Pediatric drug-related problems: a multicenter study in four French-speaking countries.

BACKGROUND: Pediatric intensive care patients represent a population at high risk for drug-related problems. There are few studies that compare the activity of clinical pharmacists between countries. OBJECTIVE: To describe the drug-related problems identified and interventions by four pharmacists in a pediatric cardiac and intensive care unit. SETTING: Four pediatric centers in France, Quebec, Switzerland and Belgium. METHOD: This was a six-month multicenter, descriptive and prospective study conducted from August 1, 2009 to January 31, 2010. Drug-related problems and clinical interventions were compiled from four pediatric centers in France, Quebec, Switzerland and Belgium. Data on patients, drugs, intervention, documentation, approval and estimated impact were compiled. MAIN OUTCOME MEASURE: Number and type of drug-related problems encountered in a large pediatric inpatient population. RESULTS: A total of 996 interventions were recorded: 238 (24 %) in France, 278 (28 %) in Quebec, 351 (35 %) in Switzerland and 129 (13 %) in Belgium. These interventions targeted 270 patients (median 21 months old, 53 % male): 88 (33 %) in France, 56 (21 %) in Quebec, 57 (21 %) in Switzerland and 69 (26 %) in Belgium. The main drug-related problems were inappropriate administration technique (29 %), untreated indication (25 %) and supra-therapeutic dose (11 %). The pharmacists' interventions were mostly optimizing the mode of administration (22 %), dose adjustment (20 %) and therapeutic monitoring (16 %). The two major drug classes that led to interventions were anti-infectives for systemic use (23 %) and digestive system and metabolism drugs (22 %). Interventions mainly involved residents and all clinical staff (21 %). Among the 878 (88 %) proposed interventions requiring physician approval, 860 (98 %) were accepted. CONCLUSION: This descriptive study illustrates drug-related problems and the ability of clinical pharmacists to identify and resolve them in pediatric intensive care units in four French-speaking countries.

Validation of an Adapted French Form of the Career Adapt-Abilities Scale in four Francophone Countries

This study presents the validation of a French version of the Career Adapt-Abilities Scale in four Francophone countries. The aim was to re-analyze the item selection and then compare this newly developed French-language form with the international form 2.0. Exploratory factor analysis was used as a tool for item selection, and confirmatory factor analysis (CFA) verified the structure of the CAAS French-language form. Measurement equivalence across the four countries was tested using multi-group CFA. Adults and adolescents (N=1,707) participated from Switzerland, Belgium, Luxembourg, and France. Items chosen for the final version of the CAAS French-language form are different to those in the CAAS international form 2.0 and provide an improvement in terms of reliability. The factor structure is replicable across country, age, and gender. Strong evidence for metric invariance and partial evidence for scalar invariance of the CAAS French-language form across countries is given. The CAAS French-language and CAAS international form 2.0 can be used in a combined form of 31 items. The CAAS French-language form will certainly be interesting for practitioners using interventions based on the life design paradigm or aiming at increasing career adapt-ability.

Global surveillance of cancer survival 1995-2009 : analysis of individual data for 25 676 887 patients from 279 population-based registries in 67 countries (CONCORD-2)

BACKGROUND: Worldwide data for cancer survival are scarce. We aimed to initiate worldwide surveillance of cancer survival by central analysis of population-based registry data, as a metric of the effectiveness of health systems, and to inform global policy on cancer control. METHODS: Individual tumour records were submitted by 279 population-based cancer registries in 67 countries for 25·7 million adults (age 15-99 years) and 75 000 children (age 0-14 years) diagnosed with cancer during 1995-2009 and followed up to Dec 31, 2009, or later. We looked at cancers of the stomach, colon, rectum, liver, lung, breast (women), cervix, ovary, and prostate in adults, and adult and childhood leukaemia. Standardised quality control procedures were applied; errors were corrected by the registry concerned. We estimated 5-year net survival, adjusted for background mortality in every country or region by age (single year), sex, and calendar year, and by race or ethnic origin in some countries. Estimates were age-standardised with the International Cancer Survival Standard weights. FINDINGS: 5-year survival from colon, rectal, and breast cancers has increased steadily in most developed countries. For patients diagnosed during 2005-09, survival for colon and rectal cancer reached 60% or more in 22 countries around the world; for breast cancer, 5-year survival rose to 85% or higher in 17 countries worldwide. Liver and lung cancer remain lethal in all nations: for both cancers, 5-year survival is below 20% everywhere in Europe, in the range 15-19% in North America, and as low as 7-9% in Mongolia and Thailand. Striking rises in 5-year survival from prostate cancer have occurred in many countries: survival rose by 10-20% between 1995-99 and 2005-09 in 22 countries in South America, Asia, and Europe, but survival still varies widely around the world, from less than 60% in Bulgaria and Thailand to 95% or more in Brazil, Puerto Rico, and the USA. For cervical cancer, national estimates of 5-year survival range from less than 50% to more than 70%; regional variations are much wider, and improvements between 1995-99 and 2005-09 have generally been slight. For women diagnosed with ovarian cancer in 2005-09, 5-year survival was 40% or higher only in Ecuador, the USA, and 17 countries in Asia and Europe. 5-year survival for stomach cancer in 2005-09 was high (54-58%) in Japan and South Korea, compared with less than 40% in other countries. By contrast, 5-year survival from adult leukaemia in Japan and South Korea (18-23%) is lower than in most other countries. 5-year survival from childhood acute lymphoblastic leukaemia is less than 60% in several countries, but as high as 90% in Canada and four European countries, which suggests major deficiencies in the management of a largely curable disease. INTERPRETATION: International comparison of survival trends reveals very wide differences that are likely to be attributable to differences in access to early diagnosis and optimum treatment. Continuous worldwide surveillance of cancer survival should become an indispensable source of information for cancer patients and researchers and a stimulus for politicians to improve health policy and health-care systems. FUNDING: Canadian Partnership Against Cancer (Toronto, Canada), Cancer Focus Northern Ireland (Belfast, UK), Cancer Institute New South Wales (Sydney, Australia), Cancer Research UK (London, UK), Centers for Disease Control and Prevention (Atlanta, GA, USA), Swiss Re (London, UK), Swiss Cancer Research foundation (Bern, Switzerland), Swiss Cancer League (Bern, Switzerland), and University of Kentucky (Lexington, KY, USA).

Development of a Business Model that Supports Mobile Value-Added Services Market Creation in Emerging Countries

Tutkielman tavoitteena on luoda liiketoimintamalli, joka tukee langattomien matkaviestintäpalveluiden markkinoiden luomista kehittyvillä markkinoilla. Teoreettinen osa tarkastelee langattomien matkaviestintäpalveluiden liiketoimintamallin kehittämisen tärkeimpiä elementtejä CIS maissa. Teoreettisen kappaleen tuloksena saadaan puitteet, jonka avulla liiketoimintamalli matkaviestintäpalveluille voidaan kehittää. Tutkielman empiirinen osa on toteutettu case tutkimuksena, jonka tavoitteena on ollut langattomien matkaviestintäpalvelujen markkinoiden luominen CIS maissa. Pääasiallinen empiirisen tiedon lähde on ollut teemahaastattelut. Tuloksena saatuja empiirisen osan tietoja verrataan teoriakappaleen vastaaviin tuloksiin Tulokset osoittavat, että radikaalin korkean teknologian innovaation markkinoiden luominen on hidas prosessi, joka vaatii kärsivällisyyttä yritykseltä. Markkinoiden, teknologian ja strategian epävarmuustekijät tuovat epävarmuutta kehittyvälle toimialalle ja markkinoille, joka vaikeuttaa liiketoimintamallin kehittämistä. Tärkein tekijä on palvelujen markkinointi ennemmin kuin teknologian. Avain kyvykkyys markkinoiden luomisessa on oppiminen, ei tietäminen.

Expanding to institutionally different countries. Reasons, Firm International Experience, and Entry Mode Choice

We examine entry mode choice and its consequences when a multinational enterprise (MNE) expands into an institutionally different country. We argue that discussions of entry mode should distinguish between informal (e.g., culture) and formal (e.g., laws) institutions, and should take into account not just the home country of the MNE and its distance to the focal host country, but the MNE's overall footprint and experience across the world in general, especially in countries with an institutional structure that is similar to that of the focal host country. Specifically, we argue that firms with experience in countries with different informal institutions will be more likely to enter via acquisitions than firms without such experience, that such experience will not matter as much in the case of formal institutions, and that such firms will exit more quickly when they enter via equity alliances than through full acquisitions. We also distinguish between balanced and unbalanced alliances and argue that balanced alliances will be more enduring, but only when the host country is culturally (not legally) different from the other countries where the MNE has experience. Our arguments suggest that entry mode should be conditioned on a firm's experience in other markets, and that intercountry differences in formal versus informal institutions have distinct influences on entry mode.

The People's Republic of China and her relations with the countries of the association of Southeast Asian nations : 1969-1975

Phe Ihesis examines the evolution of the -policies of the People fs Jtenublie of China towards J?hail°nd, PTal ysia, Singapore, Iidonesia pad the Philip-pines, organised in the Association of Southeast Asian Nations from 1969 to 1975• 2ze first central point of this study is an *ir sumption that the foreign relations of The People's Tepublic of Chi la Towards Southeast ^sia have been motivated by a dynamic interplay of t^o main factors: (1) Farxist-Leninist ideology and ICao J^e-tung Ph^ught, which dictate to China to behave as a revolutionary Dover vhich must assist the insurgent movements in the area in their strug fle to overthrow the local governments; (2) national interest, vhich demands of China to safeguard the southern flank of her territory bordering on Southerst 'sia through Friendly relations, trade and ot*»er conventional inrtniments of diplomacy. hile the tvo main motive factors are nuTually antagonistic and exclusivet the Chinere leaders are nevertheless at te mi ting to oring them iirco a coherent policy under Mao's theory of tve {hniity of op-nosites," vhich believes that it is -possible to reconcile these co-posing tendencies into a dynamic enuibrium through vhich both opnosites could be promoted at the same time although not to the same extent* la other words, the Chinese leaders conceive the dynamic equilibrium as a continuum between them in a mix in which one or the other orientation predominates in different •periods* Bins we might see China1 s conduct motivated in one period by mostly ideological considerations at the expense of the staire-to-state relations, then ve might see her policy in the middle of the continuum and suf ering from immo bill sine and just muddling through, or finally ?fe might see her emphasising friendly ties at the expense of support of revolutionary movements at the other extreme -point of the spectrum* !fhe mechanism vhich enables Peking to move from one pole to the other of the spectrum is activated by the following elementsJ (1) the result of an internal power struggle within the leadership in Peking between ideologically radical and moderate elements, which enables the victorious faction to initiate nev policies; (2) Peking's assessment of the changing intentions and capabilities of the major powers in the area; (3) internal changes within the countries of the area and the changing attitudes of their governments towards China; (4) changing fortunes of revolutionary movements operating in the area* 'Phe second major point of this study is an assertion that while China's conduct toward Southeast *lsia after her foundation in 1949 was primarily based upon ideological considerations, the beginning of the seventies saw the national interest reasserting itself as the leading motive factor* Thus China talks with her neighbours in Southeast asia in terms of relevance of fllong historical ties," casting herself into the role of a benevolent "older brother11 who is entitled to reopect and deference in exchange for patronage and protection* Hence the traditional echoes of the past are emerging ever stronger and influencing her postures towards the region, while the open support to revolutionary moevments is underplayed at the moment.

Subnational Fiscal Autonomy and Impact of Decentralization : The Case of European Transition Countries.

Rapport de recherche

Does IMF Induce Political Business Cycles? An Empirical Analysis on Latin America's Indebted Countries.

Rapport de recherche

Finance and Growth : Empirical Evidence from Developing Countries, 1960-1990

This paper examines the empirical relationship between financial intermediation and economic growth using cross-country and panel data regressions for 69 developing countries for the 1960-1990 period. The main results are : (i) financial development is a significant determinant of economic growth, as it has been shown in cross-sectional regressions; (ii) financial markets cease to exert any effect on real activity when the temporal dimension is introduced in the regressions. The paradox may be explained, in the case of developing countries, by the lack of an entrepreneurial private sector capable to transform the available funds into profitable projects; (iii) the effect of financial development on economic growth is channeled mainly through an increase in investment efficiency.

United States and México : commerce, trade, and postal facilities between tha two countries

UANL

Sharing a River among Satiable Countries

With diminishing global water reserves the problem of water allocation becomes increasingly important. We consider the problem of efficiently sharing a river among a group of satiable countries. Inducing countries to efficiently cooperate requires monetary compensations via international agreements. We show that cooperation of the other countries exerts a positive externality on the benefit of a coalition. Our problem is to distribute the benefit of efficiently sharing the river under these constraints. If the countries outside of a coalition do not cooperate at all, then the downstream incremental distribution is the unique compromise between the absolute territorial sovereignty (ATS) doctrine and the unlimited territorial integrity (UTI) doctrine. If all countries outside of a coalition cooperate, then there may not exist any distribution satisfying the UTI doctrine.