Multinational Participation Research Articles

Narratives of lingua franca English for transnational mobility

This paper explores, through narrative inquiry, the acquisition and use of English as a lingua franca in the careers of three transnationally mobile managers in the global hotel and hospitality industry. The narratives presented here are interwoven with the context in which the multinational participants were situated at the time of the study: the United Arab Emirates (UAE) which is diversifying economically and socially in preparation for the post-fossil fuel era. In a country where the temporary immigrant population outumbers national citizens, participants’ situated language practices are explored through narratives of their multilingual and translingual repertoires, while focusing on English as a key resource for their self-initiated transnational mobility. These personal stories of the acquisition and use of English as a global language weave a linguacultural web that connects the Gulf region across global space, people, and time. Participants tell of the utility of English for their careers, their multilingual repertoires, and their enjoyment of their temporary working lives in the Emirates. Such voices are seldom heard in the literature.

Racial and Ethnic Disparities in European Breast Cancer Clinical Trials.

Breast cancer is the most prevalent female cancer worldwide with known correlations between the race and tumor characteristics of the patients and prognosis. International and US-based studies, however, have reported a disproportionate representation of Black and Hispanic patients in clinical trials. This is the first study assessing race and ethnicity reporting trends and inclusion in European breast cancer trials. The PubMed and ClinicalTrials.gov databases were systematically searched for trials on breast cancer treatment conducted exclusively in Europe between 2010 and 2022. Of the 97 identified trials, race was reported in 10.31%. Multinational participation, but not the study size or trial phase, was significantly associated with higher race reporting trends. These 10 trials featured a White-predominant population, with 1.08% Asian and 0.88% Black patients included. The acquisition of the race and ethnicity data of patients in European trials is lower compared to the U.S. or worldwide studies and does not permit extensive analysis of minority participation. In a limited analysis, the low rates of minority participation are concerning, based on population-based data on minorities in select European countries. These observations should encourage race reporting practices in European breast cancer trials and adequate minority participation to support the generalizability of the results of the studies and promote healthcare equity.

Analysis of Plasma Metabolic Profile on Ganglion Cell–Inner Plexiform Layer Thickness With Mortality and Common Diseases

The neural retina is considered a unique window to systemic health, but its biological link with systemic health remains unknown. To investigate the independent associations of retinal ganglion cell-inner plexiform layer thickness (GCIPLT) metabolic profiles with rates of mortality and morbidity of common diseases. This cohort study evaluated UK Biobank participants enrolled between 2006 and 2010, and prospectively followed them up for multidisease diagnosis and mortality. Additional participants from the Guangzhou Diabetes Eye Study (GDES) underwent optical coherence tomography scanning and metabolomic profiling and were included for validation. Systematic analysis of circulating plasma metabolites to identify GCIPLT metabolic profiles; prospective associations of these profiles with mortality and morbidity of 6 common diseases with their incremental discriminative value and clinical utility. Among 93 838 community-based participants (51 182 [54.5%] women), the mean (SD) age was 56.7 (8.1) years and mean (SD) follow-up was 12.3 (0.8) years. Of 249 metabolic metrics, 37 were independently associated with GCIPLT, including 8 positive and 29 negative associations, and most were associated with the rates of future mortality and common diseases. These metabolic profiles significantly improved the models for discriminating type 2 diabetes over clinical indicators (C statistic: 0.862; 95% CI, 0.852-0.872 vs clinical indicators only, 0.803; 95% CI, 0.792-0.814; P < .001), myocardial infarction (0.792; 95% CI, 0.775-0.808 vs 0.768; 95% CI, 0.751-0.786; P < .001), heart failure (0.803; 95% CI, 0.786-0.820 vs 0.790; 95% CI, 0.773-0.807; P < .001), stroke (0.739; 95% CI, 0.714-0.764 vs 0.719; 95% CI, 0.693-0.745; P < .001), all-cause mortality (0.747; 95% CI, 0.734-0.760 vs 0.724; 95% CI, 0.711-0.738; P < .001), and cardiovascular disease mortality (0.790; 95% CI, 0.767-0.812 vs 0.763; 95% CI, 0.739-0.788; P < .001). Additionally, the potential of GCIPLT metabolic profiles for risk stratification of cardiovascular diseases were further confirmed in the GDES cohort using a different metabolomic approach. In this prospective study of multinational participants, GCIPLT-associated metabolites demonstrated the potential to inform mortality and morbidity risks. Incorporating information on these profiles may facilitate individualized risk stratification for these health outcomes.

Evolving landscape of clinical trials in gastroenteropancreatic neuroendocrine neoplasms in the past two decades.

Gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) are heterogenous malignancies that require well-designed trials to develop effective management strategies. This cross-sectional study aimed to illustrate the current landscape of clinical trials in GEP-NENs to provide insights for future research. We reviewed all clinical trials registered on ClinicalTrials.gov between 1 January 2000 and 31 December 2021 with GEP-NEN in the 'condition or disease' field. We included 206 eligible trials. Most trials enrolled less than 50 patients (59.8%) and were sponsored by institutions other than government or industry (67.0%). Most trials were conducted in high-income countries (86.6%) and countries located in Europe (30.1%) or Northern America (29.6%). The overall result reporting rates of GEP-NEN trials was 41.4%, and the median time from primary completion to result reporting was 101 months. Characteristics that improved the reporting of results included larger sample size, tumor differentiation specification for inclusion, progression-free survival as primary endpoint, industry sponsorship, and multicenter or multinational participation (all P < 0.05). Compared with trials registered between 2000 and 2011 (n = 28), trials registered between 2012 and 2021 (n = 178) were more likely to specify the Ki-67 index for inclusion (68.0% vs 35.7%, P = 0.002) and to be conducted outside Europe or Northern America (16.4% vs 3.7%, P = 0.02), while the sample size and the sponsorship did not change significantly. Novel management options have been explored for GEP-NENs with more specific inclusion criteria during the past two decades. More efforts are needed to promote international collaborations in clinical trials and enhance timely result dissemination.

Playing for Resilience in a Pandemic; Exploring the Role of an Online Board Game in Recognising Resources.

In the current climate of Covid-19 and world-wide social distancing, the mental health toll has been widely reported, with an expectation that the negative impact will last beyond the lockdowns. Facing the prospect of an unknown future and continuing challenges, resilience is both topical and necessary. With a call for digitally delivered interventions to help people affected by the pandemic, this study explores how playing an online positive psychology-informed board game supported people to recognise resources for resilience. Sixteen multi-national participants played in groups of 3–4 and qualitative data, collected via focus groups, was analysed using Thematic Analysis. Participants described a broadening of resources, primarily through reflecting on and remembering prior strategies and successes. Four themes are identified which, it is suggested, facilitated this in a sequential, upward spiral; the game mechanisms (release), psychological safety (reflect), meaningful conversations (remember) and anchoring of prior experiences (reuse). Critically, this study suggests that psychological safety may have been amplified by the online environment, which participants suggested enabled them to engage without interruption or inhibition. Additionally, whilst not part of the original intervention, the post-game reflection played an essential role in meaning-making and transferring learning into real-life. Future research into how online environments might not just facilitate but augment interventions is recommended. Finally, this study calls for further research into the impact of playful positive psychology interventions, suggesting a potential development of ‘serious play’ towards ‘seriously positive play’.

The association between financial literacy and Problematic Internet Shopping in a multinational sample

PurposeTo examine the association between financial literacy and Problematic Internet Shopping in adults. MethodsThis cross-sectional online survey recruited participants, aged between 18 and 60years, through an online research facility. The sample consisted of multinational participants from mainly three continents including Europe, North America, and Asia. Problematic Internet Shopping was assessed using the Bergen Shopping Addiction Scale (BSAS). Financial Literacy was measured by the Financial Literacy subscale of the Financial Wellbeing Questionnaire. Multiple linear regression analyses were conducted to elucidate the relationship between the study and outcome variables with adjustment for other potential risk factors. ResultsOf the total of 997 respondents with an average age of 30.9 (s.d.=8.8), 135 (13.8%) could be classified as having a high risk of being Problematic Internet Shoppers. Results from the multiple regression analyses suggested a significant and negative relationship between financial literacy and Problematic Internet Shopping with a regression coefficient of −0.13, after controlling for the effects of potential risk factors such as age, region of birth, employment, income, shopping frequency, self-regulation and anxiety (t=−6.42, p<0.001). ConclusionsThe clinical management of PIS should include a financial counselling as a component of the treatment regime. Enhancement of financial literacy in the general population, particularly among young people, will likely have a positive effect on the occurrence of PIS.

Under a Foreign Flag: Integrating Foreign Units and Personnel in the British and German Armed Forces, 1940–1945

Under a Foreign Flag: Integrating Foreign Units and Personnel in the British and German Armed Forces, 1940-1945 Significant numbers of foreign personnel served in the British and German armed forces during the Second World. Yet there is no study that compares and situates these armed forces as multinational entities. This article examines Britain's and Germany's policies towards the recruitment, organisation and employment of non-nationals in their armed forces during this conflict. There were several forms of multinational participation but this study focuses on recruits who came from German-occupied or neutral countries. It was in these units that the exchanges and tensions of the multinational militaries were most profoundly felt. The article finds that though there was significant transnational military co-operation, this did not erode the primacy of the nation state. In both the British and German cases, the multinational forces served as a stage on which ethnic and national tensions played out and, at times, were amplified. Arguably the most important aspect of the multinational forces was their legacy. For Britain and her European allies, the experience created willing partners for closer multinational military cooperation in the post-war world.

Getting to the First Handshake: Enhancing Security by Initiating Cooperation in Transboundary River Basins

AbstractHow does transboundary water cooperation begin at the initial stages, and how can third parties help to foster said cooperation? Many nations with transboundary waters do not cooperate or have ceased cooperation. Yet cooperation often prevails, resulting in 688 water‐related treaties signed from 1820 to 2007. We address the following: by which practices can development partners best design and implement cooperative projects at the state level to enhance basin water security in the earliest stages? This article identifies strategies for initiating cooperation and lessons drawn from reviewing select cases. We compiled from the Oregon State University Transboundary Freshwater Dispute Database all transboundary water resources projects over the last decade with multinational participation. We selected 10 case studies that enhance water security that fit the following filtering criteria: (1) Funding exclusively/primarily from outside sources, (2) Including nonofficial stakeholders in project design/implementation, (3) Absence of formal relations around water resources between or among the riparian nations before the project was discussed, (4) Project design possibly enhancing hydropolitical relations. Findings suggest that to enhance water security, project designs should respect participating riparians' autonomies, create basin‐wide networks of scientists, allow for each partner to garner responsibility for project activities, and consult a diverse group of stakeholders.

Economical information and communication design for multi-national projects

Purpose – The purpose of this paper is to inform information and communication design (ICD) for multi-national projects through the presentation of an example that does not rely on expensive expertise in graphic design. Design/methodology/approach – Action research involving participants from five different sectors. Findings – Successful ICD is not necessarily dependent upon costly graphic design of elaborate explanatory methods such as storyboards. Research limitations/implications – The action research involved participants from only five differect sectors. Practical implications – Economical ICD can facilitate development of understanding among multi-sector multi-national project participants. Originality/value – The originality of this research note is that it addresses recent developments in ICD. The value of this research note is that an example is provided of application in a multi-sector multi-national project.

The global conduct of cancer clinical trials: challenges and opportunities.

The nature of clinical research has changed substantially over the last 2 decades, evolving from being centered almost exclusively in developed countries to a more global scenario that is increasingly involving less developed regions of the world. Pharmaceutical companies and some academic cooperative groups have been conducting challenging, large pivotal registration studies with multinational participation. The much more needed globalization of academic research demands particular attention and represents a worthwhile subject for a more profound discussion. The requirement of large sample sizes and the potential for fast recruitment leading to a speedy completion of clinical studies are probably the most important factors that have fueled globalization of studies. Reduced operational costs and the ability to expedite the regulatory approval of drugs in various countries or regions are also important drivers. Globalization of research should be seen as having a much wider effect in the societies involved, in particular, when we consider public health, economic, social, and ethical implications. Most importantly, the process of expanding the network of clinical research sites also fosters the integration and the development of closer relationships among investigators at a global level. We consider this an essential element that should remain a prominent element in the discussion. In this article, we address the underlying reasons for globalization and we highlight some of the scientific and ethical concerns arising as a consequence. Finally, some strategies to address and mitigate the challenges of conducting multinational clinical research are proposed.

Glaucomatous Optic Neuropathy Evaluation Project

Glaucoma is a significant health problem for which diagnosis remains suboptimal. Optic disc evaluation, which is fundamental to the diagnosis, is a difficult skill to acquire. To determine the optic disc characteristics that most influence decision making in the assessment of glaucoma likelihood and to ascertain the optic disc features associated with overestimation and underestimation of glaucoma likelihood. This prospective, observational, Internet-based study with multinational participation included 197 ophthalmic clinicians (37 glaucoma subspecialists, 51 comprehensive ophthalmologists, and 109 ophthalmology trainees) from 22 countries who self-registered for the Glaucomatous Optic Neuropathy Evaluation (GONE) Project from December 1, 2008 through June 30, 2010. A series of 42 monoscopic optic disc photographs of healthy and glaucomatous eyes were presented to clinicians using the GONE Project Program. Participants were asked to assess each disc according to 9 conventional topographic features and assign a presumptive grade for glaucoma likelihood. Agreement (κ and weighted κ) among participants for disc signs and glaucoma likelihood and contributions of disc-related factors to overestimation and underestimation of glaucoma likelihood. Ophthalmology trainees and comprehensive ophthalmologists underestimated glaucoma likelihood in a mean (SD) of 22.1% (1.6%) and 23.8% (1.8%) of discs, respectively. Underestimation of vertical cup-disc ratio and failure to identify retinal nerve fiber layer loss, disc hemorrhage, or rim loss were most likely to lead to underestimation of glaucoma. When all 4 features were inaccurately assessed, underestimation of glaucoma likelihood increased to 43.0%. Ophthalmology trainees and comprehensive ophthalmologists overestimated glaucoma likelihood in a mean (SD) of 13.0% (1.2%) and 8.9% (1.3%) of discs, respectively. Overestimation of glaucoma likelihood was associated with overestimation of retinal nerve fiber layer loss, rim loss, vertical cup-disc ratio, disc hemorrhage, and incorrect assessment of disc tilt and was more likely in large discs. Ophthalmology trainees and comprehensive ophthalmologists underestimated glaucoma likelihood in approximately 1 in 5 disc photographs and were twice as likely to underestimate as overestimate glaucoma likelihood. Underestimating the vertical cup-disc ratio and cup shape and missing retinal nerve fiber layer defects and disc hemorrhage were the key errors that led to underestimation. When all 4 parameters were incorrectly assessed, underestimation increased to almost 1 in 2.

Multinational Gout Recommendations Released

Multinational Gout Recommendations Released

FRI0349 Results of a multinational survey regarding the definition of remission in juvenile idiopathic arthritis related uveitis

BackgroundCurrently new treatments appears to be more effective for the control of the disease in juvenile idiopathic arthritis (JIA) associated uveitis, that remission of JIA associated uveitis is a realistic...

Speed of accrual into published phase III oncology trials: A comparison across geographic locations.

6074 Background: There is a perception that patient accrual may be slower in the US than it is in Europe (Wang-Gillam A et al, J Clin Oncol 2010;28:3803-3807). However, a systematic study has not been performed. We seek to determine the speed at which patients are accrued into published phase III oncology trials across geographic locations and to identify factors that may influence this process. Methods: We searched MEDLINE and identified all original phase III oncology therapeutic trials published in 2006-2010 (N = 567). Trials with no reported activation and completion dates were excluded (n = 20). Accrual speed per trial was expressed as patients per month and was calculated by dividing the number of patients enrolled by number of months a trial was open. Results: The 547 trials included in our study enrolled 281,340 patients. Most trials were for adults only (95.6%), late stage cancers (77.5%), and involved multinational participation (44.1%). Funding sources were cooperative groups (45.5%), industry (33.8%) and academic centers (20.5%). The top 5 cancers studied were hematologic (19.2%), gastrointestinal (16.5%), lung (16.3%), breast (15.4%), and gynecologic (8.4%). Trial results were negative (57.4%), positive (38.2%), or equivalent (4.4%). The mean (+SD) accrual speeds varied according to trial location (multinational [25.0+25.4], US [13.3+16.5], other countries [11.4+15.7], Europe [8.7+11.8]; [P= .001]), funding source (industry [28.3+24.7], cooperative groups [13.3+19.0], academic [6.8+6.5]; [P= .001]), and cancer type (breast [24.0+29.4], gastrointestinal [20.2+24.2], lung [19.3+22.7], gynecologic [15.3+19.2], hematologic [11.2+10.7]; [P= .001]). After adjusting for funding source, accrual speeds were significantly different across trial locations only in 2 cancers: gastrointestinal (multinational [25.2+3.7], US [24.1+8.2], Europe [11.5+3.7], other [7.5+8.5]; P= .046) and gynecologic (multinational [28.9+5.4], other [10.5+7.8], US [6.6+5.3], Europe [4.2+5.9]; P= .004) studies. Conclusions: Among published phase III oncology trials, multinational studies accrued patients faster in gastrointestinal and gynecologic cancers and at a similar speed in other cancers.

Translation and Implementation of Added Sugars Consumption Recommendations

A 2-day forum was convened to (1) discuss ways to translate the 2009 American Heart Association added sugars recommendations into actions in areas such as regulation, food labeling, nutrient content claims, and practical application in the American diet; (2) review surveillance methodology and metrics for tracking and understanding the impact of reducing added sugars in the diet; and (3) initiate the development of a framework for future collaboration to help Americans implement science-based guidance relative to added sugars. More than 100 multinational participants representing scientists from academia and government and stakeholders engaged in food production, development, and processing, food manufacturing and servicing, food and nutrition policy, and nutrition recommendations for the public attended the conference. Presentations included definitions and examples of added sugars, current US and international added sugars perspectives, added sugars in diets of individuals and in the food supply, food technology behind added sugars, added sugars and health, food manufacturer perspectives, added sugars food-labeling considerations, and examples of positive approaches to improve eating behaviors and the food environment. Facilitated breakout sessions were conducted after the plenary sessions to allow participants to contribute their expertise and thoughts. The American Heart Association Added Sugars Conference is the first step in an important process that facilitates collaboration across science, public health, and industry to foster innovation, partnerships, policy, and implementation of new products and services for the benefit of the health and well-being of the American public. Science has advanced in the area of added sugars and health, creating mounting pressure to use better methods for translation and dissemination of the science for consumer education and for food companies to respond by producing foods and beverages with fewer added sugars. The new science also reinforces the importance of preventing, rather than simply treating diseases, especially overweight and obesity, diabetes mellitus, high blood pressure, heart disease, and stroke. Reducing added sugars consumption is a good target for addressing obesity, along with other sources of excess calories. However, the potential unintended consequences of substituting added sugars with ingredients that may not reduce calories and of increasing other macronutrients or food groups that may not result in a net health gain must be considered. Although there are many challenges to incorporating added sugars to the food label as was discussed during the conference, disclosure of added sugars content on food and beverage labels is an essential element in consumer education and can provide the information and motivation for making healthier food choices. This conference demonstrated the value of interactive dialogue among multiple sectors and disciplines. More disciplines should be at the table to bring expertise to discuss cross-cutting issues related to public policies and offer diverse insights to finding a solution.

‘If we know about culture it will be easier to work with one another’: developing skills for handling corporate meetings with multinational participation

The current international nature of socio-economic activities is reshaping workplace settings and creating the need for large numbers of employees to perform successful communicative acts with a wider range of interactants than in the past, often using a language other than their mother tongue. Against this backdrop much emphasis has been placed on the need for training current and future employees in order to develop their work-related communication skills. In this context, the paper reports on an ongoing study into workplace discourse and its implications for pedagogic practice. I discuss here operationalisations of the concept of culture in pedagogic materials, and focus on the meeting event as presented through texts published in some widely used Business English textbooks in the UK. Special attention is paid to the underlying assumptions about culture and preferred norms for handling meetings which feature multinational participation – as presented by the textbooks but also in relevant academic literature. The discussion also draws on data from multinational companies in Europe. The analysis shows that textbooks often take a macro-level view of culture and treat it as an entity with distinct boundaries. This paper closes by making a case for sociolinguistic research findings to feed back into the language classroom to complement language for specific purposes textbooks for further developing learners' socio-pragmatic skills. La caractère international des activités socio-économiques actuelles transforme la configuration du lieu de travail et entraîne ainsi le besoin d'un nombre important d'employés d'accomplir des actes communicatifs avec une palette d'interlocuteurs de plus en plus variée, et ce dans une langue souvent autre que leur langue maternelle. Sur cette toile de fond, l'emphase a été placée sur la nécessité de former les employés actuels et futurs afin de développer leurs compétences en matière de linguistique et de communication. C'est dans ce contexte que cet article établit le compte-rendu d'une étude en cours sur le discours dans le lieu de travail et sur les conséquences de celui-ci sur les pratiques pédagogiques. J'examine ici les ‘opérationalisations’ du concept de culture dans les matériels pédagogiques et me concentre sur l’évènement de la réunion telle qu'elle est présentée dans les textes publiés dans des manuels de l'Anglais des Affaires couramment utilisés au Royaume-Uni. Une attention particulière est portée aux hypothèses concernant la culture et les normes privilégiées afin de gérer les réunions à caractère multinational – comme le présentent les manuels mais également les travaux universitaires sur le sujet. La discussion repose également sur des données provenant de compagnies multinationales en Europe. L'analyse montre que le point de vue des manuels sur la culture est souvent statique et traite celle-ci comme une ‘unité’ homogène avec des limites bien définies. Cet article se conclut en défendant que les résultats des recherches sociolinguistiques pourraient être utiles dans les cours de langues afin de compléter les manuels de Langue Etrangère Appliquée dans le but de mieux développer les compétences socio-pragmatiques des étudiants.

Clinical trials for children with cancer in Europe – Still a long way from harmonisation: A report from SIOP Europe

Clinical trials for children with cancer have been particularly hard hit by the introduction of the EU Clinical Trials Directive in 2004. Largely investigator-led and lacking in commercial sponsorship, they have struggled to find the resources necessary to comply with the complex bureaucracy. These rare diseases require multinational participation to permit appropriately powered clinical trials to be undertaken. Differences in interpretation of the Directive by national regulatory authorities have had a disproportionate effect on trials in children, highlighted by differences in what is deemed an ‘investigational medicinal product’ when paediatric use of an old drug is outside its licensed indication. Insurance costs have increased a 100-fold with no increase in actual risk between consecutive trials from the same study group. Issues raised at the recent conference held to reappraise the operation of the Directive are summarised to emphasise the particular issues for trials in children with cancer.

Outcome Measures for Development of New Therapies in Cystic Fibrosis: Are We Making Progress and What Are the Next Steps?

Since the discovery of the gene encoding the cystic fibrosis transmembrane regulator protein (CFTR) in 1989, rapid expansion in our understanding of the basic defect has afforded the cystic fibrosis (CF) community the opportunity to develop new therapies to correct the pathobiological consequences of absent or defective CFTR and to improve the lives of patients (1). Over the same time period, the number of multicenter clinical studies directed at correcting the secondary consequences of dysfunctional CFTR has rapidly increased, with 453 clinical studies identified by PubMed (www.pubmed.gov) that were published in 2006 compared with 19 studies published in 1990. Clinical trials have led to the U.S. Food and Drug Administration (FDA) approval of two therapies (2, 3) for the treatment of CF lung disease (Pulmozyme and TOBI) and to the current evaluation of at least two new therapies in pivotal phase 3 studies (4, 5). In addition, dozens of potential therapies are making their way through earlier stages of the therapeutic pipeline. Although no approved therapies currently treat the underlying genetic defect, promising approaches to correct CFTR are currently in earlyphase trials (6–8). In spite of this enormous progress in both basic and clinical science, CF remains a challenging field for the development of new therapies. First, this illness falls within the orphan disease designation (www.rarediseases.org), with approximately 30,000 identified individuals in the United States (9), and thus a finite number of patients are available for clinical trials in any geographic location. Thus, the conduct of pivotal phase 3 trials requiring more than 500 patients often requires multinational participation, adding significant complexity and cost. Second, improved life span and stabilization of progression of lung disease, albeit encouraging, are resulting in an evolution of clinical end points. With median survival of almost 40 years, mortality is no longer a realistic outcome. A surrogatemeasure formortality, median FEV1 as a function of age, has also improved over the past two decades (9). This change makes it increasingly difficult to detect a meaningful treatment effect except in large studies of long duration (10). Thus, there is an increasing need to validate newoutcomemeasures and to improve the assessment of existing outcome measures. Beginning in the early 1990s, the Cystic Fibrosis Foundation (CFF) (Bethesda, MD) realized the need to develop clinical end points for therapeutic trials. A group of CF specialists and FDA representatives convened in 1992 to review the state of the art for outcome measures at that time (11). Eight key issues were

Online Place and Person-Making: Matters of the Heart and Self-Expression

In recent years, there has been a substantial take up in social software, but other than translating the vocabulary and arranging suitable payment facilities, little or no account is taken of cultural sense-making in the global deployment of these systems. We report on two studies of social software, an online dating site and a social network blog. We show that people need ‘places’ because it is only there persons can meaningfully be (re)presented. Further, ‘cultural’ perspectives greatly influence and shape the metaphors and models of communication. In our recommendations, we suggest that multinational participants' metaphors about ‘place’ should be used as tools-to-think-with rather than be implemented literally, and thereby used to enrich a feature set for global services such as online dating and blogging tools.

Vertical Integration, Foreign Multinationals and Stigler's Hypotheses: An Empirical Test Using Malaysian Data*

In this paper the hypotheses on motives for vertical integration as proposed by Stigler are empirically tested using a panel dataset from Malaysian manufacturing under both fixed‐effects and random‐effects specifications. Because the degree of multinational participation is expected to influence the results of the regression estimates, empirical tests are conducted with and without controlling for the effect of foreign firms’ participation. Depending on model specifications, evidence is found in favor of Stigler's hypotheses where vertical integration is positively related to demand growth and industry concentration. This result is generally consistent with those found in other vertical integration studies. Significantly, the coefficient estimates of the growth variable are not significant and biased downwards if there is no control on the effect of foreign multinationals in the estimation process.