified as isolated (IH) and non-isolated hypospadias (NIH). Global prevalence was calculated and discriminated by country. Associations between birth weight and gestational age, and NIH distribution by associated abnormality and severity of hypospadias, were analyzed. Results A total of 159 hospitals from six countries participated, reporting surveillance on 4.020.384 newborns. A total of 4.537 hypospadias cases were detected, with a global prevalence of 11.3/10.000 newborns. Trend analyses showed in Chile, Brazil and Uruguay a statistically significant increase in prevalence. Analysis of severity and associated anomalies did not to find an association for distal cases, but did for proximal (RR=1.64 [95% CI=1.33-2.03]). Conclusion This is one of only a few Latin American multicenter studies reporting on the epidemiology of hypospadias in South America in the last two decades. Our data adds to evidence suggesting an increase in some countries in the region at different times. There were also variations in prevalence according to severity. This study adds to literature describing associated anomalies at a hospital-based level. PMID:27802003

  18. ECLAMC Study: Prevalence patterns of hypospadias in South America: Multi-national analysis over a 24-year period.

    PubMed

    Fernández, Nicolás; Pérez, Jaime; Monterrey, Pedro; Poletta, Fernando A; Bägli, Darius J; Lorenzo, Armando J; Zarante, Ignacio

    2017-01-01

    To evaluate prevalence trends of hypospadias in South-America it is essential to perform multicenter and multinational studies with the same methodology. Herein we present systematic data as part of an international multicenter initiative evaluating congenital malformations in South America over a 24-year period. A nested case-control study was conducted using the Latin American Collaborative Study of Congenital Malformations (ECLAMC), between January 1989 and December 2012. Cases were stratified as isolated (IH) and non-isolated hypospadias (NIH). Global prevalence was calculated and discriminated by country. Associations between birth weight and gestational age, and NIH distribution by associated abnormality and severity of hypospadias, were analyzed. A total of 159 hospitals from six countries participated, reporting surveillance on 4.020.384 newborns. A total of 4.537 hypospadias cases were detected, with a global prevalence of 11.3/10.000 newborns. Trend analyses showed in Chile, Brazil and Uruguay a statistically significant increase in prevalence. Analysis of severity and associated anomalies did not to find an association for distal cases, but did for proximal (RR=1.64 [95% CI=1.33-2.03]). This is one of only a few Latin American multicenter studies reporting on the epidemiology of hypospadias in South America in the last two decades. Our data adds to evidence suggesting an increase in some countries in the region at different times. There were also variations in prevalence according to severity. This study adds to literature describing associated anomalies at a hospital-based level. Copyright® by the International Brazilian Journal of Urology.

  19. Evaluation of a novel antiplatelet agent for secondary prevention in patients with a history of atherosclerotic disease: design and rationale for the Thrombin-Receptor Antagonist in Secondary Prevention of Atherothrombotic Ischemic Events (TRA 2 degrees P)-TIMI 50 trial.

    PubMed

    Morrow, David A; Scirica, Benjamin M; Fox, Keith A A; Berman, Gail; Strony, John; Veltri, Enrico; Bonaca, Marc P; Fish, Polly; McCabe, Carolyn H; Braunwald, Eugene

    2009-09-01

    Thrombin potently activates platelets via interaction with the protease-activated receptor 1. SCH 530348 is a novel antiplatelet agent that selectively inhibits the cellular actions of thrombin via antagonism of the protease-activated receptor 1. Because SCH 530348 does not interfere with other pathways for hemostasis, it is possible that SCH 530348 reduces thrombosis with less increase in bleeding than do other potent antiplatelet agents. TRA 2 degrees P-TIMI 50 is a phase III, randomized, double-blind, placebo-controlled, multinational clinical trial designed to evaluate the efficacy and safety of SCH 530348 during long-term treatment of patients with established atherosclerotic disease receiving standard therapy (up to 27,000). Eligible patients with a history of myocardial infarction, ischemic stroke, or peripheral arterial disease are randomized 1:1 to SCH 530348 2.5 mg daily or matched placebo until the end of study. Randomization is stratified by the qualifying disease and planned use of a thienopyridine. The primary end point is the composite of cardiovascular death, myocardial infarction, stroke, or urgent coronary revascularization. The major secondary end point is the composite of cardiovascular death, myocardial infarction, or stroke. The evaluation of long-term safety includes bleeding defined by the GUSTO and TIMI criteria. Recruitment began in September 2007. The trial will continue until 2,279 primary end points and 1,400 secondary end points are recorded with expected completion in 36 to 44 months from first enrollment. TRA 2 degrees P-TIMI 50 is evaluating whether a new approach to platelet inhibition via interruption of thrombin-mediated platelet activation reduces major cardiovascular events with a favorable safety profile in patients with established atherosclerosis.

  20. [Economic analysis of multinational clinical trials in oncology].

    PubMed

    Lejeune, Catherine; Lueza, Béranger; Bonastre, Julia

    2018-02-01

    In oncology, as in other fields of medicine, international multicentre clinical trials came into being so as to include a sufficient number of subjects to investigate a clinical situation. The existence of tight budgetary constraints and the desire to make the best use of the resources available have resulted in the development of economic evaluations associated with these trials, which, thanks to their level of evidence and their size, provide particularly relevant material. Nonetheless, economic evaluations alongside international clinical trials raise specific questions of methodology with regard to both the design and the analysis of the results. Indeed, the costs of goods and services consumed, the types and quantities of resources, and medical practices vary from one country to another and within an individual country. Economic data from the different countries involved must be available so as to study and to take into account this variability, and appropriate techniques for cost estimations and analysis must be implemented to aggregate the results from several countries. From a review of the literature, the aim of this work was to provide an overview of the specific methodological features of economic evaluations alongside international clinical trials: analysis of efficacy data from several countries, collection of resources and real costs, methods to establish the monetary value of resources, methods to aggregate results accounting for the trial effect. Copyright © 2017 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.

  1. Lessons From LEADER - All-round Leadership.

    PubMed

    Kalra, Sanjay

    2016-08-01

    The large multinational, randomised, double-blind LEADER (Liraglutide Effect and Action in Diabetes: Evaluation of Cardiovascular Outcome Results - A Long Term Evaluation) trial recently reported the cardiovascular (CV) benefits achieved with liraglutide therapy in type 2 diabetes mellitus (T2DM). This editorial analyses the primary and secondary CV outcomes (CVO) results of the LEADER trial, and discusses the impact these will have on clinical practice of diabetes in specific, and medicine in general. It delves into the evolution of clinical and biochemical outcomes used in diabetes, and discusses the role of liraglutide in shaping future outcomes. The editorial describes the potential role of liraglutide in primary, secondary and tertiary prevention of CV disease (CVD), and suggests exaptation of this molecule for use in cardiology, nephrology and neurology.

  2. Clinical Research: A Globalized Network

    PubMed Central

    Richter, Trevor A.

    2014-01-01

    Clinical research has become increasingly globalized, but the extent of globalization has not been assessed. To describe the globalization of clinical research, we used all (n = 13,208) multinational trials registered at ClinicalTrials.gov to analyzed geographic connections among individual countries. Our findings indicate that 95% (n = 185) of all countries worldwide have participated in multinational clinical research. Growth in the globalization of clinical research peaked in 2009, suggesting that the global infrastructure that supports clinical research might have reached its maximum capacity. Growth in the globalization of clinical research is attributable to increased involvement of non-traditional markets, particularly in South America and Asia. Nevertheless, Europe is the most highly interconnected geographic region (60.64% of global connections), and collectively, Europe, North America, and Asia comprise more than 85% of all global connections. Therefore, while the expansion of clinical trials into non-traditional markets has increased over the last 20 years and connects countries across the globe, traditional markets still dominate multinational clinical research, which appears to have reached a maximum global capacity. PMID:25517976

  3. An integrated and pragmatic approach: Global plant safety management

    NASA Astrophysics Data System (ADS)

    McNutt, Jack; Gross, Andrew

    1989-05-01

    The Bhopal disaster in India in 1984 has compelled manufacturing companies to review their operations in order to minimize their risk exposure. Much study has been done on the subject of risk assessment and in refining safety reviews of plant operations. However, little work has been done to address the broader needs of decision makers in the multinational environment. The corporate headquarters of multinational organizations are concerned with identifying vulnerable areas to assure that appropriate risk-minimization measures are in force or will be taken. But the task of screening global business units for safety prowess is complicated and time consuming. This article takes a step towards simplifying this process by presenting the decisional model developed by the authors. Beginning with an overview of key issues affecting global safety management, the focus shifts to the multinational vulnerability model developed by the authors, which reflects an integration of approaches. The article concludes with a discussion of areas for further research. While the global chemical industry and major incidents therein are used for illustration, the procedures and solutions suggested here are applicable to all manufacturing operations.

  4. Examining cross-cultural differences in autism spectrum disorder: A multinational comparison from Greece, Italy, Japan, Poland, and the United States.

    PubMed

    Matson, J L; Matheis, M; Burns, C O; Esposito, G; Venuti, P; Pisula, E; Misiak, A; Kalyva, E; Tsakiris, V; Kamio, Y; Ishitobi, M; Goldin, R L

    2017-05-01

    Autism spectrum disorder (ASD) is characterized by social and communication impairments as well as restricted, repetitive behavior patterns. Despite the fact that ASD is reported worldwide, very little research exists examining ASD characteristics on a multinational scale. Cross-cultural comparisons are especially important for ASD, since cultural differences may impact the perception of symptoms. Identifying behaviors that are similarly reported as problematic across cultures as well as identifying behaviors in which there is cultural variation could aid in the development and refinement of more universally effective measures. The present study sought to examine similarities and differences in caregiver endorsement of symptom severity through scores on the Baby Infant Screen for Children with aUtIsm Traits (BISCUIT). The BISCUIT was utilized to examine ASD core symptomology in 250 toddlers diagnosed with ASD from Greece, Italy, Japan, Poland, and the United States. Significant differences in overall ASD symptom severity and endorsement were found between multinational groups. Implications of the results are discussed. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  5. Student nurses perceptions of spirituality and competence in delivering spiritual care: a European pilot study.

    PubMed

    Ross, Linda; van Leeuwen, René; Baldacchino, Donia; Giske, Tove; McSherry, Wilfred; Narayanasamy, Aru; Downes, Carmel; Jarvis, Paul; Schep-Akkerman, Annemiek

    2014-05-01

    Spiritual care is expected of nurses, but it is not clear how undergraduates can achieve competency in spiritual care at point of registration as required by nursing/midwifery regulatory bodies. To describe undergraduate nurses'/midwives' perceptions of spirituality/spiritual care, their perceived competence in delivering spiritual care, and to test out the proposed method and suitability of measures for a larger multinational follow-on study. Cross-sectional, multinational, descriptive survey design. Author administered questionnaires were completed by 86% of the intended convenience sample of 618 undergraduate nurses/midwives from 6 universities in 4 European countries in 2010. Students held a broad view of spirituality/spiritual care and considered themselves to be marginally more competent than not in spiritual care. They were predominantly Christian and reported high levels of spiritual wellbeing and spiritual attitude and involvement. The proposed method and measures were appropriate and are being used in a follow-on study. The following are worthy of further investigation: whether the pilot study findings hold in student samples from more diverse cultural backgrounds; whether students' perceptions of spirituality can be broadened to include the full range of spiritual needs patients may encounter and whether their competence can be enhanced by education to better equip them to deliver spiritual care; identification of factors contributing to acquisition of spiritual caring skills and spiritual care competency. © 2013.

  6. Patient-Related Benefits for Adults with Cochlear Implantation: A Multicultural Longitudinal Observational Study

    PubMed Central

    Lenarz, Thomas; Muller, Lida; Czerniejewska-Wolska, Hanna; Vallés Varela, Hector; Orús Dotú, César; Durko, Marcin; Huarte Irujo, Alicia; Piszczatowski, Bartosz; Zadrożniak, Marek; Irwin, Colin; Graham, Petra L.; Wyss, Josie

    2017-01-01

    Objectives To assess subjectively perceived, real-world benefits longitudinally for unilateral cochlear implant (CI) recipients in a multinational population treated routinely. To identify possible predictors of self-reported benefits. Design This was a prospective, multicenter, repeated-measures study. Self-assessment of performance at preimplantation and postimplantation at 1, 2, and 3 years using standardized, validated, local language versions of the Speech, Spatial, and Qualities of Hearing Scale (SSQ), and the Health Utilities Index Mark 3 (HUI3) was performed. Outcomes were analyzed using a longitudinal mixed-effects model incorporating country effect. Patient demographics were explored for associations with change over time. Subjects Two hundred ninety-one routinely treated, unilateral CI recipients, aged 137–81 years, from 9 clinics across 4 countries. Results Highly significant improvements were observed for all outcome measures (p < 0.0001). Postimplantation, mean outcome scores remained stable beyond 1 year, with notable individual variability. A significant association for one or more outcomes with preimplantation contralateral hearing aid use, telephone use, age at implantation, implantation side, preimplantation comorbidities, dizziness, and tinnitus was observed (p < 0.004). Conclusions Longitudinal benefits of CI treatment can be measured using clinically standardized self-assessment tools to provide a holistic view of patient-related benefits in routine clinical practice for aggregated data from multinational populations. Self-reported outcomes can provide medical-based evidence regarding CI treatment to support decision-making by health service providers. PMID:28719901

  7. Triangulation and the importance of establishing valid methods for food safety culture evaluation.

    PubMed

    Jespersen, Lone; Wallace, Carol A

    2017-10-01

    The research evaluates maturity of food safety culture in five multi-national food companies using method triangulation, specifically self-assessment scale, performance documents, and semi-structured interviews. Weaknesses associated with each individual method are known but there are few studies in food safety where a method triangulation approach is used for both data collection and data analysis. Significantly, this research shows that individual results taken in isolation can lead to wrong conclusions, resulting in potentially failing tactics and wasted investments. However, by applying method triangulation and reviewing results from a range of culture measurement tools it is possible to better direct investments and interventions. The findings add to the food safety culture paradigm beyond a single evaluation of food safety culture using generic culture surveys. Copyright © 2017. Published by Elsevier Ltd.

  8. An exploratory study of services marketing in global markets: major areas of inquiry for the health care services industry.

    PubMed

    Young, S; Erdem, S A

    1996-01-01

    It has been stated that one of the major challenges for the international marketer is the design of an efficient strategy for marketing services to international markets. This paper reviews some of the issues associated with services marketing in global markets along with the basic variables of service industries. An exploratory assessment of the health care services industry results in a list composed of several inquiry areas which should be examined by multinational companies. It is hoped that the review of the issues raised in this paper provides a basis for decision making and further research.

  9. Multinational corporations and infectious disease: Embracing human rights management techniques.

    PubMed

    Salcito, Kendyl; Singer, Burton H; Weiss, Mitchell G; Winkler, Mirko S; Krieger, Gary R; Wielga, Mark; Utzinger, Jürg

    2014-01-01

    Global health institutions have called for governments, international organisations and health practitioners to employ a human rights-based approach to infectious diseases. The motivation for a human rights approach is clear: poverty and inequality create conditions for infectious diseases to thrive, and the diseases, in turn, interact with social-ecological systems to promulgate poverty, inequity and indignity. Governments and intergovernmental organisations should be concerned with the control and elimination of these diseases, as widespread infections delay economic growth and contribute to higher healthcare costs and slower processes for realising universal human rights. These social determinants and economic outcomes associated with infectious diseases should interest multinational companies, partly because they have bearing on corporate productivity and, increasingly, because new global norms impose on companies a responsibility to respect human rights, including the right to health. We reviewed historical and recent developments at the interface of infectious diseases, human rights and multinational corporations. Our investigation was supplemented with field-level insights at corporate capital projects that were developed in areas of high endemicity of infectious diseases, which embraced rights-based disease control strategies. Experience and literature provide a longstanding business case and an emerging social responsibility case for corporations to apply a human rights approach to health programmes at global operations. Indeed, in an increasingly globalised and interconnected world, multinational corporations have an interest, and an important role to play, in advancing rights-based control strategies for infectious diseases. There are new opportunities for governments and international health agencies to enlist corporate business actors in disease control and elimination strategies. Guidance offered by the United Nations in 2011 that is widely embraced by companies, governments and civil society provides a roadmap for engaging business enterprises in rights-based disease management strategies to mitigate disease transmission rates and improve human welfare outcomes.

  10. Unleash innovation in foreign subsidiaries.

    PubMed

    Birkinshaw, J; Hood, N

    2001-03-01

    In multinational corporations, growth-triggering innovation often emerges in foreign subsidiaries from employees closest to customers and least attached to the procedures and politeness of the home office. But too often, heavy-handed responses from headquarters squelch local enthusiasm and drive out good ideas--and good people. The authors' research into more than 50 multinationals suggests that encouraging innovation in foreign subsidiaries requires a change in attitude. Companies should start to think of foreign subsidiaries as peninsulas rather than as islands--as extensions of the company's strategic domain rather than as isolated outposts. If they do, innovative ideas will flow more freely from the periphery to the corporate center. Basing their arguments on a rich array of examples, the authors say that encouraging such "innovation at the edges" also requires a new set of practices, with two aims: to improve the formal and informal channels of communication between headquarters and subsidiaries and to give foreign subsidiaries more authority to see their ideas through. The challenge for executives of multinationals is to find ways to liberalize, not tighten, internal systems and to delegate more authority to local subsidiaries. It isn't enough to ask subsidiary managers to be innovative; corporate managers need to give them incentives and support systems to facilitate their efforts. The authors suggest four approaches: give seed money to subsidiaries; use formal requests for proposals as a way of increasing the demand for seed money; encourage subsidiaries to be incubators for fledgling businesses; and build international networks. As part of the last approach, multinationals also need to create roles for idea brokers who can link entrepreneurs in foreign subsidiaries with other parts of the company.

  11. A four-country comparison of healthcare systems, implementation of diagnostic criteria, and treatment availability for functional gastrointestinal disorders: a report of the Rome Foundation Working Team on cross-cultural, multinational research.

    PubMed

    Schmulson, M; Corazziari, E; Ghoshal, U C; Myung, S-J; Gerson, C D; Quigley, E M M; Gwee, K-A; Sperber, A D

    2014-10-01

    Variations in healthcare provision around the world may impact how patients with functional gastrointestinal disorder (FGIDs) are investigated, diagnosed, and treated. However, these differences have not been reviewed. The Multinational Working Team of the Rome Foundation, established to make recommendations on the conduct of multinational, cross-cultural research in FGIDs, identified seven key issues that are analyzed herein: (i) coverage afforded by different healthcare systems/providers; (ii) level of the healthcare system where patients with FGIDs are treated; (iii) extent/types of diagnostic procedures typically undertaken to diagnose FGIDs; (iv) physicians' familiarity with and implementation of the Rome diagnostic criteria in clinical practice; (v) range of medications approved for FGIDs and approval process for new agents; (vi) costs involved in treating FGIDs; and (vii) prevalence and role of complementary/alternative medicine (CAM) for FGIDs. Because it was not feasible to survey all countries around the world, we compared a selected number of countries based on their geographical and ethno-cultural diversity. Thus, we included Italy and South Korea as representative of nations with broad-based coverage of healthcare in the population and India and Mexico as newly industrialized countries where there may be limited provision of healthcare for substantial segments of the population. In light of the paucity of formal publications on these issues, we included additional sources from the medical literature as well as perspectives provided by local experts and the media. Finally, we provide future directions on healthcare issues that should be taken into account and implemented when conducting cross-cultural and multinational research in FGIDs. © 2014 John Wiley & Sons Ltd.

  12. A multinational clinical approach to assessing the effectiveness of catheter-based ultrasound renal denervation: The RADIANCE-HTN and REQUIRE clinical study designs.

    PubMed

    Mauri, Laura; Kario, Kazuomi; Basile, Jan; Daemen, Joost; Davies, Justin; Kirtane, Ajay J; Mahfoud, Felix; Schmieder, Roland E; Weber, Michael; Nanto, Shinsuke; Azizi, Michel

    2018-01-01

    Catheter-based renal denervation is a new approach to treat hypertension via modulation of the renal sympathetic nerves. Although nonrandomized and small, open-label randomized studies resulted in significant reductions in office blood pressure 6months after renal denervation with monopolar radiofrequency catheters, the first prospective, randomized, sham-controlled study (Symplicity HTN-3) failed to meet its blood pressure efficacy end point. New clinical trials with new catheters have since been designed to address the limitations of earlier studies. Accordingly, the RADIANCE-HTN and REQUIRE studies are multicenter, blinded, randomized, sham-controlled trials designed to assess the blood pressure-lowering efficacy of the ultrasound-based renal denervation system (Paradise) in patients with established hypertension either on or off antihypertensive medications, is designed to evaluate patients in 2 cohorts-SOLO and TRIO, in the United States and Europe. The SOLO cohort includes patients with essential hypertension, at low cardiovascular risk, and either controlled on 1 to 2 antihypertensive medications or uncontrolled on 0 to 2 antihypertensive medications. Patients undergo a 4-week medication washout period before randomization to renal denervation (treatment) or renal angiogram (sham). The TRIO cohort includes patients with hypertension resistant to at least 3 antihypertensive drugs including a diuretic. Patients will be stabilized on a single-pill, triple-antihypertensive-drug combination for 4weeks before randomization to treatment or sham. Reduction in daytime ambulatory systolic blood pressure (primary end point) will be assessed at 2months in both cohorts. A predefined medication escalation protocol, as needed for blood pressure control, is implemented between 2 and 6months in both cohorts by a study staff member blinded to the randomization process. At 6months, daytime ambulatory blood pressure and antihypertensive treatment score will be assessed. REQUIRE is designed to evaluate patients with resistant hypertension on standard of care medication in Japan and Korea. Reduction in 24-hour ambulatory systolic blood pressure will be assessed at 3months (primary end point). Both studies are enrolling patients, and their results are expected in 2018. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Validation of a global scale to assess the quality of interprofessional teamwork in mental health settings.

    PubMed

    Tomizawa, Ryoko; Yamano, Mayumi; Osako, Mitue; Hirabayashi, Naotugu; Oshima, Nobuo; Sigeta, Masahiro; Reeves, Scott

    2017-12-01

    Few scales currently exist to assess the quality of interprofessional teamwork through team members' perceptions of working together in mental health settings. The purpose of this study was to revise and validate an interprofessional scale to assess the quality of teamwork in inpatient psychiatric units and to use it multi-nationally. A literature review was undertaken to identify evaluative teamwork tools and develop an additional 12 items to ensure a broad global focus. Focus group discussions considered adaptation to different care systems using subjective judgements from 11 participants in a pre-test of items. Data quality, construct validity, reproducibility, and internal consistency were investigated in the survey using an international comparative design. Exploratory factor analysis yielded five factors with 21 items: 'patient/community centred care', 'collaborative communication', 'interprofessional conflict', 'role clarification', and 'environment'. High overall internal consistency, reproducibility, adequate face validity, and reasonable construct validity were shown in the USA and Japan. The revised Collaborative Practice Assessment Tool (CPAT) is a valid measure to assess the quality of interprofessional teamwork in psychiatry and identifies the best strategies to improve team performance. Furthermore, the revised scale will generate more rigorous evidence for collaborative practice in psychiatry internationally.

  14. Medication Use Patterns, Treatment Satisfaction, and Inadequate Control of Osteoporosis Study in the Asia-Pacific Region (MUSIC OS-AP): Design of a multinational, prospective, observational study examining the impact of gastrointestinal events on osteoporosis management in postmenopausal women.

    PubMed

    Modi, Ankita; Ebeling, Peter R; Lee, Mel S; Min, Yong-Ki; Mithal, Ambrish; Yang, Xiaoqin; Sajjan, Shiva

    2015-12-01

    The burden of osteoporosis in the Asia-Pacific region is not well characterized. The Medication Use Patterns, Treatment Satisfaction, and Inadequate Control of Osteoporosis Study in the Asia-Pacific Region (MUSIC OS-AP) was designed to better understand the association of gastrointestinal events with patient-reported outcomes in postmenopausal women of this region. MUSIC OS-AP is a prospective, multinational, observational cohort study of postmenopausal women ≥ 50 years of age diagnosed with osteoporosis. The study was conducted in five Asia-Pacific countries: Australia, New Zealand, Taiwan, Korea, and India. MUSIC OS-AP has three components: a physician questionnaire, a retrospective chart review, and a prospective cohort study. The physician questionnaire investigated the role of gastrointestinal events in physicians' pharmacologic management of osteoporosis. The retrospective chart review, also completed by physicians, recorded rate of osteoporosis treatment and the types of osteoporosis medications prescribed to osteoporosis patients. The prospective cohort study investigated the associations between gastrointestinal events and patient-reported outcomes among patients taking oral medications for osteoporosis as well as reasons for non-treatment in patients who remained untreated. The prospective cohort study enrolled two groups of patients: untreated, and treated with oral osteoporosis medications. Untreated patients completed only the baseline surveys, providing information on gastrointestinal event rates, quality of life, health care resource use, and reasons for non-treatment. Treated patients, who were either new to osteoporosis medication or continuing an ongoing medication course, completed surveys at baseline and 3, 6, and 12 months post-baseline. The evaluations recorded patient characteristics, gastrointestinal events, health-related and osteoporosis-specific quality of life, health care resource use, medication adherence, and satisfaction with treatment. Physicians at 59 sites completed the physician questionnaire, and data for 300 patients from 26 sites were abstracted for the retrospective chart review. Enrollment and baseline data collection for the prospective cohort study were conducted between July 2013 and August 2014 for 301 untreated and 3287 treated patients, of whom 1416 were new users and 1871 were experienced users of oral osteoporosis medications. The results of MUSIC OS-AP will highlight the association of gastrointestinal events with patient-reported outcomes among postmenopausal women with osteoporosis and elucidate physicians' management of gastrointestinal events among this patient population in the Asia-Pacific region.

  15. National Renewable Energy Policy in a Global World

    NASA Astrophysics Data System (ADS)

    Jeong, Minji

    Increasing trade of renewable energy products has significantly contributed to reducing the costs of renewable energy sources, but at the same time, it has generated protectionist policies, which may negatively affect the trend of the cost reduction. Although a few recent studies examined the rise of renewable energy protectionism and trade disputes, they are limited in addressing the conflict between the original goal of traditional renewable energy policies and the new protectionist policies under the globalized renewable energy industry. To fill this gap, this dissertation explores how the globalized renewable energy industry has changed national renewable energy policies. Through three analyses, three aspects of the globalized renewable energy industry are examined: the rise of multinational corporations, international interactions among actors, and the changes of the global and domestic market conditions. First analysis investigates how multinational renewable energy corporations have affected national policies. A content analysis of the annual reports of 15 solar photovoltaic multinational corporation shows that solar multinationals have been influenced by national policies and have adapted to the changes rather than having attempted to change national policies. Second analysis examines how diverse actors have framed renewable energy trade issues through a network analysis of the Chinese solar panel issue in the United States. The result shows that the Chinese solar panel issue was framed differently from the traditional environmental frame of renewable energy, being dominated by multinational corporations headquartered in other countries. Third analysis explores what has caused the increasing diversity in national renewable energy policies through the case studies of the U.S. and South Korea. The result reveals that the globalization of solar industry has affected the diversification of solar policies in two countries by generating both challenges, which needed to be addressed by new and additional policies, and opportunities, which strengthened the political power of domestic solar industries. The three analyses show that the globalized renewable energy industry has led to the diversification of national renewable energy policies by increasing international interactions between actors and by introducing both challenges and opportunities to domestic renewable energy industries. This research contributes to the literature on trade and the environment by analyzing a new pattern of the conflicts between traditional environmental policies and "green" protectionist policies. It also contributes to the literature on protectionism by adding an empirical case of green protectionism, one of the forms of "murky" protectionism that has risen after the global financial crisis.

  16. The food choice at work study: effectiveness of complex workplace dietary interventions on dietary behaviours and diet-related disease risk - study protocol for a clustered controlled trial

    PubMed Central

    2013-01-01

    Background Dietary behaviour interventions have the potential to reduce diet-related disease. Ample opportunity exists to implement these interventions in the workplace. The overall aim is to assess the effectiveness and cost-effectiveness of complex dietary interventions focused on environmental dietary modification alone or in combination with nutrition education in large manufacturing workplace settings. Methods/design A clustered controlled trial involving four large multinational manufacturing workplaces in Cork will be conducted. The complex intervention design has been developed using the Medical Research Council’s framework and the National Institute for Health and Clinical Excellence (NICE) guidelines and will be reported using the TREND statement for the transparent reporting of evaluations with non-randomized designs. It will draw on a soft paternalistic “nudge” theoretical perspective. Nutrition education will include three elements: group presentations, individual nutrition consultations and detailed nutrition information. Environmental dietary modification will consist of five elements: (a) restriction of fat, saturated fat, sugar and salt, (b) increase in fibre, fruit and vegetables, (c) price discounts for whole fresh fruit, (d) strategic positioning of healthier alternatives and (e) portion size control. No intervention will be offered in workplace A (control). Workplace B will receive nutrition education. Workplace C will receive nutrition education and environmental dietary modification. Workplace D will receive environmental dietary modification alone. A total of 448 participants aged 18 to 64 years will be selected randomly. All permanent, full-time employees, purchasing at least one main meal in the workplace daily, will be eligible. Changes in dietary behaviours, nutrition knowledge, health status with measurements obtained at baseline and at intervals of 3 to 4 months, 7 to 9 months and 13 to 16 months will be recorded. A process evaluation and cost-effectiveness economic evaluation will be undertaken. Discussion A 'Food Choice at Work’ toolbox (concise teaching kit to replicate the intervention) will be developed to inform and guide future researchers, workplace stakeholders, policy makers and the food industry. Trial registration Current Controlled Trials, ISRCTN35108237 PMID:24192134

  17. International Space Station: becoming a reality.

    PubMed

    David, L

    1999-07-01

    An overview of the development of the International Space Station (ISS) is presented starting with a brief history of space station concepts from the 1960's to the decision to build the present ISS. Other topics discussed include partnerships with Japan, Canada, ESA countries, and Russia; design changes to the ISS modules, the use of the ISS for scientific purposes and the application of space research to medicine on Earth; building ISS modules on Earth, international funding for Russian components, and the political aspects of including Russia in critical building plans. Sidebar articles examine commercialization of the ISS, multinational efforts in the design and building of the ISS, emergency transport to Earth, the use of robotics in ISS assembly, application of lessons learned from the Skylab project to the ISS, initial ISS assembly in May 1999, planned ISS science facilities, and an overview of space stations in science fiction.

  18. Constructive Engineering of Simulations

    NASA Technical Reports Server (NTRS)

    Snyder, Daniel R.; Barsness, Brendan

    2011-01-01

    Joint experimentation that investigates sensor optimization, re-tasking and management has far reaching implications for Department of Defense, Interagency and multinational partners. An adaption of traditional human in the loop (HITL) Modeling and Simulation (M&S) was one approach used to generate the findings necessary to derive and support these implications. Here an entity-based simulation was re-engineered to run on USJFCOM's High Performance Computer (HPC). The HPC was used to support the vast number of constructive runs necessary to produce statistically significant data in a timely manner. Then from the resulting sensitivity analysis, event designers blended the necessary visualization and decision making components into a synthetic environment for the HITL simulations trials. These trials focused on areas where human decision making had the greatest impact on the sensor investigations. Thus, this paper discusses how re-engineering existing M&S for constructive applications can positively influence the design of an associated HITL experiment.

  19. Protection from Induced Space Environments Effects on the International Space Station

    NASA Technical Reports Server (NTRS)

    Soares, Carlos; Mikatarian, Ron; Stegall, Courtney; Schmidl, Danny; Huang, Alvin; Olsen, Randy; Koontz, Steven

    2010-01-01

    The International Space Station (ISS) is one of the largest, most complex multinational scientific projects in history and protection from induced space environments effects is critical to its long duration mission as well as to the health of the vehicle and safety of on-orbit operations. This paper discusses some of the unique challenges that were encountered during the design, assembly and operation of the ISS and how they were resolved. Examples are provided to illustrate the issues and the risk mitigation strategies that were developed to resolve these issues. Of particular importance are issues related with the interaction of multiple spacecraft as in the case of ISS and Visiting Vehicles transporting crew, hardware elements, cargo and scientific payloads. These strategies are applicable to the development of future long duration space systems, not only during design, but also during assembly and operation of these systems.

  20. Multinational Alcohol Market Development and Public Health: Diageo in India.

    PubMed

    Esser, Marissa B; Jernigan, David H

    2015-11-01

    Alcohol is a risk factor for communicable and noncommunicable diseases, and alcohol consumption is rising steadily in India. The growth of multinational alcohol corporations, such as Diageo, contributes to India's changing alcohol environment. We provide a brief history of India's alcohol regulation for context and examine Diageo's strategies for expansion in India in 2013 and 2014. Diageo is attracted to India's younger generation, women, and emerging middle class for growth opportunities. Components of Diageo's responsibility strategy conflict with evidence-based public health recommendations for reducing harmful alcohol consumption. Diageo's strategies for achieving market dominance in India are at odds with public health evidence. We conclude with recommendations for protecting public health in emerging markets.

  1. Theory of bargaining between multinational corporations and developing countries over mineral and petroleum-extraction contracts

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    King, P.G.

    1987-01-01

    The history of negotiations between multinational corporations and less-developed countries involved in mineral and petroleum extraction has been widely examined. Virtually all case studies of the history of negotiations over these contracts demonstrate that, over time, the contracts tend to be renegotiated on terms more favorable to the developing country. This thesis begins by examining three case studies of negotiations between Third World countries and mineral or petroleum extracting multinational corporations: bauxite in Jamaica, petroleum in Indonesia, and copper in Chile. Evidence is presented to demonstrate that the history of negotiations in Jamaica and Indonesia is inconsistent with the oftenmore » cited theory (Morgan (1975)) that the LDC's increase in profit-share stems from the country's development of negotiating, supervisory, and operating skills. However, in all of these case studies, renegotiations often took place when the country was experiencing an economic or political crisis. The contract renegotiations appear to be an (often successful) attempt by the ruling regime to maintain power. Another aspect of mineral and petroleum extraction is that investment tends to be lumpy. Typically, mineral and petroleum extraction involves an enormous initial investment within the sovereign territory of the LDC, generally financed by the MNC.« less

  2. Results of an International Space Crew Debrief

    NASA Technical Reports Server (NTRS)

    Santy, P. A.; Holland, A. W.; Looper, L.; Marcondes-North, R.

    1992-01-01

    In order to identify potential multi-cultural and multinational problems for future International Space Station Freedom crew, a crew debrief questionnaire was developed for U.S. astronauts who flew on shuttle missions with one or more crew members from other countries. Methods: From 1981-90, a total of 20 U.S. astronauts flew on international space missions. Debriefs were mailed to all 20 with instructions not to identify themselves or their specific mission. The debrief focused primarily on preflight training and post flight incidents of misunderstanding, miscommunication, and interpersonal friction among crewmembers. Astronauts were also asked to rate the impact of the incident to the mission (low, medium, high). Results: Ten astronauts responded, but only nine responses were able to be scored, for a return rate of 45 percent. 42 incidents were reported, 9 in the preflight period, 26 inflight, and 7 in the postflight period. Most of the incidents were rated at a low or medium impact, but 5 of the inflight incidents were rated at a 'high' mission impact. A number of causes for the problems were listed, and are discussed. Conclusions: The debrief respondents provide useful and timely recommendations on preflight training which might help facilitate the integration of multinational crews and prevent multi-cultural or multinational factors from interfering with mission operations.

  3. Design and rationale for the Effects of Ticagrelor and Clopidogrel in Patients with Peripheral Artery Disease (EUCLID) trial.

    PubMed

    Berger, Jeffrey S; Katona, Brian G; Jones, W Schuyler; Patel, Manesh R; Norgren, Lars; Baumgartner, Iris; Blomster, Juuso; Mahaffey, Kenneth W; Held, Peter; Millegård, Marcus; Heizer, Gretchen; Reist, Craig; Fowkes, F Gerry; Hiatt, William R

    2016-05-01

    Despite overwhelming data demonstrating the efficacy of antiplatelet therapy in heart disease and stroke, data in peripheral artery disease (PAD) are less compelling. Aspirin has modest evidence supporting a reduction in cardiovascular events in patients with PAD, whereas clopidogrel monotherapy may be more effective in PAD. Ticagrelor, a potent, reversibly binding P2Y12 receptor antagonist, is beneficial in patients with acute coronary syndrome and prior myocardial infarction. The EUCLID trial is designed to address the need for effective antiplatelet therapy in PAD to decrease the risk of cardiovascular events. EUCLID is a randomized, double-blind, parallel-group, multinational clinical trial designed to evaluate the efficacy and safety of ticagrelor compared with clopidogrel for the prevention of major adverse cardiovascular events in subjects with symptomatic PAD. Subjects with established PAD will be randomized in a 1:1 fashion to ticagrelor 90 mg twice daily or clopidogrel 75 mg daily. The primary end point is a composite of cardiovascular death, myocardial infarction, or ischemic stroke. Other end points address limb events including acute leg ischemia, need for revascularization, disease progression by ankle-brachial index, and quality of life. The primary safety objective is Thrombolysis in Myocardial Infarction-defined major bleeding. Recruitment began in December 2012 and was completed in March 2014; 13,887 patients were randomized. The trial will continue until at least 1,364 adjudicated primary end points occur. The EUCLID study is investigating whether treatment with ticagrelor versus clopidogrel, given as antiplatelet monotherapy, will reduce the incidence of cardiovascular and limb-specific events in patients with symptomatic PAD. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  4. European online postgraduate educational programme in neonatology-the way forward?

    PubMed

    Hall, Michael A; Cuttini, Marina; Flemmer, Andreas W; Greisen, Gorm; Marlow, Neil; Schulze, Andreas; Smith, Susan; Valls-i-Soler, Adolf; Truffert, Patrick; Conole, Gráinne; de Laat, Maarten

    2009-04-01

    The provision of specialist postgraduate training is increasingly challenging for the acute medical specialties. There are often small numbers of trainees and tutors in any one centre, and service commitments may limit attendance at educational activities. Online learning can provide high-quality education to trainees from large geographical areas. We report the outcomes of an experimental educational project which provided an online postgraduate programme in neonatology. Ninety trainees from 14 countries, primarily European, participated. Six educational modules in neonatal topics were delivered over a 1-year period, within a "Virtual Learning Environment". Trainees were divided into multi-national groups; two online tutors supported each group. Analysis of online activity demonstrated that active participation was high initially (100%) but gradually declined to 46% in the final module; tutor participation followed a similar pattern. Eighty-six trainees were contactable at the end of the programme, and 67 (78%) completed an evaluation questionnaire. Of these, 92% reported that participation had "added value" to their training, attributable to the high-quality curriculum, the educational resources, collaborative networking and the sharing of best practice. Eleven (79%) tutors completed the questionnaire, with all reporting that participation was of educational value. The main limiting factor for trainees and tutors was insufficient time. This project confirms that multi-national online education in neonatology is feasible and transferable, but for this approach to be viable formal accreditation and protected time for both trainees and tutors are required.

  5. Mission-Based Serious Games for Cross-Cultural Communication Training

    NASA Technical Reports Server (NTRS)

    Schrider, Peter J.; Friedland, LeeEllen; Valente, Andre; Camacho, Joseph

    2011-01-01

    Appropriate cross-cultural communication requires a critical skill set that is increasingly being integrated into regular military training regimens. By enabling a higher order of communication skills, military personnel are able to interact more effectively in situations that involve local populations, host nation forces, and multinational partners. The Virtual Cultural Awareness Trainer (VCAT) is specifically designed to help address these needs. VCAT is deployed by Joint Forces Command (JFCOM) on Joint Knowledge Online (JKO) as a means to provide online, mission-based culture and language training to deploying and deployed troops. VCAT uses a mix of game-based learning, storytelling, tutoring, and remediation to assist in developing the component skills required for successful intercultural communication in mission-based settings.

  6. Multinational Alcohol Market Development and Public Health: Diageo in India

    PubMed Central

    Jernigan, David H.

    2015-01-01

    Alcohol is a risk factor for communicable and noncommunicable diseases, and alcohol consumption is rising steadily in India. The growth of multinational alcohol corporations, such as Diageo, contributes to India’s changing alcohol environment. We provide a brief history of India’s alcohol regulation for context and examine Diageo’s strategies for expansion in India in 2013 and 2014. Diageo is attracted to India’s younger generation, women, and emerging middle class for growth opportunities. Components of Diageo’s responsibility strategy conflict with evidence-based public health recommendations for reducing harmful alcohol consumption. Diageo’s strategies for achieving market dominance in India are at odds with public health evidence. We conclude with recommendations for protecting public health in emerging markets. PMID:26378848

  7. Taxation of income of multinational corporations: the case of the United States petroleum industry

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Jenkins, G.P.; Wright, B.D.

    1975-02-01

    While U.S. petroleum corporations pay no U.S. tax on foreign income, they received in the 1969-1972 period a rate of return on foreign investment comparable to domestic corporate investments. The present U.S. tax system allows tax credits from one foreign country to offset U.S. taxes from foreign income, with the result that the U.S. receives virtually no corporate income tax from foreign petroleum investments. The multinational corporations use transfer pricing to shift profits between countries so that tax liabilities will be minimized. Loss of revenue to consumer countries due to transfer pricing is estimated at $205 million in 1966 andmore » $240 million in 1970. (19 references) (DCK)« less

  8. Global asbestos justice: South African asbestos victims win right to sue Cape PLC in U.K. courts.

    PubMed

    Kazan-Allen, L

    2001-01-01

    A ruling by Britain's House of Lords in July 2000 opened the doors of the English courts to foreign plaintiffs injured by the overseas operation of British companies and their subsidiaries. The ruling authorized 3,000 South African asbestos victims to continue their case in the U.K. courts against the multinational British company Cape PLC, which produced both raw asbestos and asbestos products in South Africa. The Lords sided with the asbestos victims in refusing to transfer the case to South Africa, as requested by Cape. This decision was a reversal of fortune for Cape and has implications for other British multinationals that may be called upon to defend their overseas actions domestically.

  9. Involving Communities in Deciding What Benefits They Receive in Multinational Research

    PubMed Central

    Wendler, David; Shah, Seema

    2015-01-01

    There is wide agreement that communities in lower-income countries should benefit when they participate in multinational research. Debate now focuses on how and to what extent these communities should benefit. This debate has identified compelling reasons to reject the claim that whatever benefits a community agrees to accept are necessarily fair. Yet, those who conduct clinical research may conclude from this rejection that there is no reason to involve communities in the process of deciding how they benefit. Against this possibility, the present manuscript argues that involving host communities in this process helps to promote four important goals: (1) protecting host communities, (2) respecting host communities, (3) promoting transparency, and (4) enhancing social value. PMID:26224724

  10. Improvements in Low-cost Ultrasonic Measurements of Blood Flow in "by-passes" Using Narrow & Broad Band Transit-time Procedures

    NASA Astrophysics Data System (ADS)

    Ramos, A.; Calas, H.; Diez, L.; Moreno, E.; Prohías, J.; Villar, A.; Carrillo, E.; Jiménez, A.; Pereira, W. C. A.; Von Krüger, M. A.

    The cardio-pathology by ischemia is an important cause of death, but the re-vascularization of coronary arteries (by-pass operation) is an useful solution to reduce associated morbidity improving quality of life in patients. During these surgeries, the flow in coronary vessels must be measured, using non-invasive ultrasonic methods, known as transit time flow measurements (TTFM), which are the most accurate option nowadays. TTFM is a common intra-operative tool, in conjunction with classic Doppler velocimetry, to check the quality of these surgery processes for implanting grafts in parallel with the coronary arteries. This work shows important improvements achieved in flow-metering, obtained in our research laboratories (CSIC, ICIMAF, COPPE) and tested under real surgical conditions in Cardiocentro-HHA, for both narrowband NB and broadband BB regimes, by applying results of a CYTED multinational project (Ultrasonic & computational systems for cardiovascular diagnostics). mathematical models and phantoms were created to evaluate accurately flow measurements, in laboratory conditions, before our new electronic designs and low-cost implementations, improving previous ttfm systems, which include analogic detection, acquisition & post-processing, and a portable PC. Both regimes (NB and BB), with complementary performances for different conditions, were considered. Finally, specific software was developed to offer facilities to surgeons in their interventions.

  11. Effects of the terrorist attacks of 9/11/01 on employee attitudes.

    PubMed

    Ryan, Ann Marie; West, Bradley J; Carr, Jennifer Z

    2003-08-01

    Much has been stated in the popular press about the effects of the events of 9/11/01 on employee attitudes about work. This study examined a large sample (N = 70,671) of employees of a multinational manufacturer whose annual employee survey data collection was interrupted by the events. After demonstrating measurement equivalence across time and countries, changes in attitudes pre- and post-9/11 were examined. Only negligible differences were found in Job Satisfaction, Supervisor Evaluation, Stress, and Organizational Commitment to Diversity for U.S. employees or for employees worldwide. Demographic differences in response to events were not found. Implications for understanding effects of stressful external events on employee perceptions of work are discussed.

  12. The International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE): design and methods.

    PubMed

    Katzmarzyk, Peter T; Barreira, Tiago V; Broyles, Stephanie T; Champagne, Catherine M; Chaput, Jean-Philippe; Fogelholm, Mikael; Hu, Gang; Johnson, William D; Kuriyan, Rebecca; Kurpad, Anura; Lambert, Estelle V; Maher, Carol; Maia, José; Matsudo, Victor; Olds, Tim; Onywera, Vincent; Sarmiento, Olga L; Standage, Martyn; Tremblay, Mark S; Tudor-Locke, Catrine; Zhao, Pei; Church, Timothy S

    2013-09-30

    The primary aim of the International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE) was to determine the relationships between lifestyle behaviours and obesity in a multi-national study of children, and to investigate the influence of higher-order characteristics such as behavioural settings, and the physical, social and policy environments, on the observed relationships within and between countries. The targeted sample included 6000 10-year old children from 12 countries in five major geographic regions of the world (Europe, Africa, the Americas, South-East Asia, and the Western Pacific). The protocol included procedures to collect data at the individual level (lifestyle, diet and physical activity questionnaires, accelerometry), family and neighborhood level (parental questionnaires), and the school environment (school administrator questionnaire and school audit tool). A standard study protocol was developed for implementation in all regions of the world. A rigorous system of training and certification of study personnel was developed and implemented, including web-based training modules and regional in-person training meetings. The results of this study will provide a robust examination of the correlates of adiposity and obesity in children, focusing on both sides of the energy balance equation. The results will also provide important new information that will inform the development of lifestyle, environmental, and policy interventions to address and prevent childhood obesity that may be culturally adapted for implementation around the world. ISCOLE represents a multi-national collaboration among all world regions, and represents a global effort to increase research understanding, capacity and infrastructure in childhood obesity.

  13. Communication of information to patients with inflammatory bowel disease: A European Collaborative Study in a multinational prospective inception cohort.

    PubMed

    Politi, P; Bodini, P; Mortilla, M G; Beltrami, M; Fornaciari, G; Formisano, D; Munkholm, P; Riis, L; Wolters, F; Hoie, O; Katsanos, K; O'Morain, C; Shuhaibar, M; Lalli, P; De Falco, M; Pereira, S; Freitas, J; Odes, S; Stockbrügger, R W

    2008-09-01

    Communication to patients of information about their disease has become increasingly important in modern medicine, and particularly with chronic nonfatal disorders like inflammatory bowel disease (IBD), but the subject is not adequately researched or understood. We studied the media and preferences for communication of information in a multi-national community-based inception cohort of European and Israeli patients with IBD and 10 years follow-up, using structured questionnaires categorizing demographics, disease status, current and preferred sources of information, use of electronic media, role of patients' associations, and satisfaction level. The 917 patients completing the questionnaire were derived from northern (60%) and southern (40%) countries. The mean age was 48.3 years (62% under 50 years); 51% were males; 67% had ulcerative colitis, 33% Crohn's disease. Sixty-six percent of patients designated the specialist as their primary source of information, 77% indicated satisfaction with their current information, and 65% reported not receiving information about medical treatment in the past year. Patient concerns were about new research into their illness (64%), medical treatments (58%), risks and complications (51%) and genetics (42%). Preferred sources of information were paper bulletin (76%), electronic media (30%) and international organization (79%). Diagnosis (ulcerative colitis or Crohn's disease), gender, education level and country impacted significantly on patients' choices. In providing health care information to patients with IBD their individual attitudes and preferences must be considered. There should be greater roles for IBD patients' associations and international IBD-research organizations, and an increasing use of electronic media.

  14. Testosterone treatment is not associated with increased risk of adverse cardiovascular events: results from the Registry of Hypogonadism in Men (RHYME).

    PubMed

    Maggi, Mario; Wu, Frederick C W; Jones, Thomas H; Jackson, Graham; Behre, Hermann M; Hackett, Geoffrey; Martin-Morales, Antonio; Balercia, Giancarlo; Dobs, Adrian S; Arver, Stefan T E; Maggio, Marcello; Cunningham, Glenn R; Isidori, Andrea M; Quinton, Richard; Wheaton, Olivia A; Siami, Flora S; Rosen, Raymond C

    2016-10-01

    The aim of this study was to assess cardiovascular (CV) safety of testosterone replacement therapy (TRT) in a large, diverse cohort of European men with hypogonadism (HG). The Registry of Hypogonadism in Men (RHYME) was designed as a multi-national, longitudinal disease registry of men diagnosed with hypogonadism (HG) at 25 clinical sites in six European countries. Data collection included a complete medical history, physical examination, blood sampling and patient questionnaires at multiple study visits over 2-3 years. Independent adjudication was performed on all mortalities and CV outcomes. Of 999 patients enrolled with clinically diagnosed HG, 750 (75%) initiated some form of TRT. Registry participants, including both treated and untreated patients, contributed 23 900 person-months (99.6% of the targeted) follow-up time. A total of 55 reported CV events occurred in 41 patients. Overall, five patients died of CV-related causes (3 on TRT, 2 untreated) and none of the deaths were adjudicated as treatment-related. The overall CV incidence rate was 1522 per 100 000 person-years. CV event rates for men receiving TRT were not statistically different from untreated men (P=.70). Regardless of treatment assignment, CV event rates were higher in older men and in those with increased CV risk factors or a prior history of CV events. Age and prior CV history, not TRT use, were predictors of new-onset CV events in this multi-national, prospective hypogonadism registry. © 2016 John Wiley & Sons Ltd.

  15. Organizatonal Communication Issues in Italian Multinational Corporations.

    ERIC Educational Resources Information Center

    Cesaria, Ruggero

    2000-01-01

    Provides a brief historical reconstruction of management communication in Italian companies. Suggests that dealing with communication technologies, communication professionals, and intercultural communication represent three future challenges. (NH)

  16. Cost effectiveness of amoxicillin for lower respiratory tract infections in primary care: an economic evaluation accounting for the cost of antimicrobial resistance

    PubMed Central

    Oppong, Raymond; Smith, Richard D; Little, Paul; Verheij, Theo; Butler, Christopher C; Goossens, Herman; Coenen, Samuel; Moore, Michael; Coast, Joanna

    2016-01-01

    Background Lower respiratory tract infections (LRTIs) are a major disease burden and are often treated with antibiotics. Typically, studies evaluating the use of antibiotics focus on immediate costs of care, and do not account for the wider implications of antimicrobial resistance. Aim This study sought to establish whether antibiotics (principally amoxicillin) are cost effective in patients with LRTIs, and to explore the implications of taking into account costs associated with resistance. Design and setting Multinational randomised double-blinded trial in 2060 patients with acute cough/LRTIs recruited in 12 European countries. Method A cost-utility analysis from a health system perspective with a time horizon of 28 days was conducted. The primary outcome measure was the quality-adjusted life year (QALY). Hierarchical modelling was used to estimate incremental cost-effectiveness ratios (ICERs). Results Amoxicillin was associated with an ICER of €8216 (£6540) per QALY gained when the cost of resistance was excluded. If the cost of resistance is greater than €11 (£9) per patient, then amoxicillin treatment is no longer cost effective. Including possible estimates of the cost of resistance resulted in ICERs ranging from €14 730 (£11 949) per QALY gained — when only multidrug resistance costs and health care costs are included — to €727 135 (£589 856) per QALY gained when broader societal costs are also included. Conclusion Economic evaluation of antibiotic prescribing strategies that do not include the cost of resistance may provide misleading results that could be of questionable use to policymakers. However, further work is required to estimate robust costs of resistance. PMID:27402969

  17. Economic gains stimulate negative evaluations of corporate sustainability initiatives

    NASA Astrophysics Data System (ADS)

    Makov, Tamar; Newman, George E.

    2016-09-01

    In recent years, many organizations have sought to align their financial goals with environmental ones by identifying strategies that maximize profits while minimizing environmental impacts. Examples of this `win-win' approach can be found across a wide range of industries, from encouraging the reuse of hotel towels, to the construction of energy efficient buildings, to the large-scale initiatives of multi-national corporations. Although win-win strategies are generally thought to reflect positively on the organizations that employ them, here we find that people tend to respond negatively to the notion of profiting from environmental initiatives. In fact, observers may evaluate environmental win-wins less favourably than profit-seeking strategies that have no environmental benefits. The present studies suggest that how those initiatives are communicated to the general public may be of central importance. Therefore, organizations would benefit from carefully crafting the discourse around their win-win initiatives to ensure that they avoid this type of backlash.

  18. Building international collaborative capacity: contributions of community psychologists to a European network.

    PubMed

    García-Ramírez, Manuel; Paloma, Virginia; Suarez-Balcazar, Yolanda; Balcazar, Fabricio

    2009-09-01

    Europe is in the process of building a more participative, just, and inclusive European Union. The European Social Fund, which is an initiative developed to actively promote multinational partnerships that address pressing social issues, is a good example of the European transformation. This article describes the steps taken to develop and evaluate the activities of an international network promoting collaborative capacity among regional partners involved in the prevention of labor discrimination toward immigrants in three European countries-Spain, Belgium, and Italy. An international team of community psychologists proposed an empowering approach to assess the collaborative capacity of the network. This approach consisted of three steps: (1) establishing a collaborative relationship among partners, (2) building collaborative capacity, and (3) evaluating the collaborative capacity of the network. We conclude with lessons learned from the process and provide recommendations for addressing the challenges inherent in international collaboration processes.

  19. REVIEWING HIV-RELATED RESEARCH IN EMERGING ECONOMIES: THE ROLE OF GOVERNMENT REVIEWING AGENCIES

    PubMed Central

    Klitzman, Robert; Sexton, Patrina; Hui, Katrina; Hanrahan, Donna; Barnes, Mark; Sugarman, Jeremy; London, Alex John

    2015-01-01

    Little research has explored the possible effects of government institutions in emerging economies on ethical reviews of multinational research. We conducted semi-structured, in-depth telephone interviews with 15 researchers, Research Ethics Committees (RECs) personnel, and a government agency member involved in multinational HIV Prevention Trials Network (HPTN) research in emerging economies. Ministries of Health (MOH) or other government agencies often play pivotal roles as facilitators or barriers in the research ethics approval process. Government agency RECs reviewing protocols may face particular challenges, as they can lack resources, be poorly organized, have inconsistent review processes and, limited expertise, use differing definitions of national interests, including upholding national reputation and avoiding potential exploitation and stigma of the country’s population. The MOH/governmental review body may be affected by power dynamics and politics in study reviews; may consider issues both related and unrelated to research ethics as understood elsewhere; and may prioritize particular diseases, treatments, or interventions over other topics/types of research. Poor communication and deeply-rooted tensions may exist between sponsor and host countries, impeding optimal interactions and reviews. Investigators must understand and plan for the potential effects of governmental agencies on multinational collaborative research, including preserving adequate time for agency review, and contacting these agencies beforehand to address issues that may arise. Better understanding of these issues can aid and advance appropriate global scientific collaboration. PMID:25388003

  20. Reviewing HIV-Related Research in Emerging Economies: The Role of Government Reviewing Agencies.

    PubMed

    Sexton, Patrina; Hui, Katrina; Hanrahan, Donna; Barnes, Mark; Sugarman, Jeremy; London, Alex John; Klitzman, Robert

    2016-04-01

    Little research has explored the possible effects of government institutions in emerging economies on ethical reviews of multinational research. We conducted semi-structured, in-depth telephone interviews with 15 researchers, Research Ethics Committees (RECs) personnel, and a government agency member involved in multinational HIV Prevention Trials Network (HPTN) research in emerging economies. Ministries of Health (MOH) or other government agencies often play pivotal roles as facilitators or barriers in the research ethics approval process. Government agency RECs reviewing protocols may face particular challenges, as they can lack resources, be poorly organized, have inconsistent review processes and limited expertise, and use differing definitions of national interests, including upholding national reputation and avoiding potential exploitation and stigma of the country's population. The MOH/governmental review body may be affected by power dynamics and politics in study reviews; may consider issues both related and unrelated to research ethics as understood elsewhere; and may prioritize particular diseases, treatments, or interventions over other topics/types of research. Poor communication and deeply-rooted tensions may exist between sponsor and host countries, impeding optimal interactions and reviews. Investigators must understand and plan for the potential effects of governmental agencies on multinational collaborative research, including preserving adequate time for agency review, and contacting these agencies beforehand to address issues that may arise. Better understanding of these issues can aid and advance appropriate global scientific collaboration. © 2014 John Wiley & Sons Ltd.

  1. “Lost in translation”: accounting for between-country differences in the analysis of multinational cost-effectiveness data§

    PubMed Central

    Manca, Andrea; Willan, Andrew R.

    2008-01-01

    Background Cost-effectiveness analysis has gained status over the last 15 years as an important tool for assisting resource allocation decisions in a budged-limited environment such as healthcare. Randomised (multicentre) multinational controlled trials are often the main vehicle to collect primary patient-level information on resource use, cost and clinical effectiveness associated with alternative treatment strategies. However, trial-wide cost-effectiveness results may not be directly applicable to any one of the countries that participate in a multinational trial, requiring some form of additional modelling to customise the results to the country of interest. Objective The aim is to produce recommendations regarding methods that can be (currently) considered ‘good practice’ when exploring the geographical generalisability of cost-effectiveness data. The manuscript proposes an algorithm to assist with the choice of the appropriate analytical strategy when facing the task of adapting the study results from one country to another. The algorithm considers different scenarios characterised by whether or not (a) the country of interest participated in the trial, and (b) individual patient-level data (IPD) from the trial are available. Methods Structured review with description and discussion of case studies. Conclusions Methods to reflect between-country variability in cost-effectiveness data are available. It is important to be transparent regarding the assumptions made in the analysis and (where possible) assess their impact on the study results. PMID:17067195

  2. Process-based interpretation of conceptual hydrological model performance using a multinational catchment set

    NASA Astrophysics Data System (ADS)

    Poncelet, Carine; Merz, Ralf; Merz, Bruno; Parajka, Juraj; Oudin, Ludovic; Andréassian, Vazken; Perrin, Charles

    2017-08-01

    Most of previous assessments of hydrologic model performance are fragmented, based on small number of catchments, different methods or time periods and do not link the results to landscape or climate characteristics. This study uses large-sample hydrology to identify major catchment controls on daily runoff simulations. It is based on a conceptual lumped hydrological model (GR6J), a collection of 29 catchment characteristics, a multinational set of 1103 catchments located in Austria, France, and Germany and four runoff model efficiency criteria. Two analyses are conducted to assess how features and criteria are linked: (i) a one-dimensional analysis based on the Kruskal-Wallis test and (ii) a multidimensional analysis based on regression trees and investigating the interplay between features. The catchment features most affecting model performance are the flashiness of precipitation and streamflow (computed as the ratio of absolute day-to-day fluctuations by the total amount in a year), the seasonality of evaporation, the catchment area, and the catchment aridity. Nonflashy, nonseasonal, large, and nonarid catchments show the best performance for all the tested criteria. We argue that this higher performance is due to fewer nonlinear responses (higher correlation between precipitation and streamflow) and lower input and output variability for such catchments. Finally, we show that, compared to national sets, multinational sets increase results transferability because they explore a wider range of hydroclimatic conditions.

  3. Proposal of a framework for evaluating military surveillance systems for early detection of outbreaks on duty areas

    PubMed Central

    Meynard, Jean-Baptiste; Chaudet, Herve; Green, Andrew D; Jefferson, Henry L; Texier, Gaetan; Webber, Daniel; Dupuy, Bruce; Boutin, Jean-Paul

    2008-01-01

    Background In recent years a wide variety of epidemiological surveillance systems have been developed to provide early identification of outbreaks of infectious disease. Each system has had its own strengths and weaknesses. In 2002 a Working Group of the Centers for Disease Control and Prevention (CDC) produced a framework for evaluation, which proved suitable for many public health surveillance systems. However this did not easily adapt to the military setting, where by necessity a variety of different parameters are assessed, different constraints placed on the systems, and different objectives required. This paper describes a proposed framework for evaluation of military syndromic surveillance systems designed to detect outbreaks of disease on operational deployments. Methods The new framework described in this paper was developed from the cumulative experience of British and French military syndromic surveillance systems. The methods included a general assessment framework (CDC), followed by more specific methods of conducting evaluation. These included Knowledge/Attitude/Practice surveys (KAP surveys), technical audits, ergonomic studies, simulations and multi-national exercises. A variety of military constraints required integration into the evaluation. Examples of these include the variability of geographical conditions in the field, deployment to areas without prior knowledge of naturally-occurring disease patterns, the differences in field sanitation between locations and over the length of deployment, the mobility of military forces, turnover of personnel, continuity of surveillance across different locations, integration with surveillance systems from other nations working alongside each other, compatibility with non-medical information systems, and security. Results A framework for evaluation has been developed that can be used for military surveillance systems in a staged manner consisting of initial, intermediate and final evaluations. For each stage of the process parameters for assessment have been defined and methods identified. Conclusion The combined experiences of French and British syndromic surveillance systems developed for use in deployed military forces has allowed the development of a specific evaluation framework. The tool is suitable for use by all nations who wish to evaluate syndromic surveillance in their own military forces. It could also be useful for civilian mobile systems or for national security surveillance systems. PMID:18447944

  4. Pretreatment HIV Drug Resistance and HIV-1 Subtype C Are Independently Associated With Virologic Failure: Results From the Multinational PEARLS (ACTG A5175) Clinical Trial

    PubMed Central

    Kantor, Rami; Smeaton, Laura; Vardhanabhuti, Saran; Hudelson, Sarah E.; Wallis, Carol L.; Tripathy, Srikanth; Morgado, Mariza G.; Saravanan, Shanmugham; Balakrishnan, Pachamuthu; Reitsma, Marissa; Hart, Stephen; Mellors, John W.; Halvas, Elias; Grinsztejn, Beatriz; Hosseinipour, Mina C.; Kumwenda, Johnstone; La Rosa, Alberto; Lalloo, Umesh G.; Lama, Javier R.; Rassool, Mohammed; Santos, Breno R.; Supparatpinyo, Khuanchai; Hakim, James; Flanigan, Timothy; Kumarasamy, Nagalingeswaran; Campbell, Thomas B.; Eshleman, Susan H.

    2015-01-01

    Background. Evaluation of pretreatment HIV genotyping is needed globally to guide treatment programs. We examined the association of pretreatment (baseline) drug resistance and subtype with virologic failure in a multinational, randomized clinical trial that evaluated 3 antiretroviral treatment (ART) regimens and included resource-limited setting sites. Methods. Pol genotyping was performed in a nested case-cohort study including 270 randomly sampled participants (subcohort), and 218 additional participants failing ART (case group). Failure was defined as confirmed viral load (VL) >1000 copies/mL. Cox proportional hazards models estimated resistance–failure association. Results. In the representative subcohort (261/270 participants with genotypes; 44% women; median age, 35 years; median CD4 cell count, 151 cells/µL; median VL, 5.0 log10 copies/mL; 58% non-B subtypes), baseline resistance occurred in 4.2%, evenly distributed among treatment arms and subtypes. In the subcohort and case groups combined (466/488 participants with genotypes), used to examine the association between resistance and treatment failure, baseline resistance occurred in 7.1% (9.4% with failure, 4.3% without). Baseline resistance was significantly associated with shorter time to virologic failure (hazard ratio [HR], 2.03; P = .035), and after adjusting for sex, treatment arm, sex–treatment arm interaction, pretreatment CD4 cell count, baseline VL, and subtype, was still independently associated (HR, 2.1; P = .05). Compared with subtype B, subtype C infection was associated with higher failure risk (HR, 1.57; 95% confidence interval [CI], 1.04–2.35), whereas non-B/C subtype infection was associated with longer time to failure (HR, 0.47; 95% CI, .22–.98). Conclusions. In this global clinical trial, pretreatment resistance and HIV-1 subtype were independently associated with virologic failure. Pretreatment genotyping should be considered whenever feasible. Clinical Trials Registration. NCT00084136. PMID:25681380

  5. Evaluation and comparison of predictive individual-level general surrogates.

    PubMed

    Gabriel, Erin E; Sachs, Michael C; Halloran, M Elizabeth

    2018-07-01

    An intermediate response measure that accurately predicts efficacy in a new setting at the individual level could be used both for prediction and personalized medical decisions. In this article, we define a predictive individual-level general surrogate (PIGS), which is an individual-level intermediate response that can be used to accurately predict individual efficacy in a new setting. While methods for evaluating trial-level general surrogates, which are predictors of trial-level efficacy, have been developed previously, few, if any, methods have been developed to evaluate individual-level general surrogates, and no methods have formalized the use of cross-validation to quantify the expected prediction error. Our proposed method uses existing methods of individual-level surrogate evaluation within a given clinical trial setting in combination with cross-validation over a set of clinical trials to evaluate surrogate quality and to estimate the absolute prediction error that is expected in a new trial setting when using a PIGS. Simulations show that our method performs well across a variety of scenarios. We use our method to evaluate and to compare candidate individual-level general surrogates over a set of multi-national trials of a pentavalent rotavirus vaccine.

  6. Involving Communities in Deciding What Benefits They Receive in Multinational Research.

    PubMed

    Wendler, David; Shah, Seema

    2015-10-01

    There is wide agreement that communities in lower-income countries should benefit when they participate in multinational research. Debate now focuses on how and to what extent these communities should benefit. This debate has identified compelling reasons to reject the claim that whatever benefits a community agrees to accept are necessarily fair. Yet, those who conduct clinical research may conclude from this rejection that there is no reason to involve communities in the process of deciding how they benefit. Against this possibility, the present manuscript argues that involving host communities in this process helps to promote four important goals: (1) protecting host communities, (2) respecting host communities, (3) promoting transparency, and (4) enhancing social value. Published by Oxford University Press on behalf of the Journal of Medicine and Philosophy, Inc. 2015.

  7. Exposure of US multinational corporations to foreign exchange fluctuations arising from the translation of the financial statements of their offshore subsidiaries

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Doukas, P.G.

    1984-01-01

    This study examines the nature of balance-sheet exposures (as opposed to transaction and economic exposures), arising from the translation of financial statements from one currency to another. A survey of 130 multinationals concludes that corporations viewed as economic what could actually affect their reported earnings and consequently stock prices in a material way. As a result, about 60% of the companies surveyed apparently hedged some part of their balance-sheet exposures under FAS-8. However, only four companies hedge under the new translation rules prescribed by FAS-52, which allows translation gains and losses to be posted directly to equity. A test ofmore » stock-price reaction to the disclo« less

  8. [Health impact assessment of occupational health policy reform at a multinational chemical company in Japan].

    PubMed

    Fujino, Yoshihisa; Nagata, Tomohisa; Kuroki, Naomi; Dohi, Seitaro; Uehara, Masamichi; Oyama, Ichiro; Kajiki, Shigeyuki; Mori, Koji

    2009-09-01

    A health impact assessment (HIA) was conducted to identify potential health impacts arising from policy reform of occupational health and safety at S-chemical company, a multinational global company that employs about 13,000 workers. A multidisciplinary team of health professionals including occupational physicians, an epidemiologist, and public health researchers oversaw the HIA. A project manager from S-company was also involved in the whole HIA process. A literature review, profiling using annual health examination data and interviews with stakeholders and key informants were undertaken in order to identify possible impacts. A range of positive and negative health impacts were identified and develop recommendations for implementation of the new occupational health policy were proposed. The HIA added value to the planning process for the occupational health policy reform.

  9. Physics design of the injector source for ITER neutral beam injector (invited).

    PubMed

    Antoni, V; Agostinetti, P; Aprile, D; Cavenago, M; Chitarin, G; Fonnesu, N; Marconato, N; Pilan, N; Sartori, E; Serianni, G; Veltri, P

    2014-02-01

    Two Neutral Beam Injectors (NBI) are foreseen to provide a substantial fraction of the heating power necessary to ignite thermonuclear fusion reactions in ITER. The development of the NBI system at unprecedented parameters (40 A of negative ion current accelerated up to 1 MV) requires the realization of a full scale prototype, to be tested and optimized at the Test Facility under construction in Padova (Italy). The beam source is the key component of the system and the design of the multi-grid accelerator is the goal of a multi-national collaborative effort. In particular, beam steering is a challenging aspect, being a tradeoff between requirements of the optics and real grids with finite thickness and thermo-mechanical constraints due to the cooling needs and the presence of permanent magnets. In the paper, a review of the accelerator physics and an overview of the whole R&D physics program aimed to the development of the injector source are presented.

  10. Fish Oil and Post-Operative Atrial Fibrillation – Results of the Omega-3 Fatty Acids for Prevention of Post-Operative Atrial Fibrillation (OPERA) Trial

    PubMed Central

    Mozaffarian, Dariush; Marchioli, Roberto; Macchia, Alejandro; Silletta, Maria G.; Ferrazzi, Paolo; Gardner, Timothy J.; Latini, Roberto; Libby, Peter; Lombardi, Federico; O’Gara, Patrick T.; Page, Richard L.; Tavazzi, Luigi; Tognoni, Gianni

    2013-01-01

    Context Post-operative atrial fibrillation/flutter (AF) is one of the most common complications of cardiac surgery and significantly increases morbidity and healthcare utilization. A few small trials have evaluated whether long-chain n-3-polyunsaturated fatty acids (PUFA) reduce post-op AF, with mixed results. Objective To determine whether peri-operative n-3-PUFA supplementation reduces post-op AF. Design Randomized, double-blind, placebo-controlled, multinational, clinical trial. Patients A total of 1,516 patients scheduled for cardiac surgery across 28 centers in the US, Italy, and Argentina, enrolled between Aug 2010 and Jun 2012. Inclusion criteria were broad; the main exclusions were regular use of fish oil or absence of sinus rhythm at enrollment. Forty-eight percent of screened patients and 94% of eligible patients were enrolled. Intervention Patients were randomized to receive fish oil (1 g capsules containing ≥840 mg n-3-PUFA as ethyl esters) or placebo, with pre-operative loading of 10g over 3-5 days (or 8g over 2 days) followed post-operatively by 2g/d until hospital discharge or post-op day10, whichever first. Main Outcome Measures The primary endpoint was occurrence of post-op AF >30 sec. We also evaluated post-op AF lasting >1hr, resulting in symptoms, or treated with cardioversion; other secondary post-op AF endpoints; other tachyarrhythmias; hospital utilization; and major adverse cardiovascular events, 30-day mortality, bleeding, and other adverse events. All endpoints and analyses plans were prespecified. Results At enrollment, mean±SD age was 64±13 years, 72.2% were male, and 51.8% had planned valvular surgery. The primary endpoint occurred in 233 (30.7%) and 227 (30.0%) patients assigned to placebo and n-3-PUFA, respectively (OR=0.96, 95%CI=0.77-1.20; P=0.74). None of the secondary endpoints were significantly different, including post-op AF that was sustained, symptomatic, or treated (n=231 [30.5%] vs. n=224 [29.6%], P=0.70) or number of post-op AF episodes per patient (1 episode: n=220 [29.0%] vs. n=217 [28.6%]; 2 episodes: n=156 [20.6%] vs. n=157 [20.7%]; 3+ episodes: n=18 [2.4%] vs. n=21 [2.8%]; P=0.73). n-3-PUFA was generally well-tolerated, with no evidence for increased risk of bleeding or serious adverse events. Conclusions In this large multinational trial among patients undergoing cardiac surgery, peri-operative supplementation with n-3-PUFA, compared to placebo, did not reduce the risk of post-operative AF. PMID:23128104

  11. A multinational pharmacoeconomic evaluation of acute major depressive disorder (MDD): a comparison of cost-effectiveness between venlafaxine, SSRIs and TCAs.

    PubMed

    Doyle, J J; Casciano, J; Arikian, S; Tarride, J E; Gonzalez, M A; Casciano, R

    2001-01-01

    We conducted a multinational pharmacoeconomic evaluation comparing the immediate release form of a new class of serotonin norepinephrine reuptake inhibitor (SNRI), venlafaxine IR to the selective serotonin reuptake inhibitors (SSRIs) and the tricyclic antidepressants (TCAs) in the treatment of acute major depressive disorder (MDD) in 10 countries (Germany, Italy, Netherlands, Poland, Spain, Sweden, Switzerland, United Kingdom, United States, and Venezuela). We designed a decision analytic model assessing the acute phase of MDD treatment within a 6-month time horizon. Six decision tree models were customized with country-specific estimates from a clinical management analysis, meta-analytic rates from two published meta-analyses, and a resource valuation of treatment costs representing the inpatient and outpatient settings within each country. The meta-analyses provided the clinical rates of success defined as a 50% reduction in depression scores on the Hamilton Depression Scale (HAM-D) or the Montgomery-Asberg Depression Rating Scale (MADRS). Treatment regimen costs were determined from standard lists, fee schedules, and communication with local health economists in each country. The meta-analytic rates were applied to the decision analytic model to calculate the expected cost and expected outcomes for each antidepressant comparator. Cost-effectiveness was determined using the expected values for both a successful outcome, and a composite measure of outcome termed symptom-free days. A policy analysis was conducted to examine the health system budget impact in each country of increasing the utilization of the most effective antidepressant found in our study. Initiating treatment of MDD with venlafaxine IR yielded a lower expected cost compared to the SSRIs and TCAs in all countries except Poland in the inpatient setting, and Italy and Poland within the outpatient settings. The weighted average expected cost per patient varied from US$632 (Poland) to US$5647 (US) in the six-month acute phase treatment of MDD. The estimated total budgetary impact for each 1% of venlafaxine utilization, assuming a population of one million MDD patients, ranged from US$1600 (Italy) to US$29,049 (US). Within the inpatient and outpatient treatment settings, venlafaxine IR was a more cost-effective treatment of MDD compared to the SSRIs and TCAs. Additionally, the results of this investigation indicate that increased utilization of venlafaxine in most settings across Europe and the Americas will have favorable impact on health care payer budgets. ADR, adverse drug reaction; CMA, clinical management analysis; ECT, electroconvulsive therapy; HAM-D, Hamilton Depression Scale; MADRS, Montgomery-Asberg depression rating scale; MDD, major depressive disorder; SFD, symptom-free day; SNRI, serotonin-norepinephrine reuptake inhibitor; SSRI, selective serotonin reuptake inhibitor; TCA, tricyclic antidepressant; WHO, world health organization.

  12. Privatization and the Globalization of Energy Markets

    EIA Publications

    1996-01-01

    Discusses recent efforts at privatization in petroleum, electricity, and coal, as well as the impetus that privatization has provided in fostering the evolution of the multinational and multidimensional energy company.

  13. Design and rationale for the Cardiovascular and Metabolic Effects of Lorcaserin in Overweight and Obese Patients-Thrombolysis in Myocardial Infarction 61 (CAMELLIA-TIMI 61) trial.

    PubMed

    Bohula, Erin A; Scirica, Benjamin M; Fanola, Christina; Inzucchi, Silvio E; Keech, Anthony; McGuire, Darren K; Smith, Steven R; Abrahamsen, Tim; Francis, Bruce H; Miao, Wenfeng; Perdomo, Carlos A; Satlin, Andrew; Wiviott, Stephen D; Sabatine, Marc S

    2018-03-29

    Lorcaserin, a selective serotonin 2C receptor agonist, is an effective pharmacologic weight-loss therapy that improves several cardiovascular risk factors. The long-term clinical cardiovascular and metabolic safety and efficacy in patients with elevated cardiovascular risk are unknown. CAMELLIA-TIMI 61 (NCT02019264) is a randomized, double-blind, placebo-controlled, multinational clinical trial designed to evaluate the safety and efficacy of lorcaserin with regard to major adverse cardiovascular events and progression to diabetes in overweight or obese patients at high cardiovascular risk. Overweight or obese patients either with established cardiovascular disease or with diabetes and at least 1 other cardiovascular risk factor were randomized in a 1:1 ratio to lorcaserin 10 mg twice daily or matching placebo. The primary safety objective is to assess for noninferiority of lorcaserin for the composite end point of cardiovascular death, myocardial infarction, or stroke (major adverse cardiovascular event [MACE]) (with noninferiority defined as the upper bound of a 1-sided 97.5% CI excluding a hazard ratio of 1.4) compared with placebo assessed at an interim analysis with 460 adjudicated events. The efficacy objectives, assessed at study completion, will evaluate the superiority of lorcaserin for the primary composite end point of cardiovascular death, myocardial infarction, stroke, hospitalization for unstable angina, heart failure, or any coronary revascularization (MACE+) and the key secondary end point of conversion to diabetes. Recruitment began in January 2014 and was completed in November 2015 resulting in a total population of 12,000 patients. The trial is planned to continue until at least 1,401 adjudicated MACE+ events are accrued and the median treatment duration exceeds 2.5 years. CAMELLIA-TIMI 61 is investigating the safety and efficacy of lorcaserin for MACEs and conversion to diabetes in overweight or obese patients with established cardiovascular disease or multiple cardiovascular risk factors. Copyright © 2018. Published by Elsevier Inc.

  14. A new e-beam application in the pharmaceutical industry

    NASA Astrophysics Data System (ADS)

    Sadat, Theo; Malcolm, Fiona

    2005-10-01

    The paper presents a new electron beam application in the pharmaceutical industry: an in-line self-shielded atropic transfer system using electron beam for surface decontamination of products entering a pharmaceutical filling line. The unit was developed by Linac Technologies in response to the specifications of a multi-national pharmaceutical company, to solve the risk of microbial contamination entering a filling line housed inside an isolator. In order to fit the sterilization unit inside the pharmaceutical plant, a "miniature" low-energy (200 keV) electron beam accelerator and e-beam tunnel were designed, all conforming to the pharmaceutical good manufacturing practice (GMP) regulations. Process validation using biological indicators is described, with reference to the regulations governing the pharmaceutical industry. Other industrial applications of a small-sized self-shielded electron beam sterilization unit are mentioned.

  15. A European multi-language initiative to make the general population aware of independent clinical research: the European Communication on Research Awareness Need project.

    PubMed

    Mosconi, Paola; Antes, Gerd; Barbareschi, Giorgio; Burls, Amanda; Demotes-Mainard, Jacques; Chalmers, Iain; Colombo, Cinzia; Garattini, Silvio; Gluud, Christian; Gyte, Gill; Mcllwain, Catherine; Penfold, Matt; Post, Nils; Satolli, Roberto; Valetto, Maria Rosa; West, Brian; Wolff, Stephanie

    2016-01-12

    The ECRAN (European Communication on Research Awareness Needs) project was initiated in 2012, with support from the European Commission, to improve public knowledge about the importance of independent, multinational, clinical trials in Europe. Participants in the ECRAN consortium included clinicians and methodologists directly involved in clinical trials; researchers working in partnership with the public and patients; representatives of patients; and experts in science communication. We searched for, and evaluated, relevant existing materials and developed additional materials and tools, making them freely available under a Creative Commons licence. The principal communication materials developed were: 1. A website ( http://ecranproject.eu ) in six languages, including a Media centre section to help journalists to disseminate information about the ECRAN project 2. An animated film about clinical trials, dubbed in the 23 official languages of the European Community, and an interactive tutorial 3. An inventory of resources, available in 23 languages, searchable by topic, author, and media type 4. Two educational games for young people, developed in six languages 5. Testing Treatments interactive in a dozen languages, including five official European Community languages 6. An interactive tutorial slide presentation testing viewers' knowledge about clinical trials Over a 2-year project, our multidisciplinary and multinational consortium was able to produce, and make freely available in many languages, new materials to promote public knowledge about the importance of independent and international clinical trials. Sustained funding for the ECRAN information platform could help to promote successful recruitment to independent clinical trials supported through the European Clinical Research Infrastructure Network.

  16. The hidden dragons.

    PubMed

    Zeng, Ming; Williamson, Peter J

    2003-10-01

    Most multinational corporations are fascinated with China. Carried away by the number of potential customers and the relatively cheap labor, firms seeking a presence in China have traditionally focused on selling products, setting up manufacturing facilities, or both. But they've ignored an important development: the emergence of Chinese firms as powerful rivals--in China and also in the global market. In this article, Ming Zeng and Peter Williamson describe how Chinese companies like Haier, Legend, and Pearl River Piano have quietly managed to grab market share from older, bigger, and financially stronger rivals in Asia, Europe, and the United States. Global managers tend to offer the usual explanations for why Chinese companies don't pose a threat: They aren't big enough or profitable enough to compete overseas, the managers say, and these primarily state-owned companies are ill-financed and ill-equipped for global competition. As the government's policies about the private ownership of companies changed from forbidding the practice to encouraging it, a new breed of Chinese companies evolved. The authors outline the four types of hybrid Chinese companies that are simultaneously tackling the global market. China's national champions are using their advantages as domestic leaders to build global brands. The dedicated exporters are entering foreign markets on the strength of their economies of scale. The competitive networks have taken on world markets by bringing together small, specialized companies that operate in close proximity. And the technology upstarts are using innovations developed by China's government-owned research institutes to enter emerging sectors such as biotechnology. Zeng and Williamson identify these budding multinationals, analyze their strategies, and evaluate their weaknesses.

  17. Administrative complexities for a European observational study despite directives harmonising requirements.

    PubMed

    Gülmez, Sinem Ezgi; Lignot-Maleyran, Séverine; de Vries, Corinne S; Sturkenboom, Miriam; Micon, Sophie; Hamoud, Fatima; Blin, Patrick; Moore, Nicholas

    2012-08-01

    For pharmacoepidemiological studies in Europe, accessing data should require only authorisation by the relevant data protections committees, as expected from the 1995 Data Protection Directive (95/46/EC). Our experience from a multinational observational study across seven European countries shows that this is certainly not the case. The study was a multicentre, multinational, case-population study in European liver transplant centres in seven countries, retrospectively evaluating a 3-year period. Before data collection started, the procedures to obtain the necessary authorisations for the participating countries were defined. In France, a single opinion from a single data protection committee was enough to start the study. In Italy, Portugal, Greece and the UK, there was a national authority, but the hospitals requested the approval by their local committees/bodies irrespective of whether the authorisation of the national committee came after or before that of local ones. In Ireland, only one hospital participated, and the opinion of its ethics committee was sufficient. In the Netherlands, the opinion of the institutional review board of the local coordinating centre was necessary to obtain the opinions from the institutional review boards of the other hospitals. The information requested by the different committees and the time to obtain the approvals varied, even within the same country. This degree of complexity and disharmony, and resulting cost, was observed in a simple retrospective study. Regulators will need to be aware that these time-consuming, expensive and useless complexities must be factored in when estimating the time and cost of a study. Copyright © 2012 John Wiley & Sons, Ltd.

  18. Unsafe sexual behaviour in domestic and foreign migrant male workers in multinational workplaces in Jordan: occupational-based and behavioural assessment survey.

    PubMed

    Al Rifai, Rami; Nakamura, Keiko; Seino, Kaoruko; Kizuki, Masashi; Morita, Ayako

    2015-06-11

    To examine the prevalence of unsafe sexual behaviour, sexually transmitted infection (STI)-related knowledge, health and work-related conditions, and correlates of practising unsafe sex among domestic and foreign male workers in multinational workplaces in Jordan. Cross-sectional behavioural assessment survey. Multinational workplaces in Jordan. 230 Jordanian and 480 foreign male workers aged ≥ 18 years who had worked in a Qualified Industrial Zone (QIZ) for 12 months or more. The primary outcome was the prevalence of practising unsafe sex. 'Unsafe sex' was defined as sex with a non-regular sexual partner with inconsistent condom usage. Overall, 74.3% of workers reported lifetime sexual experience. The proportion of lifetime unsafe sex was similar among domestic (31.8%) and foreign (35.6%) workers. Of those, 59.2% of domestic and 68.1% of foreign workers started practising unsafe sex after joining the QIZ. Rates of lifetime unsafe sex were significantly higher among those who had their sexual debut after joining the QIZ in domestic (aOR, 2.2, 95% CI 1.1 to 4.4) and foreign workers (aOR, 2.4, 95% CI 1.4 to 4.1). Among the domestic workers, being 18-24 years old (aOR, 4.9), unmarried (aOR, 4.8), working in the QIZ for 5-8 years (aOR, 5.0), sometimes/frequently shopped with foreign workers (aOR, 2.1) or were current/ex-alcohol drinkers (aORs, 3.4) were independently significantly associated with higher odds of practising unsafe sex. A significant proportion of domestic and foreign male workers had been practising unsafe sex. The findings indicated that not only foreigners but also domestic male workers associating with foreign workers are at high risk of unsafe sex. Tailored interventions to promote safer sex in multinational workplaces in Jordan are needed. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  19. Points to consider: efficacy and safety evaluations in the clinical development of ultra-orphan drugs.

    PubMed

    Maeda, Kojiro; Kaneko, Masayuki; Narukawa, Mamoru; Arato, Teruyo

    2017-08-23

    The unmet medical needs of individuals with very rare diseases are high. The clinical trial designs and evaluation methods used for 'regular' drugs are not applicable in the clinical development of ultra-orphan drugs (<1000 patients) in many cases. In order to improve the clinical development of ultra-orphan drugs, we examined several points regarding the efficient evaluations of drug efficacy and safety that could be conducted even with very small sample sizes, based on the review reports of orphan drugs approved in Japan. The clinical data packages of 43 ultra-orphan drugs approved in Japan from January 2001 to December 2014 were investigated. Japanese clinical trial data were not included in the clinical data package for eight ultra-orphan drugs, and non-Japanese clinical trial data were included for six of these eight drug. Japanese supportive data that included retrospective studies, published literature, clinical research and Japanese survey results were clinical data package attachments in 22 of the 43 ultra-orphan drugs. Multinational trials were conducted for three ultra-orphan drugs. More than two randomized controlled trials (RCTs) were conducted for only 11 of the 43 ultra-orphan drugs. The smaller the number of patients, the greater the proportion of forced titration and optional titration trials were conducted. Extension trials were carried out for enzyme preparations and monoclonal antibodies with high ratio. Post-marketing surveillance of all patients was required in 36 of the 43 ultra-orphan drugs. For ultra-orphan drugs, clinical endpoints were used as the primary efficacy endpoint of the pivotal trial only for two drugs. The control groups in RCTs were classified as follows: placebo groups different dosage groups, and active controls groups. Sample sizes have been determined on the basis of feasibility for some ultra-orphan drugs. We provide "Draft Guidance on the Clinical Development of Ultra-Orphan Drugs" based on this research. The development of ultra-orphan drugs requires various arrangements regarding evidence collection, data sources and the clinical trial design. We expect that this draft guidance is useful for ultra-orphan drugs developments in future.

  20. The food choice at work study: effectiveness of complex workplace dietary interventions on dietary behaviours and diet-related disease risk - study protocol for a clustered controlled trial.

    PubMed

    Geaney, Fiona; Scotto Di Marrazzo, Jessica; Kelly, Clare; Fitzgerald, Anthony P; Harrington, Janas M; Kirby, Ann; McKenzie, Ken; Greiner, Birgit; Perry, Ivan J

    2013-11-06

    Dietary behaviour interventions have the potential to reduce diet-related disease. Ample opportunity exists to implement these interventions in the workplace. The overall aim is to assess the effectiveness and cost-effectiveness of complex dietary interventions focused on environmental dietary modification alone or in combination with nutrition education in large manufacturing workplace settings. A clustered controlled trial involving four large multinational manufacturing workplaces in Cork will be conducted. The complex intervention design has been developed using the Medical Research Council's framework and the National Institute for Health and Clinical Excellence (NICE) guidelines and will be reported using the TREND statement for the transparent reporting of evaluations with non-randomized designs. It will draw on a soft paternalistic 'nudge' theoretical perspective. It will draw on a soft paternalistic "nudge" theoretical perspective. Nutrition education will include three elements: group presentations, individual nutrition consultations and detailed nutrition information. Environmental dietary modification will consist of five elements: (a) restriction of fat, saturated fat, sugar and salt, (b) increase in fibre, fruit and vegetables, (c) price discounts for whole fresh fruit, (d) strategic positioning of healthier alternatives and (e) portion size control. No intervention will be offered in workplace A (control). Workplace B will receive nutrition education. Workplace C will receive nutrition education and environmental dietary modification. Workplace D will receive environmental dietary modification alone. A total of 448 participants aged 18 to 64 years will be selected randomly. All permanent, full-time employees, purchasing at least one main meal in the workplace daily, will be eligible. Changes in dietary behaviours, nutrition knowledge, health status with measurements obtained at baseline and at intervals of 3 to 4 months, 7 to 9 months and 13 to 16 months will be recorded. A process evaluation and cost-effectiveness economic evaluation will be undertaken. A 'Food Choice at Work' toolbox (concise teaching kit to replicate the intervention) will be developed to inform and guide future researchers, workplace stakeholders, policy makers and the food industry. Current Controlled Trials, ISRCTN35108237.

  1. Efficacy and safety of CP-945,598, a selective cannabinoid CB1 receptor antagonist, on weight loss and maintenance.

    PubMed

    Aronne, Louis J; Finer, Nick; Hollander, Priscilla A; England, Richard D; Klioze, Solomon S; Chew, Robert D; Fountaine, Robert J; Powell, Coralie M; Obourn, John D

    2011-07-01

    Three double-blind, placebo-controlled, three-parallel-group, multicenter phase 3 trials were conducted to assess the efficacy and safety of CP-945,598 for weight loss and weight-loss maintenance. Two trials were designed to be 2 years in duration (in obese and overweight patients) and one as a 1-year study (in obese and overweight patients with type 2 diabetes). However, the 2-year trials and the CP-945,598 development program were terminated before completion due to changing regulatory perspectives of CB1 receptor-related drugs. In total, 1,253 and 2,536 participants in the two 2-year multinational and North American studies were randomized to 10-mg CP-945,598 (n = 360; 718); 20-mg CP-945,598 (n = 534, 1,084) and placebo (n = 359, 734), respectively; and 975 participants were randomized to 10-mg CP-945,598 (n = 318); 20-mg CP-945,598 (n = 320); and placebo (n = 337) in the 1-year multinational diabetes trial. Baseline demographics were similar between treatment groups within each trial. One year of treatment with CP-945,598 resulted in a dose-related mean percentage reduction from baseline body-weight in all trials. A significant proportion of all participants also achieved 5% and 10% weight loss after 1 year. In participants with mainly well-controlled type 2 diabetes, the combination of lifestyle and CP-945,598 induced substantial improvements in glycemic control. The most frequent adverse events (AEs) for CP-945,598 were: diarrhea, nausea, nasopharyngitis, and headache. Self-reported experiences of anxiety and suicidal thoughts were higher with CP-945,598 than placebo, as were the incidence of depression and depressed mood. However, the reported increases in psychiatric symptoms were not consistently dose dependent.

  2. A Multinational Study of Thromboprophylaxis Practice in Critically Ill Children*

    PubMed Central

    Faustino, Edward Vincent S.; Hanson, Sheila; Spinella, Philip C.; Tucci, Marisa; O'Brien, Sarah H.; Nunez, Antonio Rodriguez; Yung, Michael; Truemper, Edward; Qin, Li; Li, Simon; Marohn, Kimberly; Randolph, Adrienne G.

    2015-01-01

    Objectives Although critically ill children are at increased risk for developing deep venous thrombosis, there are few pediatric studies establishing the prevalence of thrombosis or the efficacy of thromboprophylaxis. We tested the hypothesis that thromboprophylaxis is infrequently used in critically ill children even for those in whom it is indicated. Design Prospective multinational cross-sectional study over four study dates in 2012. Setting Fifty-nine PICUs in Australia, Canada, New Zealand, Portugal, Singapore, Spain, and the United States. Patients All patients less than 18 years old in the PICU during the study dates and times were included in the study, unless the patients were 1) boarding in the unit waiting for a bed outside the PICU or 2) receiving therapeutic anticoagulation. Interventions None. Measurements and Main Results Of 2,484 children in the study, 2,159 (86.9%) had greater than or equal to 1 risk factor for thrombosis. Only 308 children (12.4%) were receiving pharmacologic thromboprophylaxis (e.g., aspirin, low-molecular-weight heparin, or unfractionated heparin). Of 430 children indicated to receive pharmacologic thromboprophylaxis based on consensus recommendations, only 149 (34.7%) were receiving it. Mechanical thromboprophylaxis was used in 156 of 655 children (23.8%) 8 years old or older, the youngest age for that device. Using nonlinear mixed effects model, presence of cyanotic congenital heart disease (odds ratio, 7.35; p < 0.001) and spinal cord injury (odds ratio, 8.85; p = 0.008) strongly predicted the use of pharmacologic and mechanical thromboprophylaxis, respectively. Conclusions Thromboprophylaxis is infrequently used in critically ill children. This is true even for children at high risk of thrombosis where consensus guidelines recommend pharmacologic thromboprophylaxis. PMID:24351371

  3. Abiraterone Improves Survival in Metastatic Prostate Cancer

    Cancer.gov

    A multinational phase III trial found that the drug abiraterone acetate prolonged the median survival of patients with metastatic castration-resistant prostate cancer by 4 months compared with patients who received a placebo.

  4. Direct Foreign Investment in the United Kingdom.

    ERIC Educational Resources Information Center

    Hinde, Kevin

    1987-01-01

    Notes introductory undergraduate economics textbooks have no formal analysis of the rationale for direct foreign investment by multinational firms. Examines this area in an attempt to develop more content information for undergraduate courses. (RKM)

  5. Multinational Species Conservation Funds Reauthorization Act of 2013

    THOMAS, 113th Congress

    Rep. Young, Don [R-AK-At Large

    2013-01-03

    House - 01/31/2013 Referred to the Subcommittee on Fisheries, Wildlife, Oceans, and Insular Affairs. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  6. Multinational Species Conservation Funds Semipostal Stamp Reauthorization Act

    THOMAS, 113th Congress

    Rep. Grimm, Michael G. [R-NY-11

    2013-01-15

    House - 01/31/2013 Referred to the Subcommittee on Fisheries, Wildlife, Oceans, and Insular Affairs. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  7. Multinational Species Conservation Funds Semipostal Stamp Reauthorization Act

    THOMAS, 112th Congress

    Rep. Grimm, Michael G. [R-NY-13

    2011-11-29

    House - 12/05/2011 Referred to the Subcommittee on Fisheries, Wildlife, Oceans, and Insular Affairs. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  8. Limitations on Disclosure of Information under Pesticide Law

    EPA Pesticide Factsheets

    Pesticide law limits disclosure of information if it contains confidential information or if the requester is a multinational entity. This Web page provides information on these issues and how they affect information disclosure.

  9. Environmental due diligence within multinational corporations

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    MacLean, R.

    1997-08-01

    Superfund and other state and federal regulations that emerged during the 80`s dramatically changed the way corporations managed property transactions. At the beginning of that decade there were very few engineers experienced in environmental due diligence. Over the past 15 years a sophisticated consulting industry has emerged to support companies in their effort to minimize liabilities associated with contaminated property. There is now a wealth of published literature on environmental due diligence, including generally accepted standards for investigating property contamination from organizations such as ASTM. This paper examines the current state of environmental due diligence among multinationals. It presents themore » underlying reasons for the current ad hoc nature of due diligence investigations and what companies can do to improve their policies and communication networks. A summary is given of the best practices used by industry leaders to minimize liabilities.« less

  10. Qualifizierung für "Industrie 4.0". Facharbeit in Deutschland und deutschen Auslandsniederlassungen in Emerging Economies

    NASA Astrophysics Data System (ADS)

    Fuchs, Martina; Pilz, Matthias; Wiemann, Judith; Wiemann, Kristina

    2017-06-01

    Frey and Osbourne's (2013) notion of the end of professional technical skills caused by Industry 4.0 (smart manufacturing), also known as increasing polarisation into "lousy and lovely jobs", is a topical issue. This contribution is a critical review of this idea in the context of German multinational companies, many of which are intensifying their efforts to introduce international customer-oriented quality production, digital high-tech and new human-machine-interfaces. Such high-tech production requires that the companies further internationalise practices of the German technical vocational education and training to emerging economies as Mexico, India and China. For German multinational companies this rather suggests an increase in professional technical skills (also on an international level) and less so rationalisation potentials in this particular segment of production work.

  11. Multi-National Banknote Classification Based on Visible-light Line Sensor and Convolutional Neural Network.

    PubMed

    Pham, Tuyen Danh; Lee, Dong Eun; Park, Kang Ryoung

    2017-07-08

    Automatic recognition of banknotes is applied in payment facilities, such as automated teller machines (ATMs) and banknote counters. Besides the popular approaches that focus on studying the methods applied to various individual types of currencies, there have been studies conducted on simultaneous classification of banknotes from multiple countries. However, their methods were conducted with limited numbers of banknote images, national currencies, and denominations. To address this issue, we propose a multi-national banknote classification method based on visible-light banknote images captured by a one-dimensional line sensor and classified by a convolutional neural network (CNN) considering the size information of each denomination. Experiments conducted on the combined banknote image database of six countries with 62 denominations gave a classification accuracy of 100%, and results show that our proposed algorithm outperforms previous methods.

  12. The roles of information technology in global chain supply: a multiple case study of multinational companies of China

    NASA Astrophysics Data System (ADS)

    He, Mao; Duan, Wanchun

    2007-12-01

    Nowadays many Chinese companies have being becoming more and more international. Therefore, these Chinese companies have to face global supply chains rather than the former domestic ones. The use of information technology (IT) is considered a prerequisite for the effective control of today's complex global supply chains. Based on empirical data from 10 multinational companies of China, this paper presents a classification of the ways in which companies use IT in SCM, and examines the drivers for these different utilization types. According to the findings of this research, the purposes of using of IT in SCM can be divided into 1) transaction processing, 2) supply chain planning and collaboration, and 3) order tracking and delivery coordination. The findings further suggest that the drivers between these three uses of IT in SCM differ.

  13. Multi-National Banknote Classification Based on Visible-light Line Sensor and Convolutional Neural Network

    PubMed Central

    Pham, Tuyen Danh; Lee, Dong Eun; Park, Kang Ryoung

    2017-01-01

    Automatic recognition of banknotes is applied in payment facilities, such as automated teller machines (ATMs) and banknote counters. Besides the popular approaches that focus on studying the methods applied to various individual types of currencies, there have been studies conducted on simultaneous classification of banknotes from multiple countries. However, their methods were conducted with limited numbers of banknote images, national currencies, and denominations. To address this issue, we propose a multi-national banknote classification method based on visible-light banknote images captured by a one-dimensional line sensor and classified by a convolutional neural network (CNN) considering the size information of each denomination. Experiments conducted on the combined banknote image database of six countries with 62 denominations gave a classification accuracy of 100%, and results show that our proposed algorithm outperforms previous methods. PMID:28698466

  14. Competing with giants. Survival strategies for local companies in emerging markets.

    PubMed

    Dawar, N; Frost, T

    1999-01-01

    The arrival of a multinational corporation often looks like a death sentence to local companies in an emerging market. After all, how can they compete in the face of the vast financial and technological resources, the seasoned management, and the powerful brands of, say, a Compaq or a Johnson & Johnson? But local companies often have more options than they might think, say the authors. Those options vary, depending on the strength of globalization pressures in an industry and the nature of a company's competitive assets. In the worst case, when globalization pressures are strong and a company has no competitive assets that it can transfer to other countries, it needs to retreat to a locally oriented link within the value chain. But if globalization pressures are weak, the company may be able to defend its market share by leveraging the advantages it enjoys in its home market. Many companies in emerging markets have assets that can work well in other countries. Those that operate in industries where the pressures to globalize are weak may be able to extend their success to a limited number of other markets that are similar to their home base. And those operating in global markets may be able to contend head-on with multinational rivals. By better understanding the relationship between their company's assets and the industry they operate in, executives from emerging markets can gain a clearer picture of the options they really have when multinationals come to stay.

  15. Implementation of graphic health warning labels on tobacco products in India: the interplay between the cigarette and the bidi industries

    PubMed Central

    Sankaran, Sujatha; Hiilamo, Heikki; Glantz, Stanton A

    2014-01-01

    Objectives To understand the competition between and among tobacco companies and health groups that led to graphical health warning labels (GHWL) on all tobacco products in India. Methods Analysis of internal tobacco industry documents in the Legacy Tobacco Document Library, documents obtained through Indias Right to Information ‘ Act, and news reports. Results Implementation of GHWLs in India reflects a complex interplay between the government and the cigarette and bidi industries, who have shared as well as conflicting interests. Joint lobbying by national-level tobacco companies (that are foreign subsidiaries of multinationals) and local producers of other forms of tobacco blocked GHWLs for decades and delayed the implementation of effective GHWLs after they were mandated in 2007. Tobacco control activists used public interest lawsuits and the Right to Information Act to win government implementation of GHWLs on cigarette, bidi and smokeless tobacco packs in May 2009 and rotating GHWLs in December 2011. Conclusions GHWLs in India illustrate how the presence of bidis and cigarettes in the same market creates a complex regulatory environment. The government imposing tobacco control on multinational cigarette companies led to the enforcement of regulation on local forms of tobacco. As other developing countries with high rates of alternate forms of tobacco use establish and enforce GHWL laws, the tobacco control advocacy community can use pressure on the multinational cigarette industry as an indirect tool to force implementation of regulations on other forms of tobacco. PMID:24950697

  16. Leadership challenges in multinational medical peacekeeping operations: Lessons from UNIFIL Hospital.

    PubMed

    Datta, Rakesh; Khanna, Sangeeta

    2017-10-01

    Commanding a military multinational and multilingual healthcare facility can be a formidable task with very little margin for error. The authors were in leadership positions of UNIFIL Hospital, unique in its diversity of both staff and clientele. Experience about the challenges faced and methods adopted to overcome them will be shared. Troops from diverse backgrounds differ in their competency, and also in their attitudinal approach to situations. It is imperative for the medical commanders to identify these differences, and work towards harnessing individual strengths to form a cohesive unit. Frequent rotation of team members and thereby difficulty in adapting to new environment makes the tasks more challenging. Challenges can be broadly categorized in those dealing with functional roles (providing medical support) and command and control issues. Linguistic challenges especially in situations where professionals have to work as a coordinated unit remains a major challenge. The threat of medical errors arising out of misunderstandings is very real. Gender sensitization is essential to avoid potential unpleasant situations. Interpersonal conflict can easily go out of hand. The leadership has to be more direct and deliberate relying less on hierarchy and more on direct communication. A strict enforcement of UN standards for equipment and competence, frequent joint medical drills help to overcome interoperability issues and develop mutual confidence. Leadership in multinational UN hospitals is a demanding task with its peculiar set of challenges. A systematic and deliberate approach focused on mutual respect, flexibility and direct leadership can help medical commanders in such situations.

  17. Evaluating Threats in Multinational Marine Ecosystems: A Coast Salish First Nations and Tribal Perspective.

    PubMed

    Gaydos, Joseph K; Thixton, Sofie; Donatuto, Jamie

    2015-01-01

    Despite the merit of managing natural resources on the scale of ecosystems, evaluating threats and managing risk in ecosystems that span multiple countries or jurisdictions can be challenging. This requires each government involved to consider actions in concert with actions being taken in other countries by co-managing entities. Multiple proposed fossil fuel-related and port development projects in the Salish Sea, a 16,925 km2 inland sea shared by Washington State (USA), British Columbia (Canada), and Indigenous Coast Salish governments, have the potential to increase marine vessel traffic and negatively impact natural resources. There is no legal mandate or management mechanism requiring a comprehensive review of the potential cumulative impacts of these development activities throughout the Salish Sea and across the international border. This project identifies ongoing and proposed energy-related development projects that will increase marine vessel traffic in the Salish Sea and evaluates the threats each project poses to natural resources important to the Coast Salish. While recognizing that Coast Salish traditions identify all species as important and connected, we used expert elicitation to identify 50 species upon which we could evaluate impact. These species were chosen because Coast Salish depend upon them heavily for harvest revenue or as a staple food source, they were particularly culturally or spiritually significant, or they were historically part of Coast Salish lifeways. We identified six development projects, each of which had three potential impacts (pressures) associated with increased marine vessel traffic: oil spill, vessel noise and vessel strike. Projects varied in their potential for localized impacts (pressures) including shoreline development, harbor oil spill, pipeline spill, coal dust accumulation and nearshore LNG explosion. Based on available published data, impact for each pressure/species interaction was rated as likely, possible or unlikely. Impacts are likely to occur in 23 to 28% of the possible pressure/species scenarios and are possible in another 15 to 28% additional pressure/species interactions. While it is not clear which impacts will be additive, synergistic, or potentially antagonistic, studies that manipulate multiple stressors in marine ecosystems suggest that threats associated with these six projects are likely to have an overall additive or even synergistic interaction and therefore impact species of major cultural importance to the Coast Salish, an important concept that would be lost by merely evaluating each project independently. Failure to address multiple impacts will affect the Coast Salish and the 7 million other people that also depend on this ecosystem. These findings show the value of evaluating multiple threats, and ultimately conducting risk assessments at the scale of ecosystems and highlight the serious need for managers of multinational ecosystems to actively collaborate on evaluating threats, assessing risk, and managing resources.

  18. Evaluating Threats in Multinational Marine Ecosystems: A Coast Salish First Nations and Tribal Perspective

    PubMed Central

    Gaydos, Joseph K.; Thixton, Sofie; Donatuto, Jamie

    2015-01-01

    Despite the merit of managing natural resources on the scale of ecosystems, evaluating threats and managing risk in ecosystems that span multiple countries or jurisdictions can be challenging. This requires each government involved to consider actions in concert with actions being taken in other countries by co-managing entities. Multiple proposed fossil fuel-related and port development projects in the Salish Sea, a 16,925 km2 inland sea shared by Washington State (USA), British Columbia (Canada), and Indigenous Coast Salish governments, have the potential to increase marine vessel traffic and negatively impact natural resources. There is no legal mandate or management mechanism requiring a comprehensive review of the potential cumulative impacts of these development activities throughout the Salish Sea and across the international border. This project identifies ongoing and proposed energy-related development projects that will increase marine vessel traffic in the Salish Sea and evaluates the threats each project poses to natural resources important to the Coast Salish. While recognizing that Coast Salish traditions identify all species as important and connected, we used expert elicitation to identify 50 species upon which we could evaluate impact. These species were chosen because Coast Salish depend upon them heavily for harvest revenue or as a staple food source, they were particularly culturally or spiritually significant, or they were historically part of Coast Salish lifeways. We identified six development projects, each of which had three potential impacts (pressures) associated with increased marine vessel traffic: oil spill, vessel noise and vessel strike. Projects varied in their potential for localized impacts (pressures) including shoreline development, harbor oil spill, pipeline spill, coal dust accumulation and nearshore LNG explosion. Based on available published data, impact for each pressure/species interaction was rated as likely, possible or unlikely. Impacts are likely to occur in 23 to 28% of the possible pressure/species scenarios and are possible in another 15 to 28% additional pressure/species interactions. While it is not clear which impacts will be additive, synergistic, or potentially antagonistic, studies that manipulate multiple stressors in marine ecosystems suggest that threats associated with these six projects are likely to have an overall additive or even synergistic interaction and therefore impact species of major cultural importance to the Coast Salish, an important concept that would be lost by merely evaluating each project independently. Failure to address multiple impacts will affect the Coast Salish and the 7 million other people that also depend on this ecosystem. These findings show the value of evaluating multiple threats, and ultimately conducting risk assessments at the scale of ecosystems and highlight the serious need for managers of multinational ecosystems to actively collaborate on evaluating threats, assessing risk, and managing resources. PMID:26691860

  19. NARSTO PROGRAM SUPPORT

    EPA Science Inventory

    The NARSTO program is a multi-national, public/private partnership of over 70 organizations sponsoring and participating in ozone and particulate air quality research in North America. Coordinate communication and planning with the NARSTO membership for air quality research, sci...

  20. Xerox' Canadian Research Facility: The Multinational and the "Offshore" Laboratory.

    ERIC Educational Resources Information Center

    Marchessault, R. H.; Myers, M. B.

    1986-01-01

    The history, logistics, and strategy behind the Xerox Corporation's Canadian research laboratory, a subsidiary firm located outside the United States for reasons of manpower, tax incentives, and quality of life, are described. (MSE)

  1. 78 FR 20893 - Legal Services Trade Mission to China, September 16-18, 2013

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-08

    ... services on United States laws for issues relating to taxation, employment, corporate finance, real estate... economy to a center of international business and finance, its need for sophisticated multinational legal...

  2. NBAA business aviation fact book, 2003

    DOT National Transportation Integrated Search

    2003-01-01

    Business aircraft are utilized by all types of people : and companies, from individuals who often fly rented, : single-engine, piston-powered airplanes, to sales : or management teams from the largest multinational : corporations, many of which own f...

  3. Rationale of the FIBROTARGETS study designed to identify novel biomarkers of myocardial fibrosis

    PubMed Central

    Ferreira, João Pedro; Machu, Jean‐Loup; Girerd, Nicolas; Jaisser, Frederic; Thum, Thomas; Butler, Javed; González, Arantxa; Diez, Javier; Heymans, Stephane; McDonald, Kenneth; Gyöngyösi, Mariann; Firat, Hueseyin; Rossignol, Patrick; Pizard, Anne

    2017-01-01

    Abstract Aims Myocardial fibrosis alters the cardiac architecture favouring the development of cardiac dysfunction, including arrhythmias and heart failure. Reducing myocardial fibrosis may improve outcomes through the targeted diagnosis and treatment of emerging fibrotic pathways. The European‐Commission‐funded ‘FIBROTARGETS’ is a multinational academic and industrial consortium with the main aims of (i) characterizing novel key mechanistic pathways involved in the metabolism of fibrillary collagen that may serve as biotargets, (ii) evaluating the potential anti‐fibrotic properties of novel or repurposed molecules interfering with the newly identified biotargets, and (iii) characterizing bioprofiles based on distinct mechanistic phenotypes involving the aforementioned biotargets. These pathways will be explored by performing a systematic and collaborative search for mechanisms and targets of myocardial fibrosis. These mechanisms will then be translated into individualized diagnostic tools and specific therapeutic pharmacological options for heart failure. Methods and results The FIBROTARGETS consortium has merged data from 12 patient cohorts in a common database available to individual consortium partners. The database consists of >12 000 patients with a large spectrum of cardiovascular clinical phenotypes. It integrates community‐based population cohorts, cardiovascular risk cohorts, and heart failure cohorts. Conclusions The FIBROTARGETS biomarker programme is aimed at exploring fibrotic pathways allowing the bioprofiling of patients into specific ‘fibrotic’ phenotypes and identifying new therapeutic targets that will potentially enable the development of novel and tailored anti‐fibrotic therapies for heart failure. PMID:28988439

  4. Evaluating the importance of policy amenable factors in explaining influenza vaccination: a cross-sectional multinational study

    PubMed Central

    Wheelock, Ana; Miraldo, Marisa; Thomson, Angus; Vincent, Charles; Sevdalis, Nick

    2017-01-01

    Objectives Despite continuous efforts to improve influenza vaccination coverage, uptake among high-risk groups remains suboptimal. We aimed to identify policy amenable factors associated with vaccination and to measure their importance in order to assist in the monitoring of vaccination sentiment and the design of communication strategies and interventions to improve vaccination rates. Setting The USA, the UK and France. Participants A total of 2412 participants were surveyed across the three countries. Outcome measures Self-reported influenza vaccination. Methods Between March and April 2014, a stratified random sampling strategy was employed with the aim of obtaining nationally representative samples in the USA, the UK and France through online databases and random-digit dialling. Participants were asked about vaccination practices, perceptions and feelings. Multivariable logistic regression was used to identify factors associated with past influenza vaccination. Results The models were able to explain 64%–80% of the variance in vaccination behaviour. Overall, sociopsychological variables, which are inherently amenable to policy, were better at explaining past vaccination behaviour than demographic, socioeconomic and health variables. Explanatory variables included social influence (physician), influenza and vaccine risk perceptions and traumatic childhood experiences. Conclusions Our results indicate that evidence-based sociopsychological items should be considered for inclusion into national immunisation surveys to gauge the public’s views, identify emerging concerns and thus proactively and opportunely address potential barriers and harness vaccination drivers. PMID:28706088

  5. Improving tablet coating robustness by selecting critical process parameters from retrospective data.

    PubMed

    Galí, A; García-Montoya, E; Ascaso, M; Pérez-Lozano, P; Ticó, J R; Miñarro, M; Suñé-Negre, J M

    2016-09-01

    Although tablet coating processes are widely used in the pharmaceutical industry, they often lack adequate robustness. Up-scaling can be challenging as minor changes in parameters can lead to varying quality results. To select critical process parameters (CPP) using retrospective data of a commercial product and to establish a design of experiments (DoE) that would improve the robustness of the coating process. A retrospective analysis of data from 36 commercial batches. Batches were selected based on the quality results generated during batch release, some of which revealed quality deviations concerning the appearance of the coated tablets. The product is already marketed and belongs to the portfolio of a multinational pharmaceutical company. The Statgraphics 5.1 software was used for data processing to determine critical process parameters in order to propose new working ranges. This study confirms that it is possible to determine the critical process parameters and create design spaces based on retrospective data of commercial batches. This type of analysis is thus converted into a tool to optimize the robustness of existing processes. Our results show that a design space can be established with minimum investment in experiments, since current commercial batch data are processed statistically.

  6. [The IARC carcinogenicity evaluation of radio-frequency electromagnetic field: with special reference to epidemiology of mobile phone use and brain tumor risk].

    PubMed

    Yamaguchi, Naohito

    2013-01-01

    The International Agency for Research on Cancer of World Health Organization announced in May 2011 the results of evaluation of carcinogenicity of radio-frequency electromagnetic field. In the overall evaluation, the radio-frequency electromagnetic field was classified as "possibly carcinogenic to humans", on the basis of the fact that the evidence provided by epidemiological studies and animal bioassays was limited. Regarding epidemiology, the results of the Interphone Study, an international collaborative case-control study, were of special importance, together with the results of a prospective cohort study in Denmark, case-control studies in several countries, and a case-case study in Japan. The evidence obtained was considered limited, because the increased risk observed in some studies was possibly spurious, caused by selection bias or recall bias as well as residual effects of confounding factors. Further research studies, such as large-scale multinational epidemiological studies, are crucially needed to establish a sound evidence base from which a more conclusive judgment can be made for the carcinogenicity of the radio-frequency electromagnetic field.

  7. EURO-CARES as Roadmap for a European Sample Curation Facility

    NASA Astrophysics Data System (ADS)

    Brucato, J. R.; Russell, S.; Smith, C.; Hutzler, A.; Meneghin, A.; Aléon, J.; Bennett, A.; Berthoud, L.; Bridges, J.; Debaille, V.; Ferrière, L.; Folco, L.; Foucher, F.; Franchi, I.; Gounelle, M.; Grady, M.; Leuko, S.; Longobardo, A.; Palomba, E.; Pottage, T.; Rettberg, P.; Vrublevskis, J.; Westall, F.; Zipfel, J.; Euro-Cares Team

    2018-04-01

    EURO-CARES is a three-year multinational project funded under the European Commission Horizon2020 research program to develop a roadmap for a European Extraterrestrial Sample Curation Facility for samples returned from solar system missions.

  8. The GLOBE Visualization Project: Using WWW in the Classroom.

    ERIC Educational Resources Information Center

    de La Beaujardiere, J-F; And Others

    1997-01-01

    Describes a World Wide Web-based, user-friendly, language-independent graphical user interface providing access to visualizations created for GLOBE (Global Learning and Observations to Benefit the Environment), a multinational program of education and science. (DDR)

  9. Generation of Combat Power by Insurgents: An Historical Analysis

    DTIC Science & Technology

    2013-06-13

    the concept of operations. Transportation incorporates military, commercial, and multinational assets. Transportation includes motor , rail, air...and water modes. Transportation nodes include motor , rail, air, and water terminal operations. Transportation also includes movement control and

  10. Multinational Experiment 7: Catalog of Products

    DTIC Science & Technology

    2013-07-08

    Organization (NATO) Allied Command Transformation (ACT), Netherlands (Observer), Norway, Poland , the Republic of Korea, Spain, Sweden, Switzerland, Turkey...Awareness. Noteworthy among the products, the Cross-Cultural Awareness concept, the anthropological study of Afghanistan, and a suite of training

  11. Cohesion in Multinational Military Units

    DTIC Science & Technology

    2010-12-10

    Assertiveness for Hofstede’s Masculinity dimension and added three dimensions: Humanistic , Performance, and Future Orientation. GLOBE researchers...values. It addresses the most profound existential issues of human life; e.g. freedom and inevitability, fear and faith, security and insecurity, right

  12. Impact on Employee Productivity From Presenteeism and Absenteeism: Evidence From a Multinational Firm in Sri Lanka.

    PubMed

    Fernando, Mario; Caputi, Peter; Ashbury, Fred

    2017-07-01

    This study examines the effects of 13 psychological and physical health conditions on work productivity. One hundred fifty-two staff at the headquarters of a Sri Lankan multinational firm completed a questionnaire asking whether they experienced 13 health conditions common in workplaces, and about their related absenteeism and presenteeism. Most respondents (85.5%) reported absenteeism, presenteeism, or both. Among those reporting a health condition, 57.6% reported losing days due to absenteeism, and 69.5% reported losing additional days to presenteeism. Among those caring for a sick adult or child, 57.3% reported losing days due to absenteeism, and 36.5% reported losing additional days due to presenteeism. Overall productivity loss was 10.43 days each year, 3.95% of employee capacity, equating to about Sri Lanka Rupees 8 million (US$54,421) for all headquarters employees. The health conditions' effects on productivity significantly increased employee costs.

  13. China: current trends in pharmaceutical drug discovery.

    PubMed

    Luo, Ying

    2008-04-01

    Pharmaceutical discovery and development is expensive and highly risky, even for multinational corporations. As a developing country with limited financial resources, China has been seeking the most cost-effective means to reach the same level of innovation and productivity as Western countries in the pharmaceutical industry sector. After more than 50 years of building up talent and experience, the time for China to become a powerhouse in pharmaceutical innovation is finally approaching. Returnee scientists to China are one of the reasons for the wave of new discovery and commercialization occurring within the country. The consolidation of local Chinese pharmaceutical companies and foreign investment is also providing an agreeable environment for the evolution of a new generation of biotechnology. The opportunity for pharmaceutical innovation is also being expedited by the entry of multinational companies into the Chinese pharmaceutical market, and by the outsourcing of research from these companies to China.

  14. The globalization of the arms industry: The next proliferation challenge

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Bitzinger, R.A.

    1994-12-31

    The globalization of the arms industry entails a significant shift away from traditional, single-country patterns of weapons production toward internationalization of the development, production, and marketing of arms. While wholly indigenous armaments production may be on the decline, multinational arms production - through collaboration on individual weapon systems and increasingly via interfirm linkages across the international arms industry - appears actually to be expanding. In several instances, in fact, multinational armaments production is increasingly supplementing or even supplanting indigenous or autonomous weapons production or arms imports. The emergence of an increasingly transnational defense technology and industrial base is fundamentally affectingmore » the shape and content of much of the global arms trade. This changing defense market, in turn, will have a profound impact on a number of national security issues concerning the Western industrialized nations. 3 figs., 2 tabs.« less

  15. Workplace violence investigations and activation of the threat management teams in a multinational corporation.

    PubMed

    Peek-Asa, Corinne; Casteel, Carri; Rugala, Eugene; Romano, Steve; Ramirez, Marizen

    2013-11-01

    We examined threat management investigations conducted by a large multinational company. The company provided a database, removing any identifiers, of investigations by the corporate Threat Management Teams in 2009 and 2010. Rates were calculated using worker population data. During the 2-year study period, the company investigated threat management cases at a rate of 13.9 per 10,000 employees per year. Cases that activated a Threat Management Team were more likely to lead to corrective action (odds ratio = 2.0; 95% confidence interval = 1.08 to 3.87) and referral to the Employee Assistance Program (odds ratio = 4.8; 95% confidence interval = 3.00 to 7.77), but were not related to likelihood of termination. When the multidisciplinary teams were involved, cases were more likely to result in some type of action but were not more likely to lead to termination.

  16. Medical support of the Sinai Multinational Force and Observers: an update, 2001.

    PubMed

    Rowe, John R

    2003-02-01

    The Multinational Force and Observers is an 11-nation coalition force with the mission of peacekeeping in the Sinai. It commenced operations in 1982 and continues today after two decades of successful enforcement of the 1979 Egyptian-Israeli Treaty of Peace. The fielding of a medical support team for this mission was the first effort of its kind for the U.S. Army Medical Department, resulting in a uniquely organized medical unit. A U.S. Army physician heads the medical team, which includes nine other physicians from six different countries. The team provides health care for the 2,500-person coalition in the remote Sinai desert. This writing compares earlier medical support with that of August 2000 through July 2001 and describes medical conditions and problems encountered during the 12-month tour of duty. This article updates two previous articles on the subject published in Military Medicine in 1983 and 1991.

  17. From public health to international law: possible protocols for inclusion in the Framework Convention on Tobacco Control.

    PubMed Central

    Joossens, L.

    2000-01-01

    Faced with a difficult business environment in the United States and the falling demand for cigarettes in industrialized countries, multinational tobacco companies have been competing fiercely to expand their sales in developing countries. Because of the worldwide threat posed by smoking to health and the emphasis being placed by international tobacco companies on marketing in developing countries, an international regulatory strategy, such as the WHO proposed Framework Convention on Tobacco Control, is needed. This review describes from a public health perspective the possible scope and key considerations of protocols that should be included in the convention. The key international areas that should be considered in tobacco control are: prices, smuggling; tax-free tobacco products; advertising and sponsorship; the Internet; testing methods; package design and labelling; agriculture; and information sharing. PMID:10994267

  18. Case Study of Engineering Risk in Automotive Industry

    NASA Astrophysics Data System (ADS)

    Popa, Dan Mihai

    2018-03-01

    The primary objective of this paper is to show where the engineering of risk management is placed and how its implementation has been tried in multinational companies in automotive industry from Romania. A large number of companies don't use a strategy to avoid the engineering risk in their design products. The main reason is not because these companies haven't heard about standards for risk management such as ISO 31000; the problem is that the business units which were summed up, have just set up a risk list at the beginning of the project, without any follow up. The purpose of this article is to create an implementation risk tracking in automotive industry companies in Romania, due to a change request from customers according to supply companies within the quality process, in the research and development phase.

  19. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Levien, Mary

    The Freight Shuttle System (FSS) is designed to provide freight transportation services between those short and intermediate distance locations (within 600 miles) that are currently handling large volumes of freight traffic. Much like trucks, the FSS's transporters are autonomous: each transporter has its own propulsion and travels independently of other transporters. Inspired by railroads, each FSS transporter has steel wheels operating on a steel running surface and can carry either a standardsize freight container or an over-the-road truck trailer. However, unlike either rail or trucks, the FSS runs on an elevated, dedicated guideway to avoid the interference of other transportationmore » systems. The objective of this report is to examine the potential viability for an alternative transportation system for trailers and containers in a multi-national, cross-border setting. The El Paso-Ciudad Juarez region serves as the environment of this analysis.« less

  20. Stress, coping and safety compliance in a multinational gold mining company.

    PubMed

    Jacobs, Melissa; Pienaar, Jacobus

    2017-06-01

    The primary objective of this study was to investigate the relationship of work stress, consisting of role stressors and job insecurity, with safety compliance at work. A secondary objective was to test for the possible moderating effect of individual employees' coping behaviour between experienced work stress and job insecurity, and their safety compliance. A cross-sectional survey design was used (n = 771). An electronic survey, with a biographical questionnaire and scales on role conflict, role ambiguity, role overload, job insecurity, coping and safety compliance at work, was administered. The results indicated that specific aspects of work stress, notably role conflict, role ambiguity and quantitative job insecurity, and of coping, namely an avoidance style and changing the situation, were important in understanding safety compliance. A moderating effect of avoidance coping was also found.

  1. Aperture Valve for the Mars Organic Molecule Analyzer (MOMA)

    NASA Technical Reports Server (NTRS)

    Engler, Charles; Canham, John

    2014-01-01

    NASA's participation in the multi-nation ExoMars 2018 Rover mission includes a critical astrobiology Mass Spectrometer Instrument on the Rover called the Mars Organic Molecule Analyzer (MOMA). The Aperture Valve is a critical electromechanical valve used by the Mass Spectrometer to facilitate the transfer of ions from Martian soil to the Mass Spectrometer for analysis. The MOMA Aperture Valve development program will be discussed in terms of the initial valve design and subsequent improvements that resulted from prototype testing. The initial Aperture Valve concept seemed promising, based on calculations and perceived merits. However, performance results of this design were disappointing, due to delamination of TiN and DLC coatings applied to the titanium base metals, causing debris from the coatings to seize the valve. While peer reviews and design trade studies are important forums to vet a concept design, results from testing should not be underestimated. Despite the lack of development progress to meet requirements, valuable information from weakness discovered in the initial Valve design was used to develop a second, more robust Aperture Valve. Based on a check-ball design, the ETU / flight valve design resulted in significantly less surface area to create the seal. Moreover, PVD coatings were eliminated in favor of hardened, non-magnetic corrosion resistant alloys. Test results were impressive, with the valve achieving five orders of magnitude better sealing leak rate over end of life requirements. Cycle life was equally impressive, achieving 280,000 cycles without failure.

  2. Aperture Valve for the Mars Organic Molecule Analyzer (MOMA)

    NASA Technical Reports Server (NTRS)

    Hakun, Claef F.; Engler, Charles D.; Barber, Willie E.; Canham, John S.

    2014-01-01

    NASA's participation in the multi-nation ExoMars 2018 Rover mission includes a critical astrobiology Mass Spectrometer Instrument on the Rover called the Mars Organic Molecule Analyzer (MOMA). The Aperture Valve is a critical electromechanical valve used by the Mass Spectrometer to facilitate the transfer of ions from Martian soil to the Mass Spectrometer for analysis. The MOMA Aperture Valve development program will be discussed in terms of the Initial valve design and subsequent improvements that resulted from prototype testing. The Initial Aperture Valve concept seemed promising, based on calculations and perceived merits. However, performance results of this design were disappointing, due to delamination of TiN and DLC coatings applied to the Titanium base metals, causing debris from the coatings to seize the valve. While peer reviews and design trade studies are important forums to vet a concept design, results from testing should not be underestimated.Despite the lack of development progress to meet requirements, valuable information from weakness discovered in the Initial Valve design was used to develop a second, more robust Aperture valve. Based on a check-ball design, the ETU flight valve design resulted in significantly less surface area to create the seal. Moreover, PVD coatings were eliminated in favor of hardened, nonmagnetic corrosion resistant alloys. Test results were impressive, with the valve achieving five orders of magnitude better sealing leak rate over end of life requirements. Cycle life was equally impressive, achieving 280,000 cycles without failure.

  3. Aperture Valve for the Mars Organic Molecule Analyzer (MOMA)

    NASA Technical Reports Server (NTRS)

    Engler, Charles D.; Canham, John S.

    2014-01-01

    NASA's participation in the multi-nation ExoMars 2018 Rover mission includes a critical astrobiology Mass Spectrometer Instrument on the Rover called the Mars Organic Molecule Analyzer (MOMA). The Aperture Valve is a critical electromechanical valve used by the Mass Spectrometer to facilitate the transfer of ions from Martian soil to the Mass Spectrometer for analysis. The MOMA Aperture Valve development program will be discussed in terms of the Initial valve design and subsequent improvements that resulted from prototype testing. The Initial Aperture Valve concept seemed promising, based on calculations and perceived merits. However, performance results of this design were disappointing, due to delamination of TiN and DLC coatings applied to the Titanium base metals, causing debris from the coatings to seize the valve. While peer reviews and design trade studies are important forums to vet a concept design, results from testing should not be underestimated. Despite the lack of development progress to meet requirements, valuable information from weakness discovered in the Initial Valve design was used to develop a second, more robust Aperture valve. Based on a check-ball design, the ETU /flight valve design resulted in significantly less surface area to create the seal. Moreover, PVD coatings were eliminated in favor of hardened, nonmagnetic corrosion resistant alloys. Test results were impressive, with the valve achieving five orders of magnitude better sealing leak rate over end of life requirements. Cycle life was equally impressive, achieving 280,000 cycles without failure.

  4. Overview of the trastuzumab (Herceptin) anti-HER2 monoclonal antibody clinical program in HER2-overexpressing metastatic breast cancer. Herceptin Multinational Investigator Study Group.

    PubMed

    Shak, S

    1999-08-01

    The recombinant humanized anti-HER2 monoclonal antibody trastuzumab (Herceptin; Genentech, San Francisco, CA) was evaluated in human clinical trials for treatment of women with metastatic breast cancer who have tumors that overexpress HER2. The trastuzumab clinical program consisted of a series of phase I, phase II, and phase III clinical trials. Clinical experience with this novel biologic has been obtained in more than 1,000 women with HER2-overexpressing metastatic breast cancer. Two pivotal trials were performed to evaluate trastuzumab efficacy and safety: (1) trastuzumab in combination with chemotherapy as first-line therapy and (2) trastuzumab as a single agent in second- and third-line chemotherapy. Preliminary results of the pivotal clinical trials that have been presented at national meetings are summarized below. The data suggest that trastuzumab will be an important new treatment option for women with HER2-overexpressing metastatic breast cancer.

  5. Ups and downs of the expatriate experience? Understanding work adjustment trajectories and career outcomes.

    PubMed

    Zhu, Jing; Wanberg, Connie R; Harrison, David A; Diehn, Erica W

    2016-04-01

    We examine changes in work adjustment among 179 expatriates from 3 multinational organizations from predeparture through the first 9 months of a new international assignment. Our 10-wave results challenge classic U-shaped theories of expatriate adjustment (e.g., Torbiorn, 1982). Consistent with uncertainty reduction theory, our results instead suggest that expatriates typically experience a gradual increase in work adjustment over time. Two resources that expatriates bring to their assignments (previous culture-specific work experience and core self-evaluations) moderate the trajectory of work adjustment. Trajectory of adjustment predicts Month 9 career instrumentality and turnover intention, as well as career advancement (job promotion) 1.5 years further. Implications for theory, as well as for changes in expatriate management practices, are discussed. (c) 2016 APA, all rights reserved).

  6. Results from a large multinational clinical trial (guardian™1) using prophylactic treatment with turoctocog alfa in adolescent and adult patients with severe haemophilia A: safety and efficacy.

    PubMed

    Lentz, S R; Misgav, M; Ozelo, M; Salek, S Z; Veljkovic, D; Recht, M; Cerqueira, M; Tiede, A; Brand, B; Mancuso, M E; Seremetis, S; Lindblom, A; Martinowitz, U

    2013-09-01

    Recombinant factor VIII (rFVIII) products provide a safe and efficacious replacement therapy for prophylaxis and treatment of bleeding episodes in patients with severe haemophilia A. This multinational, open-label, non-controlled trial investigated the safety and efficacy of turoctocog alfa, a new rFVIII product. The primary objective was to evaluate safety. A total of 150 patients (24 adolescents and 126 adults) with severe haemophilia A (FVIII activity ≤ 1%), with at least 150 exposure days (EDs) to any FVIII product and no history of inhibitors were enrolled, and 146 patients (97%) completed the trial. All patients received prophylaxis with turoctocog alfa for approximately 6 months and had a mean of 85 EDs during the trial. None of the patients developed FVIII inhibitors, there were no indications of early FVIII inhibitor development and no safety concerns were identified. A total of 225 adverse events were reported in 100 (67%) patients, with the most common being events associated with dosing procedures, headaches, and nasopharyngitis. A total of 499 bleeding episodes were reported during the trial, the majority (89%) were controlled with 1-2 infusions of turoctocog alfa. Based on patient reports, the success rate (defined as 'excellent' or 'good' haemostatic response) for treatment of bleeding episodes was 81%. The overall median annualized bleeding rate was 3.7 (interquartile range: 8.7) bleeds/patient/year. In conclusion, turoctocog alfa provides a new, safe and effective alternative for prophylaxis and treatment of bleeding episodes in patients with haemophilia A. © 2013 John Wiley & Sons Ltd.

  7. Incidence, Duration, Persistence, and Factors Associated With High-risk Anal Human Papillomavirus Persistence Among HIV-negative Men Who Have Sex With Men: A Multinational Study

    PubMed Central

    Nyitray, Alan G.; Carvalho da Silva, Roberto J.; Chang, Mihyun; Baggio, Maria Luiza; Ingles, Donna J.; Abrahamsen, Martha; Papenfuss, Mary; Lin, Hui-Yi; Salmerón, Jorge; Quiterio, Manuel; Lazcano-Ponce, Eduardo; Villa, Luisa L.; Giuliano, Anna R.

    2016-01-01

    Background. Given high rates of anal disease, we investigated the natural history of high-risk anal human papillomavirus (HPV) among a multinational group of men who have sex with men (MSM) aged 18–64 years. Methods. Anal specimens from human immunodeficiency virus–negative men from Brazil, Mexico, and the United States were genotyped. Over 2 years, 406 MSM provided evaluable specimens every 6 months for ≥2 visits. These men were stratified into men who have sex only with men (MSOM, n = 70) and men who have sex with women and men (MSWM, n = 336). Persistence was defined as ≥12 months’ type-specific duration and could begin with either a prevalent or incident infection. Prevalence ratios and 95% confidence intervals were calculated by Poisson regression. Results. Median follow-up time was 2.1 years. Retention was 82%. Annual cumulative incidence of 9-valent vaccine types was 19% and 8% among MSOM and MSWM, respectively (log-rank P = .02). Duration of anal HPV did not differ for MSOM and MSWM and was a median of 6.9 months for HPV-16 after combining men from the 2 groups. Among men with prevalent high-risk infection (n = 106), a total of 36.8%, retained the infection for at least 24 months. For those with prevalent HPV-16 (n = 27), 29.6% were persistent for at least 24 months. Persistence of high-risk HPV was associated with number of male anal sex partners and inversely associated with number of female sex partners. Conclusions. MSM with prevalent high-risk HPV infection should be considered at increased risk for nontransient infection. PMID:26962079

  8. The great transition.

    PubMed

    Lieberthal, Kenneth; Lieberthal, Geoffrey

    2003-10-01

    As China's economy grows and opens further, the opportunity it presents to multinationals is changing. Foreign companies are moving to country development and new strategic choices. Now, foreign firms can actually go after the Chinese domestic market, and it's worth going after. Improvements in China's infrastructure, workforce, and regulatory environment are making it possible for companies to lower their costs to reap new competitive advantages. Multifaceted and often-shifting risks accompany this shifting opportunity. The reforms required for admission into the WTO will be politically difficult for China to implement, and its progress will be slowed by the scarcity of resources for the country's shaky banking system, the inadequacy of the social safety net, environmental problems, and local governments' cash shortage. China's breathtaking 9% average annual GDP growth rests on an unsteady foundation of overcapitalized state-owned enterprises, which have oversupplied many markets, and fiercely protectionist regional government officials pursuing growth-at-almost-all-costs policies. Frequent changes in regulations, bureaucracies, and reporting relationships will continue to make planning difficult, and, as the SARS epidemic demonstrated, there is always the potential for serious disruptions. But for at least the next ten years, multinationals should be the biggest winners in China. To reap the benefits, a multinational must properly nest its effort into its overall organization, show "one face to China" at the national level but also tailor local strategies, be wary of joint ventures, and mitigate risk, in particular the theft of intellectual property. China is a major opportunity for companies that forthrightly face its complexities. It will remain largely inscrutable--and unprofitable--for the rest.

  9. Job strain among Malaysian office workers of a multinational company.

    PubMed

    Maizura, H; Retneswari, M; Moe, H; Hoe, V C W; Bulgiba, A

    2010-05-01

    Information on job strain exposure among Malaysian workers in multinational companies is limited. To investigate the prevalence and factors associated with high job strain among office workers of a multinational company in Malaysia. A cross-sectional study was conducted in November 2007 among 470 eligible workers. Respondents self-administered the Job Content Questionnaire downloaded from the company's intranet. A median-split procedure was applied to create four groups according to the Job Demand-Control Model: active, passive, high and low job strain. Logistic regression models were used to investigate the associations between socio-demographic, occupational and psychosocial factors and high job strain. A total of 356 questionnaires were received (response rate 76%). Twenty-one per cent of respondents were in the high job strain group, 35% were in the passive group, whereas 26% and 17% of workers were in the low strain and active groups, respectively. After controlling for confounders, three factors were found to be associated with high job strain: male workers (adjusted OR 1.94, 95% CI 1.04-3.64), working >48 h per week (adjusted OR 2.51, 95% CI 1.44-4.39) and job insecurity (adjusted OR 1.14, 95% CI 1.02-1.27). One protective factor for high job strain was the scale 'created skill', which is part of skill discretion (adjusted OR 0.70, 95% CI 0.57-0.86). About one in five workers in this study experience high job strain. Work improvement measures include reducing long working hours and job insecurity and giving workers the opportunity to learn, use creativity and develop abilities.

  10. Multinational trials-recommendations on the translations required, approaches to using the same language in different countries, and the approaches to support pooling the data: the ISPOR Patient-Reported Outcomes Translation and Linguistic Validation Good Research Practices Task Force report.

    PubMed

    Wild, Diane; Eremenco, Sonya; Mear, Isabelle; Martin, Mona; Houchin, Caroline; Gawlicki, Mary; Hareendran, Asha; Wiklund, Ingela; Chong, Lee Yee; von Maltzahn, Robyn; Cohen, Lawrence; Molsen, Elizabeth

    2009-06-01

    With the internationalization of clinical trial programs, there is an increased need to translate and culturally adapt patient-reported outcome (PRO) measures. Although guidelines for good practices in translation and linguistic validation are available, the ISPOR Patient-Reported Outcomes Translation and Linguistic Validation Task Force identified a number of areas where they felt that further discussion around methods and best practices would be beneficial. The areas identified by the team were as follows: 1) the selection of the languages required for multinational trials; 2) the approaches suggested when the same language is required across two or more countries; and 3) the assessment of measurement equivalence to support the aggregation of data from different countries. The task force addressed these three areas, reviewed the available literature, and had multiple discussions to develop this report. Decision aid tools have also been developed and presented for the selection of languages and the approaches suggested for the use of the same language in different countries. It is hoped that this report and the decision tools proposed will assist those involved with multinational trials to 1) decide on the translations required for each country; 2) choose the approach to use when the same language is spoken in more than one country; and 3) choose methods to gather evidence to support the pooling of data collected using different language versions of the same tool.

  11. Multinational evidence-based recommendations for the diagnosis and management of gout: integrating systematic literature review and expert opinion of a broad panel of rheumatologists in the 3e initiative

    PubMed Central

    Sivera, Francisca; Andrés, Mariano; Carmona, Loreto; Kydd, Alison S R; Moi, John; Seth, Rakhi; Sriranganathan, Melonie; van Durme, Caroline; van Echteld, Irene; Vinik, Ophir; Wechalekar, Mihir D; Aletaha, Daniel; Bombardier, Claire; Buchbinder, Rachelle; Edwards, Christopher J; Landewé, Robert B; Bijlsma, Johannes W; Branco, Jaime C; Burgos-Vargas, Rubén; Catrina, Anca I; Elewaut, Dirk; Ferrari, Antonio J L; Kiely, Patrick; Leeb, Burkhard F; Montecucco, Carlomaurizio; Müller-Ladner, Ulf; Østergaard, Mikkel; Zochling, Jane; Falzon, Louise; van der Heijde, Désirée M

    2014-01-01

    We aimed to develop evidence-based multinational recommendations for the diagnosis and management of gout. Using a formal voting process, a panel of 78 international rheumatologists developed 10 key clinical questions pertinent to the diagnosis and management of gout. Each question was investigated with a systematic literature review. Medline, Embase, Cochrane CENTRAL and abstracts from 2010–2011 European League Against Rheumatism and American College of Rheumatology meetings were searched in each review. Relevant studies were independently reviewed by two individuals for data extraction and synthesis and risk of bias assessment. Using this evidence, rheumatologists from 14 countries (Europe, South America and Australasia) developed national recommendations. After rounds of discussion and voting, multinational recommendations were formulated. Each recommendation was graded according to the level of evidence. Agreement and potential impact on clinical practice were assessed. Combining evidence and clinical expertise, 10 recommendations were produced. One recommendation referred to the diagnosis of gout, two referred to cardiovascular and renal comorbidities, six focused on different aspects of the management of gout (including drug treatment and monitoring), and the last recommendation referred to the management of asymptomatic hyperuricaemia. The level of agreement with the recommendations ranged from 8.1 to 9.2 (mean 8.7) on a 1–10 scale, with 10 representing full agreement. Ten recommendations on the diagnosis and management of gout were established. They are evidence-based and supported by a large panel of rheumatologists from 14 countries, enhancing their utility in clinical practice. PMID:23868909

  12. Multinational evidence-based recommendations on how to investigate and follow-up undifferentiated peripheral inflammatory arthritis: integrating systematic literature research and expert opinion of a broad international panel of rheumatologists in the 3E Initiative.

    PubMed

    Machado, P; Castrejon, I; Katchamart, W; Koevoets, R; Kuriya, B; Schoels, M; Silva-Fernández, L; Thevissen, K; Vercoutere, W; Villeneuve, E; Aletaha, D; Carmona, L; Landewé, R; van der Heijde, D; Bijlsma, J W J; Bykerk, V; Canhão, H; Catrina, A I; Durez, P; Edwards, C J; Mjaavatten, M D; Leeb, B F; Losada, B; Martín-Mola, E M; Martinez-Osuna, P; Montecucco, C; Müller-Ladner, U; Østergaard, M; Sheane, B; Xavier, R M; Zochling, J; Bombardier, C

    2011-01-01

    To develop evidence-based recommendations on how to investigate and follow-up undifferentiated peripheral inflammatory arthritis (UPIA). 697 rheumatologists from 17 countries participated in the 3E (Evidence, Expertise, Exchange) Initiative of 2008-9 consisting of three separate rounds of discussions and modified Delphi votes. In the first round 10 clinical questions were selected. A bibliographic team systematically searched Medline, Embase, the Cochrane Library and ACR/EULAR 2007-2008 meeting abstracts. Relevant articles were reviewed for quality assessment, data extraction and synthesis. In the second round each country elaborated a set of national recommendations. Finally, multinational recommendations were formulated and agreement among the participants and the potential impact on their clinical practice was assessed. A total of 39,756 references were identified, of which 250 were systematically reviewed. Ten multinational key recommendations about the investigation and follow-up of UPIA were formulated. One recommendation addressed differential diagnosis and investigations prior to establishing the operational diagnosis of UPIA, seven recommendations related to the diagnostic and prognostic value of clinical and laboratory assessments in established UPIA (history and physical examination, acute phase reactants, autoantibodies, radiographs, MRI and ultrasound, genetic markers and synovial biopsy), one recommendation highlighted predictors of persistence (chronicity) and the final recommendation addressed monitoring of clinical disease activity in UPIA. Ten recommendations on how to investigate and follow-up UPIA in the clinical setting were developed. They are evidence-based and supported by a large panel of rheumatologists, thus enhancing their validity and practical use.

  13. Seven Programs for Seven Countries

    ERIC Educational Resources Information Center

    Otte, Max R.

    1975-01-01

    Programs from abroad represented at the January, 1975 Multinational Workshop on Adult Education (Washington, D. C.) included: Rural Reconstruction Movement (Philippines); Nonformal Education for Rural Women (Andhra Pradesh, India); Accion Cultural Popular (Colombia); Village Polytechnic Centers (Kenya); CONCORDE (Honduras); National Adult…

  14. 10 CFR 1050.103 - Definitions.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... government means: (1) Any unit of foreign governmental authority, including any foreign national, State, local, or municipal government; (2) Any international or multinational organization whose membership is... of an organization performing services under such section, any individual involved in the performance...

  15. Adult Education through World Collaboration.

    ERIC Educational Resources Information Center

    Cassara, Beverly Benner, Ed.

    This book contains the following papers about development/delivery of adult education through the efforts of multinational and bilateral government donors and the International Council for Adult Education (ICAE): "Preface" (Beverly Benner Cassara); "Introduction: Adult Education and Democracy" (Francisco Vio Grossi);…

  16. Global Public Leadership in a Technological Era

    ERIC Educational Resources Information Center

    Masciulli, Joseph

    2011-01-01

    Good (ethical and effective) global public leadership--by national politicians, intergovernmental and nongovernmental international organizational leaders, multinational corporate leaders, and technoscientists--will make a significant positive difference in our global system's capacity to solve contemporary and futuristic global problems. High…

  17. Space transportation alternatives for large space programs - The International Space University summer session - 1992

    NASA Technical Reports Server (NTRS)

    Palaszewski, Bryan

    1993-01-01

    The issues discussed in this paper are the result of a 10-week study by the Space Solar Power Program design project members and the Space Transportation Group at the International Space University (ISU) summer session of 1992 to investigate new paradigms in space propulsion and how those paradigms might reduce the costs for large space programs. The program plan was to place a series of power satellites in Earth orbit. Several designs were studied where many kW, MW or GW of power would be transmitted to Earth or to other spacecraft in orbit. During the summer session, a space solar power system was also detailed and analyzed. At ISU, the focus of the study was to foster and develop some of the new paradigms that may eliminate the barriers to low cost for space exploration and exploitation. Many international and technical aspects of a large multinational program were studied. Environmental safety, space construction and maintenance, legal and policy issues of frequency allocation, technology transfer and control and many other areas were addressed.

  18. Integrated Millimeter-Wave Frequency Multiplers

    NASA Astrophysics Data System (ADS)

    Schoenthal, Gerhard S.; Deaver, B. S.; Crowe, T. W.; Bishop, W. L.; Saini, K.; Bradley, R. F.

    2001-11-01

    Many of the molecules of interest to radio astronomers and atmospheric chemists resonate at frequencies in the millimeter and submillimeter wavelength bands. To measure the spectra of these molecules scientists rely on heterodyne receivers that convert the high frequency signal to the GHz band where it is readily amplified and analyzed. One of the challenges of developing suitable receiver systems is the development of compact, reliable and affordable sources of local oscillator power at frequencies in excess of 100 GHz. One useful solution is to use GaAs Schottky diodes, in their varactor mode, to generate high frequency harmonics of lower frequency sources such as Gunn oscillators. As a part of a multi-national radio astronomy project, the Atacama Millimeter Large Array (ALMA), we have designed and fabricated a broadband frequency tripler with an output centered at 240 GHz. It is integrated on a quartz substrate to greatly reduce the parasitic capacitance and thereby improve electrical performance. The integrated circuit was designed to require no oxides or ohmic contacts, thereby easing fabrication. This talk will discuss the novel millimeter-wave integrated circuit fabrication process and the initial results.

  19. Is EQ-5D-5L Better Than EQ-5D-3L? A Head-to-Head Comparison of Descriptive Systems and Value Sets from Seven Countries.

    PubMed

    Janssen, Mathieu F; Bonsel, Gouke J; Luo, Nan

    2018-06-01

    This study describes the first empirical head-to-head comparison of EQ-5D-3L (3L) and EQ-5D-5L (5L) value sets for multiple countries. A large multinational dataset, including 3L and 5L data for eight patient groups and a student cohort, was used to compare 3L versus 5L value sets for Canada, China, England/UK (5L/3L, respectively), Japan, The Netherlands, South Korea and Spain. We used distributional analyses and two methods exploring discriminatory power: relative efficiency as assessed by the F statistic, and an area under the curve for the receiver-operating characteristics approach. Differences in outcomes were explored by separating descriptive system effects from valuation effects, and by exploring distributional location effects. In terms of distributional evenness, efficiency of scale use and the face validity of the resulting distributions, 5L was superior, leading to an increase in sensitivity and precision in health status measurement. When compared with 5L, 3L systematically overestimated health problems and consequently underestimated utilities. This led to bias, i.e. over- or underestimations of discriminatory power. We conclude that 5L provides more precise measurement at individual and group levels, both in terms of descriptive system data and utilities. The increased sensitivity and precision of 5L is likely to be generalisable to longitudinal studies, such as in intervention designs. Hence, we recommend the use of the 5L across applications, including economic evaluation, clinical and public health studies. The evaluative framework proved to be useful in assessing preference-based instruments and might be useful for future work in the development of descriptive systems or health classifications.

  20. Real-world geographic variations in the use of cardiac implantable electronic devices - The PANORAMA 2 observational cohort study.

    PubMed

    Bastian, Dirk; Ebrahim, Iftikhar O; Chen, Ju-Yi; Chen, Mien-Cheng; Huang, Dejia; Huang, Jin-Long; Kuznetsov, Vadim A; Maus, Bärbel; Naik, Ajay M; Verhees, Koen J P; Fagih, Ahmed R Al

    2018-06-13

    Currently, several geographies around the world remain underrepresented in medical device trials. The PANORAMA 2 study was designed to assess contemporary region-specific differences in clinical practice patterns of patients with cardiac implantable electronic devices (CIEDs). In this prospective, multicenter, observational, multi-national study, baseline and implant data of 4,706 patients receiving Medtronic CIEDs (either de novo device implants, replacements, or upgrades) were analyzed, consisting of: 54% implantable pulse generators (IPGs), 20.3% implantable cardiac defibrillators (ICDs), 15% cardiac resynchronization therapy defibrillators (CRT-Ds), 5.1% cardiac resynchronization therapy pacemakers (CRT-Ps), from 117 hospitals in 23 countries across 4 geographical regions between 2012 and 2016. For all device types, in all regions, there were less females than males enrolled, and women were less likely to have ischemic cardiomyopathy. Implant procedure duration differed significantly across the geographies for all device types. Subjects from emerging countries, women and older patients were less likely to receive a magnetic resonance imaging (MRI)-compatible device. Defibrillation testing differed significantly between the regions. European patients had the highest rates of atrial fibrillation (AF), and the lowest number of implanted single-chamber IPGs. Evaluation of stroke history suggested that the general embolic risk is more strongly associated with stroke than AF. We provide comprehensive descriptive data on patients receiving Medtronic CIEDs from several geographies, some of which are understudied in randomized controlled trials (RCTs). We found significant variations in patient characteristics. Several medical decisions appear to be affected by socioeconomic factors. Long-term follow-up data will help evaluate if these variations require adjustments to outcome expectations. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  1. The Neurologic Assessment in Neuro-Oncology (NANO) scale: a tool to assess neurologic function for integration into the Response Assessment in Neuro-Oncology (RANO) criteria

    PubMed Central

    DeAngelis, Lisa M.; Brandes, Alba A.; Peereboom, David M.; Galanis, Evanthia; Lin, Nancy U.; Soffietti, Riccardo; Macdonald, David R.; Chamberlain, Marc; Perry, James; Jaeckle, Kurt; Mehta, Minesh; Stupp, Roger; Muzikansky, Alona; Pentsova, Elena; Cloughesy, Timothy; Iwamoto, Fabio M.; Tonn, Joerg-Christian; Vogelbaum, Michael A.; Wen, Patrick Y.; van den Bent, Martin J.; Reardon, David A.

    2017-01-01

    Abstract Background. The Macdonald criteria and the Response Assessment in Neuro-Oncology (RANO) criteria define radiologic parameters to classify therapeutic outcome among patients with malignant glioma and specify that clinical status must be incorporated and prioritized for overall assessment. But neither provides specific parameters to do so. We hypothesized that a standardized metric to measure neurologic function will permit more effective overall response assessment in neuro-oncology. Methods. An international group of physicians including neurologists, medical oncologists, radiation oncologists, and neurosurgeons with expertise in neuro-oncology drafted the Neurologic Assessment in Neuro-Oncology (NANO) scale as an objective and quantifiable metric of neurologic function evaluable during a routine office examination. The scale was subsequently tested in a multicenter study to determine its overall reliability, inter-observer variability, and feasibility. Results. The NANO scale is a quantifiable evaluation of 9 relevant neurologic domains based on direct observation and testing conducted during routine office visits. The score defines overall response criteria. A prospective, multinational study noted a >90% inter-observer agreement rate with kappa statistic ranging from 0.35 to 0.83 (fair to almost perfect agreement), and a median assessment time of 4 minutes (interquartile range, 3–5). Conclusion. The NANO scale provides an objective clinician-reported outcome of neurologic function with high inter-observer agreement. It is designed to combine with radiographic assessment to provide an overall assessment of outcome for neuro-oncology patients in clinical trials and in daily practice. Furthermore, it complements existing patient-reported outcomes and cognition testing to combine for a global clinical outcome assessment of well-being among brain tumor patients. PMID:28453751

  2. Maximizing transportation efficiencies and economic impact of the Southwest Missouri foreign-trade zone.

    DOT National Transportation Integrated Search

    2013-07-01

    Overview of Foreign-Trade Zones (FTZ or Zone) and their impact on economic development, goods : movement jobs creation and retention. Zones provide a competitive advantage for multi-national : manufacturing and distribution firms resulting in the ret...

  3. Free Trade: A Misnomer?

    ERIC Educational Resources Information Center

    McMillan, Robert R.

    1983-01-01

    Billions of dollars are lost each year in our balance of payments because U.S. multinationals have not entered foreign markets due to trade restrictions and restrictions on the remittance of profits and royalties. Formal and informal government obstructions to free trade are examined. (RM)

  4. Democracy and "Grand" Corruption.

    ERIC Educational Resources Information Center

    Rose-Ackerman, Susan

    1996-01-01

    Defines "grand" corruption as that occurring at the higher levels of a political system and involving large sums of money. Discusses the impact and incentives for this level of corruption as well as various government responses. Identifies multinational corporations as the major malefactors. (MJP)

  5. Information Systems and Development in the Third World.

    ERIC Educational Resources Information Center

    Heitzman, James

    1990-01-01

    Discussion of the relationship between information and development in Third World countries highlights information systems development in four South Asian nations: India, Pakistan, Sri Lanka, and Bangladesh. The impact of microelectronics technology, development theories, multinational corporations, international information agencies, and…

  6. Beyond Robotics

    ERIC Educational Resources Information Center

    Tally, Beth; Laverdure, Nate

    2006-01-01

    Chantilly High School Academy Robotics Team Number 612 from Chantilly, Virginia, is an award-winning team of high school students actively involved with FIRST (For Inspiration and Recognition of Science and Technology), a multinational nonprofit organization that inspires students to transform culture--making science, math, engineering and…

  7. Western Hemisphere Defense Policy Statement

    DTIC Science & Technology

    2012-10-01

    El Salvador , Guatemala, Honduras, Paraguay, Peru and Uruguay have contributed to or led multi-national security operations and United Nations (UN...critical support during the initial stages of the Haiti earthquake relief effort. As military forces often have a unique capability to respond

  8. Organisational Learning: A New Perspective.

    ERIC Educational Resources Information Center

    O'Keefe, Ted

    2002-01-01

    A study of Irish multinational companies identified antecedents to organizational learning: nature of global business, anthropomorphism, dissatisfaction with traditional paradigms, customer-responsive culture, and intellectual capital. The path to the learning organization builds on these antecedents in an environment of innovation focused on…

  9. Pretreatment HIV Drug Resistance and HIV-1 Subtype C Are Independently Associated With Virologic Failure: Results From the Multinational PEARLS (ACTG A5175) Clinical Trial.

    PubMed

    Kantor, Rami; Smeaton, Laura; Vardhanabhuti, Saran; Hudelson, Sarah E; Wallis, Carol L; Tripathy, Srikanth; Morgado, Mariza G; Saravanan, Shanmugham; Balakrishnan, Pachamuthu; Reitsma, Marissa; Hart, Stephen; Mellors, John W; Halvas, Elias; Grinsztejn, Beatriz; Hosseinipour, Mina C; Kumwenda, Johnstone; La Rosa, Alberto; Lalloo, Umesh G; Lama, Javier R; Rassool, Mohammed; Santos, Breno R; Supparatpinyo, Khuanchai; Hakim, James; Flanigan, Timothy; Kumarasamy, Nagalingeswaran; Campbell, Thomas B; Eshleman, Susan H

    2015-05-15

    Evaluation of pretreatment HIV genotyping is needed globally to guide treatment programs. We examined the association of pretreatment (baseline) drug resistance and subtype with virologic failure in a multinational, randomized clinical trial that evaluated 3 antiretroviral treatment (ART) regimens and included resource-limited setting sites. Pol genotyping was performed in a nested case-cohort study including 270 randomly sampled participants (subcohort), and 218 additional participants failing ART (case group). Failure was defined as confirmed viral load (VL) >1000 copies/mL. Cox proportional hazards models estimated resistance-failure association. In the representative subcohort (261/270 participants with genotypes; 44% women; median age, 35 years; median CD4 cell count, 151 cells/µL; median VL, 5.0 log10 copies/mL; 58% non-B subtypes), baseline resistance occurred in 4.2%, evenly distributed among treatment arms and subtypes. In the subcohort and case groups combined (466/488 participants with genotypes), used to examine the association between resistance and treatment failure, baseline resistance occurred in 7.1% (9.4% with failure, 4.3% without). Baseline resistance was significantly associated with shorter time to virologic failure (hazard ratio [HR], 2.03; P = .035), and after adjusting for sex, treatment arm, sex-treatment arm interaction, pretreatment CD4 cell count, baseline VL, and subtype, was still independently associated (HR, 2.1; P = .05). Compared with subtype B, subtype C infection was associated with higher failure risk (HR, 1.57; 95% confidence interval [CI], 1.04-2.35), whereas non-B/C subtype infection was associated with longer time to failure (HR, 0.47; 95% CI, .22-.98). In this global clinical trial, pretreatment resistance and HIV-1 subtype were independently associated with virologic failure. Pretreatment genotyping should be considered whenever feasible. NCT00084136. © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  10. Technology Transfer: A Third World Perspective.

    ERIC Educational Resources Information Center

    Akubue, Anthony I.

    2002-01-01

    Technology transfer models are based on assumptions that do not reflect Third-World realities. Obstacles to building indigenous technology capacity include multinational corporations' control of innovations, strings attached to foreign aid, and indigenous reluctance to undertake research. Four areas of development include foreign direct…

  11. Global Personality Norms: Multicultural, Multinational, and Managerial

    ERIC Educational Resources Information Center

    Oswald, Frederick L.

    2008-01-01

    The critical importance of understanding, selecting, and developing global management talent--management operating within internationally diverse interpersonal and situational contexts--has emerged from the increasing globalization of business and the concomitant high rates of immigration, emigration, and expatriation. With an awareness of this…

  12. 22 CFR 3.3 - Definitions.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... governmental authority, including any foreign national, State, local, or municipal government; (2) any international or multinational organization whose membership is composed of any unit of foreign government as... organization, while acting as such; (c) Gift means a tangible or intangible present (other than a decoration...

  13. Restorers of Hope: Shaping Conditions for Success Against Al-Qaeda’s Regional Insurgency

    DTIC Science & Technology

    2003-01-01

    government of Afghanistan in their most important projects, including building the Teachers Training College, the Artificial Insemination Farm, and the...West; multinational corporations; international communications and data exchange systems; international news agencies and satellite media channels; and

  14. Integrating International Business Law Concepts into a High School Business Law Course.

    ERIC Educational Resources Information Center

    Golden, Cathleen J.; McDonald, Michael L.

    1998-01-01

    Outlines international business content for a high school business law curriculum: history of international business law, World Trade Organization, international disputes, contracts and sales, financing/banking, currency, taxation, intellectual property, transportation, and multinational corporations. Considers whether to teach international…

  15. International Universities: Misunderstandings and Emerging Models?

    ERIC Educational Resources Information Center

    Knight, Jane

    2015-01-01

    Internationalization has transformed higher education institutions and systems but there is much confusion as to what an international, binational, transnational, cosmopolitan, multinational, or global university actually means. There is no standardized model for an international university, nor should there be, but a deeper understanding of…

  16. International Issues in Education

    ERIC Educational Resources Information Center

    Ruggeri, Kai; Diaz, Carmen; Kelley, Karl; Papousek, Ilona; Dempster, Martin; Hanna, Donncha

    2008-01-01

    Anxiety, negative attitudes, and attrition are all issues presented in the teaching of statistics to undergraduates in research-based degrees regardless of location. Previous works have looked at these obstacles, but none have consolidated a multilingual, multinational effort using a consistent method. Over 400 Spanish-, English-, and…

  17. Maritime Tactical Command and Control Analysis of Alternatives

    DTIC Science & Technology

    2016-01-01

    JIIM joint, interagency, intergovernmental, and multinational LCC life-cycle cost MANA Map Aware Non-Uniform Automata MDA milestone decision authority...Map Aware Non-Uniform Automata (MANA), a combat and C4I, surveillance, and reconnaissance model developed by the New Zealand Defence Technology

  18. Evolving Service Poles in Presence Missions.

    DTIC Science & Technology

    1995-08-01

    were trained, equipped, deployed and re-deployed t-.hrough FMF; e.g., Morocco in Somalia and S*n* ga , Nigeria, Ghana, Siarra Leone. Uganda, and TanzarH...Mongolia, Nopal , and Bangladesh, military outraach programs, including parsonnsl exchanges and multinational conferences, provide some of our basic

  19. Interpersonal Privacy Management in Distributed Collaboration: Situational Characteristics and Interpretive Influences

    NASA Astrophysics Data System (ADS)

    Patil, Sameer; Kobsa, Alfred; John, Ajita; Brotman, Lynne S.; Seligmann, Doree

    To understand how collaborators reconcile the often conflicting needs of awareness and privacy, we studied a large software development project in a multinational corporation involving individuals at sites in the U.S. and India. We present a theoretical framework describing privacy management practices and their determinants that emerged from field visits, interviews, and questionnaire responses. The framework identifies five relevant situational characteristics: issue(s) under consideration, physical place(s) involved in interaction(s), temporal aspects, affordances and limitations presented by technology, and nature of relationships among parties. Each actor, in turn, interprets the situation based on several simultaneous influences: self, team, work site, organization, and cultural environment. This interpretation guides privacy management action(s). Past actions form a feedback loop refining and/or reinforcing the interpretive influences. The framework suggests that effective support for privacy management will require that designers follow a socio-technical approach incorporating a wider scope of situational and interpretive differences.

  20. SOBA: sequence ontology bioinformatics analysis.

    PubMed

    Moore, Barry; Fan, Guozhen; Eilbeck, Karen

    2010-07-01

    The advent of cheaper, faster sequencing technologies has pushed the task of sequence annotation from the exclusive domain of large-scale multi-national sequencing projects to that of research laboratories and small consortia. The bioinformatics burden placed on these laboratories, some with very little programming experience can be daunting. Fortunately, there exist software libraries and pipelines designed with these groups in mind, to ease the transition from an assembled genome to an annotated and accessible genome resource. We have developed the Sequence Ontology Bioinformatics Analysis (SOBA) tool to provide a simple statistical and graphical summary of an annotated genome. We envisage its use during annotation jamborees, genome comparison and for use by developers for rapid feedback during annotation software development and testing. SOBA also provides annotation consistency feedback to ensure correct use of terminology within annotations, and guides users to add new terms to the Sequence Ontology when required. SOBA is available at http://www.sequenceontology.org/cgi-bin/soba.cgi.

  1. Project Adopsys as an example of international collaboration in the field of photonics

    NASA Astrophysics Data System (ADS)

    Zoric, Nenad; Livshits, Irina; Urbach, Paul

    2015-01-01

    Tendencies of international cooperation in engineering education became very visible during recent years. We demonstrate this statement on one currently running EU project ADOPSYS in the field of optical design, which is an important part of engineering education in photonics. This example shows the importance of the input from different countries and organizations - both from industry and academia. Seven universities and eight optical companies are involved in the project ADOPSYS. Sharing experience of Academia education activity we provide new international type of education "free-of borders". We are going to discuss the key enable technology - PHOTONICS, which is widely used in modern society. Engineering science became very international. For communicating between people from different countries the English language is now used almost exclusively. For a fruitful collaboration between people from different nations, in multi-national projects, tolerance and respect are required between people of different political, cultural, educational backgrounds.

  2. Compact earth stations, hubs for energy industry expanding

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Shimabukuro, T.

    1992-02-01

    That paper reports that advances in gallium arsenide (GaAs) technology, monolithic microwave integrated circuits (MMIC) and large scale integrated (VLSF) circuits, have contributed to the mass production of very reliable small aperture terminals (VSATs). Less publicized, but equally important to multinational energy organizations, are recent developments in compact earth station design and solid-state hubs for VSAT networks made possible by the new technology. Many applications are suited for the energy industry that involve compact earth station terminals and hubs. The first group of applications describes the use of GTE's ACES earth station for the Zaire Gulf Oil Co. in Zairemore » and for AMOCO in Trinidad. The second group of applications describes the compact hub for VSAT networks, which could potentially have a number of data communication uses in the energy industry, such as, IBM/SNA, X.25, or supervisory control an data acquisition (SCADA) applications.« less

  3. Global river flood hazard maps: hydraulic modelling methods and appropriate uses

    NASA Astrophysics Data System (ADS)

    Townend, Samuel; Smith, Helen; Molloy, James

    2014-05-01

    Flood hazard is not well understood or documented in many parts of the world. Consequently, the (re-)insurance sector now needs to better understand where the potential for considerable river flooding aligns with significant exposure. For example, international manufacturing companies are often attracted to countries with emerging economies, meaning that events such as the 2011 Thailand floods have resulted in many multinational businesses with assets in these regions incurring large, unexpected losses. This contribution addresses and critically evaluates the hydraulic methods employed to develop a consistent global scale set of river flood hazard maps, used to fill the knowledge gap outlined above. The basis of the modelling approach is an innovative, bespoke 1D/2D hydraulic model (RFlow) which has been used to model a global river network of over 5.3 million kilometres. Estimated flood peaks at each of these model nodes are determined using an empirically based rainfall-runoff approach linking design rainfall to design river flood magnitudes. The hydraulic model is used to determine extents and depths of floodplain inundation following river bank overflow. From this, deterministic flood hazard maps are calculated for several design return periods between 20-years and 1,500-years. Firstly, we will discuss the rationale behind the appropriate hydraulic modelling methods and inputs chosen to produce a consistent global scaled river flood hazard map. This will highlight how a model designed to work with global datasets can be more favourable for hydraulic modelling at the global scale and why using innovative techniques customised for broad scale use are preferable to modifying existing hydraulic models. Similarly, the advantages and disadvantages of both 1D and 2D modelling will be explored and balanced against the time, computer and human resources available, particularly when using a Digital Surface Model at 30m resolution. Finally, we will suggest some appropriate uses of global scale hazard maps and explore how this new approach can be invaluable in areas of the world where flood hazard and risk have not previously been assessed.

  4. Implementation of graphic health warning labels on tobacco products in India: the interplay between the cigarette and the bidi industries.

    PubMed

    Sankaran, Sujatha; Hiilamo, Heikki; Glantz, Stanton A

    2015-11-01

    To understand the competition between and among tobacco companies and health groups that led to graphical health warning labels (GHWL) on all tobacco products in India. Analysis of internal tobacco industry documents in the Legacy Tobacco Document Library, documents obtained through India's Right to Information Act, and news reports. Implementation of GHWLs in India reflects a complex interplay between the government and the cigarette and bidi industries, who have shared as well as conflicting interests. Joint lobbying by national-level tobacco companies (that are foreign subsidiaries of multinationals) and local producers of other forms of tobacco blocked GHWLs for decades and delayed the implementation of effective GHWLs after they were mandated in 2007. Tobacco control activists used public interest lawsuits and the Right to Information Act to win government implementation of GHWLs on cigarette, bidi and smokeless tobacco packs in May 2009 and rotating GHWLs in December 2011. GHWLs in India illustrate how the presence of bidis and cigarettes in the same market creates a complex regulatory environment. The government imposing tobacco control on multinational cigarette companies led to the enforcement of regulation on local forms of tobacco. As other developing countries with high rates of alternate forms of tobacco use establish and enforce GHWL laws, the tobacco control advocacy community can use pressure on the multinational cigarette industry as an indirect tool to force implementation of regulations on other forms of tobacco. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  5. Corporate social responsibility in global health: an exploratory study of multinational pharmaceutical firms.

    PubMed

    Droppert, Hayley; Bennett, Sara

    2015-04-09

    As pharmaceutical firms experience increasing civil society pressure to act responsibly in a changing globalized world, many are expanding and/or reforming their corporate social responsibility (CSR) strategies. We sought to understand how multinational pharmaceutical companies currently engage in CSR activities in the developing world aimed at global health impact, their motivations for doing so and how their CSR strategies are evolving. We conducted a small-scale, exploratory study combining (i) an in-depth review of publicly available data on pharmaceutical firms' CSR with (ii) interviews of representatives from 6 firms, purposively selected, from the highest earning pharmaceutical firms worldwide. Corporate social responsibility differed for each firm particularly with respect to how CSR is defined, organizational structures for managing CSR, current CSR activities, and motivations for CSR. Across the firms studied, the common CSR activities were: differential pharmaceutical pricing, strengthening developing country drug distribution infrastructure, mHealth initiatives, and targeted research and development. Primary factors that motivated CSR engagement were: reputational benefits, recruitment and employee satisfaction, better rankings in sustainability indices, entrance into new markets, long-term economic returns, and improved population health. In terms of CSR strategy, firms were at different points on a spectrum ranging from philanthropic donations to integrated systemic shared value business models. CSR is of increasing importance for multinational pharmaceutical firms yet understanding of the array of CSR strategies employed and their effects is nascent. Our study points to the need to (i) develop clearer and more standardized definitions of CSR in global health (2) strengthen indices to track CSR strategies and their public health effects in developing countries and (iii) undertake more country level studies that investigate how CSR engages with national health systems.

  6. Determining the feasibility and preliminary efficacy of a stroke instructional and educational DVD in a multinational context: a randomized controlled pilot study.

    PubMed

    Jones, Kelly M; Bhattacharjee, Rohit; Krishnamurthi, Rita; Blanton, Sarah; Barker-Collo, Suzanne; Theadom, Alice; Thrift, Amanda G; Wolf, Steven L; Venketasubramanian, Narayanaswamy; Parmar, Priya; Maujean, Annick; Ranta, Annemarei; Cadilhac, Dominique; Sanya, Emmanuel O; MacKay-Lyons, Marilyn; Pandian, Jeyaraj D; Arora, Deepti; Obiako, Reginald O; Saposnik, Gustavo; Balalla, Shivanthi; Bornstein, Natan M; Langhorne, Peter; Norrving, Bo; Brown, Nita; Brainin, Michael; Taylor, Denise; Feigin, Valery L

    2018-05-01

    To assess the feasibility of conducting a randomized controlled trial of an instructional and educational stroke DVD and determine the feasibility and preliminary efficacy of this intervention in a multinational context. Non-funded, pilot randomized controlled trial of intervention versus usual care. International, multicentre, community-based. Community-living adults up to three years post stroke with moderate to severe disability and their nominated informal caregivers. Intervention patients viewed and practised rehabilitation techniques demonstrated in the DVD over six weeks. Trial feasibility by number of active recruitment sites, recruitment efficiency, randomization and follow-up. Intervention feasibility by patient and caregiver impressions. Preliminary efficacy by the quality of life - 5-level EuroQol-5D (EQ-5D) health status measure, General Health Questionnaire and Centre for Epidemiological Studies-Depression at two months. In total, 14 recruitment sites were established across eight countries. Recruitment was achieved at nine (64%) sites. Over 16 months, 66 participants were recruited (mean (SD) age = 63.5 (12.47) years) and randomized to intervention ( n = 34) and control ( n = 32) groups. In total, 54 (82%) completed a follow-up assessment. Patient and/or caregiver comments about the benefits and barriers to accessing the intervention were mixed. There were no significant between-group differences in outcomes at two months ( P > 0.05). Conducting a multinational trial of a stroke DVD requires full funding. The intervention was acceptable to some patients and their caregivers, yet a generalized education approach did not fully meet their needs and/or expectations. A more individualized method may be required to meet peoples' changing needs during stroke recovery.

  7. Multinational evidence-based recommendations on how to investigate and follow-up undifferentiated peripheral inflammatory arthritis: integrating systematic literature research and expert opinion of a broad international panel of rheumatologists in the 3E Initiative

    PubMed Central

    Machado, P; Castrejon, I; Katchamart, W; Koevoets, R; Kuriya, B; Schoels, M; Silva-Fernández, L; Thevissen, K; Vercoutere, W; Villeneuve, E; Aletaha, D; Carmona, L; Landewé, R; van der Heijde, D; Bijlsma, J W J; Bykerk, V; Canhão, H; Catrina, A I; Durez, P; Edwards, C J; Mjaavatten, M D; Leeb, B F; Losada, B; Martín-Mola, E M; Martinez-Osuna, P; Montecucco, C; Müller-Ladner, U; Østergaard, M; Sheane, B; Xavier, R M; Zochling, J; Bombardier, C

    2011-01-01

    Objective To develop evidence-based recommendations on how to investigate and follow-up undifferentiated peripheral inflammatory arthritis (UPIA). Methods 697 rheumatologists from 17 countries participated in the 3E (Evidence, Expertise, Exchange) Initiative of 2008–9 consisting of three separate rounds of discussions and modified Delphi votes. In the first round 10 clinical questions were selected. A bibliographic team systematically searched Medline, Embase, the Cochrane Library and ACR/EULAR 2007–2008 meeting abstracts. Relevant articles were reviewed for quality assessment, data extraction and synthesis. In the second round each country elaborated a set of national recommendations. Finally, multinational recommendations were formulated and agreement among the participants and the potential impact on their clinical practice was assessed. Results A total of 39 756 references were identified, of which 250 were systematically reviewed. Ten multinational key recommendations about the investigation and follow-up of UPIA were formulated. One recommendation addressed differential diagnosis and investigations prior to establishing the operational diagnosis of UPIA, seven recommendations related to the diagnostic and prognostic value of clinical and laboratory assessments in established UPIA (history and physical examination, acute phase reactants, autoantibodies, radiographs, MRI and ultrasound, genetic markers and synovial biopsy), one recommendation highlighted predictors of persistence (chronicity) and the final recommendation addressed monitoring of clinical disease activity in UPIA. Conclusions Ten recommendations on how to investigate and follow-up UPIA in the clinical setting were developed. They are evidence-based and supported by a large panel of rheumatologists, thus enhancing their validity and practical use. PMID:20724311

  8. Multinational evidence-based recommendations for the use of methotrexate in rheumatic disorders with a focus on rheumatoid arthritis: integrating systematic literature research and expert opinion of a broad international panel of rheumatologists in the 3E Initiative

    PubMed Central

    Visser, K; Katchamart, W; Loza, E; Martinez-Lopez, J A; Salliot, C; Trudeau, J; Bombardier, C; Carmona, L; van der Heijde, D; Bijlsma, J W J; Boumpas, D T; Canhao, H; Edwards, C J; Hamuryudan, V; Kvien, T K; Leeb, B F; Martín-Mola, E M; Mielants, H; Müller-Ladner, U; Murphy, G; Østergaard, M; Pereira, I A; Ramos-Remus, C; Valentini, G; Zochling, J; Dougados, M

    2009-01-01

    Objectives: To develop evidence-based recommendations for the use of methotrexate in daily clinical practice in rheumatic disorders. Methods: 751 rheumatologists from 17 countries participated in the 3E (Evidence, Expertise, Exchange) Initiative of 2007–8 consisting of three separate rounds of discussions and Delphi votes. Ten clinical questions concerning the use of methotrexate in rheumatic disorders were formulated. A systematic literature search in Medline, Embase, Cochrane Library and 2005–7 American College of Rheumatology/European League Against Rheumatism meeting abstracts was conducted. Selected articles were systematically reviewed and the evidence was appraised according to the Oxford levels of evidence. Each country elaborated a set of national recommendations. Finally, multinational recommendations were formulated and agreement among the participants and the potential impact on their clinical practice was assessed. Results: A total of 16 979 references was identified, of which 304 articles were included in the systematic reviews. Ten multinational key recommendations on the use of methotrexate were formulated. Nine recommendations were specific for rheumatoid arthritis (RA), including the work-up before initiating methotrexate, optimal dosage and route, use of folic acid, monitoring, management of hepatotoxicity, long-term safety, mono versus combination therapy and management in the perioperative period and before/during pregnancy. One recommendation concerned methotrexate as a steroid-sparing agent in other rheumatic diseases. Conclusions: Ten recommendations for the use of methotrexate in daily clinical practice focussed on RA were developed, which are evidence based and supported by a large panel of rheumatologists, enhancing their validity and practical use. PMID:19033291

  9. The global alcohol industry: an overview.

    PubMed

    Jernigan, David H

    2009-02-01

    To describe the globalized sector of the alcoholic beverage industry, including its size, principal actors and activities. Market research firms and business journalism are the primary sources for information about the global alcohol industry, and are used to profile the size and membership of the three main industry sectors of beer, distilled spirits and wine. Branded alcoholic beverages are approximately 38% of recorded alcohol consumption world-wide. Producers of these beverages tend to be large multi-national corporations reliant on marketing for their survival. Marketing activities include traditional advertising as well as numerous other activities, such as new product development, product placement and the creation and promotion of social responsibility programs, messages and organizations. The global alcohol industry is highly concentrated and innovative. There is relatively little public health research evaluating the impact of its many marketing activities.

  10. The impact of the cox-2 inhibitor issue on perceptions of the pharmaceutical industry: content analysis and communication implications.

    PubMed

    Lofstedt, Ragnar E

    2007-01-01

    The field of risk communication has its roots in the environmental, chemical, space, and nuclear arenas. As a number of these sectors have now vastly improved their communication strategies, attention is being placed on sectors that have been more problematic as of late. Examples of such sectors, include the food industries and the pharmaceutical/health sector. This article focuses on how large, multinational pharmaceutical companies can better communicate risks by analysis of one specific case, namely, that of the Cox-2 controversy.(1) For purposes of this article, risk communication is best described as "the flow of information and risk evaluations back and forth between academic experts, regulatory practitioners, interest groups and the general public," and "big pharma" refers to the more traditional R & D-based, innovative pharmaceutical companies.

  11. Design of a professional development and support program for future photonics industry team leaders

    NASA Astrophysics Data System (ADS)

    Hall-Wallace, Michelle; Regens, Nancy L.; Pompea, Stephen M.

    2002-05-01

    The University of Arizona's Collaboration to Advance Teaching Technology and Science (CATTS) program sponsored by the National Science Foundation has found a successful way to unite public and charter school students and teachers, university science outreach programs, graduate and undergraduate students, and university faculty for the betterment of science education. A key aspect of this success has been the ability of the project to assist stakeholders in understanding the different cultural perspectives of all of the participants. The success of this program has led us to create a template for a professional development and support program emphasizing the degree of cross-cultural understanding appropriate for today's multinational photonics industry. This template is designed to give future photonics technical, managerial, and manufacturing leaders training in a variety of areas that can enhance their productivity and ability to lead teams. The design would be appropriate for photonics research and development teams, sales and marketing teams, teams with diverse members new college hires, and newly emplaced managers. This education template would also be appropriate for students in photonics industry technician and graduate- level programs. This type of program is not a substitute for other forms of professional managerial training, but rather augments such programs with material that can aid in a more global perspective.

  12. Designing for multiple global user populations: increasing resource allocation efficiency for greater sustainability.

    PubMed

    Nadadur, G; Parkinson, M B

    2012-01-01

    This paper proposes a method to identify opportunities for increasing the efficiency of raw material allocation decisions for products that are simultaneously targeted at multiple user populations around the world. The values of 24 body measures at certain key percentiles were used to estimate the best-fitting anthropometric distributions for female and male adults in nine national populations, which were selected to represent the diverse target markets multinational companies must design for. These distributions were then used to synthesize body measure data for combined populations with a 1:1 female:male ratio. An anthropometric range metric (ARM) was proposed for assessing the variation of these body measures across the populations. At any percentile, ARM values were calculated as the percentage difference between the highest and lowest anthropometric values across the considered user populations. Based on their magnitudes, plots of ARM values computed between the 1st and 99 th percentiles for each body measure were grouped into low, medium, and high categories. This classification of body measures was proposed as a means of selecting the most suitable strategies for designing raw material-efficient products. The findings in this study and the contributions of subsequent work along these lines are expected to help achieve greater efficiencies in resource allocation in global product development.

  13. Intensive Language Training for Multinational Business

    ERIC Educational Resources Information Center

    Jordan, Gerda

    1977-01-01

    A two-year master's degree program in international business studies was initiated by the College of Business Administration at the University of South Carolina to educate the business manager who will deal with foreign countries. The language component comprises an important part of the program. (SW)

  14. Multinational Species Conservation Funds Semipostal Stamp Reauthorization Act of 2012

    THOMAS, 112th Congress

    Sen. Portman, Rob [R-OH

    2012-05-21

    Senate - 09/14/2012 Committee on Homeland Security and Governmental Affairs referred to Subcommittee on Federal Financial Management, Government Information, Federal Services, and International Security. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  15. Diversity in the Workplace. Symposium.

    ERIC Educational Resources Information Center

    2002

    Three papers comprise this symposium on diversity in the workplace. "Factors That Assist and Barriers That Hinder the Success of Diversity Initiatives in Multinational Corporations" (Rose Mary Wentling) reports that factors that assisted in the success were classified under diversity department, human, and work environment; barriers were…

  16. Eastern Europe's Silicon Rush

    ERIC Educational Resources Information Center

    Woodard, Colin

    2007-01-01

    This article presents how the fast expansion of information technology industry in eastern Slovakia is putting a strain on its labor supply. Suddenly, computer-science graduates have become one of the former Eastern Bloc's greatest assets, attracting multinational technology companies hungry for skilled programmers, technicians, and engineers.…

  17. When Going Global Isn't Enough.

    ERIC Educational Resources Information Center

    Randolph, Benton

    1990-01-01

    The traditional multinational approach to business strategy and human resource management, as well as the global approach, are not effective in a world no longer insular. A transnational approach requires global strategy and perspective, local responsiveness and flexibility, teamwork, shared responsibility, and empowered and innovative workers.…

  18. Innovative eLearning: Technology Shaping Contemporary Problem Based Learning: A Cross-Case Analysis

    ERIC Educational Resources Information Center

    Blackburn, Greg

    2015-01-01

    Preparing students to be critical thinkers and effective communicators is essential in today's multinational and technologically sophisticated environment. New electronic technologies provide opportunities for creating learning environments that extend the possibilities of "old" but still essential technologies: books, blackboards, and…

  19. Focused Logistics: Putting Agility in Agile Logistics

    DTIC Science & Technology

    2011-05-19

    list, ahead of companies like American Express, DuPont and Coca Cola ; Supports nearly 1,900 weapon systems; DLA manages eight supply chains and...35 7) Force Health Protection...Distribution, Information Fusion, Joint Theater Logistics Command and Control, Multinational Logistics, Joint Health Services Support, and Agile

  20. Coping with the Economic Order through the Big Mac

    ERIC Educational Resources Information Center

    Akenson, James E.

    1977-01-01

    Describes an economic education unit for use in the elementary classroom which employs a case study of McDonalds hamburger chain to teach students about multinational corporations, mass production, standardization, advertising, and capital investment. For journal availability, see SO 505 448. (Author/DB)

  1. An International Bioinformatics Infrastructure to Underpin the Arabidopsis Community

    USDA-ARS?s Scientific Manuscript database

    The future bioinformatics needs of the Arabidopsis community as well as those of other scientific communities that depend on Arabidopsis resources were discussed at a pair of recent meetings held by the Multinational Arabidopsis Steering Committee (MASC) and the North American Arabidopsis Steering C...

  2. A national study of the association between neighbourhood access to fast-food outlets and the diet and weight of local residents.

    PubMed

    Pearce, Jamie; Hiscock, Rosemary; Blakely, Tony; Witten, Karen

    2009-03-01

    Differential locational access to fast-food retailing between neighbourhoods of varying socioeconomic status has been suggested as a contextual explanation for the social distribution of diet-related mortality and morbidity. This New Zealand study examines whether neighbourhood access to fast-food outlets is associated with individual diet-related health outcomes. Travel distances to the closest fast-food outlet (multinational and locally operated) were calculated for all neighbourhoods and appended to a national health survey. Residents in neighbourhoods with the furthest access to a multinational fast-food outlet were more likely to eat the recommended intake of vegetables but also be overweight. There was no association with fruit consumption. Access to locally operated fast-food outlets was not associated with the consumption of the recommended fruit and vegetables or being overweight. Better neighbourhood access to fast-food retailing is unlikely to be a key contextual driver for inequalities in diet-related health outcomes in New Zealand.

  3. "Asia is now the priority target for the world anti-tobacco movement": attempts by the tobacco industry to undermine the Asian anti-smoking movement

    PubMed Central

    Knight, J; Chapman, S

    2004-01-01

    Study objective: To identify and examine the strategies utilised by multinational tobacco companies to undermine and discredit key anti-tobacco activists and organisations in the Asian region. Method: A series of case studies drawing upon material gathered through systematic reviews of internal tobacco industry documents. Date sources: Tobacco industry documents made public as part of the settlement of the Minnesota Tobacco Trial and the Master Settlement Agreement. Results: The industry sought to identify, monitor, and isolate key individuals and organisations. The way industry went about fulfilling this mandate in the Asian region is discussed. Industry targetted individuals and agencies along with the region's primary anti-smoking coalition. Conclusions: Attack by multinational tobacco companies is a virtual quid pro quo for any individual or agency seriously challenging industry practices and policies. Understanding their tactics allows anticipatory strategies to be developed to minimise the effectiveness of these attacks. PMID:15564217

  4. An international comparison study of pharmacy students' achievement goals and their relationship to assessment type and scores.

    PubMed

    Alrakaf, Saleh; Anderson, Claire; Coulman, Sion A; John, Dai N; Tordoff, June; Sainsbury, Erica; Rose, Grenville; Smith, Lorraine

    2015-04-25

    To identify pharmacy students' preferred achievement goals in a multi-national undergraduate population, to investigate achievement goal preferences across comparable degree programs, and to identify relationships between achievement goals, academic performance, and assessment type. The Achievement Goal Questionnaire was administered to second year students in 4 universities in Australia, New Zealand, England, and Wales. Academic performance was measured using total scores, multiple-choice questions, and written answers (short essay). Four hundred eighty-six second year students participated. Students showed an overall preference for the mastery-approach goal orientation across all sites. The predicted relationships between goal orientation and multiple-choice questions, and written answers scores, were significant. This study is the first of its kind to examine pharmacy students' achievement goals at a multi-national level and to differentiate between assessment type and measures of achievement motivation. Students adopting a mastery-approach goal are more likely to gain high scores in assessments that measure understanding and depth of knowledge.

  5. An International Comparison Study of Pharmacy Students’ Achievement Goals and their Relationship to Assessment Type and Scores

    PubMed Central

    Anderson, Claire; Coulman, Sion A.; John, Dai N.; Tordoff, June; Sainsbury, Erica; Rose, Grenville; Smith, Lorraine

    2015-01-01

    Objective: To identify pharmacy students’ preferred achievement goals in a multi-national undergraduate population, to investigate achievement goal preferences across comparable degree programs, and to identify relationships between achievement goals, academic performance, and assessment type. Methods: The Achievement Goal Questionnaire was administered to second year students in 4 universities in Australia, New Zealand, England, and Wales. Academic performance was measured using total scores, multiple-choice questions, and written answers (short essay). Results: Four hundred eighty-six second year students participated. Students showed an overall preference for the mastery-approach goal orientation across all sites. The predicted relationships between goal orientation and multiple-choice questions, and written answers scores, were significant. Conclusion: This study is the first of its kind to examine pharmacy students’ achievement goals at a multi-national level and to differentiate between assessment type and measures of achievement motivation. Students adopting a mastery-approach goal are more likely to gain high scores in assessments that measure understanding and depth of knowledge. PMID:25995510

  6. Privatization and the globalization of energy markets

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    NONE

    1996-10-01

    This report reviews recent global efforts to privatize energy resources and outlines the opportunities and challenges privatization has presented to U.S. and foreign multinational energy companies. The group of energy companies studied in this report includes the major U.S. petroleum companies and many foreign companies. The foreign companies reviewed include state-run energy enterprises, recently privatized energy enterprises, and foreign multinationals that have been privately held. The privatization of non-petroleum energy industries, such as electricity generation and transmission, natural gas transmission, and coal mining, are also discussed. Overseas investments made by electric companies, natural gas companies, and coal companies are included.more » The report is organized into six chapters: (1) economics of privatization; (2) petroleum privatization efforts among non-U.S. Organization for Economic Cooperation and Development nations; (3) petroleum privatization efforts in Latin America; (4) privatization in socialist and former socialist regimes; (5) privatization efforts in global electric power generation, transmission, and distribution industries; and (6) privatization and globalization of world coal.« less

  7. National Differences in Requirements for Ethical and Competent Authority Approval for a Multinational Vaccine Trial under the EU Directive 2001/20/EC

    PubMed Central

    van Doorn, Eva; Hak, Eelko; Wilffert, Bob

    2015-01-01

    Obtaining approval for a multinational vaccine trial from an ethics committee and the national competent authority of different Member States of the European Union (EU) is challenging under clinical trial Directive 2001/20/EC because of the differences in the implementation of the directive in national laws of Member States. In this review the national differences in requirements for ethical and competent authority approval are illustrated. The national ethical and competent authority review procedures in Finland, Hungary, The Netherlands, Norway and Slovenia are described under the EU trial directive after discussing the provisions of the trial directive related to both review procedures. The review illustrates the differences between the countries in the documents that have to be submitted for the review procedures, the submission procedures and the language requirements of the documents, the organization of the ethics committees and the role of the competent authority in the approval procedure. PMID:26343188

  8. National Differences in Requirements for Ethical and Competent Authority Approval for a Multinational Vaccine Trial under the EU Directive 2001/20/EC.

    PubMed

    van Doorn, Eva; Hak, Eelko; Wilffert, Bob

    2015-04-14

    Obtaining approval for a multinational vaccine trial from an ethics committee and the national competent authority of different Member States of the European Union (EU) is challenging under clinical trial Directive 2001/20/EC because of the differences in the implementation of the directive in national laws of Member States. In this review the national differences in requirements for ethical and competent authority approval are illustrated. The national ethical and competent authority review procedures in Finland, Hungary, The Netherlands, Norway and Slovenia are described under the EU trial directive after discussing the provisions of the trial directive related to both review procedures. The review illustrates the differences between the countries in the documents that have to be submitted for the review procedures, the submission procedures and the language requirements of the documents, the organization of the ethics committees and the role of the competent authority in the approval procedure.

  9. The Role 3 Multinational Medical Unit at Kandahar Airfield 2005–2010

    PubMed Central

    Brisebois, Ronald; Hennecke, Peter; Kao, Raymond; McAlister, Vivian; Po, Joseph; Stiegelmar, Rob; Tien, Homer

    2011-01-01

    In late 2005, Canadian Forces Health Services (CFHS) was tasked with the command of the NATO Role 3 Multinational Medical Unit (R3MMU) on Kandahar Airfield in southern Afghanistan. Preparations drew on past experience and planning. Eight complete hospital contingents were trained and deployed in rotation. Near-reality simulation training was undertaken with the combat brigade, including complete deployment of the field hospital in the exercise area. Standard operating procedures (SOP) were developed and applied by each rotation so successfully that they were adopted by the new command in late 2009. The Canadian period at R3MMU had the highest survival rate ever recorded for victims of war. Lessons learned are being applied among victims of the conflict and trauma. The experience of the R3MMU was used to successfully deploy a hospital as part of the earthquake relief effort in Haiti in 2010. The training protocols and SOP are being applied to disaster preparedness in Canadian civilian hospitals. PMID:22099325

  10. The Role 3 Multinational Medical Unit at Kandahar Airfield 2005-2010.

    PubMed

    Brisebois, Ronald; Hennecke, Peter; Kao, Raymond; McAlister, Vivian; Po, Joseph; Stiegelmar, Rob; Tien, Homer

    2011-12-01

    In late 2005, Canadian Forces Health Services (CFHS) was tasked with the command of the NATO Role 3 Multinational Medical Unit (R3MMU) on Kandahar Airfield in southern Afghanistan. Preparations drew on past experience and planning. Eight complete hospital contingents were trained and deployed in rotation. Near-reality simulation training was undertaken with the combat brigade, including complete deployment of the field hospital in the exercise area. Standard operating procedures (SOP) were developed and applied by each rotation so successfully that they were adopted by the new command in late 2009. The Canadian period at R3MMU had the highest survival rate ever recorded for victims of war. Lessons learned are being applied among victims of the conflict and trauma. The experience of the R3MMU was used to successfully deploy a hospital as part of the earthquake relief effort in Haiti in 2010.The training protocols and SOP are being applied to disaster preparedness in Canadian civilian hospitals.

  11. Sexual dysfunction in women with ESRD requiring hemodialysis.

    PubMed

    Strippoli, Giovanni F M; Vecchio, Mariacristina; Palmer, Suetonia; De Berardis, Giorgia; Craig, Jonathan; Lucisano, Giuseppe; Johnson, David; Pellegrini, Fabio; Nicolucci, Antonio; Sciancalepore, Michela; Saglimbene, Valeria; Gargano, Letizia; Bonifati, Carmen; Ruospo, Marinella; Navaneethan, Sankar D; Montinaro, Vincenzo; Stroumza, Paul; Zsom, Marianna; Torok, Mariatta; Celia, Eduardo; Gelfman, Ruben; Bednarek-Skublewska, Anna; Dulawa, Jan; Graziano, Giusi; Gentile, Giorgio; Ferrari, Juan Nin; Santoro, Antonio; Zucchelli, Annalisa; Triolo, Giorgio; Maffei, Stefano; Hegbrant, Jörgen; Wollheim, Charlotta; De Cosmo, Salvatore; Manfreda, Valeria M

    2012-06-01

    The few existing studies of sexual dysfunction in women on hemodialysis are limited by small sample size. This large, cross-sectional study evaluated the prevalence and correlates of female sexual dysfunction in advanced kidney disease. DESIGN, SETTING, PARTICIPANTS, METHODS: A total of 1472 women with ESRD undergoing hemodialysis were recruited to a multinational, cross-sectional study conducted within a collaborative dialysis network in Europe and South America. Sexual dysfunction was identified by the Female Sexual Function Index. Correlates of self-reported sexual dysfunction were identified by regression analyses. Of the 1472 women, 659 completed questionnaires (45%). More than half (362 of 659 [55%]) lived with a partner, and 232 of 659 (35%) reported being sexually active. Of these 659 respondents, 555 (84%) reported sexual dysfunction. Women with a partner (282 of 362 [78%]) were less likely to report sexual dysfunction than those without a partner (273 of 297 [92%]) (P<0.001). Sexual dysfunction was independently associated with age, depressive symptoms, less education, menopause, diabetes, and diuretic therapy. Nearly all women who were not wait-listed for a kidney transplant and were living without a partner (249 of 260 [96%]) reported sexual dysfunction. More than half (128 of 232 [55%]) of sexually active women reported sexual dysfunction, associated with age, depressive symptoms, menopause, low serum albumin, and diuretic therapy. This descriptive study suggests most women on hemodialysis experience sexual problems. Additional research on the relevance of sexual dysfunction to symptom burden and quality of life in these women is needed.

  12. Evaluating the importance of policy amenable factors in explaining influenza vaccination: a cross-sectional multinational study.

    PubMed

    Wheelock, Ana; Miraldo, Marisa; Thomson, Angus; Vincent, Charles; Sevdalis, Nick

    2017-07-12

    Despite continuous efforts to improve influenza vaccination coverage, uptake among high-risk groups remains suboptimal. We aimed to identify policy amenable factors associated with vaccination and to measure their importance in order to assist in the monitoring of vaccination sentiment and the design of communication strategies and interventions to improve vaccination rates. The USA, the UK and France. A total of 2412 participants were surveyed across the three countries. Self-reported influenza vaccination. Between March and April 2014, a stratified random sampling strategy was employed with the aim of obtaining nationally representative samples in the USA, the UK and France through online databases and random-digit dialling. Participants were asked about vaccination practices, perceptions and feelings. Multivariable logistic regression was used to identify factors associated with past influenza vaccination. The models were able to explain 64%-80% of the variance in vaccination behaviour. Overall, sociopsychological variables, which are inherently amenable to policy, were better at explaining past vaccination behaviour than demographic, socioeconomic and health variables. Explanatory variables included social influence (physician), influenza and vaccine risk perceptions and traumatic childhood experiences. Our results indicate that evidence-based sociopsychological items should be considered for inclusion into national immunisation surveys to gauge the public's views, identify emerging concerns and thus proactively and opportunely address potential barriers and harness vaccination drivers. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  13. Methods for evaluating temporal trends in noise exposure.

    PubMed

    Neitzel, R L; Galusha, D; Dixon-Ernst, C; Rabinowitz, P M

    2014-03-01

    Hearing conservation programs have been mandatory in many US industries since 1983. Since then, three program elements (audiometric testing, hearing protection, and training) have been the focus of much research. By comparison, little has been done on noise exposure evaluation. Temporal trends in time weighted average (TWA) exposures and the fraction of measurements exceeding 85 dBA were evaluated by facility, by exposure group within facility, and by individual worker within facility. A large dataset (> 10 000 measurements over 20 years) from eight facilities operated by a multinational aluminum manufacturing company was studied. Overall, exposures declined across locations over the study period. Several facilities demonstrated substantial reductions in exposure, and the results of mean noise levels and exceedance fractions generally showed good agreement. The results of analyses at the individual level diverged with analyses by facility and exposure group within facility, suggesting that individual-level analyses, while challenging, may provide important information not available from coarser levels of analysis. Validated metrics are needed to allow for assessment of temporal trends in noise exposure. Such metrics will improve our ability to characterize, in a standardized manner, efforts to reduce noise-induced hearing loss.

  14. Multiple-level stakeholder engagement in malaria clinical trials: addressing the challenges of conducting clinical research in resource-limited settings.

    PubMed

    Mtove, George; Kimani, Joshua; Kisinza, William; Makenga, Geofrey; Mangesho, Peter; Duparc, Stephan; Nakalembe, Miriam; Phiri, Kamija S; Orrico, Russell; Rojo, Ricardo; Vandenbroucke, Pol

    2018-03-22

    Multinational clinical trials are logistically complex and require close coordination between various stakeholders. They must comply with global clinical standards and are accountable to multiple regulatory and ethical bodies. In resource-limited settings, it is challenging to understand how to apply global clinical standards to international, national, and local factors in clinical trials, making multiple-level stakeholder engagement an important element in the successful conduct of these clinical trials. During the planning and implementation of a large multinational clinical trial for intermittent preventive treatment of malaria in pregnancy in resource-limited areas of sub-Saharan Africa, we encountered numerous challenges, which required implementation of a range of engagement measures to ensure compliance with global clinical and regulatory standards. These challenges included coordination with ongoing global malaria efforts, heterogeneity in national regulatory structures, sub-optimal healthcare infrastructure, local practices and beliefs, and perspectives that view healthcare providers with undue trust or suspicion. In addition to engagement with international bodies, such as the World Health Organization, the Malaria in Pregnancy Consortium, the Steve Biko Centre for Bioethics, and the London School of Hygiene and Tropical Medicine, in order to address the challenges just described, Pfizer Inc. and Medicines for Malaria Venture (the "Sponsoring Entities" for these studies) and investigators liaised with national- and district-level stakeholders such as health ministers and regional/local community health workers. Community engagement measures undertaken by investigators included local meetings with community leaders to explain the research aims and answer questions and concerns voiced by the community. The investigators also engaged with family members of prospective trial participants in order to be sensitive to local practices and beliefs. Engagement with key stakeholders at international and national levels enabled the Sponsoring Entities to address challenges by aligning the study design with the requirements of health and regulatory agencies and to understand and address healthcare infrastructure needs prior to trial initiation. Local stakeholder engagement, including community members, study participants, and family enabled the investigators to address challenges by ensuring that study design and conduct were adapted to local considerations and ensuring accurate information about the study aims was shared with the public. ClinicalTrials.gov, ID: NCT01103063 . Registered on 7 April 2010.

  15. HACEK Infective Endocarditis: Characteristics and Outcomes from a Large, Multi-National Cohort

    PubMed Central

    Chambers, Stephen T.; Murdoch, David; Morris, Arthur; Holland, David; Pappas, Paul; Almela, Manel; Fernández-Hidalgo, Nuria; Almirante, Benito; Bouza, Emilio; Forno, Davide; del Rio, Ana; Hannan, Margaret M.; Harkness, John; Kanafani, Zeina A.; Lalani, Tahaniyat; Lang, Selwyn; Raymond, Nigel; Read, Kerry; Vinogradova, Tatiana; Woods, Christopher W.; Wray, Dannah; Corey, G. Ralph; Chu, Vivian H.

    2013-01-01

    The HACEK organisms (Haemophilus species, Aggregatibacter species, Cardiobacterium hominis, Eikenella corrodens, and Kingella species) are rare causes of infective endocarditis (IE). The objective of this study is to describe the clinical characteristics and outcomes of patients with HACEK endocarditis (HE) in a large multi-national cohort. Patients hospitalized with definite or possible infective endocarditis by the International Collaboration on Endocarditis Prospective Cohort Study in 64 hospitals from 28 countries were included and characteristics of HE patients compared with IE due to other pathogens. Of 5591 patients enrolled, 77 (1.4%) had HE. HE was associated with a younger age (47 vs. 61 years; p<0.001), a higher prevalence of immunologic/vascular manifestations (32% vs. 20%; p<0.008) and stroke (25% vs. 17% p = 0.05) but a lower prevalence of congestive heart failure (15% vs. 30%; p = 0.004), death in-hospital (4% vs. 18%; p = 0.001) or after 1 year follow-up (6% vs. 20%; p = 0.01) than IE due to other pathogens (n = 5514). On multivariable analysis, stroke was associated with mitral valve vegetations (OR 3.60; CI 1.34–9.65; p<0.01) and younger age (OR 0.62; CI 0.49–0.90; p<0.01). The overall outcome of HE was excellent with the in-hospital mortality (4%) significantly better than for non-HE (18%; p<0.001). Prosthetic valve endocarditis was more common in HE (35%) than non-HE (24%). The outcome of prosthetic valve and native valve HE was excellent whether treated medically or with surgery. Current treatment is very successful for the management of both native valve prosthetic valve HE but further studies are needed to determine why HE has a predilection for younger people and to cause stroke. The small number of patients and observational design limit inferences on treatment strategies. Self selection of study sites limits epidemiological inferences. PMID:23690995

  16. HACEK infective endocarditis: characteristics and outcomes from a large, multi-national cohort.

    PubMed

    Chambers, Stephen T; Murdoch, David; Morris, Arthur; Holland, David; Pappas, Paul; Almela, Manel; Fernández-Hidalgo, Nuria; Almirante, Benito; Bouza, Emilio; Forno, Davide; del Rio, Ana; Hannan, Margaret M; Harkness, John; Kanafani, Zeina A; Lalani, Tahaniyat; Lang, Selwyn; Raymond, Nigel; Read, Kerry; Vinogradova, Tatiana; Woods, Christopher W; Wray, Dannah; Corey, G Ralph; Chu, Vivian H

    2013-01-01

    The HACEK organisms (Haemophilus species, Aggregatibacter species, Cardiobacterium hominis, Eikenella corrodens, and Kingella species) are rare causes of infective endocarditis (IE). The objective of this study is to describe the clinical characteristics and outcomes of patients with HACEK endocarditis (HE) in a large multi-national cohort. Patients hospitalized with definite or possible infective endocarditis by the International Collaboration on Endocarditis Prospective Cohort Study in 64 hospitals from 28 countries were included and characteristics of HE patients compared with IE due to other pathogens. Of 5591 patients enrolled, 77 (1.4%) had HE. HE was associated with a younger age (47 vs. 61 years; p<0.001), a higher prevalence of immunologic/vascular manifestations (32% vs. 20%; p<0.008) and stroke (25% vs. 17% p = 0.05) but a lower prevalence of congestive heart failure (15% vs. 30%; p = 0.004), death in-hospital (4% vs. 18%; p = 0.001) or after 1 year follow-up (6% vs. 20%; p = 0.01) than IE due to other pathogens (n = 5514). On multivariable analysis, stroke was associated with mitral valve vegetations (OR 3.60; CI 1.34-9.65; p<0.01) and younger age (OR 0.62; CI 0.49-0.90; p<0.01). The overall outcome of HE was excellent with the in-hospital mortality (4%) significantly better than for non-HE (18%; p<0.001). Prosthetic valve endocarditis was more common in HE (35%) than non-HE (24%). The outcome of prosthetic valve and native valve HE was excellent whether treated medically or with surgery. Current treatment is very successful for the management of both native valve prosthetic valve HE but further studies are needed to determine why HE has a predilection for younger people and to cause stroke. The small number of patients and observational design limit inferences on treatment strategies. Self selection of study sites limits epidemiological inferences.

  17. Patient baseline characteristics in an open-label multinational study of betahistine in recurrent peripheral vestibular vertigo: the OSVaLD study.

    PubMed

    Pérez-Garrigues, H; Kuessner, D; Benecke, H

    2007-11-01

    OSVaLD (Observational Study in patients suffering from recurrent peripheral vestibular Vertigo to Assess the effect of betahistine 48 mg/day on quality of Life and Dizziness symptoms) is a 3-month, open-label, multi-national post-marketing surveillance study of betahistine 48 mg/day in the management of patients with vertigo of less than 5 years in duration. The aim of the study is to examine the burden of disease associated with vertigo, as determined by scores on the Dizziness Handicap Inventory (DHI), Short Form-36 (SF-36) questionnaire and the Hospital Anxiety and Depression Scale (HADS). Changes in DHI, SF-36 and HADS scores between baseline and 3 months are used to assess the therapeutic effects of betahistine. Participants (n = 2037) have been recruited from 13 countries in four continents (North and South America, Asia and Europe), representing a wide range of cultural and linguistic traditions. Approximately two-thirds of the patients are women. Sixty per cent of patients have diagnoses of peripheral vestibular vertigo of unknown pathology or benign paroxysmal positional vertigo; 13% have a diagnosis of Ménière's disease. All three of the instruments used characterize this as a population with extensive vertigo-attributable morbidity at baseline. The mean DHI score of the population is 63.7 +/- 15.7 (DHI scale: 0 = no handicap; 100 = major self-perceived handicap), SF-36 scores in all domains are below the population average for the USA and the HADS indicated that > 50% of patients exhibit symptoms of anxiety or depression or both, including 9% who have severe manifestations of either or both conditions. This report describes the design and implementation of OSVaLD and presents baseline demographic and clinical features of the patients. Full results of the study, anticipated in 2007, will provide more details about the manifestations of vertigo in routine practice and the response to betahistine.

  18. Prevalence of diabetes complications in people with type 2 diabetes mellitus and its association with baseline characteristics in the multinational A1chieve study.

    PubMed

    Litwak, Leon; Goh, Su-Yen; Hussein, Zanariah; Malek, Rachid; Prusty, Vinay; Khamseh, Mohammad E

    2013-10-24

    Current International Diabetes Federation guidelines recommend a target HbA1c <7.0%, but many people with diabetes worldwide find this difficult to achieve, increasing their risk of developing complications. This publication examines the prevalence of diabetes complications and its association with baseline characteristics in people with type 2 diabetes who participated in the A1chieve study. A1chieve was a 24-week, multinational, open-label, observational study of 66,726 people with type 2 diabetes who had begun using biphasic insulin aspart 30, insulin aspart, or insulin detemir in routine clinical care. Participants were enrolled from 28 countries across four continents (Asia, Africa, Europe and South America). Baseline measurements of disease characteristics included: glycated haemoglobin (HbA1c), fasting (FPG) and post-prandial plasma glucose (PPG), high- and low-density lipoprotein cholesterol (H- or LDL-C), systolic blood pressure (SBP), and body mass index (BMI). Data on complications and use of vascular disease preventative drugs were collected. Complication rates were high (27.2% had macrovascular complications and 53.5% had microvascular complications), particularly in Russia, and use of vascular disease preventative drugs was lower than expected. Age, BMI, diabetes duration, LDL-C, and SBP were positively associated, and HDL-C negatively associated, with macro- and microvascular complications (all p < 0.05). HbA1c and FPG were negatively associated with macrovascular complications (both p < 0.05), which may be linked to the cross-sectional study design. These results suggest a worldwide failure to achieve glycaemic targets. Better diabetes management with earlier initiation and optimisation of insulin regimens (e.g., with insulin analogues in the A1chieve population) may reduce the prevalence of vascular complications, improve the lives of people with diabetes and reduce the burden on healthcare systems.

  19. Advancing Evidence-Based Practice in Physical Therapy Settings: Multinational Perspectives on Implementation Strategies and Interventions.

    PubMed

    Bernhardsson, Susanne; Lynch, Elizabeth; Dizon, Janine Margarita; Fernandes, Jasmin; Gonzalez-Suarez, Consuelo; Lizarondo, Lucylynn; Luker, Julie; Wiles, Louise; Grimmer, Karen

    2017-01-01

    It is of critical importance that findings from the wealth of clinical physical therapist research are transferred into clinical practice without unnecessary delays. There is a lack of knowledge about strategies that can be used to effectively implement physical therapist research findings and evidence-based practice (EBP) into everyday clinical practice in different national settings and contexts. The purpose of this article is to contribute to knowledge about effective strategies for implementing EBP that have been studied in different national physical therapy settings. The specific aims of this article are to share experiences and provide a current multinational perspective on different approaches and strategies for implementing EBP and to highlight important considerations and implications for both research and practice. Six research studies from various settings in 3 countries are described and synthesized. Key characteristics of the studies and intervention components are tabulated and mapped to the Cochrane Effective Practice and Organisation of Care taxonomy. Commonalities and differences are presented. The implementation strategies described were: a theory-based guideline implementation tailored to identified barriers and facilitators; a multifaceted EBP training package; journal clubs; a multifaceted strategy comprising contextualized procedures, protocols, and standardized resources; barrier identification, education, audit, feedback, and reminders; and contextualized guidelines. Commonalities were the use of a multifaceted approach, educational measures, and clinical guidelines. Key outcomes across the studies were improved attitudes and increased awareness, knowledge, skills, and confidence in EBP; better access to clinical practice guidelines and other EBP resources; identification of barriers that could be targeted in future implementation activities; earlier referrals; and use of recommended outcome measures. The article can serve as a template for other physical therapist researchers in designing implementation studies, as well as to inform policies and practice for health care managers and decision makers who are looking for ways to implement research findings in their organizations. © 2017 American Physical Therapy Association.

  20. Multinational Business Gaming: Is Gender Important?

    ERIC Educational Resources Information Center

    Johnson, Scott D.; And Others

    1997-01-01

    A study investigated influence of gender on undergraduate students (n=119) involved in international business games. Females tended to view the simulation as less complex, have less cohesive group structures, and show less self-confidence than males. However, game performance measures showed no significant gender differences. Implications for…

  1. Perspectives on Numeracy: Reflections from International Assessments

    ERIC Educational Resources Information Center

    Tout, Dave; Gal, Iddo

    2015-01-01

    This paper examines perspectives regarding the mathematical skills expected of adults and school graduates, comparing ideas developed as part of two major multinational comparative assessments of skills: the Programme for International Student Assessment and the Programme for International Assessment of Adult Competencies (also known as the OECD…

  2. Multicultural Ethnic Music Education in Communist China

    ERIC Educational Resources Information Center

    Zhang, Wenzhuo

    2017-01-01

    The Central Communist Party (CCP) of the People's Republic of China (PRC) describes China as a unified multinational country. National policies advocate cultural diversity in the educational system with particular emphasis on the notion that diverse ethnic minorities contribute to "zhonghua minzu"--a single united Chinese nationality.…

  3. Multinational Investment: Opportunity and Challenge.

    ERIC Educational Resources Information Center

    Perspective: Essays and Reviews of Issues in Employment Security and Employment and Training Programs, 1988

    1988-01-01

    This volume of an annual journal contains nine articles focusing on the internationalization of the world's economy and business and how employment security and employment and training programs can be involved. The opening article, "Foreign Investment Euphoria Hides Community Upheaval" (W. Scott Boyd), provides an overview of the volume…

  4. The "Celtic Tiger" and a Knowledge Economy

    ERIC Educational Resources Information Center

    Crawley, Gerard M.; O'Sullivan, Eoin

    2006-01-01

    Over the last two decades, Ireland has proactively marketed its educated workforce, its favourable corporate tax rates, membership of the European common market, and other advantages, to multinational technology corporations. The resulting foreign direct investment in high-tech manufacturing operations has driven a booming Irish economy that has…

  5. Examination of Regional Transit Service under Contracting : A Case Study in the Greater New Orleans Region : [Executive Summary

    DOT National Transportation Integrated Search

    2011-03-01

    In late 2008, New Orleans Regional Transit Authority (RTA) began to execute a delegated management contract with a multinational private firm, in order to not only increase efficiency and effectiveness in operation and maintenance of public tra...

  6. The Impact of Agribusiness on Rural Education.

    ERIC Educational Resources Information Center

    Theobald, Paul

    The dramatic growth of multinational agribusiness corporations has led to all types of rural decline--social, demographic, institutional, and environmental. Historically, rural inhabitants and rural land have been abused and neglected in the name of progress. Rural development efforts often attract small assembly or light manufacturing plants that…

  7. Globalization of Science Education: Comment and a Commentary

    ERIC Educational Resources Information Center

    Fensham, Peter J.

    2011-01-01

    The globalized nature of modern society has generated a number of pressures that impact internationally on countries' policies and practices of science education. Among these pressures are key issues of health and environment confronting global science, global economic control through multi-national capitalism, comparative and competitive…

  8. Globally Sustainable Management: A Dynamic Model of IHRM Learning and Control

    ERIC Educational Resources Information Center

    Takeda, Margaret B.; Helms, Marilyn M.

    2010-01-01

    Purpose: After a thorough literature review on multinational learning, it is apparent organizations "learn" when they capitalize on expatriate management, a "learning strategy" (international work teams, employee involvement and other human resource policies), technology transfer and political environment and cross-cultural adaptation. This…

  9. Profiles of Major Suppliers to the Automotive Industry : Vol. 5. Multinational Automotive Parts and Components Suppliers

    DOT National Transportation Integrated Search

    1982-08-01

    This study summarizes extensive information collected over a two-year period (October 1978 to October 1980) on suppliers of parts and components, materials, and machine tools to the automotive industry in the United States. The objective of the study...

  10. Multinational Exchange Mechanisms of Educational Audio-Visual Materials. Appendixes.

    ERIC Educational Resources Information Center

    Center of Studies and Realizations for Permanent Education, Paris (France).

    These appendixes contain detailed information about the existing audiovisual material exchanges which served as the basis for the analysis contained in the companion report. Descriptions of the objectives, structure, financing and services of the following national and international organizations are included: (1) Educational Resources Information…

  11. 78 FR 42148 - Advisory Committee on International Economic Policy; Notice of Open Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-15

    ... DEPARTMENT OF STATE [Public Notice 8380] Advisory Committee on International Economic Policy; Notice of Open Meeting The Advisory Committee on International Economic Policy (ACIEP) will meet from 2... for Multinational Enterprises. This meeting is open to public participation, though seating is limited...

  12. Challenges in Data Collection and Analysis in Multi-National Experimentation

    DTIC Science & Technology

    2007-06-01

    sampling of personnel when individual interviews would be labor intensive and time consuming. Ideally surveys contribute to the cognitive aspect of...the experimental data for the data collection plan. In addition to gaining data concerning the cognitive aspect , surveys can be used when no other

  13. A University for the Rural Poor in the Third World.

    ERIC Educational Resources Information Center

    Gow, Kathryn M.

    One possible way of educating residents of developing countries is through a "university for the poor" based on shared village Internet posts and village technology learning centers. Western colleges and universities could donate their courses, and multinational organizations could subsidize the program's administration. Academics could…

  14. Commercialising Comparison: Pearson Puts the TLC in Soft Capitalism

    ERIC Educational Resources Information Center

    Hogan, Anna; Sellar, Sam; Lingard, Bob

    2016-01-01

    This paper provides a critical policy analysis of "The Learning Curve" (TLC) (2012), an initiative developed by the multinational edu-business, Pearson, in conjunction with the Economist Intelligence Unit. "TLC" exemplifies the commercialising of comparison and the efforts of edu-businesses to strategically position themselves…

  15. Developing Scenarios: Linking Environmental Scanning and Strategic Planning.

    ERIC Educational Resources Information Center

    Whiteley, Meredith A.; And Others

    1990-01-01

    The multiple scenario analysis technique for organizational planning used by multinational corporations is adaptable for colleges and universities. Arizona State University launched a futures-based planning project using the Delphi technique and cross-impact analysis to produce three alternative scenarios (stable, turbulent, and chaotic) to expand…

  16. The Basic Paradigm of a Future Socio-Cultural System.

    ERIC Educational Resources Information Center

    Hine, Virginia H.

    1978-01-01

    The paradigm of a future global society may already exist in a nonbureaucratic organization structure called a Segmented Polycephalous Network (SPN). A SPN consists of autonomous segments with horizontal linkages, multiple leaders, and a common ideology. Grass roots movements and multinational corporations are examples. (SJL)

  17. Polish Foreign and Security Policy: Dilemmas of Multi-National Integration and Alliance Cohesion, 1989-2005

    DTIC Science & Technology

    2005-06-01

    Administration into providing guarantees leading toward eventual NATO membership. Polish-Americans lobbied Congress; Zbigniew Brzezinski applied...Minister, Admiral Piotr Kolodziejczyk, at the Drawsko military training ground. At a dinner in which all of the participants listed above were present

  18. Latin American Debt: Opportunities for Universities.

    ERIC Educational Resources Information Center

    Garg, Ramesh C.

    The debt crisis of the lesser developed countries (LDCs) may provide opportunities for educational institutions. Through debt-for-education programs, a part of the huge debt load can be channelled into financing various educational programs sponsored by U.S. higher education institutions. Private commercial banks and multinational corporations are…

  19. 22 CFR 61.1 - Purpose.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... DEPARTMENT OF STATE PUBLIC DIPLOMACY AND EXCHANGES WORLD-WIDE FREE FLOW OF AUDIO-VISUAL MATERIALS § 61.1 Purpose. The Department of State administers the “Beirut Agreement of 1948”, a multinational treaty... Material of an Educational, Scientific and Cultural Character. This Agreement facilitates the free flow of...

  20. Repatriation Readjustment of International Managers: An Empirical Analysis of HRD Interventions

    ERIC Educational Resources Information Center

    Osman-Gani, A Ahad M.; Hyder, Akmal S.

    2008-01-01

    Purpose: With increasing interest in overseas business expansion, particularly in the Asia-Pacific region, expatriate management, including repatriation readjustments, has become a critical international human resource development (HRD) issue for multinational enterprises (MNEs). This empirical study therefore aims to investigate the use of HRD…

  1. KEYNOTE 2 : Rebuilding the Tower of Babel - Better Communication with Standards

    DTIC Science & Technology

    2013-02-01

    and a member of the Object Management Group (OMG) SysML specification team. He has been developing multi-national complex systems for almost 35 years...critical systems development, virtual team management, systems development, and software development with UML, SysML and Architectural Frameworks

  2. Developing Preservice Teachers' Global Understanding through Computer-Mediated Communication Technology

    ERIC Educational Resources Information Center

    Zong, Guichun

    2009-01-01

    This study examines preservice teachers' conceptual understanding of global education subsequent to participation in an asynchronous web-based multinational project to discuss issues related to cultural diversity and global challenges. Data included 59 preservice teachers' online messages and reflective essays. Six perspectives emerged from this…

  3. State of family medicine practice in Lebanon

    PubMed Central

    Helou, Mariana; Rizk, Grace Abi

    2016-01-01

    Background: Many difficulties are encountered in family medicine practice and were subject to multinational studies. To date, no study was conducted in Lebanon to assess the challenges that family physicians face. This study aims to evaluate the family medicine practice in Lebanon stressing on the difficulties encountered by Lebanese family physicians. Materials and Methods: A questionnaire was sent to all 96 family medicine physicians practicing in Lebanon. Participants answered questions about characteristics of family medicine practice, evaluation of the quality of work, identification of obstacles, and their effect on the medical practice. Results: The response rate was 59%, and the average number of years of practice was 10.7 years. Physicians complain mainly of heavy load at work, too many bureaucratic tasks, demanding patients, and being undervalued by the specialists. Most physicians are able to adapt between their professional and private life. Conclusion: Despite all the obstacles encountered, Lebanese family physicians have a moderate satisfaction toward their practice. They remain positive and enthusiastic about their profession. Until the ministry of public health revises its current health system, the primary care profession in Lebanon will remain fragile as a profession. PMID:27453843

  4. State of family medicine practice in Lebanon.

    PubMed

    Helou, Mariana; Rizk, Grace Abi

    2016-01-01

    Many difficulties are encountered in family medicine practice and were subject to multinational studies. To date, no study was conducted in Lebanon to assess the challenges that family physicians face. This study aims to evaluate the family medicine practice in Lebanon stressing on the difficulties encountered by Lebanese family physicians. A questionnaire was sent to all 96 family medicine physicians practicing in Lebanon. Participants answered questions about characteristics of family medicine practice, evaluation of the quality of work, identification of obstacles, and their effect on the medical practice. The response rate was 59%, and the average number of years of practice was 10.7 years. Physicians complain mainly of heavy load at work, too many bureaucratic tasks, demanding patients, and being undervalued by the specialists. Most physicians are able to adapt between their professional and private life. Despite all the obstacles encountered, Lebanese family physicians have a moderate satisfaction toward their practice. They remain positive and enthusiastic about their profession. Until the ministry of public health revises its current health system, the primary care profession in Lebanon will remain fragile as a profession.

  5. Improving Education in the Arabian Gulf Region.

    ERIC Educational Resources Information Center

    Rasheed, Mohammed A.; Hengst, Herbert R.

    1983-01-01

    Educational development in the seven Arab states of the Gulf region has been stimulated by the Arab Bureau of Education for the Gulf States (ABEGS), established in 1976. ABEGS has focused on obtaining information on education programs from member states, educating Arabs about their own culture, and establishing a multinational university. (LC)

  6. Influences on Intercultural Classroom Communication: Student Voices

    ERIC Educational Resources Information Center

    Tarp, Gertrud

    2017-01-01

    The case study is an attempt to understand how students experience intercultural classroom communication and what kind of competence they need to cope in intercultural classroom communication. The context is a supplementary course in English for university enrolment in Denmark. It is a multinational student body and all the students have finished…

  7. The Career Choice of Business Graduates: SMEs or MNCs?

    ERIC Educational Resources Information Center

    Moy, Jane W.; Lee, Sze M.

    2002-01-01

    Business undergraduates' (n=116) ratings of job attributes were overall less favorable for small/medium-sized enterprises (SMEs) than multinational corporations. SME employers' (n=30) perceptions of the attractiveness of these attributes were very different. Comparison of recruitment packages indicated that job security and long-term career…

  8. HRD in a Multicultural Workplace: The Need for Lifelong Learning.

    ERIC Educational Resources Information Center

    Ogisu-Kamiya, Motoyo

    Advocating the development of a new vision and strategies for lifelong learning in the multicultural workplace, this paper describes the influences of cultural issues on the human resource development (HRD) interface at a Japanese multinational firm operating in Canada. Following an introduction defining lifelong learning and related terms,…

  9. Globalization, Corporatism, and Critical Language Education

    ERIC Educational Resources Information Center

    Luke, Allan; Luke, Carmen; Graham, Phil

    2007-01-01

    This article explores the impacts of economic and cultural globalization on language and language education. It acknowledges the spread of English and the negative impacts of this upon other languages and language communities. The case is made that new conditions of economic dominance by multinational corporations raise the stakes for schooling…

  10. Comprehending the Critical Importance of Vocational Technical Education in a Global Economy Era.

    ERIC Educational Resources Information Center

    Wolansky, William D.

    1990-01-01

    Industrialized nations have learned that vocational education is essential to developing a skilled work force. Newly industrialized countries competing in the global economy are finding that automation, multinational companies, and rapid growth are making investment in human resources through training a critical strategy. (SK)

  11. Organizational Structures for International Universities: Implications for Campus Autonomy, Academic Freedom, Collegiality, and Conflict

    ERIC Educational Resources Information Center

    Edwards, Ron; Crosling, Glenda; Lim, Ngat-Chin

    2014-01-01

    One significant form of transnational higher education is the International Branch Campus (IBC), in effect an "outpost" of the parent institution located in another country. Its organizational structure is alignable with offshore subsidiaries of multinational corporations (MNCs). The implications of organizational structure for academic…

  12. Connections 2016: Kettering's Multinational Research

    ERIC Educational Resources Information Center

    Gilmore, Melinda, Ed.; Stewart, Philip, Ed.; Thomas, Maxine, Ed.

    2016-01-01

    The Kettering Foundation is a nonprofit, operating foundation rooted in the American tradition of cooperative research. Kettering's research is distinctive because it is conducted from the perspective of citizens and focuses on what people can do collectively to address problems affecting their lives, their communities, and their nation. The…

  13. Selection and Interview Procedures at a Multinational Company

    ERIC Educational Resources Information Center

    Burgess-Wilkerson, Barbara

    2008-01-01

    This article presents an interview with Jim Olson, a retired auto industry executive, about his experience with his company's hiring process. The responsibility for establishing and implementing procedures and policies that adhere to government regulations is critical. It makes sense for employers and potential employees to understand laws…

  14. On Language Management in Multinational Companies in the Czech Republic

    ERIC Educational Resources Information Center

    Nekvapil, Jiri; Nekula, Marek

    2006-01-01

    In this paper, we demonstrate the dialectical relationship between micro and macro language planning: macro planning influences micro planning and yet macro planning results (or should result) from micro planning. The relation between the two planning perspectives is illustrated within the framework of Language Management Theory (Jernudd &…

  15. Areas of Cross-Cultural Difference in the Workplace

    ERIC Educational Resources Information Center

    Castaneda, Mario E.; Bateh, Justin; Heyliger, Wilton

    2013-01-01

    In the last 30 years, there has been a shift towards using multicultural management strategies. The constant shifts taking place in multi-ethnic, multicultural, and multinational workforces indicate that both administrators of these organizations and higher education practices must evolve to adapt to needs for changing skill sets. A multicultural…

  16. European Management Learning: A Cross-Cultural Interpretation of Kolb's Learning Cycle.

    ERIC Educational Resources Information Center

    Jackson, Terence

    1995-01-01

    A survey of a French business school with multinational branch campuses received 123 usable responses supporting the proposition that cross-cultural differences exist within each of Kolb's learning cycle stages. National profiles of learning preferences were developed for French, German, Spanish, Anglo-Irish, and Eastern European learners. (SK)

  17. Revisiting a Theory-Supported Approach to Teaching Cross-Cultural Management Skills

    ERIC Educational Resources Information Center

    Sizoo, Steve; Serrie, Hendrick; Shapero, Morris

    2007-01-01

    Cross-cultural skills are a major criterion for success in the global business environment. For American managers in multinational organizations, this means learning to manage cultural difference at three levels: self, interpersonal, and organizational. Since literature indicates that training programs based on cross-cultural and learning theories…

  18. Simulation as a Method of Teaching Communication for Multinational Corporations.

    ERIC Educational Resources Information Center

    Stull, James B.; Baird, John W.

    Interpersonal simulations may be used as a module in cultural awareness programs to provide realistic environments in which students, supervisors, and managers may practice communication skills that are effective in multicultural environments. To conduct and implement a cross-cultural simulation, facilitators should proceed through four stages:…

  19. Languages for the World of Work. An Idea Whose Time Has Arrived.

    ERIC Educational Resources Information Center

    Tamarkin, Toby; Wilkins, Ernest J.

    1977-01-01

    This article discusses the employment outlook for those students combining foreign language skills with expertise in another area. Information gathered from multinational organizations, the Association of Export Management Companies, the United States government, and 1975 newspaper classified advertisements all indicate a wealth of opportunities…

  20. Manufacturing (Il)Literacy in Alberta's Classrooms: The Case of an Oil-Dependent State

    ERIC Educational Resources Information Center

    Hodgkins, Andrew

    2010-01-01

    This paper examines involvement of education-business "partnerships" presently occurring in the province of Alberta, Canada. Specific attention is paid to the promotion and sponsorship by oil multinational corporations (MNCs) of corporate propaganda masquerading as energy and environmental literacy programs targeted for the K-12 school…

  1. The Future of American Defense Policy

    DTIC Science & Technology

    2017-10-01

    16-44. Sharma, Avi. "Who Leads in a G-Zero World? Multi-Nationals, Sustainable Development, and Corporate Social Responsibility in a Changing...Policies in the U.S. & Western Europe." Public Finance & Management 7, no. 3(September 2007): 295-339. Tiltiņš, Alekss and Baiba Šavriņa. "Alternative

  2. A Cross-Cultural Comparison of Managerial Practices and Their Relationship to Organizational Outcome Variables.

    ERIC Educational Resources Information Center

    Young, Leanne E.; And Others

    The rapid growth of multinational corporations has necessitated theoretical and practical concerns for operating and managing organizations in varying cultural environments. The Navy Public Works Centers (PWCs) provide engineering, maintenance, rehabilitation construction, transportation and housing to U.S. Navy customers around the world.…

  3. United States European Command

    Science.gov Websites

    put to the ultimate training test April 16-27 as they reacted to a simulated 6.0 magnitude earthquake through technical and tactical skills training during exercise Stoney Run in Germany. Nato Support U.S a multinational joint equipment training brief April 2, 2018. Steady Presence Latvian Joint Terminal

  4. Changes in U.S.-International Arms Trade Practices

    DTIC Science & Technology

    1991-09-01

    7 August 1991. 13. Deegan , Lt Cal William F, Jr. Saudi AWACS: American Foreign Policy in Conflict. Research Report Number AU- AWC-86-052. Air War...A135 594). 39. Mallory, Capt Craig J. Program Manager for FS-X, Directorate of Multinational Programs, F-16 Systems Program Office. Personal

  5. If Some Doors Close, Others Will Open

    ERIC Educational Resources Information Center

    Stapel, C.; Lutman, Martha

    1974-01-01

    Two articles under one title reveal different aspects of folk high schools in the Netherlands. One discusses their primary objective, (the participation of people in social reform), and the diversity of course offerings. The other treats the schools' international functions: cultural exchange (sponsoring bi-national and multi-national seminars),…

  6. Creating the Global Graduate: A Cross-Cultural Videoconferencing Case Study

    ERIC Educational Resources Information Center

    Ferry, Diane L.; Kydd, Christine T.; Boyles, Corinne

    2012-01-01

    Business people in multinational environments must deal with a variety of situational barriers and cultural differences, such as time zones, languages, and common practice differences. Learning to accommodate these barriers and differences effectively often takes years of practice. Students who experience some of these barriers and become aware of…

  7. Joint, Interagency, Intergovernmental, Multinational : A Selected Bibliography

    DTIC Science & Technology

    2013-12-01

    Benson , Bill. "Unified Land Operations: The Evolution of Army Doctrine for Success in the 21st Century." Military Review 92, no. 2 (March-April 2012...Coalition Partnership." Military Review 91, no. 6 (November-December 2011): 57-62. ProQuest Walsh, Randal M. "Security Cooperation: A New Functional

  8. Publishing and the Book Trade in Sub-Saharan Africa: Trends and Issues and Their Implications for American Libraries.

    ERIC Educational Resources Information Center

    Bischof, Phyllis B.

    1991-01-01

    Discusses developments in publishing in Sub-Saharan Africa and suggests implications for American libraries. Highlights include economic constraints; state-sponsored publishing; African authors; publishing in Nigeria and South Africa; publishing for children; religious publishing houses; multinational firms; cooperative efforts that offer…

  9. Maquiladoras, Women's Work, and Unemployment in Northern Mexico.

    ERIC Educational Resources Information Center

    Tiano, Susan

    1984-01-01

    Uses Marxist/feminist concepts to explain employment patterns among female workers in multinational maquiladoras (assembly plants) in northern Mexico. Concludes that maquiladoras have not alleviated regional unemployment for either sex, but have created a docile low-wage work force that includes a pool of surplus labor. Contains 48 references. (SV)

  10. Foreign Policy: The High and Low Politics of Telecommunications. Publication 76-3.

    ERIC Educational Resources Information Center

    Read, William H.

    The rise of international telecommunications reflects the growth of so called "transnational" activities engaged in by border-spanning organizations, such as multinational enterprises, cross-cultural affinity groups, and even military commands. To reevaluate the process by which telecommunications foreign policy is made, this study reviews the…

  11. Scholastics, Pabulum, Clans, Transformation: A Journey into Otherness

    ERIC Educational Resources Information Center

    Lausch, David; Teman, Eric; Perry, Cody

    2017-01-01

    International students' identities are complex and so are their needs. Semi-structured interviews with 13 of the lead researcher's former students from Dubai, United Arab Emirates, who are multi-national, multi-lingual and pursuing degrees in law, business, economics, medicine, education, art and media, in the United States, United Kingdom and…

  12. Write Right for a Job.

    ERIC Educational Resources Information Center

    Yardley, Gabriel A. J.

    1998-01-01

    Many multinational companies do their hiring locally and often require prospective candidates to submit a resume or curriculum vitae in both the local language and in English. This article describes an activity that was developed to introduce Japanese university students majoring in British and American Studies to develop an understanding of the…

  13. The Use of Fractionation Scales for Communication Audits.

    ERIC Educational Resources Information Center

    Barnett, George A.; And Others

    A study investigated a new method of measuring organizational communication other than the audit methods currently in use. The method, which employs fractionation procedures, was used with workers from five different business groups within a large multinational corporation. The results showed that: (1) workers could use the scales reliably, (2)…

  14. The Handbook of Research Impact Assessment. Edition 7. Summer 1997.

    DTIC Science & Technology

    1997-01-01

    Treatment of Patients with Chronic-Schizophrenia - A Multi-National, Multicenter, Double-Blind, Parallel-Group Study Versus Haloperidol ", BRITISH JOURNAL OF...34The Scientific Production and International Reputation of Travassos,Lauro", MEMORIAS DO INSTITUTO OSWALDO CRUZ,1992, Vol 87, Iss S1, pp R7-R10 Courtial

  15. 22 CFR 61.1 - Purpose.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Purpose. 61.1 Section 61.1 Foreign Relations DEPARTMENT OF STATE PUBLIC DIPLOMACY AND EXCHANGES WORLD-WIDE FREE FLOW OF AUDIO-VISUAL MATERIALS § 61.1 Purpose. The Department of State administers the “Beirut Agreement of 1948”, a multinational treaty...

  16. The Relationship of Cultural Similarity, Communication Effectiveness and Uncertainty Reduction.

    ERIC Educational Resources Information Center

    Koester, Jolene; Olebe, Margaret

    To investigate the relationship of cultural similarity/dissimilarity, communication effectiveness, and communication variables associated with uncertainty reduction theory, a study examined two groups of students--a multinational group living on an "international floor" in a dormitory at a state university and an unrelated group of U.S.…

  17. Do Methods Matter in Global Leadership Development? Testing the Global Leadership Development Ecosystem Conceptual Model

    ERIC Educational Resources Information Center

    Walker, Jennie L.

    2018-01-01

    As world communication, technology, and trade become increasingly integrated through globalization, multinational corporations seek employees with global leadership skills. However, the demand for these skills currently outweighs the supply. Given the rarity of globally ready leaders, global competency development should be emphasized in business…

  18. Workplace Learning in Morocco: Private Sector Practices

    ERIC Educational Resources Information Center

    Cox, J. Ben; Al Arkoubi, Khadija

    2005-01-01

    The purpose of this study was to explore training and development practices in Morocco and examine them in light of international practices provided from benchmarking data. Distinctions were also made between multinationals operating in Morocco and Moroccan owned companies. Contrasts in the results are discussed with possible explanations and…

  19. [Innovative Programs in Adult Education: Foreign.

    ERIC Educational Resources Information Center

    World Education, Inc., New York, NY.

    The six descriptive position papers were prepared after selection for the Multi-National Workshop on Basic and Functional Education for Adults. Those selected are significant innovative programs of adult education in other countries that may have direct applicability to improving program practices in various parts of the world. The six programs…

  20. Gender Differences in the Determinants of the Willingness to Accept an International Assignment

    ERIC Educational Resources Information Center

    van der Velde, Mandy E. G.; Bossink, Carin J. H.; Jansen, Paul G. W.

    2005-01-01

    Multinational organisations experience difficulties in finding managers willing to accept international assignments. This study has therefore focused on factors that can predict males' and females' willingness to accept international assignments, or to follow their partners on international assignments. Hypotheses were formulated based on the…

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