Should topical opioid analgesics be regarded as effective and safe when applied to chronic cutaneous lesions?

Objectives: The induction of analgesia for many chronic cutaneous lesions requires treatment with an opioid analgesic. In many patients suffering with these wounds such drugs are either contraindicated or shunned because of their association with death. There are now case reports involving over 100 patients with many different types of chronic superficial wounds, which suggest that the topical application of an opioid in a suitable gel leads to a significant reduction in the level of perceived pain. Key findings: Some work has been undertaken to elucidate the mechanisms by which such a reduction is achieved. To date there have been no proven deleterious effects of such an analgesic system upon wound healing. Although morphine is not absorbed through the intact epidermis, an open wound provides no such barrier and for large wounds drug absorption can be problematic. However, for most chronic cutaneous lesions, where data has been gathered, the blood levels of the drug applied ranges from undetectable to below that required for a systemic effect. Summary If proven, the use of opioids in this way would provide adequate analgesia for a collection of wounds, which are difficult to treat in patients who are often vulnerable. Proof of this concept is now urgently required. © 2011 Royal Pharmaceutical Society.

Determinants of Firm Growth with respect to Exporting and Innovation Activities: Evidence from Egyptian SMEs

Small and medium-sized enterprises (SMEs) are considered to be the driving engine for employment growth, source of innovation and technological progress. Moreover, the success of small exporters is critical for economic growth and is considered as an important development stage for many SMEs. However, their competitive advantage lies within the firm’s ability to innovate. This thesis contributes to the above literature by examining two main factors believed to promote firm growth namely ‘exporting’ and ‘innovation’ activities. Growing interests on the relationship between exporting, innovation and growth have recently been tackled. However, there remains a gap in literature on the relationship between exporting, innovation and firm growth for SMEs in emerging economies. Previous studies are conducted in developed counties such as UK, Ireland, USA, Germany, and Switzerland, which leaves the gap for those developing countries. Thus, this thesis addresses the gap by examining the importance of innovation and exporting activities in the growth of SMEs in Egypt. It is also the researcher’s intent to recognise the unique contribution of innovation on firm exporting activities covering all sectors. gypt, one of the countries that were tremendously affected by the so-called ‘Arab Spring revolution’, is suffering from slow economic growth, high unemployment and poverty rate. Thus, the government must ensure economic growth and job creation. Programmes to encourage and develop SMEs should be part of inclusive growth strategy. Meanwhile, exporting is regarded as a key factor to help the economy recover from recession and stimulate economic growth. On the other hand, innovation leads to better performance in terms of growth, exporting and productivity. Therefore, SMEs and their exporting and innovation activities should be an integral part of any recovery and growth strategy for the economy. Moreover, Egypt is suffering from the so-called ‘Missing Middle’, which is problematic as medium firms tend to provide better employment growth and productivity. Therefore, more light is to shed on the importance of exporting and innovation in the growth of firms. The research design was quantitative in nature, testing the proposed hypotheses. The study was conducted in 2013 based on questionnaires of 406 Egyptians SMEs. The results of the empirical study suggest that both exporting and innovation activities are important in firm growth. However, the results show that, after controlling for endogeneity, innovation does not affect exporting activities in SMEs.

Determinants of firm growth with repect to exporting and innovation activities:evidence from Egyptian SMEs

Small and medium-sized enterprises (SMEs) are considered to be the driving engine for employment growth, source of innovation and technological progress. Moreover, the success of small exporters is critical for economic growth and is considered as an important development stage for many SMEs. However, their competitive advantage lies within the firm’s ability to innovate. This thesis contributes to the above literature by examining two main factors believed to promote firm growth namely ‘exporting’ and ‘innovation’ activities. Growing interests on the relationship between exporting, innovation and growth have recently been tackled. However, there remains a gap in literature on the relationship between exporting, innovation and firm growth for SMEs in emerging economies. Previous studies are conducted in developed counties such as UK, Ireland, USA, Germany, and Switzerland, which leaves the gap for those developing countries. Thus, this thesis addresses the gap by examining the importance of innovation and exporting activities in the growth of SMEs in Egypt. It is also the researcher’s intent to recognise the unique contribution of innovation on firm exporting activities covering all sectors. Egypt, one of the countries that were tremendously affected by the so-called ‘Arab Spring revolution’, is suffering from slow economic growth, high unemployment and poverty rate. Thus, the government must ensure economic growth and job creation. Programmes to encourage and develop SMEs should be part of inclusive growth strategy. Meanwhile, exporting is regarded as a key factor to help the economy recover from recession and stimulate economic growth. On the other hand, innovation leads to better performance in terms of growth, exporting and productivity. Therefore, SMEs and their exporting and innovation activities should be an integral part of any recovery and growth strategy for the economy. Moreover, Egypt is suffering from the so-called ‘Missing Middle’, which is problematic as medium firms tend to provide better employment growth and productivity. Therefore, more light is to shed on the importance of exporting and innovation in the growth of firms. The research design was quantitative in nature, testing the proposed hypotheses. The study was conducted in 2013 based on questionnaires of 406 Egyptians SMEs. The results of the empirical study suggest that both exporting and innovation activities are important in firm growth. However, the results show that, after controlling for endogeneity, innovation does not affect exporting activities in SMEs.