Introduction Of New Technologies Research Articles

Identifying Factors of Operative Efficiency in Head and Neck Free Flap Reconstruction

Head and neck oncological resection and reconstruction is a complex process that requires multidisciplinary collaboration and prolonged operative time. Numerous factors are associated with operative time, including a surgeon's experience, team familiarity, and the use of new technologies. It is paramount to evaluate the contribution of these factors and modalities on operative time to facilitate broad adoption of the most effective modalities and reduce complications associated with prolonged operative time. To examine the association of head and neck cancer resection and reconstruction interventions with operative time. This large cohort study included all patients who underwent head and neck oncologic resection and free flap-based reconstruction in Calgary (Alberta, Canada) between January 1, 2007, and March 31, 2020. Data were analyzed between November 2021 and May2022. The interventions that were implemented in the program were classified into team-based strategies and the introduction of new technology. Team-based strategies included introducing a standardized operative team, treatment centralization in a single institution, and introducing a microsurgery fellowship program. New technologies included use of venous coupler anastomosis and virtual surgical planning. The primary outcome was mean operative time difference before and after the implementation of each modality. Secondary outcomes included returns to the operating room within 30 days, reasons for reoperation, returns to the emergency department or readmissions to hospital within 30 days, and 2-year and 5-year disease-specific survival. Multivariate regression analyses were performed to examine the association of each modality with operative time. A total of 578 patients (179 women [30.9%]; mean [SD] age, 60.8 [12.9] years) undergoing 590 procedures met inclusion criteria. During the study period, operative time progressively decreased and reached a 32% reduction during the final years of the study. A significant reduction was observed in mean operative time following the introduction of each intervention. However, a multivariate analysis revealed that team-based strategies, including the use of a standardized nursing team, treatment centralization, and a fellowship program, were significantly associated with a reduction in operative time. The results of this cohort study suggest that among patients with head and neck cancer, use of team-based strategies was associated with significant decreases in operative time without an increase in complications.

Ärimudelite analüüs Eesti muuseumite näitel

According to the author of this article, the developments of Estonian museums are most influenced by the country's cultural policy and funding model. As emphatically non-profit organizations, museums today are at the service of society and seek to create value in their own unique way through collecting, preserving, researching and presenting historical memory. This does not cause any problems as long as a museum functions as a memory institution, since the functions of a memory institution are largely supported by the state or municipality. In the case of a museum as an attraction, however, the bar of ambitions must be set higher and the availability of competitive relevant competences and resources must be ensured. Since the state or local government is the main financier of most of the major museums, the entire planning logic of museums mainly focuses on the funding conditions stated in the laws and regulations. However, this significantly inhibits the development of activities related to the raising of private revenue, as resources are directed towards the fulfilling of conditions set by the ‘state commission’. For most museums, the ambition to generate private revenue is quite low—their activities are constrained by limited resources and the real revenue potential is largely untapped. In order to compete as an attraction in the experience services market, museums must also invest in the development of an experiential visitor environment and additional services throughout the visitor's journey. New trends are no longer set in years, but in days. Expectations that are raised by the market demand must be responded to more quickly, for timeliness has become equivalent to relevance in creating expositions and developing the visitor environment. Both from the perspective of the visitor environment and taken as a whole, it is possible to detect trends that are influenced by the introduction of new technologies and intellectual property, as well as social media developments and lifestyle trends. Museums as visitor environments must adapt more and more to the expectations and needs of visitors in terms of their interests, lifestyle and everyday needs. To provide an experiential visitor experience, it is not enough to just organize an attractive exhibition, all stages of the visitor's journey must be thoroughly thought out and appropriately furnished. It is only by doing this that it is possible to operate sustainably in an ever-increasingly competitive situation. In summary, it has to be acknowledged that visitors' expectations of museums are becoming more and more demanding, and in order to remain competitive ever greater effort must be directed towards experience. Both as research and educational institutions and as tourist attractions, museums all over the world face challenges that require change. Whether and how these challenges are accepted and overcome depends on the maturity stage of the market in a particular country and the financing model of the museums. Museums operating with the support of the state can afford to have greater freedom in undertaking educational and research activities and can afford to forgo activities with commercial and entertainment content. Such museums can afford to develop visitor environments that directly and exclusively dovetail with the value space and operational objectives of the museum as a memory institution. If the revenue goals are set at a high level, in addition to research and educational activities, museums must also contribute to the development of an attractive visitor environment and additional services. Otherwise, they will not be competitive in the market in comparison with other attractions and other recreational services.

ОҚЫТУДЫҢ ИНТЕРБЕЛСЕНДІ ӘДІСТЕРІН ОҚУ ҮРДІСІНДЕ ҚОЛДАНУ

Abstract. This article will describe innovative learning technologies, including the types of interactive methods and how they are used in the educational process. Thus, the word "interactive"- the term "interaction" - refers to the tendency to communicate or communicate with someone (a person) or with someone (for example, a computer) in an interview mode. Innovative educational work is formulated through the rational introduction of new technologies that adapt the educational process to productive education. These are modern technologies, such as cable and satellite television, video conferences, telephone forums, telethons, party portfolios, individual achievements in education and upbringing, as well as life skills development trainings, including social training, which tell about various achievements. It was noted that interactive learning is, first of all, learning in which teachers and students interact and conduct interviews. It was about the main goals of interactive learning: – the establishment of free and open creative relationships between students; – orientation of students to independent search for knowledge; – development of skills and abilities necessary for students; He gave an interview to the interactive method and focused on its goals. Note: the purpose of the training is to establish free and open creative relations between students; orientation of the student to an independent search for knowledge; formation of the necessary skills and abilities of the student, etc. In addition, the types of interactive methods: jigsaw method, case study, design method, brainstorming, training, Fishbone method, Spider method, Istanbul game method, Backronym method, hot chair method, business games, role-playing games, essay descriptions will be given, and it will be discussed about the effectiveness of their use. The case study method (situational learning method) is a teaching method used to analyze and predict real or imaginary situations, that is, to describe specific economic and social situations. In the case of a situation (case), we mean a written transmission of the real real situation in the team. For example, it tells about the history of education, organization and creation of the organization, its development, achievements in business, etc. Key words: innovation, interactive method, jigsaw, case study, project, training, brainstorming, fishbone, essay, game, debate.

SPECIAL FEATURES OF ENERGY TRANSITION IN ASIAN COUNTRIES

The current stage of development of the world energy industry is taking place in line with the fourth industrial revolution, characterized by the changing ways of life and the introduction of new technologies based on R&D. Environmental pollution has reached a large scale, and as a result it has become necessary to change the structure of modern fuel and energy balance in favor of renewable and non-traditional energy sources. Asian countries vary widely in terms of the level of economic development, making it difficult to create an integrated energy market in Asia. A typology of countries according to the level of economic development was elaborated on the basis of a multi-scale analysis using traditional methods of economic geography. In total these countries rank first in the world in terms of greenhouse gas emissions, accounting for almost 60% of pollutants released into the environment. The fuel and energy balance of Asian countries is characterized by a high proportion of coal, which contributes to the large-scale environment pollution. In accordance with international practice, the countries of the continent adopted energy programs aimed at lesser emissions by reducing the share of coal and switching to low-carbon energy sources. The energy transition can take place primarily in the leading Asian countries that have necessary financial resources. Most Asian countries are at the early stages of industrialization, and the energy transition is almost impossible at this stage because they use energy-intensive industrial technologies. The urgent need to stop climate change comes into conflict with rising energy consumption. Asia has become the world’s leader in energy consumption, as it takes place not only in industry, but also in the utility sector, because 4.2 billion people, or more than 50% of the world’s urban population, live in cities. China has become a leader in the introduction of renewable energy sources, the country has developed and implements new environmental standards that will achieve carbon neutrality by 2060 through the accelerated commissioning of new zero-emission power plants. The rejection of coal could aggravate socio-economic problemsof Asia because of its high share in the fuel and energy balance and the large number of people employed in the industry. In line with the sustainable development goals, the Asian countries try to introduce renewable energy sources based on the local comparative advantages.

Logistic system: costs, tools and perspectives

The article focuses on the growing role and importance of logistics in economic systems. The concept of "logistic system" is investigated. The basic structural components of the logistic system, their interrelationships and functions are outlined. The article presents different approaches to defining the concept of "logistic costs" and analyzes different types of logistic costs. Additionally, the article reveals the factors that influence the formation of logistic costs and suggests the ways to minimize the costs of logistic activities. The expediency of using modern logistic tools, such as automation, digitization and artificial intelligence, and the introduction of new technologies in the logistic activities of enterprises is also substantiated. The article outlines the trends and prospects for the development of national logistic systems and proposes the measures aimed at improving the logistic activities of enterprises.

Managing the risks associated with technological disruption in the road transport system: a control structure modelling approach

Road transport is experiencing disruptive change from new first-of-a-kind technologies. While such technologies offer safety and operational benefits, they also pose new risks. It is critical to proactively identify risks during the design, development and testing of new technologies. The Systems Theoretic Accident Model and Processes (STAMP) method analyses the dynamic structure in place to manage safety risks. This study applied STAMP to develop a control structure model for emerging technologies in the Australian road transport system and identified control gaps. The control structure shows the actors responsible for managing risks associated with first-of-a-kind technologies and the existing control and feedback mechanisms. Gaps identified related to controls (e.g. legislation) and feedback mechanisms (e.g. monitoring for behavioural adaptation). The study provides an example of how STAMP can be used to identify control structure gaps requiring attention to support the safe introduction of new technologies.

Toward the Design of Sensing-Based Medication Adherence Aids That Support Individualized Activities of Daily Living: Survey and Interviews With Patients and Providers

Background Nearly half of Americans taking prescription medications do not take them properly. The resulting implications have a broad impact. Nonadhering patients develop worsened medical conditions and increased comorbidity of disease or die. Objective Clinical studies have shown that the most effective strategies for addressing adherence are those that are individualized to the context that each patient and situation require. However, existing aids for adherence are relatively ridged and poorly support adaptation to individual behaviors and lifestyles. The aim of our study was to better understand this design tension. Methods A series of 3 qualitative studies was conducted: a web-based survey of 200 Americans that investigated existing adherence strategies and behaviors and perception of how hypothetical in-home tracking technologies would assist adherence; in-person semistructured interviews with 20 medication takers from Pittsburgh, PA, that investigated personal adherence behaviors, which included demonstration of medication locations and routines as well as an assessment of hypothetical technologies; and semistructured interviews with 6 pharmacists and 3 family physicians to gain a provider perspective on patient adherence strategies, which included feedback on hypothetical technologies in the context of their patient populations. Inductive thematic coding of all interview data was performed. Studies were conducted consecutively, with the results informing the subsequent studies. Results Synthesized, the studies identified key medication adherence behaviors amenable to technological interventions, distilled important home-sensing literacy considerations, and detailed critical privacy considerations. Specifically, 4 key insights were obtained: medication routines are heavily influenced and adapted by and through the physical location and placement of medications relative to activities of daily living, routines are chosen to be inconspicuous to maintain privacy, the value of provider-involved routines is motivated by a desire to build trust in shared decision-making, and the introduction of new technologies can create further burden on patients and providers. Conclusions There is considerable potential to improve individual medication adherence by creating behavior-focused interventions that leverage emerging artificial intelligence (AI), machine learning (ML), and in-home Internet of Things (IoT) sensing technologies. However, success will be dependent on the technology’s ability to learn effectively and accurately from individual behaviors, needs, and routines and tailor interventions accordingly. Patient routines and attitudes toward adherence will likely affect the use of proactive (eg, AI-assistant routine modification) versus reactive (eg, notification of associated behaviors with missed dosages) intervention strategies. Successful technological interventions must support the detection and tracking of patient routines that can adjust to variations in patient location, schedule, independence, and habituation.

Voting Rights and Disability: Legal Challenges for Colombia

This article contains a legal interpretation of relevant international human rights law provisions relating to voting rights of persons with disabilities. The focus is on a comprehensive interpretation of Article 29(a) of the United Nations Convention on the Rights of Persons with Disabilities (CRPD), which provides for the right to political participation for persons with disabilities. This interpretation is based on the application of the rules of the Vienna Convention on the Law of Treaties (Articles 31 and 32). The overall aim of this article is to identify and analyse the legal obligations of Colombia under Article 29(a) of the CRPD regarding the introduction of new technologies for the exercise of the right to vote for persons with disabilities, including screen readers, electronic voting systems equipped with magnification devices, and tactile ballots. The analysis of these commitments presented here may serve as a guide to assess the Colombian State’s compliance with international human rights law, for example through the recent electoral reform project, including the amendment of the National Electoral Law (Legislative Decree 141 of 2022), as provided for by Legislative Decree 2241 of 1986. Reform of Colombia’s electoral law must ensure that people with disabilities have access to accessible voting materials, can vote secretly and independently, and can freely express their political opinions, in accordance with article 29(a) of the Convention on the Rights of Persons with Disabilities.

Analysis of implementation of industry 4.0 principles in furniture production

It is substantiated that the implementation of the principles of Industry 4.0 in the furniture industry will be able to significantly improve the competitiveness and efficiency of the enterprise, in particular, the replacement of workers with automated equipment in the manufacture of furniture will be able to increase the productivity and quality of production. It was found that the use of industrial robots and automated equipment can significantly reduce labor costs and increase production speed, and the introduction of sensors and their connection to the Internet can help monitor the condition of equipment, measure productivity and forecast maintenance needs. It was analyzed that the obtained data on production and interaction with clients will help in improving production processes and forecasting the demand for furniture products, and the use of virtual and augmented reality can significantly simplify the furniture design process and allow ideas to be implemented faster. It was found that the introduction of flexible production systems will allow to quickly switch to production between different types of furniture and respond to changes in demand. Also, the use of technological robots will be able to help reduce labor costs, especially in the face of growing demands for wages and labor shortages. It was found that the combination of physical and virtual systems will allow control and optimization of production processes in real time, and the use of machine learning algorithms for the analysis of large volumes of data can help identify and eliminate problems in furniture production, automate most production processes and reduce costs on the labor force. It is suggested to train personnel in advance for the introduction of new technologies - processing centers, technological robots, as this will help to ensure the successful and rapid implementation of the principles of Industry 4.0. Thus, robotics is a key element for the implementation of Industry 4.0 principles in furniture production, as it allows to increase the efficiency, quality and competitiveness of production.

The productivity of farm animals depending on the forms of management

One of the promising sectors of agricultural sector is production of livestock products, provision of high-quality food products, as well as goods for export purposes, and creation of state reserves. The development of livestock production sector, increasing productivity of animals and regulating domestic meat market, which is integrating into the world economy in the conditions of the EAEU, are the subject of research by domestic and foreign scientists. Purpose – the article is devoted to the study of economic efficiency of economic entities operating in the te rritory of Kazakhstan, their potential aimed at improving genetic indicators and increasing the number of livestock and poultry. Methods – statistical, comparisons and generalizations, logical approach to presentation. Results – the authors state an increase in the number of cattle and at the same time still low milk yields due to the concentration mainly in personal subsidiary plots with an insufficient level of selection and breeding work and introduction of new technologies. The authors consider some aspects related to the use of various breeds, in particular the dairy direction, based on the conversion rate, milk yield per 1 cow. A comparative analysis of productivity of new types and breeds of domestic selection revealed that the average milk yield per animal per lactation is 4.5-5.5 thousand kg compared to the prevailing in the republic in all categories of farms – 2.0-2.5 thousand kg Conclusions – the country has large areas of natural pastures, is traditionally a grain exporter, which contributes to the achievement of significant results in obtaining competitive beef both by increasing the number of meat contingent, obtaining high-quality breed resources, and by intensifying technologies, innovations, expanding the scale of fattening, increasing the mass of young animals sold for meat.

Business Models as a Decision Support Tool for City Management

Faced with the transformations of cities due to the introduction of new technologies and the shift in value from infrastructure to services, city managers are in search of new urban economic models. The current paper examines the development of business model frameworks as a practical tool to assist two cities in assessing business model efficiency by adapting Business Model Canvas (BMC) components to operationalize sustainable cities. This article defines the business models and their usefulness, presents the requalification of the city of Jijel (Algeria) and the selection of the Canvas business model, explains the model selected for the city of Naples (Italy), and, through these two examples, extrapolates the approach towards the generalization of the tool and the approach, which can be adapted to the local context of each city. That is why the models can act as a management strategy and decision-making support tool with a scientific basis. The findings demonstrate that these business models are a practical tool incorporating all actions and a thorough organizational structure that considers all operations and choices. They offer a framework that facilitates effective communication and sustainable growth. Furthermore, they may promote innovative approaches to the creation of sustainable value.

Проблемы развития инновационной активности Новосибирской области

The relevance of the study of problems in the field of innovation activity in the Novosibirsk region is due to the low susceptibility of the region to the introduction of new technologies, the complexity of choosing a strategy for the development of innovative companies, the lack of an effective method of finding business models for innovative products and the complex relationship of industrial partners with innovators. All these problems are a consequence of the cultural characteristics of the Russian Federation, and without proper study of them we cannot present a complete picture of the development of the innovative sphere of the region. The article discusses the concepts of “innovative susceptibility of the region” and “startups”. It is proposed to supplement the generally accepted characteristics of a startup by adding an institutional affiliation to them, dividing startups into three categories: park, academic and non-academic. Each of these categories has its own characteristics that must be taken into account when creating a development strategy and entering the market. It should be noted that the institutional affiliation of a startup, taking into account the cultural characteristics of the Russian Federation, has been studied superficially by modern economists. The problem of distortion of statistical data when calculating the innovation activity of the regions of the Russian Federation on the example of the Omsk, Tomsk and Novosibirsk regions is indicated.

ОРГАНИЗАЦИЯ РАБОЧЕГО МЕСТА ДЛЯ УДАЛЕННОЙ РАБОТы В СОВРЕМЕННыХ УСЛОВИЯХ

This article discusses the problems of organizing jobs caused by a change in public consciousness, the introduction of new technologies in business processes, as well as extreme events, a pandemic, etc. The main trends characteristic of the process of organizing jobs at the present stage are highlighted, it is emphasized that in connection with the trends towards the harmonization of life and a healthy lifestyle, the extension of human life, the increase in the retirement age, the intensification of the struggle for talents, the rise in the cost of labor, the philosophy of organizing jobs is changing towards taking into account not only the requirements of the law, but also the recommendations of industrial medicine, occupational health, psychophysiology and ergonomics. The legislative documents that are the basis for the workplace equipment, as well as the results of a study aimed at studying the expectations of modern Russian personnel in the field of organizing workplaces for remote (remote) work of an office worker, are given.

Стриктуры мочеиспускательного канала, как осложнение трансуретральной хирургии предстательной железы.

Introduction. The inclusion of antibiotic therapy into clinical practice in the second half of the 20th century radically changed the «etiological landscape» of urethral stricture disease. Against the background of a decrease in the proportion of inflammatory strictures, the introduction of new technologies, the spread of transurethral interventions in urology has led to an increase in the incidence of iatrogenic strictures. The purpose of this review is to systematize risk factors for urethral strictures after transurethral prostate surgery. Materials and methods. A search was made for the keywords «transurethral resection of the prostate», «urethral stricture», «iatrogenic urethral strictures», «urethral injuries» in the databases PubMed, eLibrary, Scopus, EMBASE, websites of professional associations. 58 publications were selected for review and analysis, 5 of which are domestic. Results. The influence of the following factors was analyzed: the method of energy supply, the type of energy, the method of removing prostatic tissue; instrument diameter and anatomical features of the patient; resection speed, operation time and volume of removed prostatic tissue; urinary tract infection; electrical damage; other risk factors for TURP. Conclusion. The proven factors include: the diameter of the instrument, operating times, urinary tract infection. Probable factors should be considered the anatomical features of the patient: «narrow urethra», a short penile suspensory ligament.

State corporations’ creation for more efficient management of public resources

In order to fulfill the tasks of sustainable state development, the creation of an innovative economy and the achievement of technological independence it is of particular importance to find ways to improve the efficiency of public resource management. Especially this concerns the development of measures to increase the impact of research and development, and the introduction of new technologies. As part of the implementation of this task, a statistical and economic analysis of the introduction effects of advanced production technologies at enterprises, including in the context of various forms of ownership has been carried out in the work. It is established that the best research results and development work are observed in companies with state participation, especially in state corporations. Thus, one of the most effective forms of innovation economy development in Russia is the further creation of state-owned companies in the most high-tech areas.

Legal regulation of IT companies’ functioning in performing tax control (domestic and foreign experience)

The paper examines the peculiarities of taxation of IT technology services in Ukraine. The introduction of digital technologies in the field of taxation today is due to the need to simplify the process of processing tax information, reduce the corruption need to improve the quality of services, improve the quality of planning and forecasting the development of the fiscal system and the national economy as a whole. Digitalization can play a key role in helping tax authorities reduce administrative costs, collect more revenue more efficiently, increase transparency and service for taxpayers, and adapt big data flows. As a result, there is a trend towards global digitalization of the tax space, digitization of tax information, and the introduction of new technologies for tax administration. In our opinion, the tax policy of digitalization will remain at the center of its global debate for a long time as to whether international tax rules will change or remain unchanged in an increasingly changing environment. The purpose of the paper is to study the impact of digitalization on the development of tax control. Researched: the trends of digitization of tax administration, such as the creation of web portals for the provision of electronic services, the introduction of an electronic check, the use of automation and data analysis to improve the efficiency of tax control, and the introduction of the practice of using pre-population of tax return. The main problems associated with these processes are outlined, namely the problems of digital exclusion, as well as the possible occurrence of under or over-tax obligations and, as a result, provoking tax avoidance and evasion. It was established that, regardless of certain problematic issues, it is worth noting the possible positive impact of digitalization on the effectiveness of tax control. In particular, changing the format of interaction between the tax authority and taxpayers, increasing the transparency and accessibility of tax services, changing the focus of tax control from activities aimed at detecting committed violations to measures for their prevention, which in turn contributes to increasing the level of trust and tax awareness of tax subjects.

Patient-specific profile guide in rhinoplasty

The introduction of new technologies in the field of facial aesthetic surgery is leading to improvement in surgical intervention quality. In the field of rhinoplasty, the design of customized surgical guides for the patient helps to perform an intervention with greater precision according to the presurgical planning. We present our design and method of fabrication of surgical profile guides for patients undergoing rhinoplasty, with free software and mostly in-house design and fabrication. The entire design process takes less than an hour. We have found that designing the guide enhances the communication process with the patient, and using that guide improves the surgical result.

A journey towards human-centric and AI-augmented marketing?

We are in the midst, or perhaps even the beginning, of transforming how banking relationships are being built and developed over time. At Handelsbanken, we took the first steps in digitisation in the 1960s. We were early to introduce Internet banking to customers in the 1990s and have, like the financial market at large, focused on digitalisation in recent decades. The activities that could previously only be done at a branch are becoming more and more accessible via digital channels, processes are being automated, yet there is still more to be done. This paper will demonstrate how a 150-year-old bank, which closed its marketing function in the 1970s and has essentially grown mainly through word of mouth, might approach using AI in marketing. In the discussion, the paper draws on previous experiences of introducing AI in other domains within the bank, performed by the Digitalisation and Innovation team in collaboration with other parts of the organisation. As always, the introduction of new technology, including in marketing and sales, starts with business principles, data, ethics, company purpose and values, rather than with the technology itself. It is still early days for the bank when it comes to AI in marketing, and until there is such a thing as attentive algorithms, humans will be very much involved in the process — especially if the aim is to continue being human-centric in our approach, where the outcome of an activity is beneficial for customers, the bank and society at large. And the meaning of ‘customer-centric’ needs to be defined as making the system work with the customer at the centre: cross-channel, relevant, timely and based on in-depth customer understanding. The paper will show that the rationale for closing the bank’s marketing function back in the 1970s might not be so different from the rationale to do things differently today.

Preventing Medical Device-Related Pressure Injuries

Pressure injuries (PIs) are a common, yet preventable complication of patient care. 1 Dang W Liu Y Zhou Q et al. Risk factors of medical device-related pressure injury in intensive care units. J Clin Nurs. 2022; 31: 1174-1183https://doi.org/10.1111/jocn.15974 Crossref Scopus (14) Google Scholar ,2 Hajhosseini B Longaker MT Gurtner GC Pressure injury. Ann Surg. 2020; 271: 671-679https://doi.org/10.1097/sla.0000000000003567 Crossref PubMed Scopus (0) Google Scholar Regulatory, quality, and health care bodies view the frequency of hospital-acquired pressure injuries (HAPIs) as indicative of the quality of nursing care and take the issue of HAPIs very seriously in terms of patient safety. 3 Pittman J Otts JA Riley B Mulekar MS Pressure injury prevention and management: a gap analysis using key stakeholder engagement. J Wound Ostomy Continence Nurs. 2022; 49: 416-427https://doi.org/10.1097/WON.0000000000000906 Crossref Scopus (0) Google Scholar Every year, approximately 2.5 million people develop HAPIs, and approximately 60,000 people die as a result of these injuries. 3 Pittman J Otts JA Riley B Mulekar MS Pressure injury prevention and management: a gap analysis using key stakeholder engagement. J Wound Ostomy Continence Nurs. 2022; 49: 416-427https://doi.org/10.1097/WON.0000000000000906 Crossref Scopus (0) Google Scholar ,4 Padula WV Delarmente BA The national cost of hospital-acquired pressure injuries in the United States. Int Wound J. 2019; 16: 634-640https://doi.org/10.1111/iwj.13071 Crossref PubMed Scopus (207) Google Scholar The total cost of HAPI care per patient ranges from $29,900 to $151,700, resulting in an estimated annual cost of $26.8 billion. 3 Pittman J Otts JA Riley B Mulekar MS Pressure injury prevention and management: a gap analysis using key stakeholder engagement. J Wound Ostomy Continence Nurs. 2022; 49: 416-427https://doi.org/10.1097/WON.0000000000000906 Crossref Scopus (0) Google Scholar ,5 Tschannen D Anderson C The pressure injury predictive model: a framework for hospital-acquired pressure injuries. J Clin Nurs. 2020; 29: 1398-1421https://doi.org/10.1111/jocn.15171 Crossref Scopus (14) Google Scholar Despite the introduction of new technology and HAPI prevention strategies, the occurrence of HAPI is still on the rise. 2 Hajhosseini B Longaker MT Gurtner GC Pressure injury. Ann Surg. 2020; 271: 671-679https://doi.org/10.1097/sla.0000000000003567 Crossref PubMed Scopus (0) Google Scholar ,3 Pittman J Otts JA Riley B Mulekar MS Pressure injury prevention and management: a gap analysis using key stakeholder engagement. J Wound Ostomy Continence Nurs. 2022; 49: 416-427https://doi.org/10.1097/WON.0000000000000906 Crossref Scopus (0) Google Scholar People suffering from this injury can experience severe discomfort, a decrease in their overall quality of life, reduced activity, decreased productivity, social alienation, depression, and increased length of stay. 2 Hajhosseini B Longaker MT Gurtner GC Pressure injury. Ann Surg. 2020; 271: 671-679https://doi.org/10.1097/sla.0000000000003567 Crossref PubMed Scopus (0) Google Scholar

CLUSTER POLICY AND ITS IMPACT ON FDI ATTRACTION MODELS AND BETTER COOPERATION BETWEEN MNEs AND SMEs

The concept of FDI has been analyzed by several theorists and many of them see FDI as an engine of growth. FDI affects economic growth directly and indirectly. It is well known that FDI has a positive impact on the domestic economy through the transfer of technology and skills, development of local suppliers in terms of providing technical assistance, training for employees, transfer of knowledge, etc. In this way, FDI affects the improvement of productivity and competitiveness of the entire economy. Multinational enterprises and their foreign affiliates recently generate one third of the global GDP, as well as two thirds of international trade. They also account for half of global exports. Precisely because of their economic importance, many governments offer subsidies and tax breaks to attract multinational enterprises, and consequently FDI. According to OECD (2005), linking MNEs and SMEs is important in the context of investment for development. The so-called "spillover" of know-how and technology from foreign investors to the local business sector is one of the biggest benefits of FDI for development. In most countries, SMEs are considered as the majority of the domestic business sector, therefore the process of overcoming the barriers to the connection between large and small enterprises is of great importance for the overall development. But the benefits of cooperation between MNEs and SMEs do not come automatically. Consequently, if we analyze specifically only one segment of the effects of FDI, such as the introduction of new technologies and innovations, as one of the biggest benefits of the host country from FDI, we come to the conclusion that this transfer is not always the same, but is very more present and effective if it is done in geographically concentrated clusters, in contrast to the cases when it is realized in dispersed companies of the same sector. Companies operating in clusters are characterized by a high degree of specialization and complementarity. This generates dynamic processes of learning, innovation and knowledge transfer. In the clusters, a process of collective learning is realized, which results in innovation and competitiveness even in sectors where high technology is not applied. This paper aims to explore models and ways of attracting FDI as well as creating preconditions for realizing as many benefits and spillovers as possible from the established cooperation between foreign MNEs and local SMEs, such as clusters. The results show that although the clusters in the Republic of North Macedonia are formally functioning, they are far from the desired condition to be in a situation to provide essential assistance in the direction of increasing the positive effects of the cooperation of SMEs and MNEs. However, the clusters should continue to be supported by the relevant competent institutions in order for the desired effects to be measurable, concrete and significant for the local economy.