Multinational Project Research Articles

11.A. Workshop: Risk-benefit Assessment of Foods and Diets for a Sustainable Future

Abstract Dietary risk factors are the most important contributors to burden of disease globally, including in European countries. Concurrently, the pressure that food systems have on the environment has amplified over time, largely driven by the increased demand for food, increased consumption of animal-based foods, and the intensification of agriculture and production systems. Shifts towards healthier and sustainable diets are needed to protect the health of populations and the environment. To define and implement public health policies that motivate these shifts, decision-makers need evidence on the overall impacts of such changes on the health of citizens, and on all aspects of sustainability: environment, socioeconomics, and culture of populations. Recent years have seen an increase in research and data to assess those impacts. Risk-Benefit Assessment (RBA) has emerged as a decision-support tool that considers both negative and positive health impacts of food consumption scenarios in a common health metric, considering both nutritional risks and benefits, and microbiological and toxicological risks. Multi-national European Projects, as well as research efforts by academic and public health authorities in different countries have contributed to important methodological developments, implementation of case studies, and raising awareness of the utility of risk-benefit outputs to inform public health policy. However, transforming food systems for combined health and sustainability benefits requires an assessment of integrated impacts that also takes a more holistic food-systems approach. Such an assessment needs to be able to integrate the impacts of diets and dietary shifts on health and the environment, while also considering social, culture and economic implications of dietary changes. Furthermore, the communication of findings from such assessments to policymakers and the public needs careful consideration. Thus, an extended interdisciplinary approach is warranted. This workshop consists of four presentations. In the first, we present an overview of RBA methodologies, case studies, and ongoing research efforts. Next, we present an example of development of methods to measure the integrated impacts of food systems and dietary shifts in terms of health and sustainability indicators, and of the steps that can be taken to increase the uptake of such methods for policymaking. The third presentation discusses the challenges and opportunities in communicating results from RBAs to different stakeholders, including policymakers and citizens. Lastly, we present current interests and call for actions on RBAs to provide evidence for policy through the lens of the World Health Organization. The workshop will end with ample time for discussions on current approaches and opportunities for methodological developments, challenges, possible solutions and potential for collaborations to increase implementation and utility of RBA of foods and diets globally. Key messages • Risk-benefit assessments of foods and diets offer an approach to assess the impacts of current and future dietary patterns on the health of populations and the planet. • Research, stakeholder involvement and international collaboration are key to promote knowledge translation and support international activities within risk-benefit assessment.

Psychometric properties of the Global Psychotrauma Screen in the United States

ABSTRACT Background Prior research assessing the psychometric properties of the Global Psychotrauma Screen provided support for its internal consistency reliability, construct validity, convergent validity, and divergent validity in several international samples, but not specifically in a U.S. subsample. Objective The purpose of this study was to assess psychometric properties of the GPS in the U.S. Method This observational study included a convenience sample of individually recruited participants (N = 231) who completed an initial study with 126-item online questionnaire and a two-week follow-up study with GPS alone through the weblinks provided by the research team. Data analyzes included measuring internal consistency and test–retest reliability, exploratory and confirmatory factor analyzes (EFA and CFA), convergent and divergent validity, sensitivity, specificity, and severity of the GPS symptom items. Additional CFA was conducted with data (N = 947) from the GPS multinational research project, U.S. subsample. Results The results showed acceptable internal consistency and test–retest reliability, convergent validity, and divergent validity of the GPS. The construct validity results supported a three-factor structure of the GPS symptoms. The GPS domains showed acceptable sensitivity and specificity with the cut-off scores of 3 for PTSD and 5 for CPTSD domains; and the scores of 1 for the anxiety, depression, and insomnia domains respectively. The GPS risk factors predicted the GPS symptom severity. Conclusions This study provides new and additional evidence on the psychometric properties of the GPS which may help health care providers with the selection of an appropriate screening instrument for trauma-related transdiagnostic symptoms. The study limitations should be addressed in future research through the replication of EFA and CFA internationally with larger samples, and the inclusion of a reference standard for dissociation.

Establishing a sustainable Malawian food composition data system harnessing available limited resources

Country-specific food composition databases (FCDB) are key resources in addressing nutrition and health-related concerns in a country. A multi-sectoral, multi-national project was initiated with the objective to develop the first country specific FCDB and tables for the country. A sequential exploratory approach was employed, commencing with desktop research collecting relevant information prior to completing a scoping mission which informed the approach and subsequent methods employed. Capacity building, data collection, quality assessment, compilation and quality assurance resulted in a DB comprising 316 food items, 8 food groups and 42 components. The baby food group encompassed the largest group contributing 27%, while fats and oils contributed 2% of foods to the DB. Malawian literature contributed 63%, of which peer-reviewed literature and student physicochemical research projects added 43% and 54%, respectively. Twenty-three percent of Malawian data comprised recipes with staples the largest contributor at 45%. The percentage of missing values respectively ranged between 13% and 51% for thiamin and biotin, while ranging between 5.4% and 68% for iron and selenium, respectively. The proximate profile except for ash was complete. Leveraging existing scientific literature, research projects, platforms and networks proved to be a viable approach to establish a country-specific FCDB and food composition data system in the country.

How to plan and manage an individual participant data meta-analysis. An illustrative toolkit.

Individual participant data meta-analyses (IPD-MAs) have several benefits over standard aggregate data meta-analyses, including the consideration of additional participants, follow-up time, and the joint consideration of study- and participant-level heterogeneity for improved diagnostic and prognostic model development and evaluation. However, IPD-MAs are resource-intensive and require careful budgeting of time from data contributing groups, a dedicated management team, diversity of expertise, clearly documented data sharing and authorship agreements, and consistent and clear communication. We present a toolkit to facilitate the implementation and management of IPD-MAs, from study recruitment to retrospective harmonization. The toolkit was developed and refined over our work on multiple multinational IPD-MA projects over the last 13 years. The toolkit's budget and email templates, agreements, project management spreadsheets, and standard operating procedures are meant to facilitate routine IPD-MA tasks to expedite implementing and managing future IPD-MA projects.

Think Big Wiradjuri Youth Participatory Research Project – what happened?

Wiradjuri are the largest Aboriginal Nation in New South Wales. Wagga Wagga, a Wiradjuri word meaning ‘dancing place’, or ‘place of many celebrations’ was the proposed site for a Think Big project, a multinational youth collaboration project. The Wagga Wagga based Think Big research never reached the stage where children carried out their research. We share that it is important to identify the factors that hindered the project so that with hindsight we can anticipate where future research pitfalls might be avoided.

Mental illness stigma as a moderator in the relationship between religiosity and help-seeking attitudes among Muslims from 16 Arab countries

BackgroundDetermining the potential barriers responsible for delaying access to care, and elucidating pathways to early intervention should be a priority, especially in Arab countries where mental health resources are limited. To the best of our knowledge, no previous studies have examined the relationship between religiosity, stigma and help-seeking in an Arab Muslim cultural background. Hence, we propose in the present study to test the moderating role of stigma toward mental illness in the relationship between religiosity and help-seeking attitudes among Muslim community people living in different Arab countries.MethodThe current survey is part of a large-scale multinational collaborative project (StIgma of Mental Problems in Arab CounTries [The IMPACT Project]). We carried-out a web-based cross-sectional, and multi-country study between June and November 2021. The final sample comprised 9782 Arab Muslim participants (mean age 29.67 ± 10.80 years, 77.1% females).ResultsBivariate analyses showed that less stigmatizing attitudes toward mental illness and higher religiosity levels were significantly associated with more favorable help-seeking attitudes. Moderation analyses revealed that the interaction religiosity by mental illness stigma was significantly associated with help-seeking attitudes (Beta = .005; p < .001); at low and moderate levels of stigma, higher religiosity was significantly associated with more favorable help-seeking attitudes.ConclusionOur findings preliminarily suggest that mental illness stigma is a modifiable individual factor that seems to strengthen the direct positive effect of religiosity on help-seeking attitudes. This provides potential insights on possible anti-stigma interventions that might help overcome reluctance to counseling in highly religious Arab Muslim communities.

Three factors of the Intrasexual Competition Scale?

In a multinational project (N = 3707), we factor analyzed a commonly used self-report measure of intrasexual competition and found a three-dimensional system. We called these factors envy (i.e., wanting what others have), jealousy (i.e., protecting what one has), and competitiveness (i.e., beliefs that one is better). To better understand these factors and test whether the solution is sensible, we examined sex differences and correlations with the Dark Triad traits (i.e., psychopathy, narcissism, and Machiavellianism), life history strategies, and age. Results are discussed using an adaptationist lens.

A Digital Collaborative Platform for the Silver Economy: Functionalities Required by Stakeholders in a Multinational Baltic Sea Region Project

This article develops functionalities for a digital collaborative platform, called the Digital Silver Hub, which aims to serve as an ecosystem for the quadruple helix actors (private sector, public sector, academic institutions, and senior citizens) to participate in knowledge exchange, collaboration, and co-creation of innovative technological solutions to facilitate the elderly population. In service of that, we have conducted 30 interviews from the partner heads of an EU-funded project as well as quadruple helix actors from each region in the Baltic Sea Region (Estonia, Latvia, Finland, Lithuania, Denmark, and St. Petersburg) to deeply understand the functionalities that are needed to be offered by the platform. A deductive thematic analysis has been conducted to analyse these functionalities in terms of collective intelligence (CI) components (namely staffing, processes, goals, and motivation) based on a most recent generic CI model. The functionalities were further evaluated by experts working in the field of science and technology in the silver economy. Overall, this article offers insights into the functionalities that are required for a digital collaborative platform to support the elderly population and facilitate co-creation among quadruple helix actors, as well as provides a foundation for future work on designing and implementing such a platform.

Alike Yet Distinct: The Effect of Language Diversity on Interpersonal Relationships Within National and Multinational Project Teams

ABSTRACTThis study examines the impact of language diversity on interpersonal relationships in multinational and national/domestic teams in a multilingual country – India. Specifically, it explores whether and how the influence of language diversity differs in the two types of multilingual project teams. To this end, using direct observations and semi-structured interviews, we conducted a thematic analysis and found that native language-based faultlines and groups exist in both kinds of teams. However, such faultlines and language-based groups can disintegrate into smaller, regional dialect-based subgroups due to the emergence of dialect faultlines. Furthermore, evidence suggests that multilingual managers are more effective as boundary spanners in bridging the faultlines in multinational teams; at the same time, they need to be aware of the distinction between language differences and faultlines. This study provides the required distinction between language diversity and the role of multilingual managers in national and multinational teams in an understudied context, thereby contributing to the literature on language diversity.

Assessing cohesion and diversity in the collaboration network of the SALURBAL project

The SALURBAL (Urban Health in Latin America) Project is an interdisciplinary multinational network aimed at generating and disseminating actionable evidence on the drivers of health in cities of Latin America. We conducted a temporal multilayer network analysis where we measured cohesion over time using network structural properties and assessed diversity within and between different project activities according to participant attributes. Between 2017 and 2020 the SALURBAL network comprised 395 participants across 26 countries, 23 disciplines, and 181 institutions. While the cohesion of the SALURBAL network fluctuated over time, overall, an increase was observed from the first to the last time point of our analysis (clustering coefficient increased [0.83–0.91] and shortest path decreased [1.70–1.68]). SALURBAL also exhibited balanced overall diversity within project activities (0.5–0.6) by designing activities for different purposes such as capacity building, team-building, research, and dissemination. The network’s growth was facilitated by the creation of new diverse collaborations across a range of activities over time, while maintaining the diversity of existing collaborations (0.69–0.75 between activity diversity depending on the attribute). The SALURBAL experience can serve as an example for multinational research projects aiming to build cohesive networks while leveraging heterogeneity in countries, disciplines, career stage, and across sectors.

#TobaccoFreeAdventCalendar: Development, Implementation and Process Evaluation of a multinational project initiated and created by youth

#TobaccoFreeAdventCalendar: Development, Implementation and Process Evaluation of a multinational project initiated and created by youth

Latin American and Caribbean Participation in China's Belt and Road Initiative

In March 2013,1 Chinese President Xi Jinping proposed the Belt and Road Initiative (BRI), a multinational infrastructure project in which China fnances initiatives in partner countries targeted towards advancing fve key cooperation priorities: policy coordination, facilities connectivity, unimpeded trade, fnancial integration, and people-to-people bond.2 In 2017, Panama became the frst country in Latin America and the Caribbean (LAC) to join the BRI.3 Since then, 21 LAC countries have joined the initiative by signing a Memorandum of Understanding (MOU) with China.4 Despite the rising popularity of the program in the region, twelve countries remain non-participants. This paper aims to employ a qualitative approach to analyze the participatory variation within Latin America and the Caribbean, asking if countries with increasing levels of trade interdependence with China are more likely to have signed a BRI MOU. It also considers potential diplomatic and political factors, such as a country’s recognition of Taiwan, that may preclude a country from joining the initiative. This paper is centered around a comparative case study of four countries with diferent levels of trade interdependence and BRI participation statuses: Chile, El Salvador, Colombia, and Guatemala. Within the scope of this case study, the results show that countries with upward trends across trade interdependence indices are more likely to participate in the BRI.

Legislative Orientation of Chinese Regulation of Transnational Corporations' Corruption in China

With the acceleration of China's opening-up, the number and scale of multinational corporations' investment projects in China are constantly increasing. However, in order to obtain greater benefits in the Chinese market, some multinational corporations choose to seek illegitimate commercial interests through bribery. The increasing corruption cases of transnational corporations have bad influences on China's economic development, business environment and international reputation. However, there are still many deficiencies in China's legal system to regulate the corruption of transnational corporations. This paper will study the legislation on transnational corporations’ corruption in China, and put forward more effective suggestions for China to regulate the corruption of transnational corporations in legislation. This paper will analyze the current anti-corruption legal system against transnational corporations in China and other countries, and use the method of comparison and case study to find deficiencies in Chinese laws. Through the analysis, it is concluded that China should formulate a special Anti-commercial Bribery Law in order to improve the legislation in relevant fields.

Construction and Cost Analysis of BladeBridges Made from Decommissioned FRP Wind Turbine Blades

This paper describes repurposing projects using decommissioned wind turbine blades in bridges conducted under a multinational research project entitled “Re-Wind”. Repurposing is defined by the Re-Wind Network as the re-engineering, redesigning, and remanufacturing of a wind blade that has reached the end of its life on a turbine and taken out of service and then reused as a load-bearing structural element in a new structure (e.g., bridge, transmission pole, sound barrier, seawall, shelter). The issue of end-of-life of wind turbine blades is becoming a significant sustainability concern for wind turbine manufacturers, many of whom have committed to the 2030 or 2040 sustainability goals that include zero-waste for their products. Repurposing is the most sustainable end-of-life solution for wind turbine blades from an environmental, economic, and social perspective. The Network has designed and constructed two full-size pedestrian/cycle bridges—one on a greenway in Cork, Ireland and the other in a quarry in Draperstown, Northern Ireland, UK. The paper describes the design, testing, and construction of the two bridges and provides cost data for the bridges. Two additional bridges that are currently being designed for construction in Atlanta, GA, USA are also described. The paper also presents a step-by-step procedure for designing and building civil structures using decommissioned wind turbine blades. The steps are: project planning and funding, blade sourcing, blade geometric characterization, material testing, structural testing, designing, cost estimating, and construction.

Project Coordinators' Perceptions according to the Organization Structure to Reduce Communication Risks in Multinational Project

Increasing risks about deficient communication and difficulties in communication management in multinational projects lead to the deployment of project coordinators (PCs). The role of coordinators and their responses to communication issues differ with the organization structure. This study focuses on the communication tendencies in different organization structures to facilitate the work of PCs. Based on the literature review, this study identified representative communication risks and organization structures in multinational projects. Thereafter, a survey and semi-structured interviews with 30 PCs were conducted to understand their perceptions, which were then analyzed by applying text-mining. Cultural and linguistic risks, such as differences in terminology, nuances, and visual gestures, occur frequently in communication. The resulting construction and design changes may lead to conflicts among stakeholders. To alleviate these risks, PCs in functional, projectized, and matrix organizations must consider the hierarchy, expert presence, and systematic approach adoption, respectively. PCs typically prefer matrix organizations, in which each department acts as a team to deliver information uniformly, and the personnel must adapt to differences in the terminology and behavioral cultures of multinational stakeholders. The systematic deployment of PCs with experience and knowledge of multinational projects in each team can help set unified goals among stakeholders. By coordinating the communication of PCs, the technology and resources of participating countries can be timely utilized.

Integrated Short-term Palliative Rehabilitation to improve quality of life and equitable care access in incurable cancer (INSPIRE): a multinational European research project.

Disability related to incurable cancer affects over a million Europeans each year and people with cancer rank loss of function among the most common unmet supportive care needs. To test the clinical and cost-effectiveness of an integrated short-term palliative rehabilitation intervention, to optimise function and quality of life in people affected by incurable cancer. This is a multinational, parallel group, randomised, controlled, assessor blind, superiority trial. The INSPIRE consortium brings together leaders in palliative care, oncology and rehabilitation from partner organisations across Europe, with complementary expertise in health service research, trials of complex interventions, mixed-method evaluations, statistics and economics. Partnership with leading European civil society organisations ensures citizen engagement and dissemination at the highest level. We will conduct a multinational randomised controlled trial across five European countries, recruiting participants to assess the effectiveness of palliative rehabilitation for people with incurable cancer on the primary outcome - quality of life - and secondary outcomes including disability, symptom burden and goal attainment. To support trial conduct and enhance analysis of trial data, we will also conduct: comparative analysis of current integration of rehabilitation across oncology and palliative care services; mixed-method evaluations of equity and inclusivity, processes and implementation for the intervention, at patient, health service and health system levels. Finally, we will conduct an evidence synthesis, incorporating INSPIRE findings, and a Delphi consensus to develop an international framework for palliative rehabilitation practice and policy, incorporating indicators, core interventions, outcomes and integration methods. If positive, the trial could produce a scalable and equitable intervention to improve function and quality of life in people with incurable cancer and reduce the burden of care for their families. It could also upskill the practitioners involved and motivate future research questions. The intervention could be adapted and integrated into different health systems using existing staff and services, with little or no additional cost.

SIGN LANGUAGE DETECTION USING PYTHON AND OPENCV

This work focuses on detection of (sign) hand gesture techniques and introduces the merits and limitations in various circumstances. The hand segmentation theories and hand detection system is used to construct hand gesture recognition using Python with OpenCV. The hand gestures use as a natural interface motivates research in gesture representations, taxonomies and recognition methods/algorithms, and software platforms/ frameworks, all of which are briefly covered in this work. All the processes have been done using webcam by keras and tensorflow. The ever-increasing public acceptance and funding for multinational projects emphasizes the need for sign language. The desire for computer-based solution is significant in recent age of technology for deaf people. Still, researchers are attacking the problem for quite sometimes and the results are showing promises. This work represents a comprehensive review of vision-based sign recognition methodologies, emphasizing importance of taking the things into consideration in addition with algorithm's recognition accuracy during predicting their success in real world applications. This project matches the sign language action with dataset images with various categories of sign (gestures) that already been trained using webcam. This project applies neural network to compare the actions with data set images. The coding language used is Python 3.10.

Promoting early language development in the Arab world and Sustainable Development Goals 3, 4, 10 and 17

Purpose This commentary describes a multi-national project which addresses gaps in the design and delivery of health and education services in Arabic-speaking countries in relation to early language development, with a focus on Egypt, Jordan, Lebanon and the Palestinian Territories. This includes: (1) co-production with early years professionals and NGOs of approaches to support early language development; (2) development and standardisation of tools to identify monolingual and multilingual Arabic-speaking children at risk of poor language development; and (3) examination of language development in refugee communities. Result The importance of inter-professional partnership and the inclusion of families in planning support for oral language development is highlighted. Arabic versions of the Communicative Development Inventory (CDI) Toddler were developed, and data collected from 1074 Egyptian, Jordanian and Palestinian monolingual infants aged 8–30 months. Data from 201 age-matched Palestinian infants in Lebanese refugee camps highlight inequalities resulting from limited maternal educational opportunities. Data from 230 multilingual Lebanese 2-year-olds enable the interpretation of CDI scores as a function of language exposure. Conclusion This work contributes to the promotion of robust language development for all Arabic-speaking children. This commentary focusses on sustainable development goal (SDG) 3, SDG 4, SDG 10 and SDG 17.

A Perspective: Challenges in Dementia Research.

Although dementia is a common and devastating disease that has been studied intensely for more than 100 years, no effective disease modifying treatment has been found. At this impasse, new approaches are important. The purpose of this paper is to provide, in the context of current research, one clinician’s perspective regarding important challenges in the field in the form of specific challenges. These challenges not only illustrate the scope of the problems inherent in finding treatments for dementia, but can also be specific targets to foster discussion, criticism and new research. One common theme is the need to transform research activities from small projects in individual laboratories/clinics to larger multinational projects, in which each clinician and researcher works as an integral part. This transformation will require collaboration between researchers, large corporations, regulatory/governmental authorities and the general population, as well as significant financial investments. However, the costs of transforming the approach are small in comparison with the cost of dementia.

Update from the Clificol Project: Omicron in Hong-Kong and worldwide overview of the pandemic

Background: The Clificol® COVID-19 Support Project is an innovative international data collection project aimed at documenting the presenting symptoms, use of homeopathy through the pandemic and tackling some of the core questions in homeopathy.&#x0D; Aims: The Covid-19 pandemic raised many questions and mobilised many resources. In order to make good use of resources, sound knowledge of the presenting complaints and demographics are required. In particular, we aimed to characterise the recent Omicron wave in Hong-Kong and to get an overall picture of the global pandemic as experienced by the homeopathic community.&#x0D; Methodology: This online multi-national data-collection project is supported by the ECH, ECCH, ICH, HRI, LMHI, and other professional associations. The collected data includes demographic information, severity, conventional diagnosis and treatment, presenting symptoms as well as the remedies prescribed. The outcome of treatment was tracked using the ORIDL scale. More recently a 23-items prospective questionnaire was added to the input in order to gather targeted data about the presenting complaints.&#x0D; Results and discussion: The recent wave of the Omicron variant in Hong-Kong, was analysed (N=372 cases) in terms of the symptomatology of this variant. The data from the 23-items questionnaire is compared to the longer questionnaire (150 items) used by the Hong-Kong team (21 practitioners). The most frequently reported common Clinical symptoms were extreme tiredness (60%), sore throat (46%), headache during fever (45%), dryness of mouth (37%), poor appetite (37%), runny nose (34%) and unusual muscle pains (31%).&#x0D; Also, the cases collected from around the world over the course of the pandemic (N=1300) were analysed, providing an overall picture of the pandemic and its specificities per country and over time.&#x0D; Conclusions: Clificol has shown and continues to show the value of data collection for the homeopathy community, providing important information for the management of future pandemics and opening new avenues for research in homeopathy.