Clinical Assessment and Management of Spondyloarthritides in the Middle East: A Multinational Investigation.

PubMed

Hammoudeh, Mohammed; Al Rayes, Hanan; Alawadhi, Adel; Gado, Kamel; Shirazy, Khalid; Deodhar, Atul

2015-01-01

Data on spondyloarthritis (SpA) from the Middle East are sparse and the management of these diseases in this area of the world faces a number of challenges, including the relevant resources to enable early diagnosis and referral and sufficient funds to aid the most appropriate treatment strategy. The objective was to report on the characteristics, disease burden, and treatment of SpA in the Middle East region and to highlight where management strategies could be improved, with the overall aim of achieving better patient outcomes. This multicenter, observational, cross-sectional study collected demographic, clinical, laboratory, and treatment data on 169 consecutive SpA patients at four centers (Egypt, Kuwait, Qatar, and Saudi Arabia). The data collected presents the average time from symptom onset to diagnosis along with the presence of comorbidities in the region and comparisons between treatment with NSAIDs and biologics. In the absence of regional registries of SpA patients, the data presented here provide a rare snapshot of the characteristics, disease burden, and treatment of these patients, highlighting the management challenges in the region.

Medical Therapy for Benign Prostatic Hyperplasia: New Terminology, New Concepts, Better Choices

PubMed Central

Kaplan, Steven A

2006-01-01

This article discusses 3 areas of medical therapy for benign prostatic hyperplasia (BPH) that are undergoing extensive research and evaluation: 1) the use of muscarinic receptor antagonists to treat lower urinary tract symptoms (LUTS) in men with BPH; 2) the definition of an “enlarged prostate”; and 3) sexual function and LUTS. Fears of worsening obstructive symptoms or causing acute urinary retention often keep practitioners from prescribing muscarinic receptor antagonists to men who might have concomitant bladder outlet obstruction; a multicenter, multinational, double-blind study showed that tolterodine is safe for men with low postvoid residual volumes. Most urologists accept that a prostate volume of more than 40 mL is consistent with an enlarged prostate; there is more debate regarding prostate volumes of 30 to 40 mL. Recently presented data suggest that combination medical therapy might be effective for men having prostates with volumes of more than 25 mL. The association between voiding and sexual function has been increasingly recognized and investigated, and there seem to be common pathophysiologic mechanisms governing both conditions. Targeted treatment algorithms addressing both conditions seem warranted. PMID:16985556

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.

The interaction between equipoise and logistics in clinical trials: A case study.

PubMed

Warshaw, Meredith G; Carey, Vincent J; McFarland, Elizabeth J; Dawson, Liza; Abrams, Elaine; Melvin, Ann; Fairlie, Lee; Spiegel, Hans; Jay, Jonathan; Agwu, Allison L

2017-06-01

Equipoise is usually discussed as an ethical issue in clinical trials. However, it also has practical implications. Clinical equipoise is usually construed to mean uncertainty or disagreement among the expert clinician community. However, an individual physician's sense of equipoise may vary by location, based on the local standard of care or availability of specific treatment options, and these differences can affect providers' willingness to enroll participants into clinical trials. There are also logistical barriers to enrollment in international trials due to prolonged timelines for approvals by government agencies and ethical review boards. A multinational clinical trial of bridging strategies for treatment of non-adherent HIV-infected youth, experienced differing perceptions of equipoise due to disparities in availability of treatment options by country. Unfortunately, the countries with most demand for the trial were those where the approval process was most delayed, and the study was closed early due to slow accrual. When planning multicenter clinical trials, it is important to take into account heterogeneity among research sites and try to anticipate differences in equipoise and logistical factors between sites, in order to plan to address these issues at the design stage.

Long-term evolution after in-hospital cardiac arrest in children: Prospective multicenter multinational study.

PubMed

Del Castillo, Jimena; López-Herce, Jesús; Matamoros, Martha; Cañadas, Sonia; Rodríguez-Calvo, Ana; Cecchetti, Corrado; Rodriguez-Núñez, Antonio; Álvarez, Angel Carrillo

2015-11-01

The main objective was to study survival and neurologic evolution of children who suffered in-hospital pediatric cardiac arrest (CA). The secondary objective was to analyze the influence of risk factors on the long term outcome after CA. prospective, international, observational, multicentric study in 48 hospitals of 12 countries. CA in children between 1 month and 18 years were analyzed using the Utstein template. Survival and neurological state measured by Pediatric Cerebral Performance Category (PCPC) scale one year after hospital discharge was evaluated. 502 patients with in-hospital CA were evaluated. 197 of them (39.2%) survived to hospital discharge. PCPC at hospital discharge was available in 156 of survivors (79.2%). 76.9% had good neurologic state (PCPC 1-2) and 23.1% poor PCPC values (3-6). One year after cardiac arrest we could obtain data from 144 patients (28.6%). PCPC was available in 116 patients. 88 (75.9%) had a good neurologic evaluation and 28 (24.1%) a poor one. A neurological deterioration evaluated by PCPC scale was observed in 40 patients (7.9%). One year after cardiac arrest PCPC scores compared to hospital discharge had worsen in 7 patients (6%), remained constant in 103 patients (88.8%) and had improved in 6 patients (5.2%). Survival one year after cardiac arrest in children after in-hospital cardiac arrest is high. Neurologic outcome of these children a year after cardiac arrest is mostly the same as after hospital discharge. The factors associated with a worst long-term neurological outcome are the etiology of arrest being a traumatic or neurologic illness, and the persistency of higher lactic acid values 24h after ROSC. A standardised basic protocol even practicable for lower developed countries would be a first step for the new multicenter studies. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Multinational Prospective Study of Patient-Reported Outcomes After Prostate Radiation Therapy: Detailed Assessment of Rectal Bleeding

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

Lee, Jae Y.; Daignault-Newton, Stephanie; Heath, Gerard

Purpose: The new short Expanded Prostate Cancer Index Composite for Clinical Practice (EPIC-CP) patient-reported health-related quality of life (HRQOL) tool has removed the rectal bleeding question from the previous much longer version, EPIC-26. Herein, we assess the impact of losing the dedicated rectal bleeding question in 2 independent prospective multicenter cohorts. Methods and Materials: In a prospective multicenter test cohort (n=865), EPIC-26 patient-reported HRQOL data were collected for 2 years after treatment from patients treated with prostate radiation therapy from 2003 to 2011. A second prospective multicenter cohort (n=442) was used for independent validation. A repeated-effects model was used to predictmore » the change from baseline in bowel summary scores from longer EPIC instruments using the change in EPIC-CP bowel summary scores with and without rectal bleeding scores. Results: Two years after radiation therapy, 91% of patients were free of bleeding, and only 2.6% reported bothersome bleeding problems. Correlations between EPIC-26 and EPIC-CP bowel scores were very high (r{sup 2}=0.90-0.96) and were statistically improved with the addition of rectal bleeding information (r{sup 2}=0.94-0.98). Considering all patients, only 0.2% of patients in the test cohort and 0.7% in the validation cohort reported bothersome bleeding and had clinically relevant HRQOL changes missed with EPIC-CP. However, of the 2.6% (n=17) of men with bothersome rectal bleeding in the test cohort, EPIC-CP failed to capture 1 patient (6%) as experiencing meaningful declines in bowel HRQOL. Conclusions: Modern prostate radiation therapy results in exceptionally low rates of bothersome rectal bleeding, and <1% of patients experience bothersome bleeding and are not captured by EPIC-CP as having meaningful HRQOL declines after radiation therapy. However, in the small subset of patients with bothersome rectal bleeding, the longer EPIC-26 should strongly be considered, given its superior performance in this patient subset.« less

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.

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)

Management of bipolar disorder in the intercontinental region: an international, multicenter, non-interventional, cross-sectional study in real-life conditions.

PubMed

Samalin, Ludovic; Vieta, Eduard; Okasha, Tarek Ahmed; Uddin, Mm Jalal; Ahmadi Abhari, Seyed Ali; Nacef, Fethi; Mishyiev, Vyacheslav; Aizenberg, Dovi; Ratner, Yaël; Melas-Melt, Lydie; Sedeki, Idir; Llorca, Pierre Michel

2016-05-16

Most of the existing data on real-life management of bipolar disorder are from studies conducted in western countries (mostly United States and Europe). This multinational, observational cohort study aimed to describe the management and clinical outcomes of bipolar patients in real-life conditions across various intercontinental countries (Bangladesh, Egypt, Iran, Israel, Tunisia, and Ukraine). Data on socio-demographic and disease characteristics, current symptomatology, and pharmacological treatment were collected. Comparisons between groups were performed using standard statistical tests. Overall, 1180 patients were included. The median time from initial diagnosis was 80 months. Major depressive disorder was the most common initial diagnosis. Mood stabilizers and antipsychotics were the most common drugs being prescribed at the time of the study. Antidepressants (mainly selective serotonin uptake inhibitors [SSRIs]) were administered to 36.1% of patients. Patients with bipolar I disorder received higher number of antipsychotics and anxiolytics than those with bipolar II disorder (p < 0.001). Presence of depressive symptoms was associated with an increase in antidepressant use (p < 0.001). Bipolar disorder real-life management practice, irrespective of region, shows a delay in diagnosis and an overuse of antidepressants. Clinical decision-making appears to be based on a multidimensional approach related to current symptomatology and type of bipolar disorder.

Asian motility studies in irritable bowel syndrome.

PubMed

Lee, Oh Young

2010-04-01

Altered motility remains one of the important pathophysiologic factors in patients with irritable bowel syndrome (IBS) who commonly complain of abdominal pain and stool changes such as diarrhea and constipation. The prevalence of IBS has increased among Asian populations these days. Gastrointestinal (GI) physiology may vary between Asian and Western populations because of differences in diets, socio-cultural backgrounds, and genetic factors. The characteristics and differences of GI dysmotility in Asian IBS patients were reviewed. MEDLINE search work was performed including following terms, 'IBS,' 'motility,' 'transit time,' 'esophageal motility,' 'gastric motility,' 'small intestinal motility,' 'colonic motility,' 'anorectal function,' and 'gallbladder motility' and over 100 articles were categorized under 'esophagus,' 'stomach,' 'small intestine,' 'colon,' 'anorectum,' 'gallbladder,' 'transit,' 'motor pattern,' and 'effect of stressors.' Delayed gastric emptying, slow tansit in constipation predominant IBS patients, rapid transit in diarrhea predominant IBS patients, accelerated motility responses to various stressors such as meals, mental stress, or corticotrophin releasing hormones, and altered rectal compliance and altered rectal accomodation were reported in many Asian studies regarding IBS. Many conflicting results were found among these studies and there are still controversies to conclude these as unique features of Asian IBS patients. Multinational and multicenter studies are needed to be performed vigorously in order to elaborate characteristics as well as differences of altered motililty in Asian patients with IBS.

Management of bipolar disorder in the intercontinental region: an international, multicenter, non-interventional, cross-sectional study in real-life conditions

PubMed Central

Samalin, Ludovic; Vieta, Eduard; Okasha, Tarek Ahmed; Uddin, MM. Jalal; Ahmadi Abhari, Seyed Ali; Nacef, Fethi; Mishyiev, Vyacheslav; Aizenberg, Dovi; Ratner, Yaël; Melas-Melt, Lydie; Sedeki, Idir; Llorca, Pierre Michel

2016-01-01

Most of the existing data on real-life management of bipolar disorder are from studies conducted in western countries (mostly United States and Europe). This multinational, observational cohort study aimed to describe the management and clinical outcomes of bipolar patients in real-life conditions across various intercontinental countries (Bangladesh, Egypt, Iran, Israel, Tunisia, and Ukraine). Data on socio-demographic and disease characteristics, current symptomatology, and pharmacological treatment were collected. Comparisons between groups were performed using standard statistical tests. Overall, 1180 patients were included. The median time from initial diagnosis was 80 months. Major depressive disorder was the most common initial diagnosis. Mood stabilizers and antipsychotics were the most common drugs being prescribed at the time of the study. Antidepressants (mainly selective serotonin uptake inhibitors [SSRIs]) were administered to 36.1% of patients. Patients with bipolar I disorder received higher number of antipsychotics and anxiolytics than those with bipolar II disorder (p < 0.001). Presence of depressive symptoms was associated with an increase in antidepressant use (p < 0.001). Bipolar disorder real-life management practice, irrespective of region, shows a delay in diagnosis and an overuse of antidepressants. Clinical decision-making appears to be based on a multidimensional approach related to current symptomatology and type of bipolar disorder. PMID:27181262

Epidemiology of Surgical Site Infections With Staphylococcus aureus in Europe: Protocol for a Retrospective, Multicenter Study.

PubMed

Mellinghoff, Sibylle C; Vehreschild, Jörg Janne; Liss, Blasius J; Cornely, Oliver A

2018-03-12

Surgical site infections (SSIs) are among the most common hospital acquired infections. While the incidence of SSI in certain indicator procedures is the subject of ongoing surveillance efforts in hospitals and health care systems around the world, SSI rates vary markedly within surgical categories and are poorly represented by routinely monitored indicator procedures (eg, mastectomy or hernia surgery). Therefore, relying on indicator procedures to estimate the burden of SSI is imprecise and introduces bias as hospitals may take special precautions to achieve lower SSI rates. The most common cause of SSI is Staphylococcus aureus (S. aureus), as recently confirmed by a Europe-wide point-prevalence study conducted by the European Centre for Disease Prevention and Control (ECDC). The primary objective of this study is to determine the overall and procedure-specific incidence of S. aureus SSI in Europe. Secondary objectives are the overall and procedure-specific outcomes as well as the economic burden of S. aureus SSI in Europe. Explorative objectives are to characterize the composition of the surgical patient population and to estimate the number of patients at risk for S. aureus SSI. A retrospective, multinational, multicenter cohort study (Staphylococcus aureus Surgical Site Infection Multinational Epidemiology in Europe [SALT] study) with a nested case-control part will be conducted. The study will include all surgical procedures at a participating center in order to prevent selection bias and strengthen the understanding of SSI risk by determining the incidence for all common surgical procedures. Data will be assessed in the cohort population, including 150,000 adult patients who underwent any surgical procedure in 2016, and the case-control population. We will match patients establishing S. aureus SSI 1:1 with controls from the same center. Data on demographics, surgery, and microbiology will be exported from electronic files. More detailed data will be captured from the case-control population. The SALT study will include 13 major or academic surgical centers in Europe, comprising 3 in France, 4 in Germany, 2 in Italy, 3 in Spain, and 1 in the United Kingdom. Sites were selected using a feasibility questionnaire. The SALT study is currently recruiting patients. The aim is to complete recruitment in February 2018 and to close the database in September 2018. The final results are expected by the end of 2018. Results of the SALT study will help to better understand the precise risk of certain procedures. They will also provide insight into the overall and procedure-specific incidence and outcome as well as the economic burden of S. aureus SSI in Europe. Findings of the study may help guide the design of clinical trials for S. aureus vaccines. ClinicalTrials.gov NCT03353532; https://clinicaltrials.gov/ct2/show/NCT03353532 (Archived by WebCite at http://www.webcitation.org/6xAK3gVmO). ©Sibylle C Mellinghoff, Jörg Janne Vehreschild, Blasius J Liss, Oliver A Cornely. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 12.03.2018.

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)

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

REVIVE Trial: Retrograde Delivery of Autologous Bone Marrow in Patients With Heart Failure.

PubMed

Patel, Amit N; Mittal, Sanjay; Turan, Goekmen; Winters, Amalia A; Henry, Timothy D; Ince, Hueseyin; Trehan, Naresh

2015-09-01

Cell therapy is an evolving option for patients with end-stage heart failure and ongoing symptoms despite optimal medical therapy. Our goal was to evaluate retrograde bone marrow cell delivery in patients with either ischemic heart failure (IHF) or nonischemic heart failure (NIHF). This was a prospective randomized, multicenter, open-label study of the safety and feasibility of bone marrow aspirate concentrate (BMAC) infused retrograde into the coronary sinus. Sixty patients were stratified by IHF and NIHF and randomized to receive either BMAC infusion or control (standard heart failure care) in a 4:1 ratio. Accordingly, 24 subjects were randomized to the ischemic BMAC group and 6 to the ischemic control group. Similarly, 24 subjects were randomized to the nonischemic BMAC group and 6 to the nonischemic control group. All 60 patients were successfully enrolled in the study. The treatment groups received BMAC infusion without complications. The left ventricular ejection fraction in the patients receiving BMAC demonstrated significant improvement compared with baseline, from 25.1% at screening to 31.1% at 12 months (p=.007) in the NIHF group and from 26.3% to 31.1% in the IHF group (p=.035). The end-systolic diameter decreased significantly in the nonischemic BMAC group from 55.6 to 50.9 mm (p=.020). Retrograde BMAC delivery is safe. All patients receiving BMAC experienced improvements in left ventricular ejection fraction, but only those with NIHF showed improvements in left ventricular end-systolic diameter and B-type natriuretic peptide. These results provide the basis for a larger clinical trial in HF patients. This work is the first prospective randomized clinical trial using high-dose cell therapy delivered via a retrograde coronary sinus infusion in patients with heart failure. This was a multinational, multicenter study, and it is novel, translatable, and scalable. On the basis of this trial and the safety of retrograde coronary sinus infusion, there are three other trials under way using this route of delivery. ©AlphaMed Press.

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…

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…

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…

A Cross-Sectional Survey of Near-Infrared Spectroscopy Use in Pediatric Cardiac ICUs in the United Kingdom, Ireland, Italy, and Germany.

PubMed

Hoskote, Aparna U; Tume, Lyvonne N; Trieschmann, Uwe; Menzel, Christoph; Cogo, Paola; Brown, Katherine L; Broadhead, Michael W

2016-01-01

Despite the increasing use of near-infrared spectroscopy across pediatric cardiac ICUs, there is significant variability and equipoise with no universally accepted management algorithms. We aimed to explore the use of near-infrared spectroscopy in pediatric cardiac ICUs in the United Kingdom, Ireland, Italy, and Germany. A cross-sectional multicenter, multinational electronic survey of one consultant in each pediatric cardiac ICU. Pediatric cardiac ICUs in the United Kingdom and Ireland (n = 13), Italy (n = 12), and Germany (n = 33). Questionnaire targeted to establish use, targets, protocols/thresholds for intervention, and perceived usefulness of near-infrared spectroscopy monitoring. Overall, 42 of 58 pediatric cardiac ICUs (72%) responded: United Kingdom and Ireland, 11 of 13 (84.6%); Italy, 12 of 12 (100%); and Germany, 19 of 33 (57%, included all major centers). Near-infrared spectroscopy usage varied with 35% (15/42) reporting that near-infrared spectroscopy was not used at all (7/42) or occasionally (8/42); near-infrared spectroscopy use was much less common in the United Kingdom (46%) when compared with 78% in Germany and all (100%) in Italy. Only four units had a near-infrared spectroscopy protocol, and 18 specifically used near-infrared spectroscopy in high-risk patients; 37 respondents believed that near-infrared spectroscopy added value to standard monitoring and 23 believed that it gave an earlier indication of deterioration, but only 19 would respond based on near-infrared spectroscopy data alone. Targets for absolute values and critical thresholds for intervention varied widely between units. The reasons cited for not or occasionally using near-infrared spectroscopy were expense (n = 6), limited evidence and uncertainty on how it guides management (n = 4), difficulty in interpretation, and unreliability of data (n = 3). Amongst the regular or occasional near-infrared spectroscopy users (n = 35), 28 (66%) agreed that a multicenter study is warranted to ascertain its use. Although most responding units used near-infrared spectroscopy for high-risk patients, the majority (31/35 [88%]) did not have any protocols or guidelines for intervention. Target thresholds and intervention algorithms are needed to support the use of near-infrared spectroscopy in pediatric cardiac ICUs; an international multicenter study is warranted.

Safety of a quadrivalent meningococcal serogroups A, C, W and Y conjugate vaccine (MenACWY-CRM) administered with routine infant vaccinations: results of an open-label, randomized, phase 3b controlled study in healthy infants.

PubMed

Abdelnour, Arturo; Silas, Peter E; Lamas, Marta Raquel Valdés; Aragón, Carlos Fernándo Grazioso; Chiu, Nan-Chang; Chiu, Cheng-Hsun; Acuña, Teobaldo Herrera; Castrejón, Tirza De León; Izu, Allen; Odrljin, Tatjana; Smolenov, Igor; Hohenboken, Matthew; Dull, Peter M

2014-02-12

The highest risk for invasive meningococcal disease (IMD) is in infants aged <1 year. Quadrivalent meningococcal conjugate vaccination has the potential to prevent IMD caused by serogroups A, C, W and Y. This phase 3b, multinational, open-label, randomized, parallel-group, multicenter study evaluated the safety of a 4-dose series of MenACWY-CRM, a quadrivalent meningococcal conjugate vaccine, concomitantly administered with routine vaccinations to healthy infants. Two-month-old infants were randomized 3:1 to receive MenACWY-CRM with routine vaccines or routine vaccines alone at ages 2, 4, 6 and 12 months. Adverse events (AEs) that were medically attended and serious adverse events (SAEs) were collected from all subjects from enrollment through 18 months of age. In a subset, detailed safety data (local and systemic solicited reactions and all AEs) were collected for 7 days post vaccination. The primary objective was a non-inferiority comparison of the percentages of subjects with ≥1 severe systemic reaction during Days 1-7 after any vaccination of MenACWY-CRM plus routine vaccinations versus routine vaccinations alone (criterion: upper limit of 95% confidence interval [CI] of group difference <6%). A total of 7744 subjects were randomized with 1898 in the detailed safety arm. The percentage of subjects with severe systemic reactions was 16% after MenACWY-CRM plus routine vaccines and 13% after routine vaccines alone (group difference 3.0% (95% CI -0.8, 6.4%). Although the non-inferiority criterion was not met, post hoc analysis controlling for significant center and group-by-center differences revealed that MenACWY-CRM plus routine vaccinations was non-inferior to routine vaccinations alone (group difference -0.1% [95% CI -4.9%, 4.7%]). Rates of solicited AEs, medically attended AEs, and SAEs were similar across groups. In a large multinational safety study, a 4-dose series of MenACWY-CRM concomitantly administered with routine vaccines was clinically acceptable with a similar safety profile to routine vaccines given alone. Copyright © 2013 Elsevier Ltd. All rights reserved.

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

Results from an international multicenter trial evaluating the ease-of-use of and preference for a newly developed disposable injection pen for the treatment of growth hormone deficiency in treatment-naïve children and adults

PubMed Central

Pleil, Andreas M; Darendeliler, Feyza; Dörr, Helmuth G; Hutchinson, Katherine; Wollmann, Hartmut A

2014-01-01

Previous research has reported that ease of use of and preference for a delivery device are associated with greater patient compliance – an important factor in achieving optimal therapeutic results. The objective of this study was to assess the ease-of-use of a new disposable pen (GoQuick®, Pfizer, Inc.) versus the current reusable pen (GENOTROPIN Pen®, Pfizer, Inc.) to inject a daily dose of recombinant DNA origin human growth hormone, Genotropin® (somatropin) in standard practice. In this randomized, crossover, multicenter, multinational, open-label study, ease-of-use of and preference for the two pens were assessed in three treatment-naïve populations: 1) parents of very young children; 2) parent–child dyads; and 3) adults via use of a validated self-report Injection Pen Assessment Questionnaire (IPAQ) after 2 months of at-home-use experience. The primary endpoint was the proportion of participants who reported the new disposable pen to be no different from or easier to use than the current reusable pen. Safety was also assessed and reported according to local legal requirements. Of the 120 screened patients, 119 were included in the ease-of-use analysis and all were included in the safety analyses. In all, 67.2% found the new somatropin disposable pen to be no different from or easier to use than the reusable pen (95% confidence interval: 58.8–75.7). Most adverse events were mild or moderate. No deaths or device- or treatment-related serious adverse events were reported. These results suggest that improvements made to the reusable somatropin pen are tangible and recognizable to treatment-naïve patients and their caregivers, child–caregiver dyads, and adults, and may positively impact continued compliance with therapy. Registry information ClinicalTrials.gov identifier: NCT01112865. PMID:24748824

Accuracy and Reliability of Emergency Department Triage Using the Emergency Severity Index: An International Multicenter Assessment.

PubMed

Mistry, Binoy; Stewart De Ramirez, Sarah; Kelen, Gabor; Schmitz, Paulo S K; Balhara, Kamna S; Levin, Scott; Martinez, Diego; Psoter, Kevin; Anton, Xavier; Hinson, Jeremiah S

2018-05-01

We assess accuracy and variability of triage score assignment by emergency department (ED) nurses using the Emergency Severity Index (ESI) in 3 countries. In accordance with previous reports and clinical observation, we hypothesize low accuracy and high variability across all sites. This cross-sectional multicenter study enrolled 87 ESI-trained nurses from EDs in Brazil, the United Arab Emirates, and the United States. Standardized triage scenarios published by the Agency for Healthcare Research and Quality (AHRQ) were used. Accuracy was defined by concordance with the AHRQ key and calculated as percentages. Accuracy comparisons were made with one-way ANOVA and paired t test. Interrater reliability was measured with Krippendorff's α. Subanalyses based on nursing experience and triage scenario type were also performed. Mean accuracy pooled across all sites and scenarios was 59.2% (95% confidence interval [CI] 56.4% to 62.0%) and interrater reliability was modest (α=.730; 95% CI .692 to .767). There was no difference in overall accuracy between sites or according to nurse experience. Medium-acuity scenarios were scored with greater accuracy (76.4%; 95% CI 72.6% to 80.3%) than high- or low-acuity cases (44.1%, 95% CI 39.3% to 49.0% and 54%, 95% CI 49.9% to 58.2%), and adult scenarios were scored with greater accuracy than pediatric ones (66.2%, 95% CI 62.9% to 69.7% versus 46.9%, 95% CI 43.4% to 50.3%). In this multinational study, concordance of nurse-assigned ESI score with reference standard was universally poor and variability was high. Although the ESI is the most popular ED triage tool in the United States and is increasingly used worldwide, our findings point to a need for more reliable ED triage tools. Copyright © 2017 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

Validation of the IHC4 Breast Cancer Prognostic Algorithm Using Multiple Approaches on the Multinational TEAM Clinical Trial.

PubMed

Bartlett, John M S; Christiansen, Jason; Gustavson, Mark; Rimm, David L; Piper, Tammy; van de Velde, Cornelis J H; Hasenburg, Annette; Kieback, Dirk G; Putter, Hein; Markopoulos, Christos J; Dirix, Luc Y; Seynaeve, Caroline; Rea, Daniel W

2016-01-01

Hormone receptors HER2/neu and Ki-67 are markers of residual risk in early breast cancer. An algorithm (IHC4) combining these markers may provide additional information on residual risk of recurrence in patients treated with hormone therapy. To independently validate the IHC4 algorithm in the multinational Tamoxifen Versus Exemestane Adjuvant Multicenter Trial (TEAM) cohort, originally developed on the trans-ATAC (Arimidex, Tamoxifen, Alone or in Combination Trial) cohort, by comparing 2 methodologies. The IHC4 biomarker expression was quantified on TEAM cohort samples (n = 2919) by using 2 independent methodologies (conventional 3,3'-diaminobezidine [DAB] immunohistochemistry with image analysis and standardized quantitative immunofluorescence [QIF] by AQUA technology). The IHC4 scores were calculated by using the same previously established coefficients and then compared with recurrence-free and distant recurrence-free survival, using multivariate Cox proportional hazards modeling. The QIF model was highly significant for prediction of residual risk (P < .001), with continuous model scores showing a hazard ratio (HR) of 1.012 (95% confidence interval [95% CI]: 1.010-1.014), which was significantly higher than that for the DAB model (HR: 1.008, 95% CI: 1.006-1.009); P < .001). Each model added significant prognostic value in addition to recognized clinical prognostic factors, including nodal status, in multivariate analyses. Quantitative immunofluorescence, however, showed more accuracy with respect to overall residual risk assessment than the DAB model. The use of the IHC4 algorithm was validated on the TEAM trial for predicting residual risk in patients with breast cancer. These data support the use of the IHC4 algorithm clinically, but quantitative and standardized approaches need to be used.

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.

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),…

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…

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…

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)

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…

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.…

Pivotal ERIVANCE basal cell carcinoma (BCC) study: 12-month update of efficacy and safety of vismodegib in advanced BCC.

PubMed

Sekulic, Aleksandar; Migden, Michael R; Lewis, Karl; Hainsworth, John D; Solomon, James A; Yoo, Simon; Arron, Sarah T; Friedlander, Philip A; Marmur, Ellen; Rudin, Charles M; Chang, Anne Lynn S; Dirix, Luc; Hou, Jeannie; Yue, Huibin; Hauschild, Axel

2015-06-01

Primary analysis from the pivotal ERIVANCE BCC study resulted in approval of vismodegib, a Hedgehog pathway inhibitor indicated for treatment of adults with metastatic or locally advanced basal cell carcinoma (BCC) that has recurred after surgery or for patients who are not candidates for surgery or radiation. An efficacy and safety analysis was conducted 12 months after primary analysis. This was a multinational, multicenter, nonrandomized, 2-cohort study in patients with measurable and histologically confirmed locally advanced or metastatic BCC taking oral vismodegib (150 mg/d). Primary outcome measure was objective response rate (complete and partial responses) assessed by independent review facility. After 12 months of additional follow-up, median duration of exposure to vismodegib was 12.9 months. Objective response rate increased from 30.3% to 33.3% in patients with metastatic disease, and from 42.9% to 47.6% in patients with the locally advanced form. Median duration of response in patients with locally advanced BCC increased from 7.6 to 9.5 months. No new safety signals emerged with extended treatment duration. Limitations include low prevalence of advanced BCC and challenges of designing a study with heterogenous manifestations. The 12-month update of the study confirms the efficacy and safety of vismodegib in management of advanced BCC. Copyright © 2015 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

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.

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.

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.

[Cellular phones and public health].

PubMed

Leventhal, Alex; Karsenty, Eric; Sadetzki, Siegal

2004-08-01

The increased use of mobile cellular phone by the public is associated with a wave of contradictory reports about the possible health effects, due to the exposure of the users to electromagnetic non-ionizing radiation. This article reviews the state of the art of the present knowledge concerning the biological and medical effects of exposure to cellular phones, with an emphasis on its possible carcinogenic effect. Health conditions, which have been ascribed to the use of mobile phones mainly include some types of cancer and changes of brain activity. However, the balance of evidence from available studies has not yet supported these claims. Following the recommendation of special international expert committees, the IARC (International Association for Research on Cancer) is conducting a multi-center study to determine the possible effect of cellular phone use on brain and salivary gland tumors. Israel is one of the participants of this study. The only established health effect associated with the use of such technology is an increased risk for road accidents, unrelated to the amount of radiation emitted by phone. The challenge posed by this new technology to health authorities all over the world has lead to the definition of a new principle, the so-called "prudent avoidance", used as guidelines for the definition of an adequate public health policy. The public policy in Israel has used the prudent avoidance principles, while awaiting the results of the multi-national epidemiological studies.

The TRIAGE-ProADM Score for an Early Risk Stratification of Medical Patients in the Emergency Department - Development Based on a Multi-National, Prospective, Observational Study

PubMed Central

Hausfater, Pierre; Amin, Devendra; Amin, Adina; Canavaggio, Pauline; Sauvin, Gabrielle; Bernard, Maguy; Conca, Antoinette; Haubitz, Sebastian; Struja, Tristan; Huber, Andreas; Mueller, Beat; Schuetz, Philipp

2016-01-01

Introduction The inflammatory biomarker pro-adrenomedullin (ProADM) provides additional prognostic information for the risk stratification of general medical emergency department (ED) patients. The aim of this analysis was to develop a triage algorithm for improved prognostication and later use in an interventional trial. Methods We used data from the multi-national, prospective, observational TRIAGE trial including consecutive medical ED patients from Switzerland, France and the United States. We investigated triage effects when adding ProADM at two established cut-offs to a five-level ED triage score with respect to adverse clinical outcome. Results Mortality in the 6586 ED patients showed a step-wise, 25-fold increase from 0.6% to 4.5% and 15.4%, respectively, at the two ProADM cut-offs (≤0.75nmol/L, >0.75–1.5nmol/L, >1.5nmol/L, p ANOVA <0.0001). Risk stratification by combining ProADM within cut-off groups and the triage score resulted in the identification of 1662 patients (25.2% of the population) at a very low risk of mortality (0.3%, n = 5) and 425 patients (6.5% of the population) at very high risk of mortality (19.3%, n = 82). Risk estimation by using ProADM and the triage score from a logistic regression model allowed for a more accurate risk estimation in the whole population with a classification of 3255 patients (49.4% of the population) in the low risk group (0.3% mortality, n = 9) and 1673 (25.4% of the population) in the high-risk group (15.1% mortality, n = 252). Conclusions Within this large international multicenter study, a combined triage score based on ProADM and established triage scores allowed a more accurate mortality risk discrimination. The TRIAGE-ProADM score improved identification of both patients at the highest risk of mortality who may benefit from early therapeutic interventions (rule in), and low risk patients where deferred treatment without negatively affecting outcome may be possible (rule out). PMID:28005916

Biomarkers from distinct biological pathways improve early risk stratification in medical emergency patients: the multinational, prospective, observational TRIAGE study.

PubMed

Schuetz, Philipp; Hausfater, Pierre; Amin, Devendra; Amin, Adina; Haubitz, Sebastian; Faessler, Lukas; Kutz, Alexander; Conca, Antoinette; Reutlinger, Barbara; Canavaggio, Pauline; Sauvin, Gabrielle; Bernard, Maguy; Huber, Andreas; Mueller, Beat

2015-10-29

Early risk stratification in the emergency department (ED) is vital to reduce time to effective treatment in high-risk patients and to improve patient flow. Yet, there is a lack of investigations evaluating the incremental usefulness of multiple biomarkers measured upon admission from distinct biological pathways for predicting fatal outcome and high initial treatment urgency in unselected ED patients in a multicenter and multinational setting. We included consecutive, adult, medical patients seeking ED care into this observational, cohort study in Switzerland, France and the USA. We recorded initial clinical parameters and batch-measured prognostic biomarkers of inflammation (pro-adrenomedullin [ProADM]), stress (copeptin) and infection (procalcitonin). During a 30-day follow-up, 331 of 7132 (4.6 %) participants reached the primary endpoint of death within 30 days. In logistic regression models adjusted for conventional risk factors available at ED admission, all three biomarkers strongly predicted the risk of death (AUC 0.83, 0.78 and 0.75), ICU admission (AUC 0.67, 0.69 and 0.62) and high initial triage priority (0.67, 0.66 and 0.58). For the prediction of death, ProADM significantly improved regression models including (a) clinical information available at ED admission (AUC increase from 0.79 to 0.84), (b) full clinical information at ED discharge (AUC increase from 0.85 to 0.88), and (c) triage information (AUC increase from 0.67 to 0.83) (p <0.01 for each comparison). Similarly, ProADM also improved clinical models for prediction of ICU admission and high initial treatment urgency. Results were robust in regard to predefined patient subgroups by center, main diagnosis, presenting symptoms, age and gender. Combination of clinical information with results of blood biomarkers measured upon ED admission allows early and more adequate risk stratification in individual unselected medical ED patients. A randomized trial is needed to answer the question whether biomarker-guided initial patient triage reduces time to initial treatment of high-risk patients in the ED and thereby improves patient flow and clinical outcomes. ClinicalTrials.gov NCT01768494 . Registered January 9, 2013.

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…

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…

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)

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…

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.…

CONCEPTT: Continuous Glucose Monitoring in Women with Type 1 Diabetes in Pregnancy Trial: A multi-center, multi-national, randomized controlled trial - Study protocol.

PubMed

Feig, Denice S; Asztalos, Elizabeth; Corcoy, Rosa; De Leiva, Alberto; Donovan, Lois; Hod, Moshe; Jovanovic, Lois; Keely, Erin; Kollman, Craig; McManus, Ruth; Murphy, Kellie; Ruedy, Katrina; Sanchez, J Johanna; Tomlinson, George; Murphy, Helen R

2016-07-18

Women with type 1 diabetes strive for optimal glycemic control before and during pregnancy to avoid adverse obstetric and perinatal outcomes. For most women, optimal glycemic control is challenging to achieve and maintain. The aim of this study is to determine whether the use of real-time continuous glucose monitoring (RT-CGM) will improve glycemic control in women with type 1 diabetes who are pregnant or planning pregnancy. A multi-center, open label, randomized, controlled trial of women with type 1 diabetes who are either planning pregnancy with an HbA1c of 7.0 % to ≤10.0 % (53 to ≤ 86 mmol/mol) or are in early pregnancy (<13 weeks 6 days) with an HbA1c of 6.5 % to ≤10.0 % (48 to ≤ 86 mmol/mol). Participants will be randomized to either RT-CGM alongside conventional intermittent home glucose monitoring (HGM), or HGM alone. Eligible women will wear a CGM which does not display the glucose result for 6 days during the run-in phase. To be eligible for randomization, a minimum of 4 HGM measurements per day and a minimum of 96 hours total with 24 hours overnight (11 pm-7 am) of CGM glucose values are required. Those meeting these criteria are randomized to RT- CGM or HGM. A total of 324 women will be recruited (110 planning pregnancy, 214 pregnant). This takes into account 15 and 20 % attrition rates for the planning pregnancy and pregnant cohorts and will detect a clinically relevant 0.5 % difference between groups at 90 % power with 5 % significance. Randomization will stratify for type of insulin treatment (pump or multiple daily injections) and baseline HbA1c. Analyses will be performed according to intention to treat. The primary outcome is the change in glycemic control as measured by HbA1c from baseline to 24 weeks or conception in women planning pregnancy, and from baseline to 34 weeks gestation during pregnancy. Secondary outcomes include maternal hypoglycemia, CGM time in, above and below target (3.5-7.8 mmol/l), glucose variability measures, maternal and neonatal outcomes. This will be the first international multicenter randomized controlled trial to evaluate the impact of RT- CGM before and during pregnancy in women with type 1 diabetes. ClinicalTrials.gov Identifier: NCT01788527 Registration Date: December 19, 2012.

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…

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...

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…

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…

Academic-industry Collaborations in Translational Stroke Research.

PubMed

Boltze, Johannes; Wagner, Daniel-Christoph; Barthel, Henryk; Gounis, Matthew J

2016-08-01

Academic-industry collaborations are an emerging format of translational stroke research. Next to classic contract research models, a multitude of collaboration models has been developed, some of which even allowing for multinational or intercontinental research programs. This development has recently been paralleled by first successful attempts to overcome the translational stroke research road block, such as the unprecedented success of novel endovascular approaches or the advent of the multicenter preclinical trial concept. While the first underlines the role of the industry as a major innovation driver in stroke research, the latter will require enrollment of industrial partners for optimal output. Moreover, academic-industry partnerships are invaluable to bridge the translational "valley of death" as well as funding gaps in times of dwindling public funding and declining high risk capital investments. However, these collaborations are also subject to relevant challenges because interests, values, and aims often significantly differ between cademia and industry. Here, we describe common academic-industry collaboration models as well as associated benefits and challenges in the stroke research arena. We also suggest strategies for improved planning, implementation, guidance, and utilization of academic-industry collaborations to the maximum mutual benefit.

Routine versus aggressive upstream rhythm control for prevention of early atrial fibrillation in heart failure: background, aims and design of the RACE 3 study.

PubMed

Alings, M; Smit, M D; Moes, M L; Crijns, H J G M; Tijssen, J G P; Brügemann, J; Hillege, H L; Lane, D A; Lip, G Y H; Smeets, J R L M; Tieleman, R G; Tukkie, R; Willems, F F; Vermond, R A; Van Veldhuisen, D J; Van Gelder, I C

2013-07-01

Rhythm control for atrial fibrillation (AF) is cumbersome because of its progressive nature caused by structural remodelling. Upstream therapy refers to therapeutic interventions aiming to modify the atrial substrate, leading to prevention of AF. The Routine versus Aggressive upstream rhythm Control for prevention of Early AF in heart failure (RACE 3) study hypothesises that aggressive upstream rhythm control increases persistence of sinus rhythm compared with conventional rhythm control in patients with early AF and mild-to-moderate early systolic or diastolic heart failure undergoing electrical cardioversion. RACE 3 is a prospective, randomised, open, multinational, multicenter trial. Upstream rhythm control consists of angiotensin converting enzyme inhibitors and/or angiotensin receptor blockers, mineralocorticoid receptor antagonists, statins, cardiac rehabilitation therapy, and intensive counselling on dietary restrictions, exercise maintenance, and drug adherence. Conventional rhythm control consists of routine rhythm control therapy without cardiac rehabilitation therapy and intensive counselling. In both arms, every effort is made to keep patients in the rhythm control strategy, and ion channel antiarrhythmic drugs or pulmonary vein ablation may be instituted if AF relapses. Total inclusion will be 250 patients. If upstream therapy proves to be effective in improving maintenance of sinus rhythm, it could become a new approach to rhythm control supporting conventional pharmacological and non-pharmacological rhythm control.

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

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,…

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.

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…

“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

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.…

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…

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

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.

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.

The burden and epidemiology of community-acquired central nervous system infections: a multinational study.

PubMed

Erdem, H; Inan, A; Guven, E; Hargreaves, S; Larsen, L; Shehata, G; Pernicova, E; Khan, E; Bastakova, L; Namani, S; Harxhi, A; Roganovic, T; Lakatos, B; Uysal, S; Sipahi, O R; Crisan, A; Miftode, E; Stebel, R; Jegorovic, B; Fehér, Z; Jekkel, C; Pandak, N; Moravveji, A; Yilmaz, H; Khalifa, A; Musabak, U; Yilmaz, S; Jouhar, A; Oztoprak, N; Argemi, X; Baldeyrou, M; Bellaud, G; Moroti, R V; Hasbun, R; Salazar, L; Tekin, R; Canestri, A; Čalkić, L; Praticò, L; Yilmaz-Karadag, F; Santos, L; Pinto, A; Kaptan, F; Bossi, P; Aron, J; Duissenova, A; Shopayeva, G; Utaganov, B; Grgic, S; Ersoz, G; Wu, A K L; Lung, K C; Bruzsa, A; Radic, L B; Kahraman, H; Momen-Heravi, M; Kulzhanova, S; Rigo, F; Konkayeva, M; Smagulova, Z; Tang, T; Chan, P; Ahmetagic, S; Porobic-Jahic, H; Moradi, F; Kaya, S; Cag, Y; Bohr, A; Artuk, C; Celik, I; Amsilli, M; Gul, H C; Cascio, A; Lanzafame, M; Nassar, M

2017-09-01

Risk assessment of central nervous system (CNS) infection patients is of key importance in predicting likely pathogens. However, data are lacking on the epidemiology globally. We performed a multicenter study to understand the burden of community-acquired CNS (CA-CNS) infections between 2012 and 2014. A total of 2583 patients with CA-CNS infections were included from 37 referral centers in 20 countries. Of these, 477 (18.5%) patients survived with sequelae and 227 (8.8%) died, and 1879 (72.7%) patients were discharged with complete cure. The most frequent infecting pathogens in this study were Streptococcus pneumoniae (n = 206, 8%) and Mycobacterium tuberculosis (n = 152, 5.9%). Varicella zoster virus and Listeria were other common pathogens in the elderly. Although staphylococci and Listeria resulted in frequent infections in immunocompromised patients, cryptococci were leading pathogens in human immunodeficiency virus (HIV)-positive individuals. Among the patients with any proven etiology, 96 (8.9%) patients presented with clinical features of a chronic CNS disease. Neurosyphilis, neurobrucellosis, neuroborreliosis, and CNS tuberculosis had a predilection to present chronic courses. Listeria monocytogenes, Staphylococcus aureus, M. tuberculosis, and S. pneumoniae were the most fatal forms, while sequelae were significantly higher for herpes simplex virus type 1 (p < 0.05 for all). Tackling the high burden of CNS infections globally can only be achieved with effective pneumococcal immunization and strategies to eliminate tuberculosis, and more must be done to improve diagnostic capacity.

A novel study design for antibiotic trials in acute exacerbations of COPD: MAESTRAL methodology

PubMed Central

Wilson, Robert; Anzueto, Antonio; Miravitlles, Marc; Arvis, Pierre; Faragó, Geneviève; Haverstock, Daniel; Trajanovic, Mila; Sethi, Sanjay

2011-01-01

Antibiotics, along with oral corticosteroids, are standard treatments for acute exacerbations of chronic obstructive pulmonary disease (AECOPD). The ultimate aims of treatment are to minimize the impact of the current exacerbation, and by ensuring complete resolution, reduce the risk of relapse. In the absence of superiority studies of antibiotics in AECOPD, evidence of the relative efficacy of different drugs is lacking, and so it is difficult for physicians to select the most effective antibiotic. This paper describes the protocol and rationale for MAESTRAL (moxifloxacin in AECBs [acute exacerbation of chronic bronchitis] trial; www.clinicaltrials.gov: NCT00656747), one of the first antibiotic comparator trials designed to show superiority of one antibiotic over another in AECOPD. It is a prospective, multinational, multicenter, randomized, double-blind controlled study of moxifloxacin (400 mg PO [ per os] once daily for 5 days) vs amoxicillin/clavulanic acid (875/125 mg PO twice daily for 7 days) in outpatients with COPD and chronic bronchitis suffering from an exacerbation. MAESTRAL uses an innovative primary endpoint of clinical failure: the requirement for additional or alternate treatment for the exacerbation at 8 weeks after the end of antibiotic therapy, powered for superiority. Patients enrolled are those at high-risk of treatment failure, and all are experiencing an Anthonisen type I exacerbation. Patients are stratified according to oral corticosteroid use to control their effect across antibiotic treatment arms. Secondary endpoints include quality of life, symptom assessments and health care resource use. PMID:21760724

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.

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.

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

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…

Multicenter, open-label study of recombinant human DNase in cystic fibrosis patients with moderate lung disease. DNase International Study Group.

PubMed

Harms, H K; Matouk, E; Tournier, G; von der Hardt, H; Weller, P H; Romano, L; Heijerman, H G; FitzGerald, M X; Richard, D; Strandvik, B; Kolbe, J; Kraemer, R; Michalsen, H

1998-09-01

Cystic fibrosis is characterized by the accumulation of thick viscous purulent secretions. Recombinant human deoxyribonuclease I (rhDNase) breaks down extracellular DNA, which contributes to the increased viscosity of sputum. A multinational, open-label study was conducted in 974 cystic fibrosis patients with moderate lung disease [forced vital capacity (FVC) 40-70% of predicted values] to examine the safety and efficacy of aerosolized rhDNase, 2.5 mg, once daily over a period of at least 12 weeks. Patients were assessed under conditions reflecting routine clinical practice. During rhDNase therapy, at least one respiratory tract infection (RTI) requiring intravenous antibiotics was experienced by 29.5% of patients. Forced expiratory volume in 1 second (FEV1) and FVC were significantly improved from baseline by a mean of 10.5% and 7.2%, respectively. Voice alteration and pharyngitis were the most frequent rhDNase-related adverse events, but only 2% of all patients discontinued treatment due to adverse events. The results obtained were similar to a subanalysis of data from the first 3 months of a placebo-controlled U.S. study. The patients in the present study had a similar frequency of RTIs and improvement in pulmonary function, and reported fewer rhDNase-related and cystic fibrosis-related adverse events than patients in the U.S. study. We conclude that administration of rhDNase is safe, well tolerated, and effective under conditions reflecting routine clinical practice in patients with cystic fibrosis and moderate lung disease.

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.

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

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

Clinical correlates of augmentation/combination treatment strategies in major depressive disorder.

PubMed

Dold, M; Bartova, L; Mendlewicz, J; Souery, D; Serretti, A; Porcelli, S; Zohar, J; Montgomery, S; Kasper, S

2018-05-01

This multicenter, multinational, cross-sectional study aimed to investigate clinical characteristics and treatment outcomes associated with augmentation/combination treatment strategies in major depressive disorder (MDD). Sociodemographic, clinical, and treatment features of 1410 adult MDD patients were compared between MDD patients treated with monotherapy and augmentation/combination medication using descriptive statistics, analyses of covariance (ancova), and Spearman's correlation analyses. 60.64% of all participants received augmentation and/or combination strategies with a mean number of 2.18 ± 1.22 simultaneously prescribed psychiatric drugs. We found male gender, older age, Caucasian descent, higher weight, low educational status, absence of occupation, psychotic symptoms, melancholic and atypical features, suicide risk, in-patient treatment, longer duration of hospitalization, some psychiatric comorbidities (panic disorder, agoraphobia, obsessive-compulsive disorder, and bulimia nervosa), comorbid somatic comorbidity in general and concurrent hypertension, thyroid dysfunction, diabetes, and heart disease in particular, higher current and retrospective Montgomery and Åsberg Depression Rating Scale total scores, treatment resistance, and higher antidepressant dosing to be significantly associated with augmentation/combination treatment. These findings were corroborated when examining the number of concurrently administered psychiatric drugs in the statistical analyses. Our findings suggest a clear association between augmentation/combination strategies and treatment-resistant/difficult-to-treat MDD conditions characterized by severe symptomatology and high amount of psychiatric and somatic comorbidities. © 2018 The Authors Acta Psychiatrica Scandinavica Published by John Wiley & Sons Ltd.

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

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.

Automated pre-processing and multivariate vibrational spectra analysis software for rapid results in clinical settings

NASA Astrophysics Data System (ADS)

Bhattacharjee, T.; Kumar, P.; Fillipe, L.

2018-02-01

Vibrational spectroscopy, especially FTIR and Raman, has shown enormous potential in disease diagnosis, especially in cancers. Their potential for detecting varied pathological conditions are regularly reported. However, to prove their applicability in clinics, large multi-center multi-national studies need to be undertaken; and these will result in enormous amount of data. A parallel effort to develop analytical methods, including user-friendly software that can quickly pre-process data and subject them to required multivariate analysis is warranted in order to obtain results in real time. This study reports a MATLAB based script that can automatically import data, preprocess spectra— interpolation, derivatives, normalization, and then carry out Principal Component Analysis (PCA) followed by Linear Discriminant Analysis (LDA) of the first 10 PCs; all with a single click. The software has been verified on data obtained from cell lines, animal models, and in vivo patient datasets, and gives results comparable to Minitab 16 software. The software can be used to import variety of file extensions, asc, .txt., .xls, and many others. Options to ignore noisy data, plot all possible graphs with PCA factors 1 to 5, and save loading factors, confusion matrices and other parameters are also present. The software can provide results for a dataset of 300 spectra within 0.01 s. We believe that the software will be vital not only in clinical trials using vibrational spectroscopic data, but also to obtain rapid results when these tools get translated into clinics.

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.

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.

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.

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

The pediatric heart network: meeting the challenges to multicenter studies in pediatric heart disease

PubMed Central

Burns, Kristin M.; Pemberton, Victoria L.; Pearson, Gail D.

2017-01-01

Purpose of review Because of the relatively small numbers of pediatric patients with congenital heart disease cared for in any individual center, there is a significant need for multicenter clinical studies to validate new medical or surgical therapies. The Pediatric Heart Network (PHN), with 15 years of experience in multicenter clinical research, has tackled numerous challenges when conducting multicenter studies. Recent findings This review describes the challenges encountered and the strategies employed to conduct high-quality, collaborative research in pediatric cardiovascular disease. Summary Sharing lessons learned from the PHN can provide guidance to investigators interested in conducting pediatric multicenter studies. PMID:26196261

Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study

PubMed Central

2009-01-01

OBJECTIVE—To examine associations of neonatal adiposity with maternal glucose levels and cord serum C-peptide in a multicenter multinational study, the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study, thereby assessing the Pederson hypothesis linking maternal glycemia and fetal hyperinsulinemia to neonatal adiposity. RESEARCH DESIGN AND METHODS—Eligible pregnant women underwent a standard 75-g oral glucose tolerance test between 24 and 32 weeks gestation (as close to 28 weeks as possible). Neonatal anthropometrics and cord serum C-peptide were measured. Associations of maternal glucose and cord serum C-peptide with neonatal adiposity (sum of skin folds >90th percentile or percent body fat >90th percentile) were assessed using multiple logistic regression analyses, with adjustment for potential confounders, including maternal age, parity, BMI, mean arterial pressure, height, gestational age at delivery, and the baby's sex. RESULTS—Among 23,316 HAPO Study participants with glucose levels blinded to caregivers, cord serum C-peptide results were available for 19,885 babies and skin fold measurements for 19,389. For measures of neonatal adiposity, there were strong statistically significant gradients across increasing levels of maternal glucose and cord serum C-peptide, which persisted after adjustment for potential confounders. In fully adjusted continuous variable models, odds ratios ranged from 1.35 to 1.44 for the two measures of adiposity for fasting, 1-h, and 2-h plasma glucose higher by 1 SD. CONCLUSIONS—These findings confirm the link between maternal glucose and neonatal adiposity and suggest that the relationship is mediated by fetal insulin production and that the Pedersen hypothesis describes a basic biological relationship influencing fetal growth. PMID:19011170

Older Age and Leg Pain Are Good Predictors of Pain and Disability Outcomes in 2710 Patients Who Receive Lumbar Fusion.

PubMed

Cook, Chad E; Frempong-Boadu, Anthony K; Radcliff, Kristen; Karikari, Isaac; Isaacs, Robert

2015-10-01

Identifying appropriate candidates for lumbar spine fusion is a challenging and controversial topic. The purpose of this study was to identify baseline characteristics related to poor/favorable outcomes at 1 year for a patient who received lumbar spine fusion. The aims of this study were to describe baseline characteristics of those who received lumbar surgery and to identify baseline characteristics from a spine repository that were related to poor and favorable pain and disability outcomes for patient who received lumbar fusion (with or without decompression), who were followed up for 1 full year and discriminate predictor variables that were either or in contrast to prognostic variables reported in the literature. This study analyzed data from 2710 patients who underwent lumbar spine fusion. All patient data was part of a multicenter, multi-national spine repository. Ten relatively commonly captured data variables were used as predictors for the study. Univariate/multivariate logistic regression analyses were run against outcome variables of pain/disability. Multiple univariate findings were associated with pain/disability outcomes at 1 year including age, previous surgical history, baseline disability, baseline pain, baseline quality of life scores, and leg pain greater than back pain. Notably significant multivariate findings for both pain and disability include older age, previous surgical history, and baseline mental summary scores, disability, and pain. Leg pain greater than back pain and older age may yield promising value when predicting positive outcomes. Other significant findings may yield less value since these findings are similar to those that are considered to be prognostic regardless of intervention type.

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

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...

Stent thrombosis and bleeding complications after implantation of sirolimus-eluting coronary stents in an unselected worldwide population: a report from the e-SELECT (Multi-Center Post-Market Surveillance) registry.

PubMed

Urban, Philip; Abizaid, Alexandre; Banning, Adrian; Bartorelli, Antonio L; Baux, Ana Cebrian; Džavík, Vladimír; Ellis, Stephen; Gao, Runlin; Holmes, David; Jeong, Myung Ho; Legrand, Victor; Neumann, Franz-Josef; Nyakern, Maria; Spaulding, Christian; Worthley, Stephen

2011-03-29

The aim of this study was to ascertain the 1-year incidence of stent thrombosis (ST) and major bleeding (MB) in a large, unselected population treated with sirolimus-eluting stents (SES). Stent thrombosis and MB are major potential complications of drug-eluting stent implantation. Their relative incidence and predisposing factors among large populations treated worldwide are unclear. The SES were implanted in 15,147 patients who were entered in a multinational registry. We analyzed the incidence of: 1) definite and probable ST as defined by the Academic Research Consortium; and 2) MB, with the STEEPLE (Safety and efficacy of Enoxaparin in PCI) definition, together with their relation to dual antiplatelet therapy (DAPT) and to 1-year clinical outcomes. The mean age of the sample was 62 ± 11 years, 30.4% were diabetic, 10% had a Charlson comorbidity index ≥3, and 44% presented with acute coronary syndrome or myocardial infarction. At 1 year, the reported compliance with DAPT as recommended by the European Society of Cardiology guidelines was 86.3%. Adverse event rates were: ST 1.0%, MB 1.0%, mortality 1.7%, myocardial infarction 1.9%, and target lesion revascularization 2.3%. Multivariate analysis identified 9 correlates of ST and 4 correlates of MB. Advanced age and a high Charlson index were associated with an increased risk of both ST and MB. After ST, the 7-day and 1-year all-cause mortality was 30% and 35%, respectively, versus 1.5% and 10% after MB. Only 2 of 13,749 patients (0.015%) experienced both MB and ST during the entire 1-year follow-up period. In this worldwide population treated with ≥1 SES, the reported compliance with DAPT was good, and the incidence of ST and MB was low. Stent thrombosis and MB very rarely occurred in the same patient. (The e-SELECT Registry: a Multicenter Post-Market Surveillance; NCT00438919). Copyright © 2011 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

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

Medication overuse headache in Europe and Latin America: general demographic and clinical characteristics, referral pathways and national distribution of painkillers in a descriptive, multinational, multicenter study.

PubMed

Find, Ninett Louise; Terlizzi, Rossana; Munksgaard, Signe Bruun; Bendtsen, Lars; Tassorelli, Cristina; Nappi, Giuseppe; Katsarava, Zaza; Lainez, Miguel; Goicochea, Maria Teresa; Shand, Beatriz; Fadic, Ricardo; Spadafora, Santiago; Pagani, Marco; Jensen, Rigmor

2015-01-01

Medication overuse headache (MOH) is a very disabling and costly disorder due to indirect costs, medication and healthcare utilization. The aim of the study was to describe general demographic and clinical characteristics of MOH, along with the national referral pathways and national painkillers distribution in several European and Latin American (LA) Countries. This descriptive cross-sectional observational study included 669 patients with MOH referred to headache-centers in Europe and LA as a part of the COMOESTAS project. Information about acute medication and healthcare utilization were collected by extensive questionnaires, supplemented with structured patient interviews. Triptans were overused by 31 % European patients and by 6 % in LA (p < 0.001), whereas ergotamines were overused by 4 % in Europe and 72 % in LA (p < 0.001). Simple analgesics were overused by 54 % in Europe and by 33 % in LA (p < 0.001), while combination-analgesics were more equally overused (24 % in Europe and 29 % in LA). More European patients (57 %) compared with LA patients (27 %) visited general practitioners (p < 0.001), and 83 % of European patients compared to 38 % in LA consulted headache specialists (p < 0.001). A total of 20 % in Europe and 30 % in LA visited emergency rooms (p = 0.007). There are marked variations between LA and Europe in healthcare pathways and in acute medication overuse regarding patients with MOH. This should be considered when planning prevention campaigns against MOH.

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.

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.

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.

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

[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.

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.

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.

77 FR 12598 - Notice Correction; A Multi-Center International Hospital-Based Case-Control Study of Lymphoma in...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-01

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Notice Correction; A Multi-Center International Hospital-Based Case-Control Study of Lymphoma in Asia (AsiaLymph) (NCI) The Federal... project titled, ``A multi-center international hospital-based case-control study of lymphoma in Asia (Asia...

[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.

Technical aspects of pediatric epilepsy surgery: Report of a multicenter, multinational web-based survey by the ILAE Task Force on Pediatric Epilepsy Surgery.

PubMed

Cukiert, Arthur; Rydenhag, Bertil; Harkness, William; Cross, J Helen; Gaillard, William D

2016-02-01

Surgical techniques may vary extensively between centers. We report on a web-based survey aimed at evaluating the current technical approaches in different centers around the world performing epilepsy surgery in children. The intention of the survey was to establish technical standards. A request was made to 88 centers to complete a web-based survey comprising 51 questions. There were 14 questions related to general issues, 13 questions investigating the different technical aspects for children undergoing epilepsy surgery, and 24 questions investigating surgical strategies in pediatric epilepsy surgery. Fifty-two centers covering a wide geographic representation completed the questionnaire. The median number of resective procedures per center per year was 47. Some important technical practices appeared (>80% of the responses) such as the use of prophylactic antibiotics (98%), the use of high-speed drills for bone opening (88%), nonresorbable material for bone flap closure (85%), head fixation (90%), use of the surgical microscope (100%), and of free bone flaps. Other questions, such as the use of drains, electrocorticography (ECoG) and preoperative withdrawal of valproate, led to mixed, inconclusive results. Complications were noted in 3.8% of the patients submitted to cortical resection, 9.9% hemispheric surgery, 5% callosotomy, 1.8% depth electrode implantation, 5.9% subdural grids implantation, 11.9% hypothalamic hamartoma resection, 0.9% vagus nerve stimulation (VNS), and 0.5% deep brain stimulation. There were no major differences across regions or countries in any of the subitems above. The present data offer the first overview of the technical aspects of pediatric epilepsy surgery worldwide. Surprisingly, there seem to be more similarities than differences. That aside many of the evaluated issues should be examined by adequately designed multicenter randomized controlled trials (RCTs). Further knowledge on these technical issues might lead to increased standardization and lower costs in the future, as well as definitive practice guidelines. Wiley Periodicals, Inc. © 2016 International League Against Epilepsy.

A phase 2, open-label, multicenter study of the long-term safety of siltuximab (an anti-interleukin-6 monoclonal antibody) in patients with multicentric Castleman disease.

PubMed

van Rhee, Frits; Casper, Corey; Voorhees, Peter M; Fayad, Luis E; van de Velde, Helgi; Vermeulen, Jessica; Qin, Xiang; Qi, Ming; Tromp, Brenda; Kurzrock, Razelle

2015-10-06

Multicentric Castleman disease (MCD) is a rare, systemic lymphoproliferative disorder driven by interleukin (IL)-6 overproduction. Siltuximab, an anti-IL-6 monoclonal antibody, has demonstrated durable tumor and symptomatic responses in a multinational, randomized, placebo-controlled study of MCD. This preplanned safety analysis was conducted to evaluate the long-term safety of siltuximab treatment among 19 patients with MCD who had stable disease or better and were enrolled in a phase-1 study and subsequent ongoing, open-label, phase-2 extension study. Dosing was 11 mg/kg administered intravenously every 3 weeks, per protocol, or every 6 weeks at the investigator's discretion. Safety monitoring focused on potential risks associated with the anti-IL-6 mechanism of action. Investigator-assessed disease control status was also documented. Median treatment duration for the 19 patients was 5.1 (range 3.4, 7.2) years, with 14 (74%) patients treated for >4 years. Grade-≥ 3 adverse events (AEs) reported in >1 patient included hypertension (n = 3) and nausea, cellulitis, and fatigue (n = 2 each). Grade-≥ 3 AEs at least possibly attributed to siltuximab were leukopenia, lymphopenia, and a serious AE of polycythemia (n = 1 each). Hypertriglyceridemia and hypercholesterolemia (total cholesterol) were reported in 8 and 9 patients, respectively. No disease relapses were observed, and 8 of 19 patients were able to switch to an every-6-week dosing schedule. All MCD patients in this extension study have received siltuximab for a prolonged duration (up to 7 years) without evidence of cumulative toxicity or treatment discontinuations and with few serious infections. All patients are alive, demonstrate sustained disease control, and continue to receive siltuximab.

GH treatment to final height produces similar height gains in patients with SHOX deficiency and Turner syndrome: results of a multicenter trial.

PubMed

Blum, Werner F; Ross, Judith L; Zimmermann, Alan G; Quigley, Charmian A; Child, Christopher J; Kalifa, Gabriel; Deal, Cheri; Drop, Stenvert L S; Rappold, Gudrun; Cutler, Gordon B

2013-08-01

Growth impairment in short stature homeobox-containing gene (SHOX) deficiency and Turner syndrome share a similar etiology. Because of the established effect of GH treatment on height in patients with Turner syndrome, we hypothesized that GH therapy would also stimulate growth in patients with SHOX deficiency. Our objectives were to evaluate long-term efficacy of GH treatment in short patients with SHOX deficiency and to compare the effect on final (adult) height (FH) in patients with SHOX deficiency and Turner syndrome. A prospective, multinational, open-label, randomized 3-arm study consisting of a 2-year control period and a subsequent extension period to FH. The treatment groups were 1) SHOX-D-C/GH (untreated during the control period, GH-treated during the extension), 2) SHOX-D-GH/GH, and 3) Turner-GH/GH (GH-treated during both study periods). Short-statured prepubertal patients with genetically confirmed SHOX deficiency (n = 49) or Turner syndrome (n = 24) who participated in the extension. Depending on the study arm, patients received a daily sc injection of 0.05 mg/kg recombinant human GH from start of the study or start of the extension until attainment of FH or study closure. Height SD score gain from start of GH treatment to FH was similar between the combined SHOX-deficient groups (n = 28, 1.34 ± 0.18 [least-squares mean ± SE]) and the Turner group (n = 19, 1.32 ± 0.22). In this FH population, 57% of the patients with SHOX deficiency and 32% of the patients with Turner syndrome achieved a FH greater than -2 SD score. GH treatment in short children with SHOX deficiency showed similar long-term efficacy as seen in girls with Turner syndrome.

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)

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)

Outcomes of Robot-assisted Partial Nephrectomy for Clinical T2 Renal Tumors: A Multicenter Analysis (ROSULA Collaborative Group).

PubMed

Bertolo, Riccardo; Autorino, Riccardo; Simone, Giuseppe; Derweesh, Ithaar; Garisto, Juan D; Minervini, Andrea; Eun, Daniel; Perdona, Sisto; Porter, James; Rha, Koon Ho; Mottrie, Alexander; White, Wesley M; Schips, Luigi; Yang, Bo; Jacobsohn, Kenneth; Uzzo, Robert G; Challacombe, Ben; Ferro, Matteo; Sulek, Jay; Capitanio, Umberto; Anele, Uzoma A; Tuderti, Gabriele; Costantini, Manuela; Ryan, Stephen; Bindayi, Ahmet; Mari, Andrea; Carini, Marco; Keehn, Aryeh; Quarto, Giuseppe; Liao, Michael; Chang, Kidon; Larcher, Alessandro; De Naeyer, Geert; De Cobelli, Ottavio; Berardinelli, Francesco; Zhang, Chao; Langenstroer, Peter; Kutikov, Alexander; Chen, David; De Luyk, Nicolo; Sundaram, Chandru P; Montorsi, Francesco; Stein, Robert J; Haber, Georges Pascal; Hampton, Lance J; Dasgupta, Prokar; Gallucci, Michele; Kaouk, Jihad; Porpiglia, Francesco

2018-05-18

While partial nephrectomy (PN) represents the standard surgical management for cT1 renal masses, its role for cT2 tumors is controversial. Robot-assisted PN (RAPN) is being increasingly implemented worldwide. To analyze perioperative, functional, and oncological outcomes of RAPN for cT2 tumors. Retrospective analysis of a large multicenter, multinational dataset of patients with nonmetastatic cT2 masses treated with robotic surgery (ROSULA: RObotic SUrgery for LArge renal mass). Robotic-assisted PN. Patients' demographics, lesion characteristics, perioperative variables, renal functional data, pathology, and oncological data were analyzed. Univariable and multivariable regression analyses assessed the relationships with the risk of intra-/postoperative complications, recurrence, and survival. A total of 298 patients were analyzed. Median tumor size was 7.6 (7-8.5) cm. Median RENAL score was 9 (8-10). Median ischemia time was 25 (20-32) min. Median estimated blood loss was 150 (100-300) ml. Sixteen patients had intraoperative complications (5.4%), whereas 66 (22%) had postoperative complications (5% were Clavien grade ≥3). Multivariable analysis revealed that a lower RENAL score (odds ratio [OR] 0.46, 95% confidence interval [CI] 0.21-0.65, p=0.02) and pathological pT2 stage (OR 0.51, 95% CI 0.12-0.86, p=0.001) were protective against postoperative complications. A total of 243 lesions (82%) were malignant. Twenty patients (8%) had positive surgical margins. Ten deaths and 25 recurrences/metastases occurred at a median follow-up of 12 (5-35) mo. At univariable analysis, higher pT stage was predictive of a likelihood of recurrences/metastases (p=0.048). While there was a significant deterioration of renal function at discharge, this remained stable over time at 1-yr follow-up. The main limitation of this study is its retrospective design. RAPN in the setting of select cT2 renal masses can safely be performed with acceptable outcomes. Further studies are warranted to corroborate our findings and to better define the role of robotic nephron sparing for this challenging indication. This report shows that robotic surgery can be used for safe removal of a large renal tumor in a minimally invasive fashion, maximizing preservation of renal function, and without compromising cancer control. Published by Elsevier B.V.

Regional differences in baseline disease activity and remission rates following golimumab treatment for RA: results from the GO-MORE trial.

PubMed

Durez, Patrick; Pavelka, Karel; Lazaro, Maria Alicia; Garcia-Kutzbach, Abraham; Moots, Robert J; Amital, Howard; Govoni, Marinella; Vastesaeger, Nathan

2018-05-01

GO-MORE (NCT00975130) was a large open-label, multinational, multicenter, prospective phase 3 trial evaluating add-on therapy with golimumab in biologic-naïve patients with active rheumatoid arthritis (RA). The objective of this post hoc analysis was to examine regional differences in baseline disease activity and remission rates following golimumab treatment for RA. This was a planned, descriptive post hoc analysis of data from the GO-MORE trial. Baseline disease activity and remission were defined as moderate or severe based on EULAR criteria. This analysis included 3280 participants from the GO-MORE trial. All participants included in this analysis had high or moderate disease activity at baseline. At baseline, high disease activity was least common in Europe (71.0%), Canada (77.0%), and the Middle East (78.2%) and most common in Latin America (90.7%), South Africa (91.5%), and Asia (92.5%). Month 6 remission rates were highest in South Africa (29.1%), Europe (27.9%), and the Middle East (27.3%) and lowest in Canada (19.7%), Latin America (17.2%), and Asia (15.0%). Higher rates of remission in each geographical region generally corresponded with lower baseline disease activity. We suspect that access to care and implementation of the treat-to-target strategy were the most important determinants, but this apparent relationship needs to be confirmed in further studies that include a statistical analysis of prognostic indicators.

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

Epidemiology of Weaning Outcome according to a New Definition. The WIND Study.

PubMed

Béduneau, Gaëtan; Pham, Tài; Schortgen, Frédérique; Piquilloud, Lise; Zogheib, Elie; Jonas, Maud; Grelon, Fabien; Runge, Isabelle; Nicolas Terzi; Grangé, Steven; Barberet, Guillaume; Guitard, Pierre-Gildas; Frat, Jean-Pierre; Constan, Adrien; Chretien, Jean-Marie; Mancebo, Jordi; Mercat, Alain; Richard, Jean-Christophe M; Brochard, Laurent

2017-03-15

The weaning process concerns all patients receiving mechanical ventilation. A previous classification into simple, prolonged, and difficult weaning ignored weaning failure and presupposed the use of spontaneous breathing trials. To describe the weaning process, defined as starting with any attempt at separation from mechanical ventilation and its prognosis, according to a new operational classification working for all patients under ventilation. This was a multinational prospective multicenter observational study over 3 months of all patients receiving mechanical ventilation in 36 intensive care units, with daily collection of ventilation and weaning modalities. Pragmatic definitions of separation attempt and weaning success allowed us to allocate patients in four groups. A total of 2,729 patients were enrolled. Although half of them could not be classified using the previous definition, 99% entered the groups on the basis of our new definition as follows: 24% never started a weaning process, 57% had a weaning process of less than 24 hours (group 1), 10% had a difficult weaning of more than 1 day and less than 1 week (group 2), and 9% had a prolonged weaning duration of 1 week or more (group 3). Duration of ventilation, intensive care unit stay, and mortality (6, 17, and 29% for the three groups, respectively) all significantly increased from one group to the next. The unadjusted risk of dying was 19% after the first separation attempt and increased to 37% after 10 days. A new classification allows us to categorize all weaning situations. Every additional day without a weaning success after the first separation attempt increases the risk of dying.

Maté drinking and esophageal squamous cell carcinoma in South America: pooled results from two large multicenter case-control studies.

PubMed

Lubin, Jay H; De Stefani, Eduardo; Abnet, Christian C; Acosta, Gisele; Boffetta, Paolo; Victora, Cesar; Graubard, Barry I; Muñoz, Nubia; Deneo-Pellegrini, Hugo; Franceschi, Silvia; Castellsagué, Xavier; Ronco, Alvaro L; Dawsey, Sanford M

2014-01-01

Maté tea is a nonalcoholic infusion widely consumed in southern South America, and may increase risk of esophageal squamous cell carcinoma (ESCC) and other cancers due to polycyclic aromatic hydrocarbons (PAH) and/or thermal injury. We pooled two case-control studies: a 1988 to 2005 Uruguay study and a 1986 to 1992 multinational study in Argentina, Brazil, Paraguay, and Uruguay, including 1,400 cases and 3,229 controls. We computed ORs and fitted a linear excess OR (EOR) model for cumulative maté consumption in liters/day-year (LPDY). The adjusted OR for ESCC with 95% confidence interval (CI) by ever compared with never use of maté was 1.60 (1.2-2.2). ORs increased linearly with LPDY (test of nonlinearity; P = 0.69). The estimate of slope (EOR/LPDY) was 0.009 (0.005-0.014) and did not vary with daily intake, indicating maté intensity did not influence the strength of association. EOR/LPDY estimates for consumption at warm, hot, and very hot beverage temperatures were 0.004 (-0.002-0.013), 0.007 (0.003-0.013), and 0.016 (0.009-0.027), respectively, and differed significantly (P < 0.01). EOR/LPDY estimates were increased in younger (<65) individuals and never alcohol drinkers, but these evaluations were post hoc, and were homogeneous by sex. ORs for ESCC increased linearly with cumulative maté consumption and were unrelated to intensity, so greater daily consumption for shorter duration or lesser daily consumption for longer duration resulted in comparable ORs. The strength of association increased with higher maté temperatures. Increased understanding of cancer risks with maté consumption enhances the understanding of the public health consequences given its purported health benefits.

Status of oral anticoagulant treatment in patients with nonvalvular atrial fibrillation in Spain. REACT-AF Study.

PubMed

de Andrés-Nogales, F; Oyagüez, I; Betegón-Nicolás, L; Canal-Fontcuberta, C; Soto-Álvarez, J

2015-03-01

Oral anticoagulant therapy is complex due to the need for control and the hemorrhagic risk the therapy entails. This study aims to determine the standard clinical practice in the treatment for preventing stroke in patients with nonvalvular atrial fibrillation (NVAF) in Spain. The Real Evidence of Anti Coagulation Treatment in AF is a European, multicenter, multinational, observational, retrospectively monitored cohort of patients with NVAF. This study included patients recruited in Spain with at least one visit during the period of inclusion (May 2010/April 2012). The study evaluated the following: a) persistence of oral anticoagulant treatment (time to discontinuation); b) persistence rate (% of patients in treatment) at 6, 12 and 24 months and at 5 years; c) therapeutic compliance (medication possession ratio); d) the correlation between the treatment followed and that recommended by the European Society of Cardiology; and the incidence of stroke and hemorrhagic events. The patients treated with oral anticoagulants (n=7,526) had a median time to discontinuation of treatment of 1.99 years and a persistence rate at 5 years of 26% (discontinuation ≥3 months). The compliance (mean MPR) was 0.54±0.36. The incidence of stroke was 0.3/100 person-years, and the incidence of hemorrhagic events was 2.4/100 person-years. Fifty-eight percent of the patients with NVAF (n=12,514) followed the recommendations of the European Society of Cardiology. Forty-two percent of the patients with NVAF did not follow the recommendations of the European Society of Cardiology. We detected low persistence and treatment compliance rates for oral anticoagulants. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

Standard of care and direct medical costs of the treatment of chronic lymphocytic leukemia among the adult population in Ukraine, Russia, and Kazakhstan: data from the LEUKOSPECT study

PubMed Central

Vasylyev, Averyan; Molostvova, Valentina; Rebrov, Boris A; Makarova, Janina; Zaritskey, Andrey; Ptushkin, Vadim; Ramazanova, Raigul; Popovych, Yuriy; Tsyapka, Orest; Pashanov, Evgeny

2017-01-01

Purpose The LEUKOSPECT study aimed to describe health service utilization and to estimate the direct medical costs (DMCs) of chronic lymphocytic leukemia (CLL) in 2013 in the adult population of three post-Soviet countries – Russia, Ukraine, and Kazakhstan. As oncologic medical care is provided by federal state-owned, specialized medical institutions, the cost estimation in this study primarily informs from a state budget perspective. Patients’ contributions to medical costs were not included in the cost evaluation. Patients and methods This was a multinational, multicenter, retrospective study conducted in eight specialized centers (four in Russia, three in Ukraine, and one in Kazakhstan). The investigators captured data from the medical documents of all adult patients with an established CLL diagnosis before December 31, 2013, and who made at least one visit to their respective center between January 1 and December 31, 2013. Results A total of 319 adult CLL patients were enrolled (124 in Kazakhstan, 106 in Russia, and 89 in Ukraine). In 2013, the DMCs of CLL management (without CLL therapy) were €215.40 in Kazakhstan, €1,342.20 in Russia, and €13,260.70 in Ukraine. Hospitalizations formed the largest proportion of total cost: 18.1%, 23.1%, and 40.4%, respectively. The mean cost of CLL medical treatment was €13,580.60 (Russia), €399.40 (Kazakhstan), and €7,453.00 (Ukraine). Conclusion CLL treatment standards varied across the selected countries; higher usage of biologic therapy was noted in Russia. Future research is needed to assess DMCs which include CLL treatment, which is another essential factor contributing to CLL DMCs. PMID:28919818

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…

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…

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. ...

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

Multicenter AIDS Cohort Study Quantitative Coronary Plaque Progression Study: rationale and design.

PubMed

Nakanishi, Rine; Post, Wendy S; Osawa, Kazuhiro; Jayawardena, Eranthi; Kim, Michael; Sheidaee, Nasim; Nezarat, Negin; Rahmani, Sina; Kim, Nicholas; Hathiramani, Nicolai; Susarla, Shriraj; Palella, Frank; Witt, Mallory; Blaha, Michael J; Brown, Todd T; Kingsley, Lawrence; Haberlen, Sabina A; Dailing, Christopher; Budoff, Matthew J

2018-01-01

The association of HIV with coronary atherosclerosis has been established; however, the progression of coronary atherosclerosis over time among participants with HIV is not well known. The Multicenter AIDS Cohort Study Quantitative Coronary Plaque Progression Study is a large prospective multicenter study quantifying progression of coronary plaque assessed by serial coronary computed tomography angiography (CTA). HIV-infected and uninfected men who were enrolled in the Multicenter AIDS Cohort Study Cardiovascular Substudy were eligible to complete a follow-up contrast coronary CTA 3-6 years after baseline. We measured coronary plaque volume and characteristics (calcified and noncalcified plaque including fibrous, fibrous-fatty, and low attenuation) and vulnerable plaque among HIV-infected and uninfected men using semiautomated plaque software to investigate the progression of coronary atherosclerosis over time. We describe a novel, large prospective multicenter study investigating incidence, transition of characteristics, and progression in coronary atherosclerosis quantitatively assessed by serial coronary CTAs among HIV-infected and uninfected men.

Conducting multicenter research in healthcare simulation: Lessons learned from the INSPIRE network.

PubMed

Cheng, Adam; Kessler, David; Mackinnon, Ralph; Chang, Todd P; Nadkarni, Vinay M; Hunt, Elizabeth A; Duval-Arnould, Jordan; Lin, Yiqun; Pusic, Martin; Auerbach, Marc

2017-01-01

Simulation-based research has grown substantially over the past two decades; however, relatively few published simulation studies are multicenter in nature. Multicenter research confers many distinct advantages over single-center studies, including larger sample sizes for more generalizable findings, sharing resources amongst collaborative sites, and promoting networking. Well-executed multicenter studies are more likely to improve provider performance and/or have a positive impact on patient outcomes. In this manuscript, we offer a step-by-step guide to conducting multicenter, simulation-based research based upon our collective experience with the International Network for Simulation-based Pediatric Innovation, Research and Education (INSPIRE). Like multicenter clinical research, simulation-based multicenter research can be divided into four distinct phases. Each phase has specific differences when applied to simulation research: (1) Planning phase , to define the research question, systematically review the literature, identify outcome measures, and conduct pilot studies to ensure feasibility and estimate power; (2) Project Development phase , when the primary investigator identifies collaborators, develops the protocol and research operations manual, prepares grant applications, obtains ethical approval and executes subsite contracts, registers the study in a clinical trial registry, forms a manuscript oversight committee, and conducts feasibility testing and data validation at each site; (3) Study Execution phase , involving recruitment and enrollment of subjects, clear communication and decision-making, quality assurance measures and data abstraction, validation, and analysis; and (4) Dissemination phase , where the research team shares results via conference presentations, publications, traditional media, social media, and implements strategies for translating results to practice. With this manuscript, we provide a guide to conducting quantitative multicenter research with a focus on simulation-specific issues.

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

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.

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

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)

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)

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…

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

Three-dimensional navigation is more accurate than two-dimensional navigation or conventional fluoroscopy for percutaneous sacroiliac screw fixation in the dysmorphic sacrum: a randomized multicenter study.

PubMed

Matityahu, Amir; Kahler, David; Krettek, Christian; Stöckle, Ulrich; Grutzner, Paul Alfred; Messmer, Peter; Ljungqvist, Jan; Gebhard, Florian

2014-12-01

To evaluate the accuracy of computer-assisted sacral screw fixation compared with conventional techniques in the dysmorphic versus normal sacrum. Review of a previous study database. Database of a multinational study with 9 participating trauma centers. The reviewed group included 130 patients, 72 from the navigated group and 58 from the conventional group. Of these, 109 were in the nondysmorphic group and 21 in the dysmorphic group. Placement of sacroiliac (SI) screws was performed using standard fluoroscopy for the conventional group and BrainLAB navigation software with either 2-dimensional or 3-dimensional (3D) navigation for the navigated group. Accuracy of SI screw placement by 2-dimensional and 3D navigation versus conventional fluoroscopy in dysmorphic and nondysmorphic patients, as evaluated by 6 observers using postoperative computerized tomography imaging at least 1 year after initial surgery. Intraobserver agreement was also evaluated. There were 11.9% (13/109) of patients with misplaced screws in the nondysmorphic group and 28.6% (6/21) of patients with misplaced screws in the dysmorphic group, none of which were in the 3D navigation group. Raw agreement between the 6 observers regarding misplaced screws was 32%. However, the percent overall agreement was 69.0% (kappa = 0.38, P < 0.05). The use of 3D navigation to improve intraoperative imaging for accurate insertion of SI screws is magnified in the dysmorphic proximal sacral segment. We recommend the use of 3D navigation, where available, for insertion of SI screws in patients with normal and dysmorphic proximal sacral segments. Therapeutic level I.

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.

Asfotase Alfa Treatment Improves Survival for Perinatal and Infantile Hypophosphatasia

PubMed Central

Rockman-Greenberg, Cheryl; Ozono, Keiichi; Riese, Richard; Moseley, Scott; Melian, Agustin; Thompson, David D.; Bishop, Nicholas; Hofmann, Christine

2016-01-01

Context: Hypophosphatasia (HPP) is an inborn error of metabolism that, in its most severe perinatal and infantile forms, results in 50–100% mortality, typically from respiratory complications. Objectives: Our objective was to better understand the effect of treatment with asfotase alfa, a first-in-class enzyme replacement therapy, on mortality in neonates and infants with severe HPP. Design/Setting: Data from patients with the perinatal and infantile forms of HPP in two ongoing, multicenter, multinational, open-label, phase 2 interventional studies of asfotase alfa treatment were compared with data from similar patients from a retrospective natural history study. Patients: Thirty-seven treated patients (median treatment duration, 2.7 years) and 48 historical controls of similar chronological age and HPP characteristics. Interventions: Treated patients received asfotase alfa as sc injections either 1 mg/kg six times per week or 2 mg/kg thrice weekly. Main Outcome Measures: Survival, skeletal health quantified radiographically on treatment, and ventilatory status were the main outcome measures for this study. Results: Asfotase alfa was associated with improved survival in treated patients vs historical controls: 95% vs 42% at age 1 year and 84% vs 27% at age 5 years, respectively (P < .0001, Kaplan-Meier log-rank test). Whereas 5% (1/20) of the historical controls who required ventilatory assistance survived, 76% (16/21) of the ventilated and treated patients survived, among whom 75% (12/16) were weaned from ventilatory support. This better respiratory outcome accompanied radiographic improvements in skeletal mineralization and health. Conclusions: Asfotase alfa mineralizes the HPP skeleton, including the ribs, and improves respiratory function and survival in life-threatening perinatal and infantile HPP. PMID:26529632

Linezolid versus Vancomycin in Treatment of Complicated Skin and Soft Tissue Infections

PubMed Central

Weigelt, John; Itani, Kamal; Stevens, Dennis; Lau, William; Dryden, Matthew; Knirsch, Charles

2005-01-01

Skin and soft tissue infections (SSTIs) are a common cause of morbidity in both the community and the hospital. An SSTI is classified as complicated if the infection has spread to the deeper soft tissues, if surgical intervention is necessary, or if the patient has a comorbid condition hindering treatment response (e.g., diabetes mellitus or human immunodeficiency virus). The purpose of this study was to compare linezolid to vancomycin in the treatment of suspected or proven methicillin-resistant gram-positive complicated SSTIs (CSSTIs) requiring hospitalization. This was a randomized, open-label, comparator-controlled, multicenter, multinational study that included patients with suspected or proven methicillin-resistant Staphylococcus aureus (MRSA) infections that involved substantial areas of skin or deeper soft tissues, such as cellulitis, abscesses, infected ulcers, or burns (<10% of total body surface area). Patients were randomized (1:1) to receive linezolid (600 mg) every 12 h either intravenously (i.v.) or orally or vancomycin (1 g) every 12 h i.v. In the intent-to-treat population, 92.2% and 88.5% of patients treated with linezolid and vancomycin, respectively, were clinically cured at the test-of-cure (TOC) visit (P = 0.057). Linezolid outcomes (124/140 patients or 88.6%) were superior to vancomycin outcomes (97/145 patients or 66.9%) at the TOC visit for patients with MRSA infections (P < 0.001). Drug-related adverse events were reported in similar numbers in both the linezolid and the vancomycin arms of the trial. The results of this study demonstrate that linezolid therapy is well tolerated, equivalent to vancomycin in treating CSSTIs, and superior to vancomycin in the treatment of CSSTIs due to MRSA. PMID:15917519

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.

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.

An International Multicenter Study Assessing the Role of Ethnicity on Variation of Lumbar Facet Joint Orientation and the Occurrence of Degenerative Spondylolisthesis in Asia Pacific: A Study from the AOSpine Asia Pacific Research Collaboration Consortium

PubMed Central

Williams, Richard; Cheung, Jason Pui Yin; Goss, Ben; Rajasekaran, Shanmuganathan; Kawaguchi, Yoshiharu; Acharya, Shankar; Kawakami, Mamoru; Satoh, Shigenobu; Chen, Wen-Jer; Park, Chun-Kun; Lee, Chong-Suh; Foocharoen, Thanit; Nagashima, Hideki; Kuh, Sunguk; Zheng, Zhaomin; Condor, Richard; Ito, Manabu; Iwasaki, Motoki; Jeong, Je Hoon; Luk, Keith D. K.; Prijambodo, Bambang; Rege, Amol; Jahng, Tae-Ahn; Luo, Zhuojing; Tassanawipas, Warat; Acharya, Narayana; Pokharel, Rohit; Shen, Yong; Ito, Takui; Zhang, Zhihai; Aithala P, Janardhana; Kumar, Gomatam Vijay; Jabir, Rahyussalim Ahmad; Basu, Saumyajit; Li, Baojun; Moudgil, Vishal; Sham, Phoebe; Samartzis, Dino

2015-01-01

Study Design A multinational, multiethnic, cross-sectional image-based study was performed in 33 institutions, representing 10 countries, which were part of the AOSpine Asia Pacific Research Collaboration Consortium. Objective Lumbar facet joint orientation has been reported to be associated with the development of degenerative spondylolisthesis (DS). The role of ethnicity regarding facet joint orientation remains uncertain. As such, the following study was performed across a wide-ranging population base to assess the role of ethnicity in facet joint orientation in patients with DS in the Asia Pacific region. Methods Lateral standing X-rays and axial magnetic resonance imaging scans were obtained for patients with lumbar DS. The DS parameters and facet joint angulations were assessed from L3–S1. Sex, age, body mass index (BMI), and ethnicity were also noted. Results The study included 371 patients with known ethnic origin (mean age: 62.0 years; 64% males, 36% females). The mean BMI was 25.6 kg/m2. The level of DS was most prevalent at L4–L5 (74.7%). There were 28.8% Indian, 28.6% Japanese, 18.1% Chinese, 8.6% Korean, 6.5% Thai, 4.9% Caucasian, 2.7% Filipino, and 1.9% Malay patients. Variations in facet joint angulations were noted from L3 to S1 and between patients with and without DS (p < 0.05). No differences were noted with regards to sex and overall BMI to facet joint angulations (p > 0.05); however, increasing age was found to increase the degree of angulation throughout the lumbar spine (p < 0.05). Accounting for age and the presence or absence of DS at each level, no statistically significant differences between ethnicity and degree of facet joint angulations from L3–L5 were noted (p > 0.05). Ethnic variations were noted in non-DS L5–S1 facet joint angulations, predominantly between Caucasian, Chinese, and Indian ethnicities (p < 0.05). Conclusions This study is the first to suggest that ethnicity may not play a role in facet joint orientation in the majority of cases of DS in the Asia-Pacific region. Findings from this study may facilitate future comparative studies in other multiethnic populations. An understanding of ethnic variability may assist in identifying those patients at risk of postsurgical development or progression of DS. This study also serves as a model for large-scale multicenter studies across different ethnic groups and cultural boundaries in Asia. PMID:26835200

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…

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...

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…

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.

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...

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…

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…

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…

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…

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…

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…

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,…

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…

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…

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.…

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…

“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

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.

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.

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.

A comparison of the efficacy and safety of intravenous followed by oral delafloxacin with vancomycin plus aztreonam for the treatment of acute bacterial skin and skin structure infections: a phase 3, multinational, double-blind, randomized study.

PubMed

O'Riordan, William; McManus, Alison; Teras, Juri; Poromanski, Ivan; Cruz-Saldariagga, Maria; Quintas, Megan; Lawrence, Laura; Liang, ShuJui; Cammarata, Sue

2018-03-06

Delafloxacin is an IV/oral anionic fluoroquinolone with activity against Gram-positive (including MRSA), Gram-negative, atypical and anaerobic organisms. It is approved in the US for acute bacterial skin and skin structure infections caused by designated susceptible Gram-positive and Gram-negative organisms, and is in development for the treatment of community-acquired bacterial pneumonia. A multicenter, randomized, double-blind trial of 850 adults with ABSSSI compared delafloxacin 300 mg IV Q12h for 3 days with a switch to 450 mg oral delafloxacin, to vancomycin 15 mg/kg IV with aztreonam for 5-14 days. The primary endpoint was objective response (OR) at 48-72 hours. Investigator‑assessed response based on resolution of signs and symptoms at Follow up (FU [Day 14±1]), and Late Follow up (LFU [Day 21- 28]) were secondary endpoints. In the intent-to-treat analysis set, the OR was 83.7% in the delafloxacin arm and 80.6% in the comparator arm. Investigator-assessed success was similar at FU (87.2% versus 84.4%) and LFU (83.5% versus 82.2%). Delafloxacin was comparable to vancomycin + aztreonam in eradication of MRSA at 96.0% vs 97.0% at FU. Frequency of treatment-emergent adverse events (TEAEs) between the groups was similar. TEAEs leading to study drug discontinuation was higher in the vancomycin + aztreonam group (1.2% vs 2.4%). In ABSSSI patients, IV/oral delafloxacin monotherapy was noninferior to IV vancomycin + aztreonam combination therapy for both the OR and the investigator-assessed response at FU and LFU. Delafloxacin was well tolerated as monotherapy in treatment of ABSSSI.

A multicenter multinational study of abdominal candidiasis: epidemiology, outcomes and predictors of mortality.

PubMed

Bassetti, Matteo; Righi, Elda; Ansaldi, Filippo; Merelli, Maria; Scarparo, Claudio; Antonelli, Massimo; Garnacho-Montero, Jose; Diaz-Martin, Ana; Palacios-Garcia, Inmaculada; Luzzati, Roberto; Rosin, Chiara; Lagunes, Leonel; Rello, Jordi; Almirante, Benito; Scotton, Pier Giorgio; Baldin, Gianmaria; Dimopoulos, George; Nucci, Marcio; Munoz, Patricia; Vena, Antonio; Bouza, Emilio; de Egea, Viviana; Colombo, Arnaldo Lopes; Tascini, Carlo; Menichetti, Francesco; Tagliaferri, Enrico; Brugnaro, Pierluigi; Sanguinetti, Maurizio; Mesini, Alessio; Sganga, Gabriele; Viscoli, Claudio; Tumbarello, Mario

2015-09-01

Clinical data on patients with intra-abdominal candidiasis (IAC) is still scarce. We collected data from 13 hospitals in Italy, Spain, Brazil, and Greece over a 3-year period (2011-2013) including patients from ICU, medical, and surgical wards. A total of 481 patients were included in the study. Of these, 27% were hospitalized in ICU. Mean age was 63 years and 57% of patients were male. IAC mainly consisted of secondary peritonitis (41%) and abdominal abscesses (30%); 68 (14%) cases were also candidemic and 331 (69%) had concomitant bacterial infections. The most commonly isolated Candida species were C. albicans (n = 308 isolates, 64%) and C. glabrata (n = 76, 16%). Antifungal treatment included echinocandins (64%), azoles (32%), and amphotericin B (4%). Septic shock was documented in 40.5% of patients. Overall 30-day hospital mortality was 27% with 38.9% mortality in ICU. Multivariate logistic regression showed that age (OR 1.05, 95% CI 1.03-1.07, P < 0.001), increments in 1-point APACHE II scores (OR 1.05, 95% CI 1.01-1.08, P = 0.028), secondary peritonitis (OR 1.72, 95% CI 1.02-2.89, P = 0.019), septic shock (OR 3.29, 95% CI 1.88-5.86, P < 0.001), and absence of adequate abdominal source control (OR 3.35, 95% CI 2.01-5.63, P < 0.001) were associated with mortality. In patients with septic shock, absence of source control correlated with mortality rates above 60% irrespective of administration of an adequate antifungal therapy. Low percentages of concomitant candidemia and high mortality rates are documented in IAC. In patients presenting with septic shock, source control is fundamental.

International Survey of Critically Ill Children With Acute Neurologic Insults: The Prevalence of Acute Critical Neurological Disease in Children: A Global Epidemiological Assessment Study.

PubMed

Fink, Ericka L; Kochanek, Patrick M; Tasker, Robert C; Beca, John; Bell, Michael J; Clark, Robert S B; Hutchison, Jamie; Vavilala, Monica S; Fabio, Anthony; Angus, Derek C; Watson, R Scott

2017-04-01

The international scope of critical neurologic insults in children is unknown. Our objective was to assess the prevalence and outcomes of children admitted to PICUs with acute neurologic insults. Prospective study. Multicenter (n = 107 PICUs) and multinational (23 countries, 79% in North America and Europe). Children 7 days to 17 years old admitted to the ICU with new traumatic brain injury, stroke, cardiac arrest, CNS infection or inflammation, status epilepticus, spinal cord injury, hydrocephalus, or brain mass. None. We evaluated the prevalence and outcomes of children with predetermined acute neurologic insults. Child and center characteristics were recorded. Unfavorable outcome was defined as change in pre-post insult Pediatric Cerebral Performance Category score greater than or equal to 2 or death at hospital discharge or 3 months, whichever came first. Screening data yielded overall prevalence of 16.2%. Of 924 children with acute neurologic insults, cardiac arrest (23%) and traumatic brain injury (19%) were the most common. All-cause mortality at hospital discharge was 12%. Cardiac arrest subjects had highest mortality (24%), and traumatic brain injury subjects had the most unfavorable outcomes (49%). The most common neurologic insult was infection/inflammation in South America, Asia, and the single African site but cardiac arrest in the remaining regions. Neurologic insults are a significant pediatric international health issue. They are frequent and contribute substantial morbidity and mortality. These data suggest a need for an increased focus on acute critical neurologic diseases in infants and children including additional research, enhanced availability of clinical resources, and the development of new therapies.

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

Association Between Peritoneal Glucose Exposure and Peritonitis in Peritoneal Dialysis Patients: The balANZ Trial.

PubMed

Nataatmadja, Melissa; Cho, Yeoungjee; Pascoe, Elaine M; Darssan, Darsy; Hawley, Carmel M; Johnson, David W

2017-01-01

Glucose is the primary osmotic medium used in most peritoneal dialysis (PD) solutions, and exposure to glucose has been shown to exert detrimental effects both locally, at the peritoneal membrane, and systemically. Moreover, high dialysate glucose exposure may predispose patients to an increased risk of peritonitis, perhaps as a result of impaired host defences, vascular disease, and damage to the peritoneal membrane. In this post-hoc analysis of a multicenter, multinational, open-label randomized controlled trial of neutral pH, low-glucose degradation product (GDP) versus conventional PD solutions ( bal ANZ trial), the relationship between peritonitis rates of low (< 123.1 g/day) versus high (≥ 123.1 g/day) dialysate glucose exposure was evaluated in 177 incident PD patients over a 2-year study period. Peritonitis rates were 0.44 episodes per patient-year in the low-glucose exposure group and 0.31 episodes per patient-year in the high-glucose exposure group, (incidence rate ratio [IRR] 0.69, p = 0.09). There was no significant association between dialysate glucose exposure and peritonitis-free survival on univariable analysis (high glucose exposure hazard ratio [HR] 0.66, 95% confidence interval [CI] 0.40 - 1.08) or on multivariable analysis (adjusted HR 0.64, 95% CI 0.39 - 1.05). Moreover, there was no relationship between peritoneal glucose exposure and type of organism causing peritonitis. Physician-rated severity of first peritonitis episodes was similar between groups, as was rate and duration of hospital admission. Overall, this study did not identify an association between peritoneal dialysate glucose exposure and peritonitis occurrence, severity, hospitalization, or outcomes. A further large-scale, prospective, randomized controlled trial evaluating patient-level outcomes is merited. Copyright © 2017 International Society for Peritoneal Dialysis.

International Survey of Critically Ill Children with Acute Neurological Insults: The PANGEA study

PubMed Central

Fink, Ericka L.; Kochanek, Patrick M.; Tasker, Robert C.; Beca, John; Bell, Michael J.; Clark, Robert S. B.; Hutchison, Jamie; Vavilala, Monica S.; Fabio, Anthony; Angus, Derek C.; Watson, R. Scott

2016-01-01

Objective The international scope of critical neurological insults in children is unknown. Our objective was to assess the prevalence and outcomes of children admitted to pediatric intensive care units (PICUs) with acute neurological insults. Design Prospective study. Setting Multicenter (n=107 PICUs) and multinational (23 countries, 79% in North America and Europe). Patients Children aged 7d–17y admitted to the ICU with new traumatic brain injury, stroke, cardiac arrest, central nervous system infection or inflammation, status epilepticus, spinal cord injury, hydrocephalus, or brain mass. Interventions None. Measurements and main results We evaluated the prevalence and outcomes of children with pre-determined acute neurological insults. Child and center characteristics were recorded. Unfavorable outcome was defined as change in pre-post insult Pediatric Cerebral Performance Category (PCPC) score ≥ 2 or death at hospital discharge or 3 months, whichever came first. Screening data yielded overall prevalence of 16.2%. Of 924 children with acute neurological insults, cardiac arrest (23%) and traumatic brain injury (19%) were the most common. All-cause mortality at hospital discharge was 12%. Cardiac arrest subjects had highest mortality (24%), and TBI subjects had the most unfavorable outcomes (49%). The most common neurological insult was infection/inflammation in South America, Asia, and the single African site but cardiac arrest in the remaining regions. Conclusions Neurological insults are a significant pediatric international health issue. They are frequent and contribute substantial morbidity and mortality. These data suggest a need for an increased focus on acute critical neurological diseases in infants and children including additional research, enhanced availability of clinical resources, and the development of new therapies. PMID:28207570

Characteristics and in-hospital outcomes of patients with acute coronary syndromes and heart failure in the United Arab Emirates.

PubMed

Shehab, Abdulla; Al-Dabbagh, Bayan; Almahmeed, Wael; Bustani, Nazar; Nagelkerke, Nicolaas; Yusufali, Afzal; Wassef, Adel; Ibrahim, Mohamed; Brek, Azan Bin

2012-09-26

Heart failure (HF) is a serious complication of acute coronary syndromes (ACS), and is associated with high in-hospital mortality and poor long-term survival. The aims of this study were to describe the clinical characteristics, management and in-hospital outcomes of coronary syndrome (ACS) patients with HF in the United Arab Emirates. The study was selected from the Gulf Registry of Acute Coronary Events (Gulf RACE), a prospective multi-national, multicenter registry of patients hospitalized with ACS in six Middle East countries. The present analysis was focused on participants admitted to various hospitals in the UAE with a diagnosis of ACS in 2007 and were analyzed in terms of HF (Killip class II/III and IV) on admission. Of 1691 patients (mean age: 52.6 ± 11.7 years; 210 Females, 1481 Males) with ACS, 356 (21%) had an admission diagnosis of HF (Killip class II/III and IV). HF patients were less frequently males (19.2% vs. 34.3%; P < 0.001). HF was more frequently associated with hypertension (64.3% vs. 43.9%; P < 0.001), hyperlipidemia (49.4% vs. 31.8%; P < 0.001) and diabetes mellitus (DM) (51.1% vs. 36.2%; P < 0.001). HF was significantly associated with in-hospital mortality (OR = 11.821; 95% CI: 5.385-25.948; P < 0.001). In multivariate logistic regression, age, hyperlipidemia, heart rate and DM were associated with higher in-hospital HF. HF is observed in about 1 in 5 patients with ACS in the UAE and is associated with a significant increase in in-hospital mortality and other adverse outcomes.

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…

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…

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…

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

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…

"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…

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…

Fertility conserving management of early cervical cancer: our experience of LLETZ and pelvic lymph node dissection.

PubMed

Lindsay, Rhona; Burton, Kevin; Shanbhag, Smruta; Tolhurst, Jenny; Millan, David; Siddiqui, Nadeem

2014-01-01

Presently, for those diagnosed with early cervical cancer who wish to conserve their fertility, there is the option of radical trachelectomy. Although successful, this procedure is associated with significant obstetric morbidity. The recurrence risk of early cervical cancer is low and in tumors measuring less than 2 cm; if the lymphatics are negative, the likelihood of parametrial involvement is less than 1%. Therefore, pelvic lymph nodes are a surrogate marker of parametrial involvement and radical excision of the parametrium can be omitted if they are negative. The aim of this study was to report our experience of the fertility conserving management of early cervical cancer with repeat large loop excision of the transformation zone and laparoscopic pelvic lymph node dissection. Between 2004 and 2011, a retrospective review of cases of early cervical cancer who had fertility conserving management within Glasgow Royal Infirmary was done. Forty-three patients underwent fertility conserving management of early cervical cancer. Forty were screen-detected cancers; 2 were stage IA1, 4 were stage IA2, and 37 were stage IB1. There were 2 central recurrences during the follow-up period. There have been 15 live children to 12 women and there are 4 ongoing pregnancies. To our knowledge, this is the largest case series described and confirms the low morbidity and mortality of this procedure. However, even within our highly select group, there have been 2 cases of central recurrent disease. We, therefore, are urging caution in the global adoption of this technique and would welcome a multicenter multinational randomized controlled trial.

Attempted salvage of infected cardiovascular implantable electronic devices: Are there clinical factors that predict success?

PubMed

Peacock, James E; Stafford, Jeanette M; Le, Katherine; Sohail, Muhammad Rizwan; Baddour, Larry M; Prutkin, Jordan M; Danik, Stephan B; Vikram, Holenarasipur R; Hernandez-Meneses, Marta; Miró, José M; Blank, Elisabeth; Naber, Christoph K; Carrillo, Roger G; Greenspon, Arnold J; Tseng, Chi-Hong; Uslan, Daniel Z

2018-03-08

Published guidelines mandate complete device removal in cases of cardiovascular implantable electronic device (CIED) infection. Clinical predictors of successful salvage of infected CIEDs have not been defined. Data from the Multicenter Electrophysiologic Device Infection Collaboration, a prospective, observational, multinational cohort study of CIED infection, were used to investigate whether clinical predictors of successful salvage of infected devices could be identified. Of 433 adult patients with CIED infections, 306 (71%) underwent immediate device explantation. Medical management with device retention and antimicrobial therapy was initially attempted in 127 patients (29%). "Early failure" of attempted salvage occurred in 74 patients (58%) who subsequently underwent device explantation during the index hospitalization. The remaining 53 patients (42%) in the attempted salvage group retained their CIED. Twenty-six (49%) had resolution of CIED infection (successful salvage group) whereas 27 patients (51%) experienced "late" salvage failure. Upon comparing the salvage failure group, early and late (N = 101), to the group experiencing successful salvage of an infected CIED (N = 26), no clinical or laboratory predictors of successful salvage were identified. However, by univariate analysis, coagulase-negative staphylococci as infecting pathogens (P = 0.0439) and the presence of a lead vegetation (P = 0.024) were associated with overall failed salvage. In patients with definite CIED infections, clinical and laboratory variables cannot predict successful device salvage. Until new data are forthcoming, device explantation should remain a mandatory and early management intervention in patients with CIED infection in keeping with existing expert guidelines unless medical contraindications exist or patients refuse device removal. © 2018 Wiley Periodicals, Inc.

Prior Cannabis Use Is Associated with Outcome after Intracerebral Hemorrhage.

PubMed

Di Napoli, Mario; Zha, Alicia M; Godoy, Daniel A; Masotti, Luca; Schreuder, Floris H B M; Popa-Wagner, Aurel; Behrouz, Réza

2016-01-01

Recent evidence suggests that a potential harmful relationship exists between cannabis use and ischemic stroke. The purpose of this study was to determine the implications of cannabis use in intracerebral hemorrhage (ICH) patients. An analysis of an international, multicenter, observational database of consecutive patients with spontaneous ICH was conducted. We extracted the following characteristics on presentation: demographics, risk factors, antiplatelet or anticoagulant use, Glasgow Coma Scale, ICH score, neuroimaging parameters, and urine toxicology screen (UTS) results. Modified Rankin Scale (mRS) score was utilized for determination of outcome at discharge. Adjusted logistic ordinal regression was used as shift analysis to assess the impact of cannabis use on mRS score at discharge. The adjusted common OR measured the likelihood that cannabis use would lead to lower mRS scores. Within a cohort of 725 spontaneous ICH patients, UTS was positive for cannabinoids in 8.6%. Cannabinoids-positive (CB+) patients were more frequently Caucasian (p < 0.001), younger (p < 0.001), and had lower median ICH scores on admission (p = 0.017) than those who were cannabinoids-negative. CB+ patients also showed a shift toward better outcome in the distribution of mRS categories, with an adjusted common OR of 0.544 (95% CI 0.330-0.895, p = 0.017). In this multinational cohort, cannabis use was discovered in nearly 10% of patients with spontaneous ICH. Although there was no relationship between cannabis use and specific ICH characteristics, CB+ patients had milder ICH presentation and less disability at discharge. © 2016 S. Karger AG, Basel.

Molecular testing for the clinical diagnosis of fibrolamellar carcinoma

PubMed Central

Graham, Rondell P; Yeh, Matthew M; Lam-Himlin, Dora; Roberts, Lewis R; Terracciano, Luigi; Cruise, Michael W; Greipp, Patricia T; Zreik, Riyam T; Jain, Dhanpat; Zaid, Nida; Salaria, Safia N; Jin, Long; Wang, Xiaoke; Rustin, Jeanette G; Kerr, Sarah E; Sukov, William R; Solomon, David A; Kakar, Sanjay; Waterhouse, Emily; Gill, Ryan M; Ferrell, Linda; Alves, Venancio AF; Nart, Deniz; Yilmaz, Funda; Roessler, Stephanie; Longerich, Thomas; Schirmacher, Peter; Torbenson, Michael S

2018-01-01

Fibrolamellar carcinoma has a distinctive morphology and immunophenotype, including cytokeratin 7 and CD68 co-expression. Despite the distinct findings, accurate diagnosis of fibrolamellar carcinoma continues to be a challenge. Recently, fibrolamellar carcinomas were found to harbor a characteristic somatic gene fusion, DNAJB1–PRKACA. A break-apart fluorescence in situ hybridization (FISH) assay was designed to detect this fusion event and to examine its diagnostic performance in a large, multicenter, multinational study. Cases initially classified as fibrolamellar carcinoma based on histological features were reviewed from 124 patients. Upon central review, 104 of the 124 cases were classified histologically as typical of fibrolamellar carcinoma, 12 cases as ‘possible fibrolamellar carcinoma’ and 8 cases as ‘unlikely to be fibrolamellar carcinoma’. PRKACA FISH was positive for rearrangement in 102 of 103 (99%) typical fibrolamellar carcinomas, 9 of 12 ‘possible fibrolamellar carcinomas’ and 0 of 8 cases ‘unlikely to be fibrolamellar carcinomas’. Within the morphologically typical group of fibrolamellar carcinomas, two tumors with unusual FISH patterns were also identified. Both cases had the fusion gene DNAJB1–PRKACA, but one also had amplification of the fusion gene and one had heterozygous deletion of the normal PRKACA locus. In addition, 88 conventional hepatocellular carcinomas were evaluated with PRKACA FISH and all were negative. These findings demonstrate that FISH for the PRKACA rearrangement is a clinically useful tool to confirm the diagnosis of fibrolamellar carcinoma, with high sensitivity and specificity. A diagnosis of fibrolamellar carcinoma is more accurate when based on morphology plus confirmatory testing than when based on morphology alone. PMID:28862261

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.

Stakeholders' views on data sharing in multicenter studies.

PubMed

Mazor, Kathleen M; Richards, Allison; Gallagher, Mia; Arterburn, David E; Raebel, Marsha A; Nowell, W Benjamin; Curtis, Jeffrey R; Paolino, Andrea R; Toh, Sengwee

2017-09-01

To understand stakeholders' views on data sharing in multicenter comparative effectiveness research studies and the value of privacy-protecting methods. Semistructured interviews with five US stakeholder groups. We completed 11 interviews, involving patients (n = 15), researchers (n = 10), Institutional Review Board and regulatory staff (n = 3), multicenter research governance experts (n = 2) and healthcare system leaders (n = 4). Perceptions of the benefits and value of research were the strongest influences toward data sharing; cost and security risks were primary influences against sharing. Privacy-protecting methods that share summary-level data were acknowledged as being appealing, but there were concerns about increased cost and potential loss of research validity. Stakeholders were open to data sharing in multicenter studies that offer value and minimize security risks.

Interlaboratory quality control of total HIV-1 DNA load measurement for multicenter reservoir studies.

PubMed

Gantner, Pierre; Mélard, Adeline; Damond, Florence; Delaugerre, Constance; Dina, Julia; Gueudin, Marie; Maillard, Anne; Sauné, Karine; Rodallec, Audrey; Tuaillon, Edouard; Plantier, Jean-Christophe; Rouzioux, Christine; Avettand-Fenoel, Véronique

2017-11-01

Viral reservoirs represent an important barrier to HIV cure. Accurate markers of HIV reservoirs are needed to develop multicenter studies. The aim of this multicenter quality control (QC) was to evaluate the inter-laboratory reproducibility of total HIV-1-DNA quantification. Ten laboratories of the ANRS-AC11 working group participated by quantifying HIV-DNA with a real-time qPCR assay (Biocentric) in four samples (QCMD). Good reproducibility was found between laboratories (standard deviation ≤ 0.2 log 10 copies/10 6 PBMC) for the three positive QC that were correctly classified by each laboratory (QC1

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

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

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.

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

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…

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…

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

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.

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

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.

Effects of acetyl-DL-leucine on cerebellar ataxia (ALCAT trial): study protocol for a multicenter, multinational, randomized, double-blind, placebo-controlled, crossover phase III trial.

PubMed

Feil, Katharina; Adrion, Christine; Teufel, Julian; Bösch, Sylvia; Claassen, Jens; Giordano, Ilaria; Hengel, Holger; Jacobi, Heike; Klockgether, Thomas; Klopstock, Thomas; Nachbauer, Wolfgang; Schöls, Ludger; Stendel, Claudia; Uslar, Ellen; van de Warrenburg, Bart; Berger, Ingrid; Naumann, Ivonne; Bayer, Otmar; Müller, Hans-Helge; Mansmann, Ulrich; Strupp, Michael

2017-01-10

Cerebellar ataxia (CA) is a frequent and often disabling condition that impairs motor functioning and impacts on quality of life (QoL). No medication has yet been proven effective for the symptomatic or even causative treatment of hereditary or non-hereditary, non-acquired CA. So far, the only treatment recommendation is physiotherapy. Therefore, new therapeutic options are needed. Based on three observational studies, the primary objective of the acetyl-DL-leucine on ataxia (ALCAT) trial is to examine the efficacy and tolerability of a symptomatic therapy with acetyl-DL-leucine compared to placebo on motor function measured by the Scale for the Assessment and Rating of Ataxia (SARA) in patients with CA. An investigator-initiated, multicenter, European, randomized, double-blind, placebo-controlled, 2-treatment 2-period crossover phase III trial will be carried out. In total, 108 adult patients who meet the clinical criteria of CA of different etiologies (hereditary or non-hereditary, non-acquired) presenting with a SARA total score of at least 3 points will be randomly assigned in a 1:1 ratio to one of two different treatment sequences, either acetyl-DL-leucine (up to 5 g per day) followed by placebo or vice versa. Each sequence consists of two 6-week treatment periods, separated by a 4-week wash-out period. A follow-up examination is scheduled 4 weeks after the end of treatment. The primary efficacy outcome is the absolute change in the SARA total score. Secondary objectives are to demonstrate that acetyl-DL-leucine is effective in improving (1) motor function measured by the Spinocerebellar Ataxia Functional Index (SCAFI) and SARA subscore items and (2) QoL (EuroQoL 5 dimensions and 5 level version, EQ-5D-5 L), depression (Beck Depression Inventory, BDI-II) and fatigue (Fatigue Severity Score, FSS). Furthermore, the incidence of adverse events will be investigated. The results of this trial will inform whether symptomatic treatment with the modified amino-acid acetyl-DL-leucine is a worthy candidate for a new drug therapy to relieve ataxia symptoms and to improve patient care. If superiority of the experimental drug to placebo can be established it will also be re-purposing of an agent that has been previously used for the symptomatic treatment of dizziness. The trial was prospectively registered at www.clinicaltrialsregister.eu (EudraCT no. 2015-000460-34) and at https://www.germanctr.de (DRKS-ID: DRKS00009733 ).

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.

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

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.

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

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.

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

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.

The 2017 AANS Presidential Address. A world of innovation.

PubMed

Boop, Frederick A

2017-12-01

The 2016 scientific meeting of the American Association of Neurological Surgeons (AANS) focused on the theme "A World of Innovation." In his presidential address, 2016 AANS President Frederick Boop compared the historical development of the specialty of neurological surgery with that of the development of global communications. In the early years, general surgeons training in the United States would spend post-residency time abroad learning from surgical masters in Europe and other places. Since Harvey Cushing's day, neurosurgeons from around the world continue to travel abroad, with many now coming to America for training at centers of excellence. Current clinical practice is defined by multi-national, multi-center clinical trials, and the AANS subsidiary NeuroPoint Alliance has positioned itself to serve as an international center for the oversight of such trials. The Neurosurgery Research & Education Foundation and the Journal of Neurosurgery Publishing Group have made it possible for a neurosurgeon anywhere with Internet access to learn relevant surgical anatomy, learn new neurosurgical procedures, and watch masters in the field perform operations via high-definition surgical videos at no cost via learning platforms such as the Rhoton Collection, the Neurosurgical Atlas, and Neurosurgical Focus video supplements. At the same time, patients are now traveling abroad to seek medical specialty care. Although the globalization of health care poses certain threats, it also presents neurosurgeons with a world of opportunities.

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

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

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.

L-threo-dihydroxyphenylserine (L-threo-DOPS; droxidopa) in the management of neurogenic orthostatic hypotension: a multi-national, multi-center, dose-ranging study in multiple system atrophy and pure autonomic failure.

PubMed

Mathias, C J; Senard, J M; Braune, S; Watson, L; Aragishi, A; Keeling, J E; Taylor, M D

2001-08-01

This study was designed to determine the efficacy and tolerability of increasing doses of L-threo-dihydroxyphenylserine (L-threo-DOPS) in treating symptomatic orthostatic hypotension associated with multiple system atrophy (MSA) and pure autonomic failure (PAF). Following a one-week run-in, patients (26 MSA; 6 PAF) with symptomatic orthostatic hypotension received increasing doses of L-threo-DOPS (100, 200 and 300 mg, twice daily) in an open, dose-ranging study. Incremental dose adjustment (after weeks two and four of outpatient treatment) was based on clinical need until blood pressure (BP), and symptoms improved. Final dosage was maintained for six weeks. With L-threo-DOPS, systolic BP decrease was reduced during orthostatic challenge (-22+/-28 mm Hg reduction from a baseline decrease of 54.3+/-27.7 mm Hg, p = 0.0001, n = 32; supine systolic BP at final visit was 118.9+/-28.2 mm Hg). By the end of the study, 25 patients (78%) improved, and in 14 patients (44%) orthostatic hypotension was no longer observed. Decreased orthostatic systolic BP decrease occurred in 22% (7/32), 24% (6/25) and 61% (11/18) of patients treated with 100, 200, and 300 mg L-threo-DOPS twice daily, respectively. An improvement occurred in symptoms associated with orthostatic hypotension, such as light-headedness, dizziness (p = 0.0125), and blurred vision (p = 0.0290). L-threo-DOPS was well tolerated, with the 2 serious adverse events reported being a possible complication of the disease under study, and with no reports of supine hypertension. In conclusion, L-threo-DOPS (100, 200, and 300 mg, twice daily) was well tolerated. The dosage of 300 mg twice daily L-threo-DOPS seemed to offer the most effective control of symptomatic orthostatic hypotension in MSA and PAF.

Initiation of insulin glargine therapy in type 2 diabetes subjects suboptimally controlled on oral antidiabetic agents: results from the AT.LANTUS trial.

PubMed

Davies, M; Lavalle-González, F; Storms, F; Gomis, R

2008-05-01

For many patients with type 2 diabetes, oral antidiabetic agents (OADs) do not provide optimal glycaemic control, necessitating insulin therapy. Fear of hypoglycaemia is a major barrier to initiating insulin therapy. The AT.LANTUS study investigated optimal methods to initiate and maintain insulin glargine (LANTUS, glargine, Sanofi-aventis, Paris, France) therapy using two treatment algorithms. This subgroup analysis investigated the initiation of once-daily glargine therapy in patients suboptimally controlled on multiple OADs. This study was a 24-week, multinational (59 countries), multicenter (611), randomized study. Algorithm 1 was a clinic-driven titration and algorithm 2 was a patient-driven titration. Titration was based on target fasting blood glucose < or =100 mg/dl (< or =5.5 mmol/l). Algorithms were compared for incidence of severe hypoglycaemia [requiring assistance and blood glucose <50 mg/dl (<2.8 mmol/l)] and baseline to end-point change in haemoglobin A(1c) (HbA(1c)). Of the 4961 patients enrolled in the study, 865 were included in this subgroup analysis: 340 received glargine plus 1 OAD and 525 received glargine plus >1 OAD. Incidence of severe hypoglycaemia was <1%. HbA(1c) decreased significantly between baseline and end-point for patients receiving glargine plus 1 OAD (-1.4%, p < 0.001; algorithm 1 -1.3% vs. algorithm 2 -1.5%; p = 0.03) and glargine plus >1 OAD (-1.7%, p < 0.001; algorithm 1 -1.5% vs. algorithm 2 -1.8%; p = 0.001). This study shows that initiation of once-daily glargine with OADs results in significant reduction of HbA(1c) with a low risk of hypoglycaemia. The greater reduction in HbA(1c) was seen in patients randomized to the patient-driven algorithm (algorithm 2) on 1 or >1 OAD.

A Prospective, Cross-Sectional Survey Study of the Natural History of Niemann-Pick B Disease

PubMed Central

McGovern, Margaret M.; Wasserstein, Melissa P.; Giugliani, Roberto; Bembi, Bruno; Vanier, Marie; Mengel, Eugen; Brodie, Scott E.; Mendelson, David; Skloot, Gwen; Desnick, Robert J.; Kuriyama, Noriko; Cox, Gerald F.

2009-01-01

Objective The objective of this study was to characterize the clinical features of patients with Niemann-Pick disease Type B and to identify efficacy endpoints for future clinical trials of enzyme replacement therapy. Patients and Methods Fifty-nine patients who had Niemann-Pick disease Type B, were at least 6 years of age, and manifested at least 2 disease symptoms participated in this multicenter, multinational, cross-sectional survey study. Medical histories; physical examinations; and assessments of cardiorespiratory function, clinical laboratory data, and liver and spleen volumes; radiographic evaluation of the lungs and bone age; and quality-of-life were obtained during a 2 to 3 day period. Results Fifty-three percent of the patients were male, 92% white, and the median age was 17.6 years. The R508del mutation accounted for 25% of all disease alleles. Most patients initially presented with splenomegaly (78%) or hepatomegaly (73%). Frequent symptoms included bleeding (49%), pulmonary infections and shortness of breath (42% each), and joint/limb pain (39%). Growth was markedly delayed during adolescence. Patients commonly had low levels of platelets and high-density lipoprotein, elevated levels of LDL, VLDL, triglycerides, leukocyte sphingomyelin, and serum chitotriosidase, and abnormal liver function tests. Nearly all patients had documented splenomegaly and hepatomegaly and interstitial lung disease. Patients commonly showed restrictive lung disease physiology with impaired pulmonary gas exchange and decreased maximal exercise tolerance. Quality of life was only mildly decreased by standardized questionnaires. The degree of splenomegaly correlated with most aspects of disease, including hepatomegaly, growth, lipid profile, hematologic parameters, and pulmonary function. Conclusions This study documents the multisystem involvement and clinical variability of Niemann-Pick B disease. Several efficacy endpoints were identified for future clinical treatment studies. Because of its correlation with disease severity, spleen volume may be a useful surrogate endpoint in treatment trials, whereas biomarkers such as chitotriosidase also may play a role in monitoring treatment responses. PMID:18625664

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.

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.

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.

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

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

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

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

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.

Incidence and risk factors of aplastic anemia in Latin American countries: the LATIN case-control study

PubMed Central

Maluf, Eliane; Hamerschlak, Nelson; Cavalcanti, Alexandre Biasi; Júnior, Álvaro Avezum; Eluf-Neto, José; Falcão, Roberto Passetto; Lorand-Metze, Irene G.; Goldenberg, Daniel; Santana, Cézar Leite; de Oliveira Werneck Rodrigues, Daniela; da Motta Passos, Leny Nascimento; Rosenfeld, Luis Gastão Mange; Pitta, Marimilia; Loggetto, Sandra; Feitosa Ribeiro, Andreza A.; Velloso, Elvira Deolinda; Kondo, Andrea Tiemi; de Miranda Coelho, Erika Oliveira; Pintão, Maria Carolina Tostes; de Souza, Hélio Moraes; Borbolla, José Rafael; Pasquini, Ricardo

2009-01-01

Background Associations between aplastic anemia and numerous drugs, pesticides and chemicals have been reported. However, at least 50% of the etiology of aplastic anemia remains unexplained. Design and Methods This was a case-control, multicenter, multinational study, designed to identify risk factors for agranulocytosis and aplastic anemia. The cases were patients with diagnosis of aplastic anemia confirmed through biopsy or bone marrow aspiration, selected through an active search of clinical laboratories, hematology clinics and medical records. The controls did not have either aplastic anemia or chronic diseases. A total of 224 patients with aplastic anemia were included in the study, each case was paired with four controls, according to sex, age group, and hospital where the case was first seen. Information was collected on demographic data, medical history, laboratory tests, medications, and other potential risk factors prior to diagnosis. Results The incidence of aplastic anemia was 1.6 cases per million per year. Higher rates of benzene exposure (≥30 exposures per year) were associated with a greater risk of aplastic anemia (odds ratio, OR: 4.2; 95% confidence interval, CI: 1.82–9.82). Individuals exposed to chloramphenicol in the previous year had an adjusted OR for aplastic anemia of 8.7 (CI: 0.87–87.93) and those exposed to azithromycin had an adjusted OR of 11.02 (CI 1.14–108.02). Conclusions The incidence of aplastic anemia in Latin America countries is low. Although the research study centers had a high coverage of health services, the underreporting of cases of aplastic anemia in selected regions can be discussed. Frequent exposure to benzene-based products increases the risk for aplastic anemia. Few associations with specific drugs were found, and it is likely that some of these were due to chance alone. PMID:19734415

A Mixed-Methods, Randomized, Controlled Feasibility Trial to Inform the Design of a Phase III Trial to Test the Effect of the Handheld Fan on Physical Activity and Carer Anxiety in Patients With Refractory Breathlessness.

PubMed

Johnson, Miriam J; Booth, Sara; Currow, David C; Lam, Lawrence T; Phillips, Jane L

2016-05-01

The handheld fan is an inexpensive and safe way to provide facial airflow, which may reduce the sensation of chronic refractory breathlessness, a frequently encountered symptom. To test the feasibility of developing an adequately powered, multicenter, multinational randomized controlled trial comparing the efficacy of a handheld fan and exercise advice with advice alone in increasing activity in people with chronic refractory breathlessness from a variety of medical conditions, measuring recruitment rates; data quality; and potential primary outcome measures. This was a Phase II, multisite, international, parallel, nonblinded, mixed-methods randomized controlled trial. Participants were centrally randomized to fan or control. All received breathlessness self-management/exercise advice and were followed up weekly for four weeks. Participants/carers were invited to participate in a semistructured interview at the study's conclusion. Ninety-seven people were screened, 49 randomized (mean age 68 years; 49% men), and 43 completed the study. Site recruitment varied from 0.25 to 3.3/month and screening:randomization from 1.1:1 to 8.5:1. There were few missing data except for the Chronic Obstructive Pulmonary Disease Self-Efficacy Scale (two-thirds of data missing). No harms were observed. Three interview themes included 1) a fan is a helpful self-management strategy, 2) a fan aids recovery, and 3) a symptom control trial was welcome. A definitive, multisite trial to study the use of the handheld fan as part of self-management of chronic refractory breathlessness is feasible. Participants found the fan useful. However, the value of information for changing practice or policy is unlikely to justify the expense of such a trial, given perceived benefits, the minimal costs, and an absence of harms demonstrated in this study. Copyright © 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

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

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...

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

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

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

An instrument assessing satisfaction with iron chelation therapy: Psychometric testing from an open-label clinical trial.

PubMed

Rofail, Diana; Viala, Muriel; Gater, Adam; Abetz-Webb, Linda; Baladi, Jean-Francois; Cappellini, Maria Domenica

2010-08-01

The Satisfaction with Iron Chelation Therapy (SICT) instrument was developed based on a literature review, in-depth patient and clinician interviews, and cognitive debriefing interviews. An, open-label, single arm, multicenter trial evaluating the efficacy and safety of deferasirox in patients diagnosed with transfusion-dependent iron overload, provided an opportunity to assess the psychometric measurement properties of the instrument. Psychometric analyses were performed using data at baseline from 273 patients with a range of transfusion-dependent iron overload conditions who were participating in a multinational study. Responsiveness was further evaluated for all patients who also had subsequent satisfaction domain scores collected at week 4. Baseline SICT domain scores had acceptable floor and ceiling effects and internal consistency reliability (Cronbach's alpha: 0.75-0.85). Item discriminant and item convergent validity were both excellent although one item in each analysis did not meet the specified criterion. Small to moderate correlations were observed between SICT and Short Form 36 Health Survey (SF-36) domain scores. Patients with the highest levels of serum ferritin at baseline (>3100 ng/mL) were the least satisfied about the Perceived Effectiveness of ICT and vice versa. Satisfaction improved in all patients, although there were no clear differences observed between groups of patients defined according to changes in serum ferritin levels from baseline to week 4 (stable, improved, or worsened). The SICT domains are reliable and valid. Further testing using a more specific criterion (such as assessing patient global ratings of change in satisfaction domains that correspond to the SICT domains) could help to establish with greater confidence the responsiveness of the instrument.

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

Martin, R. C. G., E-mail: rcmart03@gwise.louisville.ed; Howard, J.; Tomalty, D.

PurposeTo evaluate the predictors of toxicity of drug-eluting beads loaded with irinotecan (DEBIRI) in the treatment of hepatic malignancies.Materials and MethodsA total of 330 patients were enrolled in a prospective, open-label, multicenter, multinational, single-arm study administering two types of drug-eluting beads (DEBIRI and drug-eluting beads loaded with doxorubicin). Complications were graded by Cancer Therapy Evaluation Program's Common Terminology Criteria for Adverse Events (CTCAE) version 3.0. All events requiring additional physician treatment or requiring extended hospital stay or readmission within 30 days were included.ResultsA total of 109 patients received 187 DEBIRI treatments (range 1 to 5 per patient). The most commonmore » histology was metastatic colorectal cancer in 76% of patients, cholangiocarcinoma in 7% of patients, and other metastatic disease in 17% of patients. There were 35 patients (19%) with irinotecan treatments who sustained 158 treatment-related adverse events, with the median CTCAE event grade being CTCAE grade 2 (range 1 to 5). The most common adverse events were postembolic symptoms (42%). Multivariate analysis identified pretreatment and treatment-related risk factors as follows: lack of pretreatment with hepatic arterial lidocaine (p = 0.005), {>=}3 treatments (p = 0.05), achievement of complete stasis (p = 0.04), treatment with >100 mg DEBIRI in 1 treatment (p = 0.03), and bilirubin >2.0 {mu}g/dl with >50% liver involvement (p = 0.05). These factors were predictive of adverse events and significantly greater hospital length of stay.ConclusionsDEBIRI is safe when appropriate technique and treatment are used. Adverse events can be predicted based on pretreatment- and treatment-related factors, and their occurrence can become part of the informed consent process. Continued standardization of this treatment will lead to fewer adverse events and improved patient quality of life.« less

Off-Hour Admission and Outcomes in Patients with Acute Intracerebral Hemorrhage in the INTERACT2 Trial.

PubMed

Sato, Shoichiro; Arima, Hisatomi; Heeley, Emma; Hirakawa, Yoichiro; Delcourt, Candice; Lindley, Richard I; Robinson, Thompson; Huang, Yining; Morgenstern, Lewis; Stapf, Christian; Wang, Jiguang; Chalmers, John; Anderson, Craig S

2015-01-01

Conflicting data exist of an association between off-hour (weekend, holiday, or night-time) hospital admission and adverse outcome in intracerebral hemorrhage (ICH). We determined the association between off-hour admissions and poor clinical outcome, and of any differential effect of early intensive blood pressure (BP) lowering treatment between off- and on-hour admissions, among participants of the Intensive BP Reduction in Acute Cerebral Hemorrhage Trial (INTERACT2). Subsidiary analysis of INTERACT2, a multinational, multicenter, clinical trial of patients with spontaneous ICH with elevated systolic BP, randomly assigned to intensive (target systolic BP <140 mm Hg) or guideline-based (<180 mm Hg) BP management. Primary outcome was death or major disability (modified Rankin scale of 3-6) at 90 days. Off-hour admission was defined as night-time (4:30 p.m. to 8:30 a.m.) on weekdays, weekends (Saturday and Sunday), and public holidays in each participating country. Of 2,794 patients with information on the primary outcome, 1,770 (63%) were admitted to study centers during off-hours. Off-hour admission was not associated with risk of poor outcome at 90 days (53% off-hour vs. 55% on-hour; p = 0.49), even after adjustment for comorbid risk factors (odds ratio 0.92; 95% CI 0.76-1.12). Consistency exists in the effects of intensive BP lowering between off- and on-hour admission (p = 0.85 for homogeneity). Off-hour admission was not associated with increased risks of death or major disability among trial protocol participants with acute ICH. Intensive BP lowering can provide similar treatment effect irrespective of admission hours. © 2015 S. Karger AG, Basel.

Risk Factors for Increased ED Utilization in a Multinational Cohort of Children with Sickle Cell Disease

PubMed Central

Glassberg, Jeffrey A.; Wang, Jason; Cohen, Robyn; Richardson, Lynne D.; DeBaun, Michael R.

2012-01-01

Objectives To identify clinical, social, and environmental risk factors for increased emergency department (ED) use in children with sickle cell disease (SCD). Methods This study was a secondary analysis of ED utilization data from the international multicenter Silent Cerebral Infarct Transfusion (SIT) trial. Between December 2004 and June 2010, baseline demographic, clinical, and laboratory data were collected from children with SCD participating in the trial. The primary outcome was the frequency of ED visits for pain. A secondary outcome was the frequency of ED visits for acute chest syndrome. Results The sample included 985 children from the US, Canada, England, and France, for a total of 2,955 patient-years of data. There were 0.74 ED visits for pain per patient-year. A past medical history of asthma was associated with an increased risk of ED utilization for both pain (RR = 1.28, 95% CI = 1.04 to 1.58) and acute chest syndrome (RR = 1.60, 95% CI = 1.03 to 2.49). Exposure to environmental tobacco smoke in the home was associated with 73% more ED visits for acute chest syndrome (RR 1.73, 95% CI = 1.09 to 2.74). Each $10,000 increase in household income was associated with 5% fewer ED visits for pain (RR 0.95, 95% CI = 0.91 to 1.00, p = 0.05). The association between low income and ED utilization was not significantly different in the USA vs. countries with universal health care (p = 0.51). Conclusions Asthma and exposure to environmental tobacco smoke are potentially modifiable risk factors for greater ED use in children with SCD. Low income is associated with greater ED use for SCD pain in countries with and without universal health care. PMID:22687181

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

A Dynamic Analysis of Social Capital-Building of International and UK Students

ERIC Educational Resources Information Center

Rienties, Bart; Johan, Novie; Jindal-Snape, Divya

2015-01-01

Although many international students experience transitional issues, most research assumes these issues will disappear over time. Using principles of social capital theory, this study addressed whether after three years of study students were able to build multi-national and host social capital links. In this quantitative study of 81 students from…

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…

Sail Training as Education: More than Mere Adventure

ERIC Educational Resources Information Center

McCulloch, K.; McLaughlin, P.; Allison, P.; Edwards, V.; Tett, L.

2010-01-01

This paper describes the process and findings of a multinational study of the characteristics of sail training for young people. The study used a structured qualitative method and involved "indigenous practitioner-researchers" who collected the majority of the data. Our findings show that participation provides an opportunity for…

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…

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

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

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

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

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

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

Respiratory medication used in COPD patients from seven Latin American countries: the LASSYC study

PubMed Central

Casas, Alejandro; Montes de Oca, Maria; Menezes, Ana MB; Wehrmeister, Fernando C; Lopez Varela, Maria Victorina; Mendoza, Laura; Ramírez, Larissa; Miravitlles, Marc

2018-01-01

Background Limited information is available regarding medication use in COPD patients from Latin America. This study evaluated the type of medication used and the adherence to different inhaled treatments in stable COPD patients from the Latin American region. Methods This was an observational, cross-sectional, multinational, and multicenter study in COPD patients attended by specialist doctors from seven Latin American countries. Adherence to inhaled therapy was assessed using the Test of Adherence to Inhalers (TAI) questionnaire. The type of medication was assessed as: short-acting β-agonist (SABA) or short-acting muscarinic antagonist (SAMA) only, long-acting muscarinic antagonist (LAMA), long-acting β-agonist (LABA), LABA/LAMA, inhaled corticosteroid (ICS), ICS/LABA, ICS/LAMA/LABA, or other. Results In total, 795 patients were included (59.6% male), with a mean age of 69.5±8.7 years and post-bronchodilator FEV1 of 50.0%±18.6%. The ICS/LAMA/LABA (32.9%) and ICS/LABA (27.7%) combinations were the most common medications used, followed by LABA/LAMA (11.3%), SABA or SAMA (7.9%), LABA (6.4%), LAMA (5.8%), and ICS (4.3%). The types of medication most commonly used in each Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2013 category were ICS/LABA (A: 32.7%; B: 19.8%; C: 25.7%; D: 28.2%) and ICS/LAMA/LABA (A: 17.3%; B: 30.2%; C: 33%; D: 41.1%). The use of long-acting bronchodilators showed the highest adherence (good or high adherence >50%) according to the TAI questionnaire. Conclusion COPD management in specialist practice in Latin America does not follow the current guideline recommendations and there is an overuse of ICSs in patients with COPD from this region. Treatment regimens including the use of long-acting bronchodilators are associated with the highest adherence. PMID:29785104

Respiratory medication used in COPD patients from seven Latin American countries: the LASSYC study.

PubMed

Casas, Alejandro; Montes de Oca, Maria; Menezes, Ana Mb; Wehrmeister, Fernando C; Lopez Varela, Maria Victorina; Mendoza, Laura; Ramírez, Larissa; Miravitlles, Marc

2018-01-01

Limited information is available regarding medication use in COPD patients from Latin America. This study evaluated the type of medication used and the adherence to different inhaled treatments in stable COPD patients from the Latin American region. This was an observational, cross-sectional, multinational, and multicenter study in COPD patients attended by specialist doctors from seven Latin American countries. Adherence to inhaled therapy was assessed using the Test of Adherence to Inhalers (TAI) questionnaire. The type of medication was assessed as: short-acting β-agonist (SABA) or short-acting muscarinic antagonist (SAMA) only, long-acting muscarinic antagonist (LAMA), long-acting β-agonist (LABA), LABA/LAMA, inhaled corticosteroid (ICS), ICS/LABA, ICS/LAMA/LABA, or other. In total, 795 patients were included (59.6% male), with a mean age of 69.5±8.7 years and post-bronchodilator FEV 1 of 50.0%±18.6%. The ICS/LAMA/LABA (32.9%) and ICS/LABA (27.7%) combinations were the most common medications used, followed by LABA/LAMA (11.3%), SABA or SAMA (7.9%), LABA (6.4%), LAMA (5.8%), and ICS (4.3%). The types of medication most commonly used in each Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2013 category were ICS/LABA (A: 32.7%; B: 19.8%; C: 25.7%; D: 28.2%) and ICS/LAMA/LABA (A: 17.3%; B: 30.2%; C: 33%; D: 41.1%). The use of long-acting bronchodilators showed the highest adherence (good or high adherence >50%) according to the TAI questionnaire. COPD management in specialist practice in Latin America does not follow the current guideline recommendations and there is an overuse of ICSs in patients with COPD from this region. Treatment regimens including the use of long-acting bronchodilators are associated with the highest adherence.

Refractory Status Epilepticus in Children: intention-to-treat with continuous infusions of midazolam and pentobarbital

PubMed Central

Tasker, Robert C; Goodkin, Howard P; Fernández, Iván Sánchez; Chapman, Kevin E; Abend, Nicholas S; Arya, Ravindra; Brenton, James N; Carpenter, Jessica L; Gaillard, William D; Glauser, Tracy A; Goldstein, Joshua; Helseth, Ashley R; Jackson, Michele C; Kapur, Kush; Mikati, Mohamad A; Peariso, Katrina; Wainwright, Mark S; Wilfong, Angus A; Williams, Korwyn; Loddenkemper, Tobias

2016-01-01

Objective To describe pediatric patients with convulsive refractory status epilepticus (RSE) in whom there is intention-to-use an intravenous anesthetic for seizure control. Design Two-year prospective observational study evaluating patients (age range one month to 21 years) with RSE not responding to two antiepileptic drug classes and treated with continuous infusion of anesthetic agent. Setting Nine pediatric hospitals in the United States. Patients In a cohort of 111 patients with RSE (median age 3.7 years, 50% male), 54 (49%) underwent continuous infusion of anesthetic treatment. Main Results The median (interquartile range, IQR) intensive care unit length-of-stay was 10 (3–20) days. Up to four ‘cycles’ of serial anesthetic therapy were used and seizure termination was achieved in 94% by the second cycle. Seizure duration in controlled patients was 5.9 (1.9–34) hours for the first cycle, and longer when a second cycle was required (30 [4,−120] hours, p=0.048). Midazolam was the most frequent first-line anesthetic agent (78%); pentobarbital was the most frequently used second-line agent after midazolam failure (82%). An electroencephalographic endpoint was used in over half of the patients; higher midazolam dosing was used with a burst suppression endpoint. In midazolam non-responders, transition to a second agent occurred after a median of one day. Most patients (94%) experienced seizure termination with these two therapies. Conclusions Midazolam and pentobarbital remains the mainstay of continuous infusion therapy for RSE in the pediatric patient. The majority of patients experience seizure termination within a median of 30 hours. These data have implications for the design and feasibility of future intervention trials. That is, testing a new anesthetic anticonvulsant after failure of both midazolam and pentobarbital is unlikely to be feasible in a pediatric study, whereas a decision to test an alternative to pentobarbital, after midazolam failure, may be possible in a multicenter multinational study. PMID:27500721

Refractory Status Epilepticus in Children: Intention to Treat With Continuous Infusions of Midazolam and Pentobarbital.

PubMed

Tasker, Robert C; Goodkin, Howard P; Sánchez Fernández, Iván; Chapman, Kevin E; Abend, Nicholas S; Arya, Ravindra; Brenton, James N; Carpenter, Jessica L; Gaillard, William D; Glauser, Tracy A; Goldstein, Joshua; Helseth, Ashley R; Jackson, Michele C; Kapur, Kush; Mikati, Mohamad A; Peariso, Katrina; Wainwright, Mark S; Wilfong, Angus A; Williams, Korwyn; Loddenkemper, Tobias

2016-10-01

To describe pediatric patients with convulsive refractory status epilepticus in whom there is intention to use an IV anesthetic for seizure control. Two-year prospective observational study evaluating patients (age range, 1 mo to 21 yr) with refractory status epilepticus not responding to two antiepileptic drug classes and treated with continuous infusion of anesthetic agent. Nine pediatric hospitals in the United States. In a cohort of 111 patients with refractory status epilepticus (median age, 3.7 yr; 50% male), 54 (49%) underwent continuous infusion of anesthetic treatment. The median (interquartile range) ICU length of stay was 10 (3-20) days. Up to four "cycles" of serial anesthetic therapy were used, and seizure termination was achieved in 94% by the second cycle. Seizure duration in controlled patients was 5.9 (1.9-34) hours for the first cycle and longer when a second cycle was required (30 [4-120] hr; p = 0.048). Midazolam was the most frequent first-line anesthetic agent (78%); pentobarbital was the most frequently used second-line agent after midazolam failure (82%). An electroencephalographic endpoint was used in over half of the patients; higher midazolam dosing was used with a burst suppression endpoint. In midazolam nonresponders, transition to a second agent occurred after a median of 1 day. Most patients (94%) experienced seizure termination with these two therapies. Midazolam and pentobarbital remain the mainstay of continuous infusion therapy for refractory status epilepticus in the pediatric patient. The majority of patients experience seizure termination within a median of 30 hours. These data have implications for the design and feasibility of future intervention trials. That is, testing a new anesthetic anticonvulsant after failure of both midazolam and pentobarbital is unlikely to be feasible in a pediatric study, whereas a decision to test an alternative to pentobarbital, after midazolam failure, may be possible in a multicenter multinational study.

Impact of the Patient-Reported Outcomes Management Information System (PROMIS) upon the design and operation of multi-center clinical trials: a qualitative research study.

PubMed

Eisenstein, Eric L; Diener, Lawrence W; Nahm, Meredith; Weinfurt, Kevin P

2011-12-01

New technologies may be required to integrate the National Institutes of Health's Patient Reported Outcome Management Information System (PROMIS) into multi-center clinical trials. To better understand this need, we identified likely PROMIS reporting formats, developed a multi-center clinical trial process model, and identified gaps between current capabilities and those necessary for PROMIS. These results were evaluated by key trial constituencies. Issues reported by principal investigators fell into two categories: acceptance by key regulators and the scientific community, and usability for researchers and clinicians. Issues reported by the coordinating center, participating sites, and study subjects were those faced when integrating new technologies into existing clinical trial systems. We then defined elements of a PROMIS Tool Kit required for integrating PROMIS into a multi-center clinical trial environment. The requirements identified in this study serve as a framework for future investigators in the design, development, implementation, and operation of PROMIS Tool Kit technologies.

Impact of the Patient-Reported Outcomes Management Information System (PROMIS) upon the Design and Operation of Multi-center Clinical Trials: a Qualitative Research Study

PubMed Central

Diener, Lawrence W.; Nahm, Meredith; Weinfurt, Kevin P.

2013-01-01

New technologies may be required to integrate the National Institutes of Health’s Patient Reported Outcome Management Information System (PROMIS) into multi-center clinical trials. To better understand this need, we identified likely PROMIS reporting formats, developed a multi-center clinical trial process model, and identified gaps between current capabilities and those necessary for PROMIS. These results were evaluated by key trial constituencies. Issues reported by principal investigators fell into two categories: acceptance by key regulators and the scientific community, and usability for researchers and clinicians. Issues reported by the coordinating center, participating sites, and study subjects were those faced when integrating new technologies into existing clinical trial systems. We then defined elements of a PROMIS Tool Kit required for integrating PROMIS into a multi-center clinical trial environment. The requirements identified in this study serve as a framework for future investigators in the design, development, implementation, and operation of PROMIS Tool Kit technologies. PMID:20703765

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.

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

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.

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.

Multicenter Guidelines | Division of Cancer Prevention

Cancer.gov

A Lead Organization conducting multi-institutional studies in the consortium has specific responsibilities in order to comply with the DCP Multicenter Guidelines. The Lead Organization is responsible for the following at all Participating Organizations as well as the Lead Organization: |

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.

Hepatic veno-occlusive disease after hematopoietic stem cell transplantation: review and update on the use of defibrotide.

PubMed

Ho, Vincent T; Linden, Erica; Revta, Carolyn; Richardson, Paul G

2007-06-01

Veno-occlusive disease (VOD) of the liver remains one of the most feared complications associated with high-dose chemotherapy and hematopoietic stem cell transplantation (SCT). As a clinical syndrome characterized by fluid retention, hyperbilirubinemia, and painful hepatomegaly, VOD incidence varies widely, but it is universally recognized that severe cases of VOD have an extremely poor prognosis, with mortality at day 100 after SCT in excess of 80%. Systemic anticoagulant and thrombolytic therapies have been tested extensively in this disease, but are largely ineffective and are associated with significant bleeding complications. In recent years, defibrotide (DF; a polydisperse oligonucleotide derived from porcine intestinal mucosa with antithrombotic and protective properties on the microvasculature but minimal hemorrhagic risk) has emerged as a promising therapy for VOD. In large, multicenter, international phase I/II trials targeting patients with severe VOD, DF has been associated with complete response rates between 36 and 60%, survival past transplant day 100 in the range of 32 to 50%, and few significant attributable side effects. On the basis of these encouraging results, a pivotal, prospective, multinational, phase III trial of DF is underway in patients with severe VOD, and should provide validation of this agent as a therapy for established disease with a high risk of mortality. This article reviews our current understanding of hepatic VOD after SCT and provides a summary of the data to date on the use of DF as both therapy and prophylaxis for this disease.

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.

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.

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.

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

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.

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.

Wiki as a Corporate Learning Tool: Case Study for Software Development Company

ERIC Educational Resources Information Center

Milovanovic, Milos; Minovic, Miroslav; Stavljanin, Velimir; Savkovic, Marko; Starcevic, Dusan

2012-01-01

In our study, we attempted to further investigate how Web 2.0 technologies influence workplace learning. Our particular interest was on using Wiki as a tool for corporate exchange of knowledge with the focus on informal learning. In this study, we collaborated with a multinational software development company that uses Wiki as a corporate tool…

Recommendations for Using the Case Study Method in International Business Research

ERIC Educational Resources Information Center

Vissak, Tiia

2010-01-01

The case study method has not been as frequently used in international business (IB) research as quantitative methods. Moreover, it has been sometimes misused and quite often criticized. Still, it can be very useful for understanding such complex phenomena as the internationalization process or the management of multinational enterprises. Based on…

Perceptions of Psychological and Physical Safety Environments of Information Technology Employees: A Phenomenological Study

ERIC Educational Resources Information Center

Payne, Sheila C.

2012-01-01

A qualitative phenomenological study was conducted to gain a deeper understanding of psychological and safety environments of an oil and gas multinational enterprise. Twenty information technology professionals were interviewed to explore their feelings, perceptions, beliefs, and values of the phenomenon. The interviews elicited data about facets…

Expanding Simulations as a Means of Tactical Training with Multinational Partners

DTIC Science & Technology

2017-06-09

gap through DOTMLPF in combination with an assessment of two case studies involving higher echelon use of simulations. Through this methodology , the...DOTMLPF in combination with an assessment of two case studies involving higher echelon use of simulations. Through this methodology , the findings...CHAPTER 3 RESEARCH METHODOLOGY .................................................................26 CHAPTER 4 ANALYSIS

Crossing Boundaries: Multi-National Action Research on Family-School Collaboration. Report No. 33.

ERIC Educational Resources Information Center

Davies, Don, Ed.; Johnson, Vivian, Ed.

This report details studies by eight researchers from five countries--Australia, Chile, the Czech Republic, Portugal, and Spain--that examine boundary-crossing issues between teachers and parents, between policies and school reality, between cultures, and between research and practice. All of the studies were based in elementary schools and…

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)

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)

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)

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

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

[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.

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.

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.

"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

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.

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

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.

Single-Incision Multiport/Single Port Laparoscopic Abdominal Surgery (SILAP): A Prospective Multicenter Observational Quality Study.

PubMed

Mantke, Rene; Diener, Markus; Kropf, Siegfried; Otto, Ronny; Manger, Thomas; Vestweber, Boris; Mirow, Lutz; Winde, Günther; Lippert, Hans

2016-09-07

Increasing experience with minimally invasive surgery and the development of new instruments has resulted in a tendency toward reducing the number of abdominal skin incisions. Retrospective and randomized prospective studies could show the feasibility of single-incision surgery without any increased risk to the patient. However, large prospective multicenter observational datasets do not currently exist. This prospective multicenter observational quality study will provide a relevant dataset reflecting the feasibility and safety of single-incision surgery. This study focuses on external validity, clinical relevance, and the patients' perspective. Accordingly, the single-incision multiport/single port laparoscopic abdominal surgery (SILAP) study will supplement the existing evidence, which does not currently allow evidence-based surgical decision making. The SILAP study is an international prospective multicenter observational quality study. Mortality, morbidity, complications during surgery, complications postoperatively, patient characteristics, and technical aspects will be monitored. We expect more than 100 surgical centers to participate with 5000 patients with abdominal single-incision surgery during the study period. Funding was obtained in 2012. Enrollment began on January 01, 2013, and will be completed on December 31, 2018. As of January 2016, 2119 patients have been included, 106 German centers are registered, and 27 centers are very active (>5 patients per year). This prospective multicenter observational quality study will provide a relevant dataset reflecting the feasibility and safety of single-incision surgery. An international enlargement and recruitment of centers outside of Germany is meaningful. German Clinical Trials Register: DRKS00004594; https://drks-neu.uniklinik-freiburg.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00004594 (Archived by WebCite at http://www.webcitation.org/6jK6ZVyUs).

Prospective, Multicenter Validation Study of Magnetic Resonance Volumetry for Response Assessment After Preoperative Chemoradiation in Rectal Cancer: Can the Results in the Literature be Reproduced?

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

Martens, Milou H., E-mail: mh.martens@hotmail.com; Department of Surgery, Maastricht University Medical Center, Maastricht; GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht

2015-12-01

Purpose: To review the available literature on tumor size/volume measurements on magnetic resonance imaging for response assessment after chemoradiotherapy, and validate these cut-offs in an independent multicenter patient cohort. Methods and Materials: The study included 2 parts. (1) Review of the literature: articles were included that assessed the accuracy of tumor size/volume measurements on magnetic resonance imaging for tumor response assessment. Size/volume cut-offs were extracted; (2) Multicenter validation: extracted cut-offs from the literature were tested in a multicenter cohort (n=146). Accuracies were calculated and compared with reported results from the literature. Results: The review included 14 articles, in which 3more » different measurement methods were assessed: (1) tumor length; (2) 3-dimensonial tumor size; and (3) whole volume. Study outcomes consisted of (1) complete response (ypT0) versus residual tumor; (2) tumor regression grade 1 to 2 versus 3 to 5; and (3) T-downstaging (ypT« less

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.

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.

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.

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.

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…

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...

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…

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…

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…

Impact of novel techniques on minimally invasive adrenal surgery: trends and outcomes from a contemporary international large series in urology.

PubMed

Pavan, Nicola; Autorino, Riccardo; Lee, Hak; Porpiglia, Francesco; Sun, Yinghao; Greco, Francesco; Jeff Chueh, S; Han, Deok Hyun; Cindolo, Luca; Ferro, Matteo; Chen, Xiang; Branco, Anibal; Fornara, Paolo; Liao, Chun-Hou; Miyajima, Akira; Kyriazis, Iason; Puglisi, Marco; Fiori, Cristian; Yang, Bo; Fei, Guo; Altieri, Vincenzo; Jeong, Byong Chang; Berardinelli, Francesco; Schips, Luigi; De Cobelli, Ottavio; Chen, Zhi; Haber, Georges-Pascal; He, Yao; Oya, Mototsugu; Liatsikos, Evangelos; Brandao, Luis; Challacombe, Benjamin; Kaouk, Jihad; Darweesh, Ithaar

2016-10-01

To evaluate contemporary international trends in the implementation of minimally invasive adrenalectomy and to assess contemporary outcomes of different minimally invasive techniques performed at urologic centers worldwide. A retrospective multinational multicenter study of patients who underwent minimally invasive adrenalectomy from 2008 to 2013 at 14 urology institutions worldwide was included in the analysis. Cases were categorized based on the minimally invasive adrenalectomy technique: conventional laparoscopy (CL), robot-assisted laparoscopy (RAL), laparoendoscopic single-site surgery (LESS), and mini-laparoscopy (ML). The rates of the four treatment modalities were determined according to the year of surgery, and a regression analysis was performed for trends in all surgical modalities. Overall, a total of 737 adrenalectomies were performed across participating institutions and included in this analysis: 337 CL (46 % of cases), 57 ML (8 %), 263 LESS (36 %), and 80 RA (11 %). Overall, 204 (28 %) operations were performed with a retroperitoneal approach. The overall number of adrenalectomies increased from 2008 to 2013 (p = 0.05). A transperitoneal approach was preferred in all but the ML group (p < 0.001). European centers mostly adopted CL and ML techniques, whereas those from Asia and South America reported the highest rate in LESS procedures, and RAL was adopted to larger extent in the USA. LESS had the fastest increase in utilization at 6 %/year. The rate of RAL procedures increased at slower rates (2.2 %/year), similar to ML (1.7 %/year). Limitations of this study are the retrospective design and the lack of a cost analysis. Several minimally invasive surgical techniques for the management of adrenal masses are successfully implemented in urology institutions worldwide. CL and LESS seem to represent the most commonly adopted techniques, whereas ML and RAL are growing at a slower rate. All the MIS techniques can be safely and effectively performed for a variety of adrenal disease.

Autologous hematopoietic stem cell transplantation in extranodal natural killer/T cell lymphoma: a multinational, multicenter, matched controlled study.

PubMed

Lee, Jeeyun; Au, Wing-Yan; Park, Min Jae; Suzumiya, Junji; Nakamura, Shigeo; Kameoka, Jun-Ichi; Sakai, Chikara; Oshimi, Kazuo; Kwong, Yok-Lam; Liang, Raymond; Yiu, Harry; Wong, Kam-Hung; Cheng, Hoi-Ching; Ryoo, Baek-Yeol; Suh, Cheolwon; Ko, Young Hyeh; Kim, Kihyun; Lee, Jae-Won; Kim, Won Seog; Suzuki, Ritsuro

2008-12-01

Extranodal natural killer (NK)/T cell lymphoma, nasal type, is a recently recognized distinct entity and the most common type of non-B cell extranodal lymphoma in Asia. This retrospective analysis studied the potential survival benefits of hematopoeitic stem cell transplantation (HSCT) compared with a historical control group. A total of 47 patients from 3 previously published series of HSCT were matched according to NK/T cell lymphoma International Prognostic Index (NKIPI) risk groups and disease status at transplantation with 107 patients from a historical control group for analysis. After a median follow-up of 116.5 months, the median survival time was not determined for the HSCT group, but it was 43.5 months for the control group (95% confidence interval [CI] = 6.7 to 80.3 months; P = .127, log-rank test). In patients who were in complete remission (CR) at the time of HSCT or at surveillance after remission, disease-specific survival rates were significantly higher in the HSCT group compared with the control group (disease-specific 5-year survival rate, 87.3% for HSCT vs 67.8% for non-HSCT; P = .027). In contrast, in subgroup analysis on non-CR patients at the time of HSCT or non-HSCT treatment, disease-specific survival rates were not significantly prolonged in the HSCT group compared with the control group (1-year survival rate, 66.7% for HSCT vs 28.6% for non-HSCT; P = .141). The impact of HSCT on the survival of all patients was significantly retained at the multivariate level with a 2.1-fold (95% CI =1.2- to 3.7-fold) reduced risk of death (P = .006). HSCT seems to confer a survival benefit in patients who attained CR on postremission consolidation therapy. These findings suggest that, in particular, patients in CR with high NKIPI risk scores at diagnosis should receive full consideration for HSCT.

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

Nayak, Lakshmi; 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

2017-05-01

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. 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. 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). 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. © The Author(s) 2017. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Mixed features in patients with a major depressive episode: the BRIDGE-II-MIX study.

PubMed

Perugi, Giulio; Angst, Jules; Azorin, Jean-Michel; Bowden, Charles L; Mosolov, Sergey; Reis, Joao; Vieta, Eduard; Young, Allan H

2015-03-01

To estimate the frequency of mixed states in patients diagnosed with major depressive episode (MDE) according to conceptually different definitions and to compare their clinical validity. This multicenter, multinational cross-sectional Bipolar Disorders: Improving Diagnosis, Guidance and Education (BRIDGE)-II-MIX study enrolled 2,811 adult patients experiencing an MDE. Data were collected per protocol on sociodemographic variables, current and past psychiatric symptoms, and clinical variables that are risk factors for bipolar disorder. The frequency of mixed features was determined by applying both DSM-5 criteria and a priori described Research-Based Diagnostic Criteria (RBDC). Clinical variables associated with mixed features were assessed using logistic regression. Overall, 212 patients (7.5%) fulfilled DSM-5 criteria for MDE with mixed features (DSM-5-MXS), and 818 patients (29.1%) fulfilled diagnostic criteria for a predefined RBDC depressive mixed state (RBDC-MXS). The most frequent manic/hypomanic symptoms were irritable mood (32.6%), emotional/mood lability (29.8%), distractibility (24.4%), psychomotor agitation (16.1%), impulsivity (14.5%), aggression (14.2%), racing thoughts (11.8%), and pressure to keep talking (11.4%). Euphoria (4.6%), grandiosity (3.7%), and hypersexuality (2.6%) were less represented. In multivariate logistic regression analysis, RBDC-MXS was associated with the largest number of variables including diagnosis of bipolar disorder, family history of mania, lifetime suicide attempts, duration of the current episode > 1 month, atypical features, early onset, history of antidepressant-induced mania/hypomania, and lifetime comorbidity with anxiety, alcohol and substance use disorders, attention-deficit/hyperactivity disorder, and borderline personality disorder. Depressive mixed state, defined as the presence of 3 or more manic/hypomanic features, was present in around one-third of patients experiencing an MDE. The valid symptom, illness course and family history RBDC criteria we assessed identified 4 times more MDE patients as having mixed features and yielded statistically more robust associations with several illness characteristics of bipolar disorder than did DSM-5 criteria. © Copyright 2015 Physicians Postgraduate Press, Inc.

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.

Variability of the institutional review board process within a national research network.

PubMed

Khan, Muhammad A; Barratt, Michelle S; Krugman, Scott D; Serwint, Janet R; Dumont-Driscoll, Marilyn

2014-06-01

To determine the variability of the institutional review board (IRB) process for a minimal risk multicenter study. Participants included 24 Continuity Research Network (CORNET) sites of the Academic Pediatric Association that participated in a cross-sectional study. Each site obtained individual institutional IRB approval. An anonymous questionnaire went to site investigators about the IRB process at their institution. Twenty-two of 24 sites (92%) responded. Preparation time ranged from 1 to 20 hours, mean of 7.1 hours. Individuals submitting ≤3 IRB applications/year required more time for completion than those submitting >3/year (P < .05). Thirteen of 22 (59%) study sites received approval with "exempt" status, and 6 (27%) approved as "expedited" studies. IRB experiences were highly variable across study sites. These findings indicate that multicenter research projects should anticipate barriers to timely study implementation. Improved IRB standardization or centralization for multicenter clinical studies would facilitate this type of practice-based clinical research.

A Prospective Study of Acute Diarrhea in a Cohort of United States Military Personnel on Deployment to the Multinational Force and Observers, Sinai, Egypt

PubMed Central

Riddle, Mark S.; Rockabrand, David M.; Schlett, Carey; Monteville, Marshall R.; Frenck, Robert W.; Romine, Marcy; Ahmed, Salwa F.; Sanders, John W.

2011-01-01

To better understand the epidemiology of diarrhea in deployed personnel to the Middle East, a prospective cohort study of travelers' diarrhea (TD) was conducted between May 2004 and January 2005 at the Multinational Force and Observers (MFO) camp in the southern Sinai. A baseline entry questionnaire and stool specimen was provided on study entry, and volunteers were followed every 6 weeks. Of 211 volunteers, 145 (68.7%) completed one or more follow-up visits. In total, 416 follow-up surveys were completed, which described an overall incidence of 25.2 episodes per 100 person months (95% confidence interval = 21.2–30.0). Additionally, stools were collected in 72 of 77 diarrhea-associated clinic visits, with bacterial pathogens most commonly isolated (enterotoxigenic Escherichia coli in 30 [42%] samples and Campylobacter jejuni in 7 [10%] samples) Despite modern preventive methods, diarrhea is still a common problem for deployed US military personnel in Egypt, frequently resulting in diminished ability to work. PMID:21212203

Factors that influence the employment status of people with multiple sclerosis: a multi-national study.

PubMed

Messmer Uccelli, M; Specchia, C; Battaglia, M A; Miller, D M

2009-12-01

Paid employment is valuable for society and for the individual. A diagnosis of a chronic illness such as multiple sclerosis (MS) can influence a person's employment status. Previous studies have reported that demographic and disease-related aspects can predict whether a person with MS will leave their job. The aim of the study was to assess the factors that people with MS believe to contribute to their employment status and to determine whether any of these differentiate people with MS who are employed from those who are not employed. A multinational questionnaire assessed aspects related to employment that facilitate or hinder job maintenance. Data was collected in 18 European countries. A total of 1,141 questionnaires were completed. Of those responding, 694 (61%) subjects were employed and 477 (39%) were unemployed. The items that significantly differentiated the groups were related to MS symptoms, workplace environment and financial considerations. While MS influences employment status for many people who face difficult symptoms, aspects like a flexible work schedule and financial security are important and perhaps key to promoting job maintenance among people with MS.

Herbal medicine use in pregnancy: results of a multinational study

PubMed Central

2013-01-01

Background The use of complementary and alternative medicines (CAM) is growing in the general population. Herbal medicines are used in all countries of the world and are included in the top CAM therapies used. Methods A multinational study on how women treat disease and pregnancy-related health ailments was conducted between October 2011 and February 2012 in Europe, North and South America and Australia. In this study, the primary aim was to determine the prevalence of herbal medicine use in pregnancy and factors related to such use across participating countries and regions. The secondary aim was to investigate who recommended the use of herbal medication in pregnancy. Results There were 9,459 women from 23 countries participating in the study. Of these, 28.9% reported the use of herbal medicines in pregnancy. Most herbal medicines were used for pregnancy-related health ailments such as cold and nausea. Ginger, cranberry, valerian and raspberry were the most commonly used herbs in pregnancy. The highest reported rate of herbal use medicines was in Russia (69%). Women from Eastern Europe (51.8%) and Australia (43.8%) were twice as likely to use an herbal medicine versus other regions. Women using herbal medicines were characteristically having their first child, non-smokers, using folic acid and consuming some alcohol in pregnancy. Also, women who were currently students and women with an education other than a high school degree were more likely to use herbal medicines than other women. Although 1 out of 5 women stated that a physician had recommended the herbal use, most women used herbal medicine in pregnancy on their own initiative. Conclusions In this multinational study herbal medicine use in pregnancy was high although there were distinct differences in the herbs and users of herbal medicines across regions. Most commonly the women self-medicated with herbal medicine to treat pregnancy-related health ailments. More knowledge regarding the efficacy and safety of herbal medicines in pregnancy is warranted. PMID:24330413

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…

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…

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

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.

Spine device clinical trials: design and sponsorship.

PubMed

Cher, Daniel J; Capobianco, Robyn A

2015-05-01

Multicenter prospective randomized clinical trials represent the best evidence to support the safety and effectiveness of medical devices. Industry sponsorship of multicenter clinical trials is purported to lead to bias. To determine what proportion of spine device-related trials are industry-sponsored and the effect of industry sponsorship on trial design. Analysis of data from a publicly available clinical trials database. Clinical trials of spine devices registered on ClinicalTrials.gov, a publicly accessible trial database, were evaluated in terms of design, number and location of study centers, and sample size. The relationship between trial design characteristics and study sponsorship was evaluated using logistic regression and general linear models. One thousand six hundred thrity-eight studies were retrieved from ClinicalTrials.gov using the search term "spine." Of the 367 trials that focused on spine surgery, 200 (54.5%) specifically studied devices for spine surgery and 167 (45.5%) focused on other issues related to spine surgery. Compared with nondevice trials, device trials were far more likely to be sponsored by the industry (74% vs. 22.2%, odds ratio (OR) 9.9 [95% confidence interval 6.1-16.3]). Industry-sponsored device trials were more likely multicenter (80% vs. 29%, OR 9.8 [4.8-21.1]) and had approximately four times as many participating study centers (p<.0001) and larger sample sizes. There were very few US-based multicenter randomized trials of spine devices not sponsored by the industry. Most device-related spine research is industry-sponsored. Multicenter trials are more likely to be industry-sponsored. These findings suggest that previously published studies showing larger effect sizes in industry-sponsored vs. nonindustry-sponsored studies may be biased as a result of failure to take into account the marked differences in design and purpose. Copyright © 2015 Elsevier Inc. All rights reserved.

Factors Influencing Medical Student Attrition and Their Implications in a Large Multi-Center Randomized Education Trial

ERIC Educational Resources Information Center

Kalet, A.; Ellaway, R. H.; Song, H. S.; Nick, M.; Sarpel, U.; Hopkins, M. A.; Hill, J.; Plass, J. L.; Pusic, M. V.

2013-01-01

Participant attrition may be a significant threat to the generalizability of the results of educational research studies if participants who do not persist in a study differ from those who do in ways that can affect the experimental outcomes. A multi-center trial of the efficacy of different computer-based instructional strategies gave us the…

Alcohol Consumption among University Students in North Rhine-Westphalia, Germany--Results from a Multicenter Cross-Sectional Study

ERIC Educational Resources Information Center

Akmatov, Manas K.; Mikolajczyk, Rafael T.; Meier, Sabine; Kramer, Alexander

2011-01-01

Objective: To assess alcohol use and problem drinking among university students in the German Federal State of North Rhine-Westphalia (NRW) and to examine the associated factors. Method: A multicenter cross-sectional study was conducted in 16 universities in 2006-2007 in NRW by a standardized questionnaire and 3,306 students provided information…

Identification and Validation of Established and Novel Biomarkers for Infections in Burns

DTIC Science & Technology

2017-10-01

in burn patients have been proposed, but not validated. In our four site study , we are enrolling severely burned adults and children , and...identify the early stages of infection prior to clinical detection. This multicenter study will enable us to identify novel biomarkers, validate whether...a multicenter study 3. Develop a model of prediction of infection using clinical data and proteomic information. Relevance: 5% of combat-sustained

Theoretical study of electron impact triple differential cross sections of N2O by a multicenter distorted-wave method

NASA Astrophysics Data System (ADS)

Gong, Maomao; Li, Xingyu; Zhang, Song Bin; Chen, Xiangjun

2018-05-01

A coplanar asymmetric (e, 2e) measurement on N2O has been reported in 1999 by Cavanagh and Lohmann (1999 J. Phys. B: At. Mol. Opt. Phys. 32 L261), however, the relevant ab initio theoretical study is not available even up to now. In this work, we report theoretical studies of (e, 2e) triple differential cross sections of N2O at the same kinematics using a multicenter distorted-wave method. The influence of the multicenter nature of N2O molecule on the continuum wave function of the ejected electron has been largely considered. The computed results show good agreement with the experimental data for both outer valence 2π and inner valence 4σ orbitals.

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…

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…

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…

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…

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)…

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…

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.…

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…

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…

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…

Learning To Compete: Education, Training & Enterprise in Ghana, Kenya & South Africa. Education Research Paper.

ERIC Educational Resources Information Center

Afenyadu, Dela; King, Kenneth; McGrath, Simon; Oketch, Henry; Rogerson, Christian; Visser, Kobus

A multinational, multidisciplinary team examined the impact of globalization on education, training, and small and medium sized enterprise development in Ghana, Kenya, and South Africa. The study focused on the following issues: developing a learner-led competitiveness approach; building learning enterprises; education for microenterprises and…

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…

Lower extremity revascularization using directional atherectomy: 12-month prospective results of the DEFINITIVE LE study.

PubMed

McKinsey, James F; Zeller, Thomas; Rocha-Singh, Krishna J; Jaff, Michael R; Garcia, Lawrence A

2014-08-01

The aim of this study was to assess the safety and effectiveness of directional atherectomy (DA) for endovascular treatment of peripheral arterial disease (PAD) in infrainguinal arteries in patients with claudication or critical limb ischemia. To date, no prospective, multicenter, independently-adjudicated study has evaluated the effectiveness and durability of DA in the treatment of PAD. Previous DA studies have not been prospectively powered to evaluate any differences in outcomes in patients with and without diabetes. DEFINITIVE LE (Determination of EFfectiveness of the SilverHawk(®) PerIpheral Plaque ExcisioN System (SIlverHawk Device) for the Treatment of Infrainguinal VEssels / Lower Extremities) prospectively enrolled subjects at 47 multinational centers with an infrainguinal lesion length up to 20 cm. Primary endpoints were defined as primary patency at 12 months for claudicants and freedom from major unplanned amputation for critical limb ischemia (CLI) subjects. A pre-specified statistical hypothesis evaluated noninferiority of primary patency in diabetic versus nondiabetic claudicants. Independent angiographic and sonographic core laboratories assessed outcomes, and events were adjudicated by a clinical events committee. A total of 800 subjects were enrolled. The 12-month primary patency was 78% (95% confidence interval: 74.0% to 80.6%) in claudicants, with a 77% rate in the diabetic subgroup versus 78% in the nondiabetic subgroup (noninferior, p < 0.001). The rate of freedom from major unplanned amputation of the target limb at 12 months in CLI subjects was 95% (95% confidence interval: 90.7% to 97.4%). Periprocedural adverse events included embolization (3.8%), perforation (5.3%), and abrupt closure (2.0%). The bail-out stent rate was 3.2%. The DEFINITIVE LE study demonstrated that DA is a safe and effective treatment modality at 12 months for a diverse patient population with either claudication or CLI. Furthermore, DA was shown to be noninferior for treating PAD in patients with diabetes compared with those without diabetes. (Study of SilverHawk/TurboHawk in Lower Extremity Vessels [DEFINITIVE LE]; NCT00883246). Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Who Donates Their Body to Science? An International, Multicenter, Prospective Study

ERIC Educational Resources Information Center

Cornwall, Jon; Perry, Gary F.; Louw, Graham; Stringer, Mark D.

2012-01-01

The altruistic act of body donation provides a precious resource for both teaching and researching human anatomy. However, relatively little is known about individuals who donate their bodies to science (donors), and in particular whether donors in different geographical locations share similar characteristics. A multicenter prospective survey of…

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.

Economic analysis of centralized vs. decentralized electronic data capture in multi-center clinical studies.

PubMed

Walden, Anita; Nahm, Meredith; Barnett, M Edwina; Conde, Jose G; Dent, Andrew; Fadiel, Ahmed; Perry, Theresa; Tolk, Chris; Tcheng, James E; Eisenstein, Eric L

2011-01-01

New data management models are emerging in multi-center clinical studies. We evaluated the incremental costs associated with decentralized vs. centralized models. We developed clinical research network economic models to evaluate three data management models: centralized, decentralized with local software, and decentralized with shared database. Descriptive information from three clinical research studies served as inputs for these models. The primary outcome was total data management costs. Secondary outcomes included: data management costs for sites, local data centers, and central coordinating centers. Both decentralized models were more costly than the centralized model for each clinical research study: the decentralized with local software model was the most expensive. Decreasing the number of local data centers and case book pages reduced cost differentials between models. Decentralized vs. centralized data management in multi-center clinical research studies is associated with increases in data management costs.

Economic Analysis of Centralized vs. Decentralized Electronic Data Capture in Multi-Center Clinical Studies

PubMed Central

Walden, Anita; Nahm, Meredith; Barnett, M. Edwina; Conde, Jose G.; Dent, Andrew; Fadiel, Ahmed; Perry, Theresa; Tolk, Chris; Tcheng, James E.; Eisenstein, Eric L.

2012-01-01

Background New data management models are emerging in multi-center clinical studies. We evaluated the incremental costs associated with decentralized vs. centralized models. Methods We developed clinical research network economic models to evaluate three data management models: centralized, decentralized with local software, and decentralized with shared database. Descriptive information from three clinical research studies served as inputs for these models. Main Outcome Measures The primary outcome was total data management costs. Secondary outcomes included: data management costs for sites, local data centers, and central coordinating centers. Results Both decentralized models were more costly than the centralized model for each clinical research study: the decentralized with local software model was the most expensive. Decreasing the number of local data centers and case book pages reduced cost differentials between models. Conclusion Decentralized vs. centralized data management in multi-center clinical research studies is associated with increases in data management costs. PMID:21335692

Prospective Multicenter Study of Pneumocystis jirovecii Colonization among Cystic Fibrosis Patients in France

PubMed Central

Hernández-Hernández, Francisca; Fréalle, Emilie; Caneiro, Patrick; Salleron, Julia; Durand-Joly, Isabelle; Accoceberry, Isabelle; Bouchara, Jean-Philippe; Wallaert, Benoit; Dei-Cas, Eduardo

2012-01-01

Pneumocystis carriage was detected in 12.5% of 104 cystic fibrosis (CF) patients during a prospective multicenter French study, with a prevalence of genotype 85C/248C and geographic variations. It was significantly associated with the absence of Pseudomonas aeruginosa colonization and a greater forced expiratory volume in 1 s. Results are discussed considering the natural history of CF. PMID:23015669

Prospective multicenter study of Pneumocystis jirovecii colonization among cystic fibrosis patients in France.

PubMed

Hernández-Hernández, Francisca; Fréalle, Emilie; Caneiro, Patrick; Salleron, Julia; Durand-Joly, Isabelle; Accoceberry, Isabelle; Bouchara, Jean-Philippe; Wallaert, Benoit; Dei-Cas, Eduardo; Delhaes, Laurence

2012-12-01

Pneumocystis carriage was detected in 12.5% of 104 cystic fibrosis (CF) patients during a prospective multicenter French study, with a prevalence of genotype 85C/248C and geographic variations. It was significantly associated with the absence of Pseudomonas aeruginosa colonization and a greater forced expiratory volume in 1 s. Results are discussed considering the natural history of CF.

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

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

Confidence and Perceived Competence of Preservice Teachers to Implement Biodiversity Education in Primary Schools--Four Comparative Case Studies from Europe

ERIC Educational Resources Information Center

Lindemann-Matthies, Petra; Constantinou, Costas; Lehnert, Hans-Joachim; Nagel, Ueli; Raper, George; Kadji-Beltran, Chrysanthi

2011-01-01

This multinational research study was carried out between 2004 and 2006 in four teacher education institutions in Cyprus, England, Switzerland, and Germany. With the help of a written questionnaire, the confidence and perceived competence of preservice primary teachers (N = 690) to deliver biodiversity education in school were investigated. Data…

Phase 2 of CATALISE: A Multinational and Multidisciplinary Delphi Consensus Study of Problems with Language Development--Terminology

ERIC Educational Resources Information Center

Bishop, Dorothy V. M.; Snowling, Margaret J.; Thompson, Paul A.; Greenhalgh, Trisha

2017-01-01

Background: Lack of agreement about criteria and terminology for children's language problems affects access to services as well as hindering research and practice. We report the second phase of a study using an online Delphi method to address these issues. In the first phase, we focused on criteria for language disorder. Here we consider…

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

Nutrition and dietary intake and their association with mortality and hospitalisation in adults with chronic kidney disease treated with haemodialysis: protocol for DIET-HD, a prospective multinational cohort study.

PubMed

Palmer, Suetonia C; Ruospo, Marinella; Campbell, Katrina L; Garcia Larsen, Vanessa; Saglimbene, Valeria; Natale, Patrizia; Gargano, Letizia; Craig, Jonathan C; Johnson, David W; Tonelli, Marcello; Knight, John; Bednarek-Skublewska, Anna; Celia, Eduardo; Del Castillo, Domingo; Dulawa, Jan; Ecder, Tevfik; Fabricius, Elisabeth; Frazão, João Miguel; Gelfman, Ruben; Hoischen, Susanne Hildegard; Schön, Staffan; Stroumza, Paul; Timofte, Delia; Török, Marietta; Hegbrant, Jörgen; Wollheim, Charlotta; Frantzen, Luc; Strippoli, G F M

2015-03-20

Adults with end-stage kidney disease (ESKD) treated with haemodialysis experience mortality of between 15% and 20% each year. Effective interventions that improve health outcomes for long-term dialysis patients remain unproven. Novel and testable determinants of health in dialysis are needed. Nutrition and dietary patterns are potential factors influencing health in other health settings that warrant exploration in multinational studies in men and women treated with dialysis. We report the protocol of the "DIETary intake, death and hospitalisation in adults with end-stage kidney disease treated with HaemoDialysis (DIET-HD) study," a multinational prospective cohort study. DIET-HD will describe associations of nutrition and dietary patterns with major health outcomes for adults treated with dialysis in several countries. DIET-HD will recruit approximately 10,000 adults who have ESKD treated by clinics administered by a single dialysis provider in Argentina, France, Germany, Hungary, Italy, Poland, Portugal, Romania, Spain, Sweden and Turkey. Recruitment will take place between March 2014 and June 2015. The study has currently recruited 8000 participants who have completed baseline data. Nutritional intake and dietary patterns will be measured using the Global Allergy and Asthma European Network (GA(2)LEN) food frequency questionnaire. The primary dietary exposures will be n-3 and n-6 polyunsaturated fatty acid consumption. The primary outcome will be cardiovascular mortality and secondary outcomes will be all-cause mortality, infection-related mortality and hospitalisation. The study is approved by the relevant Ethics Committees in participating countries. All participants will provide written informed consent and be free to withdraw their data at any time. The findings of the study will be disseminated through peer-reviewed journals, conference presentations and to participants via regular newsletters. We expect that the DIET-HD study will inform large pragmatic trials of nutrition or dietary interventions in the setting of advanced kidney disease. 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.

In vivo measurements of proton relaxation times in human brain, liver, and skeletal muscle: a multicenter MRI study.

PubMed

de Certaines, J D; Henriksen, O; Spisni, A; Cortsen, M; Ring, P B

1993-01-01

Quantitative magnetic resonance imaging may offer unique potential for tissue characterization in vivo. In this connection texture analysis of quantitative MR images may be of special importance. Because evaluation of texture analysis needs large data material, multicenter approaches become mandatory. Within the frame of BME Concerted Action on Tissue Characterization by MRI and MRS, a pilot multicenter study was launched in order to evaluate the technical problems including comparability of relaxation time measurements carried out in the individual sites. Human brain, skeletal muscle, and liver were used as models. A total of 218 healthy volunteers were studied. Fifteen MRI scanners with field strength ranging from 0.08 T to 1.5 T were induced. Measurement accuracy was tested on the Eurospin relaxation time test object (TO5) and the obtained calibration curve was used for correction of the in vivo data. The results established that, by following a standardized procedure, comparable quantitative measurements can be obtained in vivo from a number of MR sites. The overall variation coefficient in vivo was in the same order of magnitude as ex vivo relaxometry. Thus, it is possible to carry out international multicenter studies on quantitative imaging, provided that quality control with respect to measurement accuracy and calibration of the MR equipments are performed.

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…

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...

Learning Approaches and Cultural Influences: A Comparative Study of Confucian and Western-Heritage Students

ERIC Educational Resources Information Center

Dennehy, Edward

2015-01-01

With the advent of increasingly multinational student cohorts in many higher education institutes, the possible influence of 'national culture' on students' learning approaches has become a focal point of attention. In particular, the claim that Asian (Confucian) students adopt (primarily) surface learning approaches has attracted much debate…

How To Internationalize the Business School Curriculum: The Case of Japan and Multinational Corporations.

ERIC Educational Resources Information Center

Esemuede, Samuel I.

In the wake of recent global political changes and an increase in international trade, this study examines principles for restructuring United States business school curricula to meet the challenges in global trade. First the paper examines business perceptions in Asia, Europe, Latin America, and Africa and recommends incorporating business…

The Processes and Effects of an Internal Technology Discovery Program upon Management.

ERIC Educational Resources Information Center

Schuelke, L. David

This paper summarizes the results of a field study conducted by the Center for Research in Scientific Communication at the University of Minnesota, Saint Paul, which concerned the effects of a technology-monitoring program on communication activities, behaviors, and attitudes of employees at a multinational, Minneapolis-based company. It was…

Women Expatriate Leaders: How Leadership Behaviors Can Reduce Gender Barriers

ERIC Educational Resources Information Center

Speranza, Carly

2017-01-01

Multinational organizations that have integrated female expatriates into their leadership ranks have experienced a number of benefits; yet, many organizations are hesitant to send females overseas because they perceive that women will have difficulty in the cross-cultural environment. This study contributes to the limited body of work on female…

Talent Management in Academia: The Effect of Discipline and Context on Recruitment

ERIC Educational Resources Information Center

Paisey, Catriona; Paisey, Nicholas J.

2018-01-01

Although talent management is widely discussed in large for-profit organisations and multinationals, it has been little discussed in relation to higher education. This paper examines one aspect of talent management, recruitment, in academia in accounting, in two different countries, Scotland and the Republic of Ireland. It frames the study around…

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…

Early Childhood Worldwide--More Alike Than Different: An Interview with David Weikart.

ERIC Educational Resources Information Center

Neugebauer, Roger

1999-01-01

Presents interview with Weikart, founder and president of High/Scope Foundation, on a multi-national study of the nature, quality, and effects of children's experiences prior to formal schooling. Discusses findings related to international similarities in children and parents, engagement levels, the impact of training on teachers, parent roles,…

Communication linguistique: Etude comparative faite sur le terrain (Linguistic Communication: A Comparative Field Study).

ERIC Educational Resources Information Center

Piron, Claude

2002-01-01

Compares the four international systems of linguistic communication used in the field (systems used in the United Nations, multinationals, the European Union, and Esperanto organizations) on select criteria (e.g., previous government investment). Discusses research that shows unilingual systems (English used alone, Esperanto) are those that…

The Influence of Organisational Identification on Employee Attitudes and Behaviours in Multinational Higher Education Institutions

ERIC Educational Resources Information Center

Wilkins, Stephen; Butt, Muhammad Mohsin; Annabi, Carrie Amani

2018-01-01

In order to operate effectively and efficiently, most higher education institutions depend on employees performing extra-role behaviours and being committed to staying with the organisation. This study assesses the extent to which organisational identification and employee satisfaction are antecedents of these two important behaviours. Key…

Revisiting Individualism and Collectivism: A Multinational Examination of Pre-Service Teachers' Perceptions on Student Academic Performances

ERIC Educational Resources Information Center

Jiang, Heng

2016-01-01

This study explores how pre-service teachers in Singapore, Hong Kong, Taiwan, and the United States perceive educational diversity in relation to students' academic achievement by means of qualitative content analysis. It takes cultural psychological perspectives to revisit the attribute reasoning embedded in individualist and collectivist…

Negotiating Meaning in Cross-National Studies of Mathematics Teaching: Kissing Frogs to Find Princes

ERIC Educational Resources Information Center

Andrews, Paul

2007-01-01

This paper outlines the iterative processes by which a multinational team of researchers developed a low-inference framework for the analysis of video recordings of mathematics lessons drawn from Flemish Belgium, England, Finland, Hungary and Spain. Located within a theoretical framework concerning learning as the negotiation of meaning, we…

The Business Communication Course and the Moodle Framework System

ERIC Educational Resources Information Center

Krisko, Edina

2011-01-01

In this article I will argue that the use of learning content management systems is also justified in full-time education, especially in business education and communication studies. Nowadays not only multinational companies, but domestic medium enterprises also manage the training of new employees and existing staff with LCMSs. Companies in…

So You Were a Language Major: Corporate Interviewing and Training in Foreign Languages and Cross-Cultural Skills.

ERIC Educational Resources Information Center

Seabrook, Roberta; Valdes, Berardo

A study of the attitudes and practices in multinational corporations concerning second language and intercultural skills as criteria for employment of international managers consisted of three elements: (1) a survey of corporations; (2) followup interviews with respondents and with commercial language schools and cross-cultural training…

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.

The corporate impact of addressing social issues: a financial case study of a project in Peru.

PubMed

Dabbs, Alan; Bateson, Matthew

2002-05-01

Large, multinational resource development projects can affect many aspects, including social, economic and ecological realities, in the regions where they operate. Social and environmental issues that are usually ignored in such projects are increasingly affecting the financial future of multinational corporations in negative ways. In this article, we advance the argument that corporations can successfully manage these issues and that if they choose to view these management efforts as an investment rather than an expense, they may well acquire a competitive advantage over companies that do not. We describe as a case study the Camisea natural gas and condensates development project in Peru, operated by Shell Prospecting and Development Peru (SPDP). Camisea is one of the first projects anywhere in the world to conduct a detailed analysis of key industry-related social issues and the processes, required investment and financial impact of managing them. The Camisea example supports the argument that addressing social and environmental concerns makes financial sense. In present value terms, the benefit of managing these concerns was expected to surpass the cost investment by approximately US$50 million.

A Multicenter Study of Volumetric Computed Tomography for Staging Malignant Pleural Mesothelioma

PubMed Central

Rusch, Valerie W.; Gill, Ritu; Mitchell, Alan; Naidich, David; Rice, David C.; Pass, Harvey I.; Kindler, Hedy; De Perrot, Marc; Friedberg, Joseph

2016-01-01

Background Standard imaging modalities are inaccurate in staging malignant pleural mesothelioma (MPM). Single institution studies suggest that volumetric computed tomography (VolCT) is more accurate but labor intensive. We established a multicenter network to test interobserver variability, accuracy (relative to pathologic stage) and prognostic significance of semi-automated VolCT. Methods Six institutions electronically submitted clinical and pathologic data to an established multicenter database on patients with MPM who had surgery. Institutional radiologists reviewed preoperative CT scans for quality then submitted via electronic network (AG mednet) to biostatistical center (BC). Two reference radiologists, blinded to clinical data, performed semi-automated tumor volume calculations using commercially available software (Vitrea Enterprise 6.0), then submitted readings to BC. Study endpoints included: feasibility of network; interobserver variability for VolCT; correlation of tumor volume to pTN stages, and overall survival (OS). Results Of 164 cases, 129 were analyzable and read by reference radiologists. Most tumors were <500cm3. A small bias was observed between readers, as one provided consistently larger measurements than the other (mean difference=47.9, p=.0027), but for 80% of cases, the absolute difference was ≤ 200cm3. Spearman correlation between readers was 0.822. Volume correlated with pTN stages and OS, best defined by 3 groups with average volumes of: 91.2, 245.3, 511.3cm3, associated with median OS of 37, 18, 8 months respectively. Conclusions For the first time, a multicenter network was established and initial correlations of tumor volume to pTN stages and OS shown. A larger multicenter international study is planned to confirm results and refine correlations. PMID:27596916

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

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

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.

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.

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.

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.

A Multicenter, Open-Label Trial to Evaluate the Quality of Life in Adults with ADHD Treated with Long-Acting Methylphenidate (OROS MPH): Concerta Quality of Life (CONQoL) Study

ERIC Educational Resources Information Center

Mattos, Paulo; Rodrigues Louza, Mario; Fernandes Palmini, Andre Luis; de Oliveira, Irismar Reis; Lopes Rocha, Fabio

2013-01-01

The available literature provides few studies on the effectiveness of methylphenidate in improving quality of life in individuals with ADHD. Objective: To assess the effectiveness of Methyphenidate OROS formulation (OROS MPH) through QoL in adults with ADHD. Method: A 12-week, multicenter, open-label trial involving 60 patients was used. The…

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.

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

Does Quality of Radiation Therapy Predict Outcomes of Multicenter Cooperative Group Trials? A Literature Review

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

Fairchild, Alysa, E-mail: alysa.fairchild@albertahealthservices.ca; Straube, William; Laurie, Fran

2013-10-01

Central review of radiation therapy (RT) delivery within multicenter clinical trials was initiated in the early 1970s in the United States. Early quality assurance publications often focused on metrics related to process, logistics, and timing. Our objective was to review the available evidence supporting correlation of RT quality with clinical outcomes within cooperative group trials. A MEDLINE search was performed to identify multicenter studies that described central subjective assessment of RT protocol compliance (quality). Data abstracted included method of central review, definition of deviations, and clinical outcomes. Seventeen multicenter studies (1980-2012) were identified, plus one Patterns of Care Study. Diseasemore » sites were hematologic, head and neck, lung, breast, and pancreas. Between 0 and 97% of treatment plans received an overall grade of acceptable. In 7 trials, failure rates were significantly higher after inadequate versus adequate RT. Five of 9 and 2 of 5 trials reported significantly worse overall and progression-free survival after poor-quality RT, respectively. One reported a significant correlation, and 2 reported nonsignificant trends toward increased toxicity with noncompliant RT. Although more data are required, protocol-compliant RT may decrease failure rates and increase overall survival and likely contributes to the ability of collected data to answer the central trial question.« less

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…

A Multicase Study: Exploring Human Resource Information System Implementation and Utilization in Multinational Corporations in Kenya

ERIC Educational Resources Information Center

Nzyoka Yongo, Cyd W.

2016-01-01

Implementation and utilization of human resource information system (HRIS) though a very desirable prospect for many organizations, still remains a daunting task for many. This has been daunting because of prohibitive costs, security risks, top management resistance, employee attitudes, and so forth. Trends globally show that, organizations that…

An Analysis of English Language Education and Its Impact on Business Practice in Taiwan.

ERIC Educational Resources Information Center

Du-Babcock, Bertha; Babcock, Richard D.

The state of English language instruction in Taiwan and its impact on firms doing business there are examined. The analysis draws on case studies of language training and use in four national and multinational corporations, each representing different nationalities and a different industry: Texas Instruments, Kaohsiung Monomer Company Limited,…

Exploring Bebras Tasks Content and Performance: A Multinational Study

ERIC Educational Resources Information Center

Izu, Cruz; Mirolo, Claudio; Settle, Amber; Mannila, Linda; Stupuriene, Gabriele

2017-01-01

Although there is no universal agreement that students should learn programming, many countries have reached a consensus on the need to expose K-12 students to Computational Thinking (CT). When, what and how to teach CT in schools are open questions and we attempt to address them by examining how well students around the world solved problems in…

Public Attitude toward Optician Education as Human Capital.

ERIC Educational Resources Information Center

Gerardi, Steven J.; Woods, Thomas A.; White, Debra R.; Hill, Roger S.

A study sought to identify what the public thinks about the appropriate level of education and training for opticians. A 10% random sample of 1,510 New York State customers (n=151) of a large multinational opticianry corporation was surveyed. Two categories of data were social background (combined annual family income, age, marital status, race,…

The Secret Lives of Undergraduate International Business Students: An Analysis of Cross-Cultural Experience in Multinational Corporations.

ERIC Educational Resources Information Center

Pederson de Castaneda, Viann

This study involved students majoring in business/economics and foreign language in an international business program. The students were participants in a semester-long international experience where students were integrated into a host university to learn about management, economics, and marketing from professors abroad, and in an internship in a…

International Students' Social Network: Network Mapping to Gage Friendship Formation and Student Engagement on Campus

ERIC Educational Resources Information Center

McFaul, Susannah

2016-01-01

Addressing the importance of international student engagement on campus and creating friendships with host-country nationals during their time abroad, this small-scale study explores the question of, "Are there trends in how or through what means international students are making connections with co-national, multi-national, or host-national…

The United States and the British Commonwealth in Korea, 1950-53: A Critical Study of the Origins of Joint Publication 3-16, Multinational Operations

DTIC Science & Technology

2013-12-13

common Anglo - Saxon heritage with the United States. Furthermore, Canada and the United States shared national borders and interdependent economies...sought and received French military assistance through an alliance during the American War for Independence. The United States joined the Anglo -French...

A Comparative Study of Ethical Values of Business Students: American vs. Middle Eastern Cultures

ERIC Educational Resources Information Center

Shurden, Michael; Shurden, Susan; Cagwin, Douglass

2008-01-01

Business schools must prepare students to face the world and yet maintain strong ethical convictions. The question of ethics in the business environment is not exclusive to the United States. Ethical business behavior is a multinational issue, and all business schools world-wide must deal with this issue. However, cultural differences often define…

Training in the Retail Sector. A Survey for the FORCE Programme. First Edition.

ERIC Educational Resources Information Center

Kruse, Wilfried; And Others

Training in the retail sector throughout the 12 European Community (EC) member countries was examined through in-depth case studies of 55 retail firms that were selected as representing a wide range of firm types (19 multinational, 36 national, 4 cooperative, 7 family-owned firms), forms of retailing (department stores, supermarkets, and chain and…

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.

Role of CCL3L1-CCR5 Genotypes in the Epidemic Spread of HIV-1 and Evaluation of Vaccine Efficacy

DTIC Science & Technology

2008-08-01

S) 12. DISTRIBUTION/AVAILABILITY STATEMENT Approved for public release; distribution unlimited 13 . SUPPLEMENTARY NOTES 14. ABSTRACT Background...GRG-defined population groups to the overall epidemic varied significantly (0 to 13 %). Consistent with findings shown in Figure 2c, the highest AFs...Multicenter AIDS Cohort Study (MACS), Multicenter Hemophilia Cohort Study (MHCS), San Francisco City Cohort (SFCC). Science 279: 389–393. 13 . Gonzalez E

Prediction of serious complications in patients with seemingly stable febrile neutropenia: validation of the Clinical Index of Stable Febrile Neutropenia in a prospective cohort of patients from the FINITE study.

PubMed

Carmona-Bayonas, Alberto; Jiménez-Fonseca, Paula; Virizuela Echaburu, Juan; Antonio, Maite; Font, Carme; Biosca, Mercè; Ramchandani, Avinash; Martínez, Jerónimo; Hernando Cubero, Jorge; Espinosa, Javier; Martínez de Castro, Eva; Ghanem, Ismael; Beato, Carmen; Blasco, Ana; Garrido, Marcelo; Bonilla, Yaiza; Mondéjar, Rebeca; Arcusa Lanza, María Ángeles; Aragón Manrique, Isabel; Manzano, Aránzazu; Sevillano, Elena; Castañón, Eduardo; Cardona, Mercé; Gallardo Martín, Elena; Pérez Armillas, Quionia; Sánchez Lasheras, Fernando; Ayala de la Peña, Francisco

2015-02-10

To validate a prognostic score predicting major complications in patients with solid tumors and seemingly stable episodes of febrile neutropenia (FN). The definition of clinical stability implies the absence of organ dysfunction, abnormalities in vital signs, and major infections. We developed the Clinical Index of Stable Febrile Neutropenia (CISNE), with six explanatory variables associated with serious complications: Eastern Cooperative Oncology Group performance status ≥ 2 (2 points), chronic obstructive pulmonary disease (1 point), chronic cardiovascular disease (1 point), mucositis of grade ≥ 2 (National Cancer Institute Common Toxicity Criteria; 1 point), monocytes < 200 per μL (1 point), and stress-induced hyperglycemia (2 points). We integrated these factors into a score ranging from 0 to 8, which classifies patients into three prognostic classes: low (0 points), intermediate (1 to 2 points), and high risk (≥ 3 points). We present a multicenter validation of CISNE. We prospectively recruited 1,133 patients with seemingly stable FN from 25 hospitals. Complication rates in the training and validation subsets, respectively, were 1.1% and 1.1% in low-, 6.1% and 6.2% in intermediate-, and 32.5% and 36% in high-risk patients; mortality rates within each class were 0% in low-, 1.6% and 0% in intermediate-, and 4.3% and 3.1% in high-risk patients. Areas under the receiver operating characteristic curves in the validation subset were 0.652 (95% CI, 0.598 to 0.703) for Talcott, 0.721 (95% CI, 0.669 to 0.768) for Multinational Association for Supportive Care in Cancer (MASCC), and 0.868 (95% CI, 0.827 to 0.903) for CISNE (P = .002 for comparison between CISNE and MASCC). CISNE is a valid model for accurately classifying patients with cancer with seemingly stable FN episodes. © 2015 by American Society of Clinical Oncology.

MiDas: Automatic Extraction of a Common Domain of Discourse in Sleep Medicine for Multi-center Data Integration

PubMed Central

Sahoo, Satya S.; Ogbuji, Chimezie; Luo, Lingyun; Dong, Xiao; Cui, Licong; Redline, Susan S.; Zhang, Guo-Qiang

2011-01-01

Clinical studies often use data dictionaries with controlled sets of terms to facilitate data collection, limited interoperability and sharing at a local site. Multi-center retrospective clinical studies require that these data dictionaries, originating from individual participating centers, be harmonized in preparation for the integration of the corresponding clinical research data. Domain ontologies are often used to facilitate multi-center data integration by modeling terms from data dictionaries in a logic-based language, but interoperability among domain ontologies (using automated techniques) is an unresolved issue. Although many upper-level reference ontologies have been proposed to address this challenge, our experience in integrating multi-center sleep medicine data highlights the need for an upper level ontology that models a common set of terms at multiple-levels of abstraction, which is not covered by the existing upper-level ontologies. We introduce a methodology underpinned by a Minimal Domain of Discourse (MiDas) algorithm to automatically extract a minimal common domain of discourse (upper-domain ontology) from an existing domain ontology. Using the Multi-Modality, Multi-Resource Environment for Physiological and Clinical Research (Physio-MIMI) multi-center project in sleep medicine as a use case, we demonstrate the use of MiDas in extracting a minimal domain of discourse for sleep medicine, from Physio-MIMI’s Sleep Domain Ontology (SDO). We then extend the resulting domain of discourse with terms from the data dictionary of the Sleep Heart and Health Study (SHHS) to validate MiDas. To illustrate the wider applicability of MiDas, we automatically extract the respective domains of discourse from 6 sample domain ontologies from the National Center for Biomedical Ontologies (NCBO) and the OBO Foundry. PMID:22195180

MiDas: automatic extraction of a common domain of discourse in sleep medicine for multi-center data integration.

PubMed

Sahoo, Satya S; Ogbuji, Chimezie; Luo, Lingyun; Dong, Xiao; Cui, Licong; Redline, Susan S; Zhang, Guo-Qiang

2011-01-01

Clinical studies often use data dictionaries with controlled sets of terms to facilitate data collection, limited interoperability and sharing at a local site. Multi-center retrospective clinical studies require that these data dictionaries, originating from individual participating centers, be harmonized in preparation for the integration of the corresponding clinical research data. Domain ontologies are often used to facilitate multi-center data integration by modeling terms from data dictionaries in a logic-based language, but interoperability among domain ontologies (using automated techniques) is an unresolved issue. Although many upper-level reference ontologies have been proposed to address this challenge, our experience in integrating multi-center sleep medicine data highlights the need for an upper level ontology that models a common set of terms at multiple-levels of abstraction, which is not covered by the existing upper-level ontologies. We introduce a methodology underpinned by a Minimal Domain of Discourse (MiDas) algorithm to automatically extract a minimal common domain of discourse (upper-domain ontology) from an existing domain ontology. Using the Multi-Modality, Multi-Resource Environment for Physiological and Clinical Research (Physio-MIMI) multi-center project in sleep medicine as a use case, we demonstrate the use of MiDas in extracting a minimal domain of discourse for sleep medicine, from Physio-MIMI's Sleep Domain Ontology (SDO). We then extend the resulting domain of discourse with terms from the data dictionary of the Sleep Heart and Health Study (SHHS) to validate MiDas. To illustrate the wider applicability of MiDas, we automatically extract the respective domains of discourse from 6 sample domain ontologies from the National Center for Biomedical Ontologies (NCBO) and the OBO Foundry.

Understanding Social Justice Leadership: An International Exploration of the Perspectives of Two School Leaders in Costa Rica and England

ERIC Educational Resources Information Center

Slater, Charles; Potter, Ian; Torres, Nancy; Briceno, Fernando

2014-01-01

This article is an examination of two social justice leaders, one in Costa Rica and one in England. It is part of the International Study of Leadership Development Network, a multi-nation study of social justice and educational leadership. A brief discussion of the philosophy of social justice and an examination of the macro and micro context in…

“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

"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.

A multinational, open-label, phase 2 study of ruxolitinib in Asian patients with myelofibrosis: Japanese subset analysis.

PubMed

Oritani, Kenji; Okamoto, Shinichiro; Tauchi, Tetsuzo; Saito, Shigeki; Ohishi, Kohshi; Handa, Hiroshi; Takenaka, Katsuto; Gopalakrishna, Prashanth; Amagasaki, Taro; Ito, Kazuo; Akashi, Koichi

2015-03-01

Ruxolitinib is a potent Janus kinase (JAK) 1/JAK2 inhibitor that has demonstrated rapid and durable improvements in splenomegaly and symptoms and a survival benefit in 2 phase 3 trials in patients with myelofibrosis. Ruxolitinib was well tolerated and effectively reduced splenomegaly and symptom burden in Asian patients with myelofibrosis in the Asian multinational, phase 2 Study A2202. We present a subset analysis of Japanese patients (n = 30) in Study A2202. At data cutoff, 22 patients were ongoing; 8 discontinued, mainly due to adverse events (n = 4). At week 24, 33 % of patients achieved ≥35 % reduction from baseline in spleen volume; 56.0 % achieved ≥50 % reduction from baseline in total symptom score, as measured by the 7-day Myelofibrosis Symptom Assessment Form v2.0. The most common adverse events were anemia (63 %), thrombocytopenia (40 %), nasopharyngitis (37 %), decreased platelet counts (30 %), and diarrhea (30 %). Dose reductions or interruptions due to hemoglobin decreases were more frequent in Japanese patients; no loss of efficacy and no discontinuations due to hematologic abnormalities were observed. Ruxolitinib was well tolerated in Japanese patients and provided substantial reductions in splenomegaly and myelofibrosis-related symptoms similar to those observed in the overall Asian population and phase 3 COMFORT studies.

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.

Multicenter neonatal databases: Trends in research uses.

PubMed

Creel, Liza M; Gregory, Sean; McNeal, Catherine J; Beeram, Madhava R; Krauss, David R

2017-01-13

In the US, approximately 12.7% of all live births are preterm, 8.2% of live births were low birth weight (LBW), and 1.5% are very low birth weight (VLBW). Although technological advances have improved mortality rates among preterm and LBW infants, improving overall rates of prematurity and LBW remains a national priority. Monitoring short- and long-term outcomes is critical for advancing medical treatment and minimizing morbidities associated with prematurity or LBW; however, studying these infants can be challenging. Several large, multi-center neonatal databases have been developed to improve research and quality improvement of treatments for and outcomes of premature and LBW infants. The purpose of this systematic review was to describe three multi-center neonatal databases. We conducted a literature search using PubMed and Google Scholar over the period 1990 to August 2014. Studies were included in our review if one of the databases was used as a primary source of data or comparison. Included studies were categorized by year of publication; study design employed, and research focus. A total of 343 studies published between 1991 and 2014 were included. Studies of premature and LBW infants using these databases have increased over time, and provide evidence for both neonatology and community-based pediatric practice. Research into treatment and outcomes of premature and LBW infants is expanding, partially due to the availability of large, multicenter databases. The consistency of clinical conditions and neonatal outcomes studied since 1990 demonstrates that there are dedicated research agendas and resources that allow for long-term, and potentially replicable, studies within this population.

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.

Reliability of 3-Dimensional Measures of Single-Leg Cross Drop Landing Across 3 Different Institutions: Implications for Multicenter Biomechanical and Epidemiological Research on ACL Injury Prevention.

PubMed

DiCesare, Christopher A; Bates, Nathaniel A; Barber Foss, Kim D; Thomas, Staci M; Wordeman, Samuel C; Sugimoto, Dai; Roewer, Benjamin D; Medina McKeon, Jennifer M; Di Stasi, Stephanie; Noehren, Brian W; Ford, Kevin R; Kiefer, Adam W; Hewett, Timothy E; Myer, Gregory D

2015-12-01

Anterior cruciate ligament (ACL) injuries are physically and financially devastating but affect a relatively small percentage of the population. Prospective identification of risk factors for ACL injury necessitates a large sample size; therefore, study of this injury would benefit from a multicenter approach. To determine the reliability of kinematic and kinetic measures of a single-leg cross drop task across 3 institutions. Controlled laboratory study. Twenty-five female high school volleyball players participated in this study. Three-dimensional motion data of each participant performing the single-leg cross drop were collected at 3 institutions over a period of 4 weeks. Coefficients of multiple correlation were calculated to assess the reliability of kinematic and kinetic measures during the landing phase of the movement. Between-centers reliability for kinematic waveforms in the frontal and sagittal planes was good, but moderate in the transverse plane. Between-centers reliability for kinetic waveforms was good in the sagittal, frontal, and transverse planes. Based on these findings, the single-leg cross drop task has moderate to good reliability of kinematic and kinetic measures across institutions after implementation of a standardized testing protocol. Multicenter collaborations can increase study numbers and generalize results, which is beneficial for studies of relatively rare phenomena, such as ACL injury. An important step is to determine the reliability of risk assessments across institutions before a multicenter collaboration can be initiated.

Participation of a coordinating center pharmacy in a multicenter international study.

PubMed

Jeon, Jihyun Esther; Mighty, Janet; Lane, Karen; McBee, Nichol; Majkowski, Ryan; Mayo, Steven; Hanley, Daniel

2016-11-15

The activities of a coordinating center pharmacy (CCP) supporting a multicenter, international clinical trial are described. Serving in a research support role comparable to that of a commercial clinical trial supply company, a CCP within the Johns Hopkins Hospital Investigational Drug Service (JHH IDS) uses its management expertise and infrastructure to support multicenter trials, such as the recently completed Clot Lysis: Evaluating Accelerated Resolution of Intraventricular Hemorrhage, Phase III (CLEAR III) trial. The role of the CCP staff in supporting the CLEAR III trial was overall investigational product (IP) management through coordination of IP-related operations to ensure high-quality care for study participants at study sites in the United States and abroad. For the CLEAR III trial, the CCP coordinated IP supply activities; provided education to site pharmacists; developed study-specific documents, including pharmacy manuals; communicated with trial stakeholders, including third-party IP distributors; monitored treatment assignments; and performed quality assurance monitoring to ensure compliance with institutional, state, federal, and international regulations regarding IP procurement and storage. Acting as a CCP for a multicenter international study poses a number of operational challenges while providing opportunities for the CCP to contribute to research of global importance and enrich the skill sets of its personnel. The development and implementation of the CCP at JHH IDS for the CLEAR III trial included several responsibilities, such as IP supply management, communication, and database, regulatory, and finance management. Copyright © 2016 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Multi-investigator collaboration in orthopaedic surgery research compared to other medical fields.

PubMed

Brophy, Robert H; Smith, Matthew V; Latterman, Christian; Jones, Morgan H; Reinke, Emily K; Flanigan, David C; Wright, Rick W; Wolf, Brian R

2012-10-01

An increasing emphasis has been placed across health care on evidence-based medicine with higher level studies, such as randomized trials and prospective cohort studies. Historically, clinical research in orthopaedic surgery has been dominated by studies with low patient numbers from a limited number of surgeons. The purpose of this study was to test our hypothesis that orthopaedics has fewer multi-center collaborative studies as compared to other medical disciplines. We chose three leading journals from general medicine, a leading journal from the surgical subspecialties of obstetrics and gynecology, ophthalmology and otolaryngology, and three leading journals from orthopaedic surgery based on highest impact factor. We compared the percentage of collaborative studies and the number of contributing institutions and authors in original research manuscripts published in 2009 between general medical, surgical subspecialty and orthopaedic surgery journals. A significantly higher percentage of manuscripts resulted from multicenter collaborative efforts in the general medical literature (p < 0.000001) and the other surgical subspecialty literature (p < 0.000001) compared to the orthopaedic surgery literature. Manuscripts published in the general medical journals came from more institutions (p < 0.0001) and had significantly more authors (p < 0.000001) than those published in the orthopaedic surgery journals. There is an opportunity to stimulate greater multicenter collaborative research, which correlates with increased patient numbers, a higher level of evidence and more generalizable findings, in the orthopaedic surgery community. These efforts can be supported through increased funding, surgeon participation, and appropriate expansion of authorship for multicenter studies in orthopaedic journals. Copyright © 2012 Orthopaedic Research Society.

Local production of medical technologies and its effect on access in low and middle income countries: a systematic review of the literature

PubMed Central

Kaplan, Warren Allan; Ritz, Lindsay Sarah; Vitello, Marie

2011-01-01

Objectives: The objective of this study was to assess the existing theoretical and empirical literature examining the link between "local production" of pharmaceuticals and medical devices and increased local access to these products. Our preliminary hypothesis is that studies showing a robust relationship between local production and access to medical products are sparse, at best. Methods: An extensive literature search was conducted using a wide variety of databases and search terms intending to capture as many different aspects of this issue as possible. The results of the search were reviewed and categorized according to their relevance to the research question. The literature was also reviewed to determine the rigor used to examine the effects of local production and what implications these experiences hold for other developing countries. Results: Literature addressing the benefits of local production and the link between it and access to medical products is sparse, mainly descriptive and lacking empirical evidence. Of the literature we reviewed that addressed comparative economics and strategic planning of multinational and domestic firms, there are few dealing with emerging markets and lower-middle income countries and even fewer that compare local biomedical producers with multinational corporations in terms of a reasonable metric. What comparisons exist mainly relate to prices of local versus foreign/multinational produced medicines. Conclusions: An assessment of the existing theoretical and empirical literature examining the link between "local production" of pharmaceuticals and medical devices and increased local access to these products reveals a paucity of literature explicitly dealing with this issue. Of the literature that does exist, methods used to date are insufficient to prove a robust relationship between local production of medical products and access to these products. There are mixed messages from various studies, and although the studies may correctly depict specific situations in specific countries with reference to specific products, such evidence cannot be generalized. Our review strongly supports the need for further research in understanding the dynamic link between local production and access to medical products PMID:23093883

Problem Solving and Immigrant Student Mathematics and Science Achievement: Multination Findings from the Programme for International Student Assessment (PISA)

ERIC Educational Resources Information Center

Martin, Andrew J.; Liem, Gregory A. D.; Mok, Magdalena M. C.; Xu, Jacob

2012-01-01

The present study investigates problem-solving skill alongside more widely recognized settlement and sociodemographic factors in first-generation (1G) and second-generation (2G) immigrant students' science and mathematics achievement. A total of 113,767 students (ages 15-16 years) from 17 countries were drawn from the 2003 Programme for…

ECOLOGICAL RESEARCH IN THE LARGE-SCALE BIOSPHERE–ATMOSPHERE EXPERIMENT IN AMAZONIA: EARLY RESULTS.

Treesearch

M. Keller; A. Alencar; G. P. Asner; B. Braswell; M. Bustamente; E. Davidson; T. Feldpausch; E. Fern ndes; M. Goulden; P. Kabat; B. Kruijt; F. Luizao; S. Miller; D. Markewitz; A. D. Nobre; C. A. Nobre; N. Priante Filho; H. Rocha; P. Silva Dias; C von Randow; G. L. Vourlitis

2004-01-01

The Large-scale Biosphere–Atmosphere Experiment in Amazonia (LBA) is a multinational, interdisciplinary research program led by Brazil. Ecological studies in LBA focus on how tropical forest conversion, regrowth, and selective logging influence carbon storage, nutrient dynamics, trace gas fluxes, and the prospect for sustainable land use in the Amazon region. Early...

Improving Cultural Intelligence through Experiential Learning in Nontraditional Adult Students at a Private Mid-Atlantic University MBA Program

ERIC Educational Resources Information Center

Weed Harnisch, Ashley Sue

2014-01-01

The demand for culturally competent employees continues to increase both domestically in the United States and abroad. Educational institutions must be aware of the demand and make accommodations for this shift in employee requirements as well as the growing business needs of multinational corporations. Study abroad programs often emerge as the…

A DS106 Thing Happened on the Way to the 3M Tech Forum

ERIC Educational Resources Information Center

Lockridge, Rochelle; Levine, Alan; Funes, Mariana

2014-01-01

This case study illustrates how DS106, a computer science course in Digital Storytelling from the University of Mary Washington (UMW) and accessible as an open course on the web, is being explored in a corporate environment at 3M, an American multinational corporation based in St. Paul, Minnesota, to build community, collaboration, and more…

A Multination Study of Socioeconomic Inequality in Expectations for Progression to Higher Education: The Role of Between-School Tracking and Ability Stratification

ERIC Educational Resources Information Center

Parker, Philip D.; Jerrim, John; Schoon, Ingrid; Marsh, Herbert W.

2016-01-01

Persistent inequalities in educational expectations across societies are a growing concern. Recent research has explored the extent to which inequalities in education are due to primary effects (i.e., achievement differentials) versus secondary effects (i.e., choice behaviors net of achievement). We explore educational expectations in order to…

Development of Ethnic, Racial, and National Prejudice in Childhood and Adolescence: A Multinational Meta-Analysis of Age Differences

ERIC Educational Resources Information Center

Raabe, Tobias; Beelmann, Andreas

2011-01-01

This meta-analysis summarizes 113 research reports worldwide (121 cross-sectional and 7 longitudinal studies) on age differences in ethnic, racial, or national prejudice among children and adolescents. Overall, results indicated a peak in prejudice in middle childhood (5-7 years) followed by a slight decrease until late childhood (8-10 years). In…

User Satisfaction Affecting the Acceptance of an E-Learning Platform as a Mean for the Development of the Human Capital

ERIC Educational Resources Information Center

Capece, Guendalina; Campisi, Domenico

2013-01-01

This study aims to explore how satisfaction--from employees' view--using e-learning technology influences organisational learning effectiveness. To this aim, the level of satisfaction using an e-learning platform as a complementary instrument of training and education is measured in a multinational company operating in the energy sector. Our…

Application of Standard Project Management Tools to Research--A Case Study from a Multi-National Clinical Trial

ERIC Educational Resources Information Center

Gist, Peter; Langley, David

2007-01-01

PRINCE2, which stands for Projects in Controlled Environments, is a project management method covering the organisation, management, and control of projects and is widely used in both government and commercial IT and building projects in the UK. This paper describes the application of PRINCE2 to the management of large clinical trials…

International News Flows in the Post-Cold War World: Mapping the News and the News Producers.

ERIC Educational Resources Information Center

Sreberny-Mohammadi, Annabelle

1995-01-01

Reviews the global political environment, major global news providers, and technologies of global news production. Argues for a multinational comparative mapping of international news representation in the 1990s. Outlines a major international venture to update and elaborate the 1979 UNESCO/IAMCR study of foreign news in the media of 29 countries,…

Measurement Equivalence of the Job Descriptive Index Across Chinese and American Workers: Results from Confirmatory Factor Analysis and Item Response Theory

ERIC Educational Resources Information Center

Wang, Mo; Russell, Steven S.

2005-01-01

Despite increased awareness of practical issues in multinational data collection, few studies have addressed the issue of measurement equivalence across Western and Eastern cultures, especially using measures of job attitudes. Therefore, the measurement equivalence of the Job Descriptive Index (JDI) was examined across 2,638 Chinese workers and…

Partnership in Skill Development and Credentialisation: Career Development from School to Work to Tertiary Study

ERIC Educational Resources Information Center

Reid, Maureen; Melrose, Mary

2004-01-01

This article explores the partnership between a New Zealand university and the New Zealand arm of a large multinational employer. A major focus is career development in the New Zealand workplace, which is considered in the context of government policies and initiatives. A research project, which was originally intended to promote staff recruitment…

"I Am a "Kirogi" Mother": Education Exodus and Life Transformation among Korean Transnational Women

ERIC Educational Resources Information Center

Lee, Hakyoon

2010-01-01

This study focuses on the recent social phenomenon of the "kirogi," which means wild goose in Korean. This word also refers to a multinational household in which the mother has moved overseas for the children's education while the father lives alone in Korea to support his family economically. I investigate the narratives of kirogi…

Age-Differences in Work Motivation and Job Satisfaction. The Influence of Age on the Relationships between Work Characteristics and Workers' Outcomes

ERIC Educational Resources Information Center

Boumans, Nicolle P. G.; de Jong, Ad H. J.; Janssen, Sara M.

2011-01-01

This study investigated the influence of age on the relationship between work characteristics and workers' work motivation and job satisfaction. In total, 1036 workers of a Dutch division of a multinational organization participated. Data were collected by a digital questionnaire. Two interaction terms in the regression on work motivation were…

The Impact of a Computer Based Information System (CBIS) on Foreign Investments Opportunities.

ERIC Educational Resources Information Center

Goodwin, Chester

The purpose of this paper is to analyze the impact that computer based information systems (CBIS) could have on U.S. multinational corporations operating in Canada, particularly in the province of Quebec, and the implications for the North American Free Trade Agreement (NAFTA) that went into effect on January 1, 1994. The study focused on how the…

Factors associated with substance use among Spanish military personnel involved in "Bosnia-Herzegovina".

PubMed

Vargas Pecino, Cristina; Castellano, Enrique; Trujillo, Humberto

2017-06-28

The use of both legal and illegal drugs has rarely been investigated among the Spanish military population involved in multinational military operations. The aim of the current study was to examine the consumption of drugs by Spanish military personnel in Bosnia-Herzegovina, and the variables associated with such substance use. A total of 605 military personnel participated in the cross-sectional study. The participants' mean age was 25.9 years (SD = 5.9), and 93.9% of the sample was male. The majority of the participants were enlisted personnel (83.5%). The most widely used drugs were tobacco (54.2%), and alcohol (39.9%). With respect to illegal drugs, the results showed that the drug with the highest prevalence of "use at some point during a lifetime" was cannabis (36.2%), followed by cocaine (14.9%) and amphetamines (12.1%). The most important variable associated with a decrease in the consumption of illegal drugs was social support. Conversely, participants with friends who have used illegal drugs had an increased likelihood of drug consumption. Given that the use of drugs can adversely affect soldiers' performance, preventive measures should be applied in multinational military operations.

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.

Consistency of clinical biomechanical measures between three different institutions: implications for multi-center biomechanical and epidemiological research.

PubMed

Myer, Gregory D; Wordeman, Samuel C; Sugimoto, Dai; Bates, Nathaniel A; Roewer, Benjamin D; Medina McKeon, Jennifer M; DiCesare, Christopher A; Di Stasi, Stephanie L; Barber Foss, Kim D; Thomas, Staci M; Hewett, Timothy E

2014-05-01

Multi-center collaborations provide a powerful alternative to overcome the inherent limitations to single-center investigations. Specifically, multi-center projects can support large-scale prospective, longitudinal studies that investigate relatively uncommon outcomes, such as anterior cruciate ligament injury. This project was conceived to assess within- and between-center reliability of an affordable, clinical nomogram utilizing two-dimensional video methods to screen for risk of knee injury. The authors hypothesized that the two-dimensional screening methods would provide good-to-excellent reliability within and between institutions for assessment of frontal and sagittal plane biomechanics. Nineteen female, high school athletes participated. Two-dimensional video kinematics of the lower extremity during a drop vertical jump task were collected on all 19 study participants at each of the three facilities. Within-center and between-center reliability were assessed with intra- and inter-class correlation coefficients. Within-center reliability of the clinical nomogram variables was consistently excellent, but between-center reliability was fair-to-good. Within-center intra-class correlation coefficient for all nomogram variables combined was 0.98, while combined between-center inter-class correlation coefficient was 0.63. Injury risk screening protocols were reliable within and repeatable between centers. These results demonstrate the feasibility of multi-site biomechanical studies and establish a framework for further dissemination of injury risk screening algorithms. Specifically, multi-center studies may allow for further validation and optimization of two-dimensional video screening tools. 2b.

Regional Military Integration in West Africa: A Case Study of the Multi-National Joint Task Force in the Fight against Boko Haram

DTIC Science & Technology

2016-06-10

detailed description of issues surrounding a subject matter. The use of case studies provides the experimental foundation for qualitative analysis. As...The chapter provided a description of the case studies -based QCA methodology, highlighted how the Charles Ragin QCA will be used for data analysis...world. Against this backdrop, a study assessing the challenges and prospects of sub- regional post -conflict peacebuilding efforts will not only be

A Multinational Study Examining the Cross Cultural Differences in Reported Symptoms of Autism Spectrum Disorders: Israel, South Korea, the United Kingdom, and the United States of America

ERIC Educational Resources Information Center

Matson, Johnny L.; Worley, Julie A.; Fodstad, Jill C.; Chung, Kyong-Mee; Suh, Dongsoo; Jhin, Hea Kyung; Ben-Itzchak, Esther; Zachor, Ditza A.; Furniss, Frederick

2011-01-01

Purportedly, there is a worldwide acceptance of diagnostic criteria for Autism Spectrum Disorders (ASD); however, cultural differences in regards to what is considered normal development may affect the diagnosis despite the biological basis for the condition. The aim of the current study was to examine the differences in reports of symptoms of ASD…

Improvement of Coordination in the Multi-National Military Coordination Center of the Nepal Army in Respond to Disasters

DTIC Science & Technology

2017-06-09

primary question. This thesis has used the case study research methodology with Capability-Based Assessment (CBA) approach. My engagement in this...protected by more restrictions in their home countries, in which case further publication or sale of copyrighted images is not permissible...effective coordinating mechanism. The research follows the case study method utilizing the Capability Based Analysis (CBA) approach to scrutinize the

Road safety perspectives among employees of a multinational corporation in urban India: local context for global injury prevention.

PubMed

Jacoby, Sara F; Winston, Flaura K; Richmond, Therese S

2017-12-01

In rapidly developing economies, like urban India, where road traffic injury rates are among the world's highest, the corporate workplace offers a non-traditional venue for road safety interventions. In partnership with a major multinational corporation (MNC) with a large Indian workforce, this study aimed to elicit local employee perspectives on road safety to inform a global corporate health platform. The safety attitudes and behaviours of 75 employees were collected through self-report survey and focus groups in the MNC offices in Bangalore and Pune. Analysis of these data uncovered incongruity between employee knowledge of safety strategies and their enacted safety behaviours and identified local preference for interventions and policy-level actions. The methods modelled by this study offer a straightforward approach for eliciting employee perspective for local road safety interventions that fit within a global strategy to improve employee health. Study findings suggest that MNCs can employ a range of strategies to improve the road traffic safety of their employees in settings like urban India including: implementing corporate traffic safety policy, making local infrastructure changes to improve road and traffic conditions, advocating for road safety with government partners and providing employees with education and access to safety equipment and safe transportation options.

Understanding multinational companies in public health systems, using a competitive advantage framework.

PubMed

Lethbridge, Jane

2011-07-01

This paper discusses the findings of a study which developed five case studies of five multinational health care companies involved in public health care systems. Strategies were analysed in terms of attitude to marketing, pricing and regulation. The company strategies have been subjected to an analysis using Porter's Five Forces, a business strategy framework, which is unusual in health policy studies. This paper shows how analysing company strategy using a business tool can contribute to understanding the strategies of global capital in national health systems. It shows how social science methodologies can draw from business methods to explain company strategies. The five companies considered in this paper demonstrate that their strategies have many dimensions, which fit into Porter's Five Forces of comparative advantage. More importantly the Five Forces can be used to identify factors that influence company entry into public health care systems. The process of examining the strategic objectives of five health care companies shows that a business tool can help to explain the actions and motives of health care companies towards public health care systems, and so contribute to a better understanding of the strategies of global capital in national health systems. Health service commissioners need to understand this dynamic process, which will evolve as the nature of public health care systems change.

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.

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.

The new chimaera: the industrialization of organ transplantation. International Forum for Transplant Ethics.

PubMed

Tilney, N L; Guttmann, R D; Daar, A S; Hoffenberg, R; Kennedy, I; Lock, M; Radcliffe-Richards, J; Sells, R A

2001-03-15

Clinical organ transplantation has evolved through advances in patient care in parallel with investigations in associated biologies. It has developed from a cottage industry to an important medical specialty driven increasingly by the availability of newer and more effective immunosuppressive drugs, and dependent on consistently close collaborations between university-based clinical scientists and the pharmaceutical industry. Particularly during the past decade, however, this industry has undergone striking changes, consolidating into huge multi-national corporations, each competing for patients, their doctors, and for support of the allied hospitals. Because of the growth of "Big Pharma," the relationship between academia and industry has changed. There have been many advantages to such mutually dependent interactions. A combination of university-based expertise and the specialized knowledge and resources of industry have produced important scientific gains in drug development. Commercial sponsorship of applied research has been crucial. The orchestration of multicenter controlled clinical drug trials has provided invaluable information about the effectiveness of newer agents. But there are also disadvantages of increasing concern. Indeed, the power of "Big Pharma" in many medical fields including transplantation is such that presentation of data can be delayed, adverse results withheld, and individual investigations hampered. Clinical trials may be protracted to stifle competition. Monetary considerations may transcend common sense. Several measures to enhance the clinical relationship between the pharmaceutical industry and those involved with organ transplantation are suggested, particularly the use of third party advisors in the production of clinical trials, support for more basic research and in the dissemination of results. In this way, the increasingly problematic phenomenon of commercialization of the field of transplantation can be tempered and controlled.

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.

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

Technology transfer and other public policy implications of multi-national arrangements for the production of commercial airframes

NASA Technical Reports Server (NTRS)

Gellman, A. J.; Price, J. P.

1978-01-01

A study to examine the question of technology transfer through international arrangements for production of commercial transport aircraft is presented. The likelihood of such transfer under various representative conditions was determined and an understanding of the economic motivations for, effects of, joint venture arrangements was developed. Relevant public policy implications were also assessed. Multinational consortia with U.S. participation were focused upon because they generate the full range of pertinent public issues (including especially technology transfer), and also because of recognized trends toward such arrangements. An extensive search and analysis of existing literature to identify the key issues, and in-person interviews with executives of U.S. and European commercial airframe producers was reviewed. Distinctions were drawn among product-embodied, process, and management technologies in terms of their relative possibilities of transfer and the significance of such transfer. Also included are observations on related issues such as the implications of U.S. antitrust policy with respect to the formation of consortia and the competitive viability of the U.S. aircraft manufacturing industry.

Clinical epidemiology in the era of big data: new opportunities, familiar challenges.

PubMed

Ehrenstein, Vera; Nielsen, Henrik; Pedersen, Alma B; Johnsen, Søren P; Pedersen, Lars

2017-01-01

Routinely recorded health data have evolved from mere by-products of health care delivery or billing into a powerful research tool for studying and improving patient care through clinical epidemiologic research. Big data in the context of epidemiologic research means large interlinkable data sets within a single country or networks of multinational databases. Several Nordic, European, and other multinational collaborations are now well established. Advantages of big data for clinical epidemiology include improved precision of estimates, which is especially important for reassuring ("null") findings; ability to conduct meaningful analyses in subgroup of patients; and rapid detection of safety signals. Big data will also provide new possibilities for research by enabling access to linked information from biobanks, electronic medical records, patient-reported outcome measures, automatic and semiautomatic electronic monitoring devices, and social media. The sheer amount of data, however, does not eliminate and may even amplify systematic error. Therefore, methodologies addressing systematic error, clinical knowledge, and underlying hypotheses are more important than ever to ensure that the signal is discernable behind the noise.

Clinical epidemiology in the era of big data: new opportunities, familiar challenges

PubMed Central

Ehrenstein, Vera; Nielsen, Henrik; Pedersen, Alma B; Johnsen, Søren P; Pedersen, Lars

2017-01-01

Routinely recorded health data have evolved from mere by-products of health care delivery or billing into a powerful research tool for studying and improving patient care through clinical epidemiologic research. Big data in the context of epidemiologic research means large interlinkable data sets within a single country or networks of multinational databases. Several Nordic, European, and other multinational collaborations are now well established. Advantages of big data for clinical epidemiology include improved precision of estimates, which is especially important for reassuring (“null”) findings; ability to conduct meaningful analyses in subgroup of patients; and rapid detection of safety signals. Big data will also provide new possibilities for research by enabling access to linked information from biobanks, electronic medical records, patient-reported outcome measures, automatic and semiautomatic electronic monitoring devices, and social media. The sheer amount of data, however, does not eliminate and may even amplify systematic error. Therefore, methodologies addressing systematic error, clinical knowledge, and underlying hypotheses are more important than ever to ensure that the signal is discernable behind the noise. PMID:28490904

Cancer control in India: a multinational approach involving the USA and the USSR.

PubMed Central

Sutnick, A I; Saunders, J F; Puchkov, Y I

1982-01-01

Based on a long-standing cooperation in medicine and public health between the United States and the Soviet Union, and on the potential contributions to be made by scientists from both of these countries, the World Health Organization invited an American-Soviet collaborative team to recommend a cancer control program for the Government of India. The consultants defined the importance of cancer of the cervix uteri and of the oral cavity, which comprise one-half of India's cancer cases, as the basis for a cancer control program. They recommended incorporation of cancer control functions into the organizational structure of the Ministry of Health as well as specific recommendations in education, prevention, and early detection, diagnosis, treatment, and epidemiologic studies. The mission underscores the value of multinational cooperation on health care problems that are faced in common by the United States, the Soviet Union, and other countries of the world. In addition it serves as a basis for international friendship and understanding in the context of mutually productive activities which may provide a benefit for all nations. PMID:7091462

Using Stimulated Recall to Investigate Pupils' Thinking about Online Bilingual Communication: Code-Switching and Pronominal Address in L2 French

ERIC Educational Resources Information Center

Evans, Michael

2009-01-01

This article demonstrates how evidence related to performance in computer mediated communication (CMC) can be used as a vehicle for researching pupils' thinking about using and learning a foreign language. The analysis is based on a qualitative study of pupils from two contrasting schools who had taken part in a multinational CMC project involving…

Transforming for Multinational Operations: A Study of the National Army of Moldova

DTIC Science & Technology

2014-06-13

suggestions for reducing this burden to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports...M.A. , Member Gregory J. Cook, M.A. Accepted this 13th day of June 2014 by: , Director , Graduate Degree Programs Robert F...countries are financially remunerated for the units they contribute. The amount of financial reimbursement is stated in the Memorandum of Understanding

An Analysis of Multinational Corporations' Perception of Their Requirements for International M.B.A. Degree Holders.

ERIC Educational Resources Information Center

Colquitt, J.; And Others

This study was undertaken to assess: (1) the U.S. corporate demand for Americans holding an MBA degree with a concentration in International Management, (2) the U.S. corporate demand for foreign nationals holding a similar American MBA degree, and (3) the corporate perception of the value of foreign languages in such an international curriculum. A…

Removing the Walls and Textbook from the Classroom: A Case Study of a Creative Entrepreneurship Class of Multinational Students in South Korea

ERIC Educational Resources Information Center

Parry, Zen; Baird, Craig

2012-01-01

Introducing creative elements into the syllabus and pedagogy of an Entrepreneurship class in a business school can be a risky endeavour for an educator and students alike. Populating the class with students from traditionally risk-averse cultures provides opportunities for everyone involved. Identifying the core behavioural issues for students in…

Exploring Diversity of Learning Outcomes in E-Learning Courses: Results of a Qualitative Study in a French Multinational Company

ERIC Educational Resources Information Center

Baudoin, Emmanuel

2010-01-01

The implementation of e-learning by companies in France is ongoing. One of their issues is to improve the learning experience of their employees. From our point of view, this implies that they must better understand the learning experience of the employees. This paper suggests a qualitative approach to learning in order to identify the diversity…

Multicenter validation of the VITEK MS v2.0 MALDI-TOF mass spectrometry system for the identification of fastidious gram-negative bacteria.

PubMed

Branda, John A; Rychert, Jenna; Burnham, Carey-Ann D; Bythrow, Maureen; Garner, Omai B; Ginocchio, Christine C; Jennemann, Rebecca; Lewinski, Michael A; Manji, Ryhana; Mochon, A Brian; Procop, Gary W; Richter, Sandra S; Sercia, Linda F; Westblade, Lars F; Ferraro, Mary Jane

2014-02-01

The VITEK MS v2.0 MALDI-TOF mass spectrometry system's performance in identifying fastidious gram-negative bacteria was evaluated in a multicenter study. Compared with the reference method (DNA sequencing), the VITEK MS system provided an accurate, species-level identification for 96% of 226 isolates; an additional 1% were accurately identified to the genus level. © 2013.

Seroprevalence survey of varicella, measles, rubella, and hepatitis A and B viruses in a multinational healthcare workforce in Saudi Arabia.

PubMed

Almuneef, M A; Memish, Z A; Balkhy, H H; Otaibi, B; Helmi, M

2006-11-01

To determine the prevalence of the vaccine-preventable diseases caused by varicella, measles, rubella, and hepatitis A and B viruses in a multinational healthcare workforce. Prospective cohort study. A 750-bed tertiary care center located in Riyadh, Saudi Arabia. In compliance with hospital policy, newly recruited healthcare workers (HCWs) were enrolled in the study from September 2001 to March 2005. Serum samples were collected from all HCWs during the initial hiring process and tested for IgG antibodies against each of the 5 viral agents. Nonimmune HCWs were subsequently vaccinated at the earliest opportunity. A total of 4,006 newly hired (international and local) employees were included in the study. All underwent serologic testing for IgG antibodies against varicella, measles, rubella, hepatitis A, and hepatitis B viruses. Of the total, 63% were female and 37% were male. Middle Eastern employees comprised 47% of the total, followed by employees from the Far East (35%), the West (10%), and Africa (8%). Forty-two percent were nurses, 27% were in administration, 18% were medical technicians, and 13% were physicians. Among the 4,006 newly hired HCWs, 14% had negative IgG antibody test results for varicella virus, 13% for measles virus, 10% for rubella virus, 33% for hepatitis A virus, and 43% for hepatitis B virus. More women than men were susceptible to hepatitis A (40% vs. 24%; P<.001), whereas more men were susceptible to hepatitis B (55% vs. 35%; P<.001). Varicella susceptibility was more common among HCWs from the Far East (19%), whereas susceptibility to measles, rubella, hepatitis A, and hepatitis B was highest among HCWs from the Middle East. Both relative youth and male sex were associated with lack of antibodies against hepatitis B virus and rubella virus. In contrast, female sex and younger age were associated with lack of antibodies against hepatitis A virus (P<.001). Seroprevalence surveys of vaccine-preventable diseases among HCWs, although labor intensive, are invaluable in caring for a multinational workforce.

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

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

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.

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

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.

Reliability of 3-Dimensional Measures of Single-Leg Drop Landing Across 3 Institutions: Implications for Multicenter Research for Secondary ACL-Injury Prevention.

PubMed

Myer, Gregory D; Bates, Nathaniel A; DiCesare, Christopher A; Barber Foss, Kim D; Thomas, Staci M; Wordeman, Samuel C; Sugimoto, Dai; Roewer, Benjamin D; Medina McKeon, Jennifer M; Di Stasi, Stephanie L; Noehren, Brian W; McNally, Michael; Ford, Kevin R; Kiefer, Adam W; Hewett, Timothy E

2015-05-01

Due to the limitations of single-center studies in achieving appropriate sampling with relatively rare disorders, multicenter collaborations have been proposed to achieve desired sampling levels. However, documented reliability of biomechanical data is necessary for multicenter injury-prevention studies and is currently unavailable. To measure the reliability of 3-dimensional (3D) biomechanical waveforms from kinetic and kinematic variables during a single-leg landing (SLL) performed at 3 separate testing facilities. Multicenter reliability study. 3 laboratories. 25 female junior varsity and varsity high school volleyball players who visited each facility over a 1-mo period. Subjects were instrumented with 43 reflective markers to record 3D motion as they performed SLLs. During the SLL the athlete balanced on 1 leg, dropped down off of a 31-cm-high box, and landed on the same leg. Kinematic and kinetic data from both legs were processed from 2 trials across the 3 laboratories. Coefficients of multiple correlations (CMC) were used to statistically compare each joint angle and moment waveform for the first 500 ms of landing. Average CMC for lower-extremity sagittal-plane motion was excellent between laboratories (hip .98, knee .95, ankle .99). Average CMC for lower-extremity frontal-plane motion was also excellent between laboratories (hip .98, knee .80, ankle .93). Kinetic waveforms were repeatable in each plane of rotation (3-center mean CMC ≥.71), while knee sagittal-plane moments were the most consistent measure across sites (3-center mean CMC ≥.94). CMC waveform comparisons were similar relative to the joint measured to previously published reports of between-sessions reliability of sagittal- and frontal-plane biomechanics performed at a single institution. Continued research is needed to further standardize technology and methods to help ensure that highly reliable results can be achieved with multicenter biomechanical screening models.

Pirfenidone: a review of its use in idiopathic pulmonary fibrosis.

PubMed

Kim, Esther S; Keating, Gillian M

2015-02-01

Pirfenidone (Esbriet®) is an orally administered, synthetic, pyridone compound that is approved for the treatment of adults with mild to moderate idiopathic pulmonary fibrosis (IPF) in the EU, and for the treatment of IPF in the USA. This article summarizes pharmacological, efficacy and tolerability data relevant to the use of pirfenidone in these indications. In the randomized, double-blind, placebo-controlled, multinational CAPACITY trials in patients with mild to moderate IPF, a significant reduction in the rate of decline in forced vital capacity (FVC) was seen with pirfenidone versus placebo in study 004 but not in study 006. Pirfenidone also reduced the rate of decline in FVC to a significantly greater extent than placebo in the randomized, double-blind, multinational ASCEND trial in this patient population. In addition, pirfenidone showed a significant treatment effect on the 6-min walking test distance and progression-free survival in the ASCEND trial and in a pooled analysis of the CAPACITY trials. Pirfenidone had a manageable tolerability profile in all three studies. Gastrointestinal and skin-related events (e.g. nausea, rash, photosensitivity reaction), which were the most commonly occurring treatment-emergent adverse events, were generally mild to moderate in severity. In addition, a prespecified mortality analysis across all three studies demonstrated a significant reduction in IPF-related and all-cause mortality with pirfenidone. In conclusion, oral pirfenidone is a valuable agent for use in patients with IPF.

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.

IEA Wind Task 26 - Multi-national Case Study of the Financial Cost of Wind Energy; Work Package 1 Final Report

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

Schwabe, P.; Lensink, S.; Hand, M.

2011-03-01

The lifetime cost of wind energy is comprised of a number of components including the investment cost, operation and maintenance costs, financing costs, and annual energy production. Accurate representation of these cost streams is critical in estimating a wind plant's cost of energy. Some of these cost streams will vary over the life of a given project. From the outset of project development, investors in wind energy have relatively certain knowledge of the plant's lifetime cost of wind energy. This is because a wind energy project's installed costs and mean wind speed are known early on, and wind generation generallymore » has low variable operation and maintenance costs, zero fuel cost, and no carbon emissions cost. Despite these inherent characteristics, there are wide variations in the cost of wind energy internationally, which is the focus of this report. Using a multinational case-study approach, this work seeks to understand the sources of wind energy cost differences among seven countries under International Energy Agency (IEA) Wind Task 26 - Cost of Wind Energy. The participating countries in this study include Denmark, Germany, the Netherlands, Spain, Sweden, Switzerland, and the United States. Due to data availability, onshore wind energy is the primary focus of this study, though a small sample of reported offshore cost data is also included.« less

Scheduled versus Pro Re Nata Dosing in the VIEW Trials.

PubMed

Richard, Gisbert; Monés, Jordi; Wolf, Sebastian; Korobelnik, Jean François; Guymer, Robyn; Goldstein, Michaella; Norenberg, Christiane; Sandbrink, Rupert; Zeitz, Oliver

2015-12-01

To analyze visual acuity (VA) outcomes before and after preplanned treatment regimen change in the VIEW studies at week 52 (W52). Multiple post hoc analyses for retrospectively defined subgroups in 2 multicenter, multinational, double-masked trials. Two thousand four hundred fifty-seven neovascular age-related macular degeneration (AMD) patients. Patients were randomized to treatment with 0.5 mg ranibizumab given monthly, a 0.5-mg or 2-mg intravitreal aflibercept injection given monthly, or 2 mg intravitreal aflibercept given every other month, after 3 initial monthly doses, up to W52. From W52 through W96, patients received their original dosing assignment using a capped pro re nata (PRN) regimen, with defined retreatment criteria based on VA and morphologic signs of disease activity and mandatory dosing at least every 12 weeks. Best-corrected VA (BCVA) and optical coherence tomography assessments were mandatory at all visits from baseline to W96. Outcomes were changes in BCVA and central retinal thickness. Outcomes were evaluated in all patients who completed 2 years of the VIEW studies using the last observation carried forward method for missing data at interim visits. After W52, approximately 20% of patients lost 5 Early Treatment Diabetic Retinopathy Study (ETDRS) letters or more across all treatment arms with PRN treatment. Patients who met the retreatment criterion of loss of 5 ETDRS letters or more in the first quarter of the PRN dosing phase did not recover; mean final VA loss across the 4 study arms was -4.4 to -5.8 letters. Outcomes of these patients up to W52 were indistinguishable from those of the overall population. There were no differences between groups in serious ocular adverse events or Anti-Platelet Trialists' Collaboration arterial thromboembolic events through W96. These analyses suggest that there are subgroups of patients for whom VA outcomes in the second year of the VIEW studies were less stable than in the first year and for whom W52 seems to be an important inflection point. Although alternate reasons specific to the nature of the underlying AMD cannot be fully excluded, the switch in treatment regimen at W52 is a plausible explanation. Copyright © 2015 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

A Multicenter Study of the Presentation, Treatment, and Outcomes of Cervical Dural Tears.

PubMed

O'Neill, Kevin R; Fehlings, Michael G; Mroz, Thomas E; Smith, Zachary A; Hsu, Wellington K; Kanter, Adam S; Steinmetz, Michael P; Arnold, Paul M; Mummaneni, Praveen V; Chou, Dean; Nassr, Ahmad; Qureshi, Sheeraz A; Cho, Samuel K; Baird, Evan O; Smith, Justin S; Shaffrey, Christopher; Tannoury, Chadi A; Tannoury, Tony; Gokaslan, Ziya L; Gum, Jeffrey L; Hart, Robert A; Isaacs, Robert E; Sasso, Rick C; Bumpass, David B; Bydon, Mohamad; Corriveau, Mark; De Giacomo, Anthony F; Derakhshan, Adeeb; Jobse, Bruce C; Lubelski, Daniel; Lee, Sungho; Massicotte, Eric M; Pace, Jonathan R; Smith, Gabriel A; Than, Khoi D; Riew, K Daniel

2017-04-01

Retrospective multicenter case series study. Because cervical dural tears are rare, most surgeons have limited experience with this complication. A multicenter study was performed to better understand the presentation, treatment, and outcomes following cervical dural tears. Multiple surgeons from 23 institutions retrospectively identified 21 rare complications that occurred between 2005 and 2011, including unintentional cervical dural tears. Demographic data and surgical history were obtained. Clinical outcomes following surgery were assessed, and any reoperations were recorded. Neck Disability Index (NDI), modified Japanese Orthopaedic Association (mJOA), Nurick classification (NuC), and Short-Form 36 (SF36) scores were recorded at baseline and final follow-up at certain centers. All data were collected, collated, and analyzed by a private research organization. There were 109 cases of cervical dural tears among 18 463 surgeries performed. In 101 cases (93%) there was no clinical sequelae following successful dural tear repair. There were statistical improvements ( P < .05) in mJOA and NuC scores, but not NDI or SF36 scores. No specific baseline or operative factors were found to be associated with the occurrence of dural tears. In most cases, no further postoperative treatments of the dural tear were required, while there were 13 patients (12%) that required subsequent treatment of cerebrospinal fluid drainage. Analysis of those requiring further treatments did not identify an optimum treatment strategy for cervical dural tears. In this multicenter study, we report our findings on the largest reported series (n = 109) of cervical dural tears. In a vast majority of cases, no subsequent interventions were required and no clinical sequelae were observed.

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)

Help a Brother Out: A Case Study in Multinational Intelligence Sharing, NATO SOF

DTIC Science & Technology

2011-12-01

increases the likelihood of operational failure and further risks the personal safety of the operators. NATO (and many of the individual member states... personalities in a region. The more 33 Lucien S. Vandenbroucke, Perilous Options: Special Operations as an...ICBMs, tank armies -- they were actually relatively easy to find , but they were very hard to kill. Intelligence was important, don’t get me wrong, but

Beyond the Chinese Dream: How Women Executives Working in Multinational Corporations in the People's Republic of China Describe and Make Meaning of Midlife Transition

ERIC Educational Resources Information Center

Woo, Marjorie J.

2012-01-01

The purpose of this study is to gain understanding of Chinese women executives going beyond the Chinese dream, to learn how they describe and make meaning of their midlife transition experience. A narrative inquiry and holistic content and form approach was used to explore two-stage life stories: narratives of self-actualization of women…

Developing Expatriates for the Asia-Pacific Region: A Comparative Analysis of Multinational Enterprise Managers from Five Countries across Three Continents. [and] Invited Reaction: Developing Expatriates for the Asia-Pacific Region.

ERIC Educational Resources Information Center

Osman-Gani, AAhad M.; van Reine, Peter Prud'homme; Trompenaars, Fons

2000-01-01

Osman-Gani's study surveyed 501 U.S., Germany, Japanese, Korean, and Singaporean managers working abroad, finding significant differences in views of types of training (pre- and postarrival, repatriation, language, cross-cultural) and appropriate delivery methods. Van Reine and Trompenaars' reaction article highlights how cultural background,…

"Dualities of interest": the inter-organizational relationships between disease-specific nonprofits and the pharmaceutical industry.

PubMed

Paluzzi, Joan E

2012-01-01

Health care and biomedical research environments in the United States are largely characterized by strategic relational practices conducted beyond the public gaze. The very nature of health care has been widely reconceptualized from a response to physical/biological imperatives regulated by health promotion and the epidemiological distribution of diseases to profit/market imperatives regulated by "product/brand" promotion and market dynamics. At critical decision points throughout the system, we find the multinational pharmaceutical industry wielding the influence that its wealth and power have bought. This study contributes to the growing body of work that seeks to illuminate the relationships between the pharmaceutical industry and the various entities that constitute the U.S. health and research systems. Through the use of case studies, it examines the relationships between the multinational pharmaceutical industry and the large disease-specific public and professional nonprofit organizations. It explores several questions, including: Is the concept of what constitutes a conflict of interest being purposefully manipulated? Is the public benevolence afforded to nonprofits extended to their corporate partners in ways that preclude critical oversight of relational dynamics? And are public donations, solicited by and given in good faith to these organizations, inevitably serving the economic interests and profits of donor pharmaceutical companies?

The Emergence of `Power with': The Case of a Born Global Organization

NASA Astrophysics Data System (ADS)

Yan, Lin; Panteli, Niki

Thanks to the advancement of Information and Communications Technologies, the past decade has seen the rise of Born Global organizations (Rennie, 1993; Oviatt and McDougall, 1994; Karra and Philips, 2004; Zahra, 2005). Broadly defined as ‘business organizations that, right from inception, seek to derive significant competitive advantages from the use of resources and the sales of outputs in multiple countries’ (Oviatt and McDougall, 1994: 49), Born Global organizations are small, young, and internationally dispersed. While sharing the characteristics of ‘smallness’ and ‘newness’ of Small- and Medium-sized Enterprises (SMEs), Born Global organizations also bear ‘foreignness’, similar to that of Multinational Corporations (Zahra, 2005). Born Globals therefore need to strike a balance between ‘global reach’ and ‘local touch’ as in Multinational Corporations (Bartlett and Ghoshal, 1989); yet they have to do so with scare resources and organizational uncertainty similar to SMEs, and with ‘lean’ and ‘mean’ communications afforded by ICT (e.g. Sproull and Kiesler, 1986). This study is an initial attempt to untangle the combined challenges in Born Globals’ innovative way of management. Through a longitudinal case study, we aim to explore the issue of power in a Born Global’s endeavour to manage its global knowledge via technology mediation.

Introduction to special issue 'Gender, Culture and Alcohol Problems: a Multi-national Study'.

PubMed

Bloomfield, Kim; Gmel, Gerhard; Wilsnack, Sharon

2006-01-01

This paper provides an introduction to a series of articles reporting results from the EU concerted action "Gender, Culture and Alcohol Problems: A Multi-national Study" which examined differences in drinking among women and men in 13 European and two non-European countries. The gender gap in alcohol drinking is one of the few universal gender differences in human social behavior. However, the size of these differences varies greatly from one society to another. The papers in this issue examine, across countries, (1) men's and women's drinking patterns, (2) the prevalence of men's and women's experience of alcohol-related problems, (3) gender differences in social inequalities in alcohol use and abuse, (4) gender differences in the influence of combinations of social roles on heavy alcohol use, and (5) how societal-level factors predict women's and men's alcohol use and problems on a regional and global level. Country surveys were independently conducted and then centralized at one institution for further data standardization and processing. Several results indicated that the greater the societal gender equality in a country, the smaller the gender differences in drinking behavior. In most analyses the smallest gender differences in drinking behaviour were found in Nordic countries, followed by western and central European countries, with the largest gender differences in countries with developing economies.

The effect of exemestane and tamoxifen on bone health within the Tamoxifen Exemestane Adjuvant Multinational (TEAM) trial: a meta-analysis of the US, German, Netherlands, and Belgium sub-studies.

PubMed

Hadji, Peyman; Asmar, Lina; van Nes, Johanna G H; Menschik, Thomas; Hasenburg, Annette; Kuck, Joachim; Nortier, Johan W R; van de Velde, Cornelis J H; Jones, Stephen E; Ziller, May

2011-06-01

We performed a meta-analysis of three sub-studies of the randomized Tamoxifen Exemestane Adjuvant Multinational (TEAM) trial to determine the effects of exemestane and tamoxifen on bone health. Patients received exemestane or tamoxifen as adjuvant therapy for hormone receptor-positive breast cancer. Bone mineral density (BMD) was assessed at baseline and after 12 and 24 months of treatment. Bone turnover markers were also measured. Patients receiving tamoxifen showed a mean increase from baseline in lumbar spine BMD of 1.2% at month 12 and 0.2% at month 24. Patients receiving exemestane showed a mean decrease from baseline of 2.6% after 12 months and 3.5% after 24 months. There were significant differences in the changes in lumbar spine BMD between treatment groups (P < 0.0001 at both time points). Changes in BMD from baseline at the total hip were also significantly different between exemestane and tamoxifen (P < 0.05 at both time points). Bone turnover markers decreased from baseline with tamoxifen and increased with exemestane. Exemestane resulted in decreases in BMD and increases in bone turnover markers. BMD increased and bone turnover markers decreased with tamoxifen.

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

Socio-demographic and clinical profiles of paranoid and nonparanoid schizophrenia: a prospective, multicenter study in China.

PubMed

Xiang, Yu-Tao; Wang, Chuan-Yue; Chiu, Helen F K; Weng, Yong-Zhen; Bo, Qi-Jing; Chan, Sandra S M; Lee, Edwin H M; Ungvari, Gabor S

2011-07-01

This study aimed to explore the socio-demographic and clinical characteristics of paranoid and nonparanoid subtypes of schizophrenia. In a multicenter, randomized, controlled, longitudinal study, 374 clinically stable schizophrenia patients were interviewed at entry with standardized assessment instruments and followed for 12-26 months. In the multivariate analysis, male sex, married marital status, urban abode, and more frequent relapse over the study period were independently associated with paranoid schizophrenia. The socio-demographic and clinical characteristics of Chinese patients with the paranoid subtype of schizophrenia are different from those of their Caucasian counterparts who are more likely to be women and have a better outcome. © 2010 Wiley Periodicals, Inc.

Influence of applied quantity of sunscreen products on the sun protection factor--a multicenter study organized by the DGK Task Force Sun Protection.

PubMed

Bimczok, R; Gers-Barlag, H; Mundt, C; Klette, E; Bielfeldt, S; Rudolph, T; Pflucker, F; Heinrich, U; Tronnier, H; Johncock, W; Klebon, B; Westenfelder, H; Flosser-Muller, H; Jenni, K; Kockott, D; Lademann, J; Herzog, B; Rohr, M

2007-01-01

It is often debated that the protection against solar-induced erythema under real conditions is dependent upon the amount of sunscreen applied. It is believed that when too little is applied a lower sun protection than indicated on the label will result. The aim of this study was to quantify this effect. In this multicenter study, the influence of three different amounts (0.5, 1.0, 2.0 mg/cm(2)) of three commercial sunscreen products in three reliable test centers was investigated according to the test protocol of The International Sun Protection Factor Test Method. The main result was a linear dependence of the SPF on the quantity applied. Taking into consideration the volunteer-specific variations, an exponential dependence of confidence interval of the in vivo SPF and amount applied was found. The highest amount applied (2.0 mg/cm(2)) was linked to the lowest confidence intervals. Thus, from the point of view of producing reliable and reproducible in vivo results under laboratory conditions, the recommendation of this multicenter study is an application quantity of 2.0 mg/cm(2).

The use of group sequential, information-based sample size re-estimation in the design of the PRIMO study of chronic kidney disease.

PubMed

Pritchett, Yili; Jemiai, Yannis; Chang, Yuchiao; Bhan, Ishir; Agarwal, Rajiv; Zoccali, Carmine; Wanner, Christoph; Lloyd-Jones, Donald; Cannata-Andía, Jorge B; Thompson, Taylor; Appelbaum, Evan; Audhya, Paul; Andress, Dennis; Zhang, Wuyan; Solomon, Scott; Manning, Warren J; Thadhani, Ravi

2011-04-01

Chronic kidney disease is associated with a marked increase in risk for left ventricular hypertrophy and cardiovascular mortality compared with the general population. Therapy with vitamin D receptor activators has been linked with reduced mortality in chronic kidney disease and an improvement in left ventricular hypertrophy in animal studies. PRIMO (Paricalcitol capsules benefits in Renal failure Induced cardia MOrbidity) is a multinational, multicenter randomized controlled trial to assess the effects of paricalcitol (a selective vitamin D receptor activator) on mild to moderate left ventricular hypertrophy in patients with chronic kidney disease. Subjects with mild-moderate chronic kidney disease are randomized to paricalcitol or placebo after confirming left ventricular hypertrophy using a cardiac echocardiogram. Cardiac magnetic resonance imaging is then used to assess left ventricular mass index at baseline, 24 and 48 weeks, which is the primary efficacy endpoint of the study. Because of limited prior data to estimate sample size, a maximum information group sequential design with sample size re-estimation is implemented to allow sample size adjustment based on the nuisance parameter estimated using the interim data. An interim efficacy analysis is planned at a pre-specified time point conditioned on the status of enrollment. The decision to increase sample size depends on the observed treatment effect. A repeated measures analysis model, using available data at Week 24 and 48 with a backup model of an ANCOVA analyzing change from baseline to the final nonmissing observation, are pre-specified to evaluate the treatment effect. Gamma-family of spending function is employed to control family-wise Type I error rate as stopping for success is planned in the interim efficacy analysis. If enrollment is slower than anticipated, the smaller sample size used in the interim efficacy analysis and the greater percent of missing week 48 data might decrease the parameter estimation accuracy, either for the nuisance parameter or for the treatment effect, which might in turn affect the interim decision-making. The application of combining a group sequential design with a sample-size re-estimation in clinical trial design has the potential to improve efficiency and to increase the probability of trial success while ensuring integrity of the study.

Pre-morbid glycemic control modifies the interaction between acute hypoglycemia and mortality.

PubMed

Egi, Moritoki; Krinsley, James S; Maurer, Paula; Amin, Devendra N; Kanazawa, Tomoyuki; Ghandi, Shruti; Morita, Kiyoshi; Bailey, Michael; Bellomo, Rinaldo

2016-04-01

To study the impact of pre-morbid glycemic control on the association between acute hypoglycemia in intensive care unit (ICU) patients and subsequent hospital mortality in critically ill patients. We performed a multicenter, multinational, retrospective observational study of patients with available HbA1c levels within the 3-month period preceding ICU admission. We separated patients into three cohorts according to pre-admission HbA1c levels (<6.5, 6.5-7.9, ≥8.0%, respectively). Based on published data, we defined a glucose concentration of 40-69 mg/dL (2.2-3.8 mmol/L) as moderate hypoglycemia and <40 mg/dL (<2.2 mmol/L) as severe hypoglycemia. We applied logistic regression analysis to study the impact of pre-morbid glycemic control on the relationship between acute hypoglycemia and mortality. A total of 3084 critically ill patients were enrolled in the study. Among these patients, with increasing HbA1c levels from <6.5, to 6.5-7.9, and to ≥8.0%, the incidence of both moderate (3.8, 11.1, and 16.4%, respectively; p < 0.001) and severe (0.9, 2.5, and 4.3%, respectively; p < 0.001) hypoglycemia progressively and significantly increased. The relationship between the occurrence of hypoglycemic episodes in the ICU and in-hospital mortality was independently and significantly affected by pre-morbid glucose control, as assessed by adjusted odds ratio (OR) and 95 % confidence interval (CI) for hospital mortality: (1) moderate hypoglycemia: in patients with <6.5, 6.5-7.9, and ≥8.0 % of HbA1c level-OR 0.54, 95% CI 0.25-1.16; OR 0.82, 95 % CI 0.33-2.05; OR 3.42, 95 % CI 1.29-9.06, respectively; (2) severe hypoglycemia: OR 1.50, 95% CI 0.42-5.33; OR 1.59, 95% CI 0.36-7.10; OR 23.46, 95% CI 5.13-107.28, respectively (interaction with pre-morbid glucose control, p = 0.009). We found that the higher the glucose level before admission to the ICU, the higher the mortality risk when patients experienced hypoglycemia. In critically ill patients, chronic pre-morbid hyperglycemia increases the risk of hypoglycemia and modifies the association between acute hypoglycemia and mortality.

Global marketing of cholesterol-lowering drugs as therapy.

PubMed

Elimimian, Jonathan U; Gilmore, James M; Singletary, Tony J

2006-01-01

Pharmaceutical marketing services (PMS) are a key component of pharmaceutical companies' marketing strategies in that they create links between the pharmaceutical company and the physician. They are is also a link between physician and patients locally and globally. PMS discussed in this paper provide various services from tangible to intangible products in order to increase the physicians and pharmacists prescribing activities of their treatment modalities. Given the high cost of recruiting, training, and supporting PMS global marketing efforts, it is important for PMS channels to understand the significance of pharmaceutical multinational companies to ascribe to prescription drug services provided in Thailand. This created the unique marketing environment for the pharmaceutical companies. This study examines whether there is a gap in the existing cholesterol-lowering medication prescribed by physicians in Thailand and the newly introduced brand to the U.S. market. The degree of the new product adoption is analyzed through physician prescription frequency and records. Results of the study indicate there is significant improvement in the health conditions of the users of the new cholesterol medication among Thailand patients. Physicians in Thailand were, however, faced with competing brands in the market due to aggressiveness of advertising and promotion by multinational pharmaceutical marketing and manufacturers Associations. Perceived value and benefit to users were significant outcome of the study. More diagnostic and prescriptive research is recommended to cover Southeast Asia and other parts of the developing countries.

Understanding multinational companies in public health systems, using a competitive advantage framework

PubMed Central

2011-01-01

Background This paper discusses the findings of a study which developed five case studies of five multinational health care companies involved in public health care systems. Strategies were analysed in terms of attitude to marketing, pricing and regulation. The company strategies have been subjected to an analysis using Porter's Five Forces, a business strategy framework, which is unusual in health policy studies. Methods This paper shows how analysing company strategy using a business tool can contribute to understanding the strategies of global capital in national health systems. It shows how social science methodologies can draw from business methods to explain company strategies. Results The five companies considered in this paper demonstrate that their strategies have many dimensions, which fit into Porter's Five Forces of comparative advantage. More importantly the Five Forces can be used to identify factors that influence company entry into public health care systems. Conclusions The process of examining the strategic objectives of five health care companies shows that a business tool can help to explain the actions and motives of health care companies towards public health care systems, and so contribute to a better understanding of the strategies of global capital in national health systems. Health service commissioners need to understand this dynamic process, which will evolve as the nature of public health care systems change. PMID:21722372

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

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.

[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.

DUrable polymer-based sTent CHallenge of Promus ElemEnt versus ReSolute integrity (DUTCH PEERS): rationale and study design of a randomized multicenter trial in a Dutch all-comers population.

PubMed

Tandjung, Kenneth; Basalus, Mounir W Z; Sen, Hanim; Jessurun, Gillian A J; Danse, Peter W; Stoel, Martin; Linssen, Gerard C M; Derks, Anita; van Loenhout, Ton T; Nienhuis, Mark B; Hautvast, Raymond W M; von Birgelen, Clemens

2012-04-01

Drug-eluting stents (DES) are increasingly used for the treatment of coronary artery disease. An optimized DES performance is desirable to successfully treat various challenging coronary lesions in a broad population of patients. In response to this demand, third-generation DES with an improved deliverability were developed. Promus Element (Boston Scientific, Natick, MA) and Resolute Integrity (Medtronic Vascular, Santa Rosa, CA) are 2 novel third-generation DES for which limited clinical data are available. Accordingly, we designed the current multicenter study to investigate in an all-comers population whether the clinical outcome is similar after stenting with Promus Element versus Resolute Integrity. DUTCH PEERS is a multicenter, prospective, single-blinded, randomized trial in a Dutch all-comers population. Patients with all clinical syndromes who require percutaneous coronary interventions with DES implantation are eligible. In these patients, the type of DES implanted will be randomized in a 1:1 ratio between Resolute Integrity versus Promus Element. The trial is powered based on a noninferiority hypothesis. For each stent arm, 894 patients will be enrolled, resulting in a total study population of 1,788 patients. The primary end point is the incidence of target vessel failure at 1-year follow-up. DUTCH PEERS is the first randomized multicenter trial with a head-to-head comparison of Promus Element and Resolute Integrity to investigate the safety and efficacy of these third-generation DES. Copyright © 2012 Mosby, Inc. All rights reserved.

Renal Replacement Therapy in Severe Burns: A Multicenter Observational Study.

PubMed

Chung, Kevin K; Coates, Elsa C; Hickerson, William L; Arnold-Ross, Angela L; Caruso, Daniel M; Albrecht, Marlene; Arnoldo, Brett D; Howard, Christina; Johnson, Laura S; McLawhorn, Melissa M; Friedman, Bruce; Sprague, Amy M; Mosier, Michael J; Conrad, Peggie F; Smith, David J; Karlnoski, Rachel A; Aden, James K; Mann-Salinas, Elizabeth A; Wolf, Steven E

2018-06-20

Acute kidney injury (AKI) after severe burns is historically associated with a high mortality. Over the past two decades, various modes of renal replacement therapy (RRT) have been utilized in this population. The purpose of this multicenter study was to evaluate demographic, treatment and outcomes data among severe burn patients treated with RRT collectively at various burn centers around the United States. After institutional review board approval, a multicenter observational study was conducted. All adult patients 18 or older, admitted with severe burns who were placed on RRT for acute indications but not randomized into a concurrently enrolling interventional trial were included. Across 8 participating burn centers, 171 subjects were enrolled during a 4 year period. Complete data was available in 170 subjects with a mean age of 51±17, percent total body surface area (TBSA) burn of 38±26% and Injury Severity Score of 27±21. 80% of subjects were male and 34% were diagnosed with smoke inhalation injury. The preferred mode of therapy was continuous venovenous hemofiltration at a mean delivered dose of 37±19 (mL/kg/hr) and a treatment duration of 13±24 days. Overall, in hospital mortality was 50%. Among survivors, 21% required RRT upon discharge from the hospital while 9% continued to require RRT 6 months after discharge. This is the first multi-center cohort of burn patients who underwent RRT reported to date. Overall mortality is comparable to other critically ill populations who undergo RRT. Most patients who survive to discharge eventually recover renal function.

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.

Development and Feasibility Testing of a Critical Care EEG Monitoring Database for Standardized Clinical Reporting and Multicenter Collaborative Research.

PubMed

Lee, Jong Woo; LaRoche, Suzette; Choi, Hyunmi; Rodriguez Ruiz, Andres A; Fertig, Evan; Politsky, Jeffrey M; Herman, Susan T; Loddenkemper, Tobias; Sansevere, Arnold J; Korb, Pearce J; Abend, Nicholas S; Goldstein, Joshua L; Sinha, Saurabh R; Dombrowski, Keith E; Ritzl, Eva K; Westover, Michael B; Gavvala, Jay R; Gerard, Elizabeth E; Schmitt, Sarah E; Szaflarski, Jerzy P; Ding, Kan; Haas, Kevin F; Buchsbaum, Richard; Hirsch, Lawrence J; Wusthoff, Courtney J; Hopp, Jennifer L; Hahn, Cecil D

2016-04-01

The rapid expansion of the use of continuous critical care electroencephalogram (cEEG) monitoring and resulting multicenter research studies through the Critical Care EEG Monitoring Research Consortium has created the need for a collaborative data sharing mechanism and repository. The authors describe the development of a research database incorporating the American Clinical Neurophysiology Society standardized terminology for critical care EEG monitoring. The database includes flexible report generation tools that allow for daily clinical use. Key clinical and research variables were incorporated into a Microsoft Access database. To assess its utility for multicenter research data collection, the authors performed a 21-center feasibility study in which each center entered data from 12 consecutive intensive care unit monitoring patients. To assess its utility as a clinical report generating tool, three large volume centers used it to generate daily clinical critical care EEG reports. A total of 280 subjects were enrolled in the multicenter feasibility study. The duration of recording (median, 25.5 hours) varied significantly between the centers. The incidence of seizure (17.6%), periodic/rhythmic discharges (35.7%), and interictal epileptiform discharges (11.8%) was similar to previous studies. The database was used as a clinical reporting tool by 3 centers that entered a total of 3,144 unique patients covering 6,665 recording days. The Critical Care EEG Monitoring Research Consortium database has been successfully developed and implemented with a dual role as a collaborative research platform and a clinical reporting tool. It is now available for public download to be used as a clinical data repository and report generating tool.

A Multi-center Comparison of the Safety of Oral versus Intravenous Acetylcysteine for Treatment of Acetaminophen Overdose

PubMed Central

2010-01-01

Oral and intravenous (IV) acetylcysteine are used for treatment of acetaminophen poisoning. The objective of this multi-center study was to compare the safety of these two routes of administration. METHODS We conducted a multi-center chart review of all patients treated with acetylcysteine for acetaminophen poisoning. The primary safety outcome was the percentage of patients with of acetylcysteine-related adverse events. RESULTS A total of 503 subjects were included in the safety analysis (306 IV only, 145 oral only and 52 both routes).There were no serious adverse events related to acetylcysteine for either route. Nausea and vomiting were the most common related adverse events and were more common with oral treatment (23% vs 9%). Anaphylactoid reactions were more common with IV administration (6% vs 2%). Conclusions Intravenous and oral acetylcysteine are both associated with minimal side effects and are safe for treatment of acetaminophen toxicity. PMID:20524832

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.

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

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.

Multicenter surveillance of species distribution and antifungal susceptibilities of Candida bloodstream isolates in South Korea.

PubMed

Jung, Sook-In; Shin, Jong Hee; Song, Jae-Hoon; Peck, Kyong Ran; Lee, Kyungwon; Kim, Mi-Na; Chang, Hyun Ha; Moon, Chi Sook

2010-06-01

Multicenter data on in vitro susceptibility of Candida bloodstream isolates to echinocandin antifungal agents is still lacking in South Korea. We performed a prospective multicenter study to determine the species distribution of Candida bloodstream isolates and their susceptibility to five antifungal agents, including caspofungin and micafungin. A total of 639 isolates were collected from 20 tertiary hospitals between September 2006 and August 2007. Antifungal susceptibilities were determined through the use of the CLSI broth microdilution method M27-A3. The overall species distribution was as follows; Candida albicans (38%), Candida parapsilosis (26%), Candia tropicalis (20%), Candida glabrata (11%), and miscellaneous Candida species (5%). Although C. parapsilosis and miscellaneous Candida species were less susceptible to both echinocandins, all 639 isolates were susceptible to both caspofungin and micafungin (MIC,

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.

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.

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

Expanding educational access and opportunities: The globalization and foreign direct investment of multinational corporations and their influence on STEM, project-based learning and the national science and technology fair in schools in Costa Rica

NASA Astrophysics Data System (ADS)

Valdez, Joaquin G.

The purpose of this qualitative study was to examine the influence of globalization and the foreign direct investment (FDI) of multinational corporations (MNCs) on the curriculum in schools in Costa Rica. The study focused primarily on Science, Technology, Engineering and Mathematics (STEM), Project-Based Learning (PBL), 21st century skills, and the national science and technology fair. The high influx of MNCs such as Intel has changed the global and educational culture of the country increasing the number of knowledge-based workers in Costa Rica. As a result, policy changes have been instituted in education to mirror the demands of sustaining the country's global economy. This study was supported by the creation of three research questions that would attempt to answer 1) the extent that teachers implementing STEM curriculum trace their practices back to policy, globalization, and multinational corporations as well as the extent to which the economic growth of Costa Rica and STEM education are related, 2) how mandating the national science and technology fair has influenced 21st century skills through project-based learning and the use of technology by teachers and its impact on curriculum and instruction, and 3) how has the national science and technology fair policy changed the value of STEM education for students, teachers, and educational leaders. To further understand the outcome of this study, four theoretical frameworks were applied that included, Spring's theory of world educational culture, Friedman's world flatteners, Wagner's 21st century skills and partnerships for 21st century skills, and Slough and Milam's STEM project-based learning theoretical framework. Each framework was applied to support the changes to the educational system; survival skills necessary to compete in the global job market; application of 21st century skills in the classroom and in the science projects students created. A research team comprised of 14 doctoral students, led by Dr. Michael Escalante, studied the influence of globalization and FDI on MNCs on the educational system in Costa Rica. Data collection for this qualitative case study included the use of various instruments including surveys, interviews, and observations. A total of 20 participants were interviewed and 174 students and 33 teachers were surveyed in support of the findings for this study. The use of multiple sources helped to triangulate the data and increase the validity of the findings.

Proceedings of the Annual Meeting of the Association for Education in Journalism and Mass Communication (79th, Anaheim, CA, August 10-13, 1996). Status of Women and Minorities and Communication Division.

ERIC Educational Resources Information Center

Association for Education in Journalism and Mass Communication.

The Status of Women and Minorities and Communication section of the proceedings contains the following 14 papers: "Who Harasses Women Journalists? A Qualitative Look at Sexual Harassment among U.S. Newswomen" (Kim Walsh-Childers and others); "Not There Yet--Coverage of Women in Foreign News: A 1995 Multi-National Study" (Anat…

Officer Professional Development for Service in Multinational Organizations

DTIC Science & Technology

2012-05-17

NY: Penguin Books, 1984), 61–2. 56 Dwight David Eisenhower: The Centennial (Washington D.C.: Center for Military History, 1986), 20. 57 Ibid. 17...perhaps depressed is the better word — by the folly, futility and waste of war as a means of resolving man’s problems.”116 Case Study Results...Dwight David Eisenhower: The Centennial . Washington D.C.: Center for Military History, 1986. 42 Edwards, Paul M. General Matthew B. Ridgway: An

Developing U.S. Army Officers’ Capabilities for Joint, Interagency, Intergovernmental, and Multinational Environments

DTIC Science & Technology

2011-01-01

Combat Studies Institute, 2006. Harrell, Margaret C., John F. Schank, Harry J. Thie, Clifford M. Graf II, and Paul Steinberg, How Many Can Be Joint...Officers’ Capabilities for JIIM Environments and agencies (Rumsfeld, 2006). With the passage of the John Warner National Defense Authorization Act...Colonel Fitz Lee, the Department of Defense represen- tative at the Department of State’s Coordinator for Reconstruction and Stabilization, asserted

Barriers to the implementation and uptake of simulation-based training programs in general surgery: a multinational qualitative study.

PubMed

Hosny, Shady G; Johnston, Maximilian J; Pucher, Philip H; Erridge, Simon; Darzi, Ara

2017-12-01

Despite evidence demonstrating the advantages of simulation training in general surgery, it is not widely integrated into surgical training programs worldwide. The aim of this study was to identify barriers and facilitators to the implementation and uptake of surgical simulation training programs. A multinational qualitative study was conducted using semi-structured interviews of general surgical residents and experts. Each interview was audio recorded, transcribed verbatim, and underwent emergent theme analysis. All data were anonymized and results pooled. A total of 37 individuals participated in the study. Seventeen experts (Program Directors and Surgical Attendings with an interest in surgical education) and 20 residents drawn from the United States, Canada, United Kingdom, France, and Japan were interviewed. Barriers to simulation-based training were identified based on key themes including financial cost, access, and translational benefit. Participants described cost (89%) and access (76%) as principal barriers to uptake. Common facilitators included a mandatory requirement to complete simulation training (78%) and on-going assessment of skills (78%). Participants felt that simulation training could improve patient outcomes (76%) but identified a lack of evidence to demonstrate benefit (38%). There was a consensus that simulation training has not been widely implemented (70%). There are multiple barriers to the implementation of surgical simulation training programs, however, there is agreement that these programs could potentially improve patient outcomes. Identifying these barriers enable the targeted use of facilitators to deliver simulation training programs. Copyright © 2017 Elsevier Inc. All rights reserved.

Filgrastim mobilization and collection of allogeneic blood progenitor cells from adult family donors: first interim report of a prospective German multicenter study.

PubMed

Beelen, D W; Ottinger, H; Kolbe, K; Pönisch, W; Sayer, H G; Knauf, W; Stockschläder, M; Scheid, C; Schaefer, U W

2002-12-01

Recombinant human granulocyte colony-stimulating factor (rhG-CSF) mobilized peripheral blood progenitor cells (PBPCs) from healthy individuals are a rapidly emerging alternative source to bone marrow for allogeneic transplantation. Although widely applied in the meantime, only limited information on feasibility and safety of mobilization and collection of PBPCs is currently available from prospective multicenter studies specifically designed to investigate this donation modality. This ongoing multicenter study on the performance as well as the short- and long-term safety profile of rhG-CSF-induced mobilization and collection of PBPCs was initiated in October 1999. The study is designed to recruit a total of 300 healthy family donors who will be followed regularly for a period of 5 years after donation. The first interim report presented here summarizes results obtained after enrollment of 150 donors from nine German institutions. The study protocol allowed the individual choice between two dose regimens of rh-CSF (10 micro g/kg per day vs 2x8 micro g/kg per day of donor body weight). The primary endpoint was defined as a yield of > or =5x10(6) CD34(+) cells/kg of recipient body weight in a single leukapheresis product. This endpoint was attained by 50% of donors receiving the lower rhG-CSF dose regimen and by 75% of donors with the higher dose regimen ( p<0.0009). A total of 478 acute adverse events attributable to the mobilization procedure were recorded and manifested predominantly as transient bone pain and headaches (80%). No persistent hematologic or nonhematologic adverse events have occurred in this study so far. Thus, the current experience in a prospective multicenter study supports previous single-center and retrospective registry reports in that the collection of PBPCs after rhG-CSF mobilization is feasible and associated with frequent, but generally mild and acceptable side effects.

Accuracy of cotinine serum test to detect the smoking habit and its association with periodontal disease in a multicenter study.

PubMed

Duque, A; Martínez, P-J; Giraldo, A; Gualtero, D-F; Ardila, C-M; Contreras, A; Duarte, S; Lafaurie, G-I

2017-07-01

The validity of the surveys on self-reported smoking status is often questioned because smokers underestimate cigarette use and deny the habit. It has been suggested that self-report should be accompanied by cotinine test. This report evaluates the usefulness of serum cotinine test to assess the association between smoking and periodontal status in a study with a large sample population to be used in studies with other serum markers in epidemiologic and periodontal medicine researches. 578 patients who were part of a multicenter study on blood biomarkers were evaluated about smoking and its relation to periodontal disease. Severity of periodontal disease was determinate using clinical attachment loss (CAL). Smoking was assessed by a questionnaire and a blood sample drawn for serum cotinine determination. The optimal cut-off point for serum cotinine was 10 ng/ml. Serum cotinine showed greater association with severity of CAL than self-report for mild-moderate CAL [OR 2.03 (CI95% 1.16-3.53) vs. OR 1.08 (CI95% 0.62-1.87) ] advanced periodontitis [OR 2.36 (CI95% 1.30- 4.31) vs. OR 2.06 (CI95% 0.97-4.38) ] and extension of CAL > 3 mm [ OR 1.78 (CI95% 1.16-1.71) vs. 1.37 (CI95% 0.89-2.11)]. When the two tests were evaluated together were not shown to be better than serum cotinine test. Self-reported smoking and serum cotinine test ≥ 10ng/ml are accurate ,complementary and more reliable methods to assess the patient's smoking status and could be used in studies evaluating serum samples in large population and multicenter studies. The serum cotinine level is more reliable to make associations with the patient's periodontal status than self-report questionnaire and could be used in multicenter and periodontal medicine studies.

Accuracy of cotinine serum test to detect the smoking habit and its association with periodontal disease in a multicenter study

PubMed Central

Duque, Andrés; Martínez, Paula-Juliana; Giraldo, Astrid; Gualtero, Diego F.; Ardila, Carlos-Martín; Contreras, Adolfo; Duarte, Silvia

2017-01-01

Background The validity of the surveys on self-reported smoking status is often questioned because smokers underestimate cigarette use and deny the habit. It has been suggested that self-report should be accompanied by cotinine test. This report evaluates the usefulness of serum cotinine test to assess the association between smoking and periodontal status in a study with a large sample population to be used in studies with other serum markers in epidemiologic and periodontal medicine researches. Material and Methods 578 patients who were part of a multicenter study on blood biomarkers were evaluated about smoking and its relation to periodontal disease. Severity of periodontal disease was determinate using clinical attachment loss (CAL). Smoking was assessed by a questionnaire and a blood sample drawn for serum cotinine determination. Results The optimal cut-off point for serum cotinine was 10 ng/ml. Serum cotinine showed greater association with severity of CAL than self-report for mild-moderate CAL [OR 2.03 (CI95% 1.16-3.53) vs. OR 1.08 (CI95% 0.62-1.87) ] advanced periodontitis [OR 2.36 (CI95% 1.30- 4.31) vs. OR 2.06 (CI95% 0.97-4.38) ] and extension of CAL > 3 mm [ OR 1.78 (CI95% 1.16-1.71) vs. 1.37 (CI95% 0.89-2.11)]. When the two tests were evaluated together were not shown to be better than serum cotinine test. Conclusions Self-reported smoking and serum cotinine test ≥ 10ng/ml are accurate, complementary and more reliable methods to assess the patient’s smoking status and could be used in studies evaluating serum samples in large population and multicenter studies. Clinical Relevance: The serum cotinine level is more reliable to make associations with the patient’s periodontal status than self-report questionnaire and could be used in multicenter and periodontal medicine studies. Key words:Biological markers, serum, cotinine, periodontitis, smoking. PMID:28578367

Retrieval of the Leadless Cardiac Pacemaker: A Multicenter Experience.

PubMed

Reddy, Vivek Y; Miller, Marc A; Knops, Reinoud E; Neuzil, Petr; Defaye, Pascal; Jung, Werner; Doshi, Rahul; Castellani, Mark; Strickberger, Adam; Mead, R Hardwin; Doppalapudi, Harish; Lakkireddy, Dhanunjaya; Bennett, Matthew; Sperzel, Johannes

2016-12-01

Leadless cardiac pacemakers have emerged as a safe and effective alternative to conventional transvenous single-chamber ventricular pacemakers. Herein, we report a multicenter experience on the feasibility and safety of acute retrieval (<6 weeks) and chronic retrieval (>6 weeks) of the leadless cardiac pacemaker in humans. This study included patients enrolled in 3 multicenter trials, who received a leadless cardiac pacemaker implant and who subsequently underwent a device removal attempt. The overall leadless pacemaker retrieval success rate was 94%: for patients whose leadless cardiac pacemaker had been implanted for <6 weeks (acute retrieval cohort), complete retrieval was achieved in 100% (n=5/5); for those implanted for ≥ 6 weeks (chronic retrieval cohort), retrieval was achieved in 91% (n=10/11) of patients. The mean duration of time from implant to retrieval attempt was 346 days (range, 88-1188 days) in the chronic retrieval cohort, and nearly two thirds (n=7; 63%) had been implanted for >6 months before the retrieval attempt. There were no procedure-related adverse events at 30 days post retrieval procedure. This multicenter experience demonstrated the feasibility and safety of retrieving a chronically implanted single-chamber (right ventricle) active fixation leadless pacemaker. URL: https://www.clinicaltrials.gov. Unique identifiers: NCT02051972, NCT02030418, and NCT01700244. © 2016 American Heart Association, Inc.

Biomarker combinations for diagnosis and prognosis in multicenter studies: Principles and methods.

PubMed

Meisner, Allison; Parikh, Chirag R; Kerr, Kathleen F

2017-01-01

Many investigators are interested in combining biomarkers to predict a binary outcome or detect underlying disease. This endeavor is complicated by the fact that many biomarker studies involve data from multiple centers. Depending upon the relationship between center, the biomarkers, and the target of prediction, care must be taken when constructing and evaluating combinations of biomarkers. We introduce a taxonomy to describe the role of center and consider how a biomarker combination should be constructed and evaluated. We show that ignoring center, which is frequently done by clinical researchers, is often not appropriate. The limited statistical literature proposes using random intercept logistic regression models, an approach that we demonstrate is generally inadequate and may be misleading. We instead propose using fixed intercept logistic regression, which appropriately accounts for center without relying on untenable assumptions. After constructing the biomarker combination, we recommend using performance measures that account for the multicenter nature of the data, namely the center-adjusted area under the receiver operating characteristic curve. We apply these methods to data from a multicenter study of acute kidney injury after cardiac surgery. Appropriately accounting for center, both in construction and evaluation, may increase the likelihood of identifying clinically useful biomarker combinations.

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.

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)

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:

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:

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:

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.

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

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.

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.

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.

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

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.

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.

Stable Atlas-based Mapped Prior (STAMP) machine-learning segmentation for multicenter large-scale MRI data.

PubMed

Kim, Eun Young; Magnotta, Vincent A; Liu, Dawei; Johnson, Hans J

2014-09-01

Machine learning (ML)-based segmentation methods are a common technique in the medical image processing field. In spite of numerous research groups that have investigated ML-based segmentation frameworks, there remains unanswered aspects of performance variability for the choice of two key components: ML algorithm and intensity normalization. This investigation reveals that the choice of those elements plays a major part in determining segmentation accuracy and generalizability. The approach we have used in this study aims to evaluate relative benefits of the two elements within a subcortical MRI segmentation framework. Experiments were conducted to contrast eight machine-learning algorithm configurations and 11 normalization strategies for our brain MR segmentation framework. For the intensity normalization, a Stable Atlas-based Mapped Prior (STAMP) was utilized to take better account of contrast along boundaries of structures. Comparing eight machine learning algorithms on down-sampled segmentation MR data, it was obvious that a significant improvement was obtained using ensemble-based ML algorithms (i.e., random forest) or ANN algorithms. Further investigation between these two algorithms also revealed that the random forest results provided exceptionally good agreement with manual delineations by experts. Additional experiments showed that the effect of STAMP-based intensity normalization also improved the robustness of segmentation for multicenter data sets. The constructed framework obtained good multicenter reliability and was successfully applied on a large multicenter MR data set (n>3000). Less than 10% of automated segmentations were recommended for minimal expert intervention. These results demonstrate the feasibility of using the ML-based segmentation tools for processing large amount of multicenter MR images. We demonstrated dramatically different result profiles in segmentation accuracy according to the choice of ML algorithm and intensity normalization chosen. Copyright © 2014 Elsevier Inc. All rights reserved.

A multicenter observational study of US adults with acute asthma: who are the frequent users of the emergency department?

PubMed

Hasegawa, Kohei; Sullivan, Ashley F; Tovar Hirashima, Eva; Gaeta, Theodore J; Fee, Christopher; Turner, Stuart J; Massaro, Susan; Camargo, Carlos A

2014-01-01

Despite the substantial burden of asthma-related emergency department (ED) visits, there have been no recent multicenter efforts to characterize this high-risk population. We aimed to characterize patients with asthma according to their frequency of ED visits and to identify factors associated with frequent ED visits. A multicenter chart review study of 48 EDs across 23 US states. We identified ED patients ages 18 to 54 years with acute asthma during 2011 and 2012. Primary outcome was frequency of ED visits for acute asthma in the past year, excluding the index ED visit. Of the 1890 enrolled patients, 863 patients (46%) had 1 or more (frequent) ED visits in the past year. Specifically, 28% had 1 to 2 visits, 11% had 3 to 5 visits, and 7% had 6 or more visits. Among frequent ED users, guideline-recommended management was suboptimal. For example, of patients with 6 or more ED visits, 85% lacked evidence of prior evaluation by an asthma specialist, and 43% were not treated with inhaled corticosteroids. In a multivariable model, significant predictors of frequent ED visits were public insurance, no insurance, and markers for chronic asthma severity (all P < .05). Stronger associations were found among those with a higher frequency of asthma-related ED visits (eg, 6 or more ED visits). This multicenter study of US adults with acute asthma demonstrated many frequent ED users and suboptimal preventive management in this high-risk population. Future reductions in asthma morbidity and associated health care utilization will require continued efforts to bridge these major gaps in asthma care. Copyright © 2014 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

ALS Multicenter Cohort Study of Oxidative Stress (ALS COSMOS): study methodology, recruitment, and baseline demographic and disease characteristics.

PubMed

Mitsumoto, Hiroshi; Factor-Litvak, Pam; Andrews, Howard; Goetz, Raymond R; Andrews, Leslie; Rabkin, Judith G; McElhiney, Martin; Nieves, Jeri; Santella, Regina M; Murphy, Jennifer; Hupf, Jonathan; Singleton, Jess; Merle, David; Kilty, Mary; Heitzman, Daragh; Bedlack, Richard S; Miller, Robert G; Katz, Jonathan S; Forshew, Dallas; Barohn, Richard J; Sorenson, Eric J; Oskarsson, Bjorn; Fernandes Filho, J Americo M; Kasarskis, Edward J; Lomen-Hoerth, Catherine; Mozaffar, Tahseen; Rollins, Yvonne D; Nations, Sharon P; Swenson, Andrea J; Shefner, Jeremy M; Andrews, Jinsy A; Koczon-Jaremko, Boguslawa A

2014-06-01

Abstract In a multicenter study of newly diagnosed ALS patients without a reported family history of ALS, we are prospectively investigating whether markers of oxidative stress (OS) are associated with disease progression. Methods utilize an extensive structured telephone interview ascertaining environmental, lifestyle, dietary and psychological risk factors associated with OS. Detailed assessments were performed at baseline and at 3-6 month intervals during the ensuing 30 months. Our biorepository includes DNA, plasma, urine, and skin. Three hundred and fifty-five patients were recruited. Subjects were enrolled over a 36-month period at 16 sites. To meet the target number of subjects, the recruitment period was prolonged and additional sites were included. Results showed that demographic and disease characteristics were similar between 477 eligible/non-enrolled and enrolled patients, the only difference being type of health insurance among enrolled patients. Sites were divided into three groups by the number of enrolled subjects. Comparing these three groups, the Columbia site had fewer 'definite ALS' diagnoses. This is the first prospective, interdisciplinary, in-depth, multicenter epidemiological investigation of OS related to ALS progression and has been accomplished by an aggressive recruitment process. The baseline demographic and disease features of the study sample are now fully characterized.

The Evolution of the Security Order in Europe: Importance of Multinational Forces

DTIC Science & Technology

1992-02-25

facto-- prevented the economic self - sufficiency of the republics.1 Therefore, it would have been necessary to agree some form of common market and...Defense Identity", Survival (July/August 1991), 336. 32 Douglas T. Stuart, "Can NATO Trascend Its Europeans Borders? NATO Out of Area Disputes", Strategic...Overaio (Novembre 1990): 1-18. Stuart, Douglas T. "Can NATO Trascend Its European Borders?." Strateoic Studies Institute (USAWC): 1-21. 48 Taylor

Multinational Operations: A Selected Bibliography

DTIC Science & Technology

2007-02-01

Backgrounder: Logistics Support for NATO Operations. Brus - sels: NATO, February 2006. 12pp. http://www.nato.int/docu/logistics/logistics-e.pdf North...racks: U.S. Army War College, Strategic Studies Institute, 2004. 112pp. (U413 .A66P64 2004) http://handle.dtic.mil/100.2/ADA429105 Pond, Elizabeth ...U.S., Britain, Europe, and the War in Iraq. New York: Public Af- fairs, 2004. 261pp. (DS79.76 .S31 2004) Sherwood-Randall, Elizabeth . Alliances and

Operational Level Information Sharing Between the U.S. Navy and Southeast Asia Maritime Institutions

DTIC Science & Technology

2017-06-09

material for the case study. The Seventh Fleet lessons learned and media documentary of the multinational search for Malaysia Airlines flight MH370...transnational partners.3 2 In its 2015 Asia-Pacific Maritime Security Strategy, the U.S. Department of Defense outlined a framework to manage these...Southeast Asia maritime region—and particularly in the SCS—is too extensive for the U.S., or any single stakeholder, to manage unilaterally.8 The

Quality of life in relation to tamoxifen or exemestane treatment in postmenopausal breast cancer patients: a Tamoxifen Exemestane Adjuvant Multinational (TEAM) Trial side study.

PubMed

van Nes, J G H; Fontein, D B Y; Hille, E T M; Voskuil, D W; van Leeuwen, F E; de Haes, J C J M; Putter, H; Seynaeve, C; Nortier, J W R; van de Velde, C J H

2012-07-01

Tamoxifen and aromatase inhibitors are associated with side effects which can significantly impact quality of life (QoL). We assessed QoL in the Tamoxifen Exemestane Adjuvant Multinational (TEAM) Trial and compared these data with reported adverse events in the main database. 2,754 Dutch postmenopausal early breast cancer patients were randomized between 5 years of exemestane, or tamoxifen (2.5-3 years) followed by exemestane (2.5-2 years). 742 patients were invited to participate in the QoL side study and complete questionnaires at 1 (T1) and 2 (T2) years after start of endocrine treatment. Questionnaires comprised the EORTC QLQ-C30 and BR23 questionnaires, supplemented with FACT-ES questions. 543 patients completed questionnaires at T1 and 454 patients (84%) at T2. Overall QoL and most functioning scales improved over time. The only clinically relevant and statistically significant difference between treatment types concerned insomnia; exemestane-treated patients reported more insomnia than tamoxifen-treated patients. Discrepancy was observed between QoL issue scores reported by the patients and adverse events reported by physicians. Certain QoL issues are treatment- and/or time-specific and deserve attention by health care providers. There is a need for careful inquiry into QoL issues by those prescribing endocrine treatment to optimize QoL and treatment adherence.

Patterns of care in Dutch postmenopausal patients with hormone-sensitive early breast cancer participating in the Tamoxifen Exemestane Adjuvant Multinational (TEAM) trial.

PubMed

van Nes, J G H; Seynaeve, C; Maartense, E; Roumen, R M H; de Jong, R S; Beex, L V A M; Meershoek-Klein Kranenbarg, W M; Putter, H; Nortier, J W R; van de Velde, C J H

2010-05-01

The Tamoxifen and Exemestane Adjuvant Multinational (TEAM) trial investigates the efficacy and safety of adjuvant exemestane alone and in sequence after tamoxifen in postmenopausal women with hormone-sensitive early breast cancer. As there was a nationwide participation in The Netherlands, we studied the variations in patterns of care in the Comprehensive Cancer Centre Regions (CCCRs) and compliance with national guidelines. Clinicopathological characteristics, carried out local treatment strategies and adjuvant chemotherapy data were collected. From 2001 to January 2006, 2754 Dutch patients were randomised to the study. Mean age of patients was 65 years (standard deviation 9). Tumours were < or =2 cm in 46% (within CCCRs 39%-50%), node-negative disease varied from 25% to 45%, and PgR status was determined in 75%-100% of patients. Mastectomy was carried out in 55% (45%-70%), sentinel lymph node procedure in 68% (42%-79%) and axillary lymph node dissections in 77% (67%-83%) of patients, all different between CCCRs (P < 0.0001). Adjuvant chemotherapy was given in 15%-70% of eligible patients (P < 0.001). In spite of national guidelines, breast cancer treatment on specific issues widely varied between the various Dutch regions. These data provide valuable information for breast cancer organisations indicating (lack of) guideline adherence and areas for breast cancer care improvement.

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...

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)