Addressing the complexities of managing domestic and multinational corporate brands

Purpose – The purpose of this paper is to focus on the differences between managing domestic corporate brands (DCBs) and multinational corporate brands (MCBs), and presents a framework highlighting six types of complexity associated with managing both forms of corporate brands in an international business context. Design/methodology/approach – This paper proposes a framework addressing six types of complexity involved in managing DCBs and MCBs drawing on the literature related to corporate branding, corporate brands, and domestic and multinational corporations. The six types of complexity examined include: strategic role, organisational structure, culture, knowledge, positioning and extended responsibility. Findings – The research identifies that DCBs have a lower degree of complexity in regard to strategic role, knowledge and positioning, but have a higher level in regard to organisational structure, cultural and extended responsibility complexity. MCBs face more complexity than DCBs across all dimensions because they operate across business environments and need to coordinate activities while adapting to environmental differences. Practical implications – The findings highlight the importance of environmental complexity for firms managing brands globally. The issues of complexity identified in this paper need to be understood if firms are to effectively build and manage their corporate brands within and across markets. Originality/value – The paper highlights the concepts of DCBs and MCBs, and identifies the factors that contribute to the complexity of managing these two types of corporate brands domestically and internationally

Whole genome sequencing reveals high clonal diversity of Escherichia coli isolated from patients in a tertiary care hospital in Moshi, Tanzania

Abstract Background Limited information regarding the clonality of circulating E. coli strains in tertiary care hospitals in low and middle-income countries is available. The purpose of this study was to determine the serotypes, antimicrobial resistance and virulence genes. Further, we carried out a phylogenetic tree reconstruction to determine relatedness of E. coli isolated from patients in a tertiary care hospital in Tanzania. Methods E. coli isolates from inpatients admitted at Kilimanjaro Christian Medical Centre between August 2013 and August 2015 were fully genome-sequenced at KCMC hospital. Sequence analysis was done for identification of resistance genes, Multi-Locus Sequence Typing, serotyping, and virulence genes. Phylogeny reconstruction using CSI Phylogeny was done to ascertain E. coli relatedness. Stata 13 (College Station, Texas 77,845 USA) was used to determine Cohen’s kappa coefficient of agreement between the phenotypically tested and whole genome sequence predicted antimicrobial resistance. Results Out of 38 E. coli isolates, 21 different sequence types (ST) were observed. Eight (21.1%) isolates belonged to ST131; of which 7 (87.5.%) were serotype O25:H4. Ten (18.4%) isolates belonged to ST10 clonal complex; of these, four (40.0%) were ST617 with serotype O89:H10. Twenty-eight (73.7%) isolates carried genes encoding beta-lactam resistance enzymes. On average, agreement across all drugs tested was 83.9%. Trimethoprim/sulphamethoxazole (co-trimoxazole) showed moderate agreement: 45.8%, kappa =15% and p = 0.08. Amoxicillin-clavulanate showed strongest agreement: 87.5%, kappa = 74% and p = 0.0001. Twenty-two (57.9%) isolates carried virulence factors for host cells adherence and 25 (65.7%) for factors that promote E. coli immune evasion by increasing survival in serum. The phylogeny analysis showed that ST131 clustering close together whereas ST10 clonal complex had a very clear segregation of the ST617 and a mix of the rest STs. Conclusion There is a high diversity of E. coli isolated from patients admitted to a tertiary care hospital in Tanzania. This underscores the necessity to routinely screen all bacterial isolates of clinical importance in tertiary health care facilities. WGS use for laboratory-based surveillance can be an effective early warning system for emerging pathogens and resistance mechanisms in LMICs

Domestic violence and decision-making power of married women in Myanmar: analysis of a nationally representative sample

BACKGROUND: Women in Myanmar are not considered decision makers in the community and the physical and psychological effect of violence makes them more vulnerable. There is a strong negative reaction, usually violent, to any economic activity generated by women among poorer and middle-class families in Myanmar because a woman's income is not considered necessary for basic survival. OBJECTIVE: Explore the relationship between domestic violence on the decision-making power of married women in Myanmar. DESIGN: Cross-sectional. SETTING: National, both urban and rural areas of Myanmar. PATIENTS AND METHODS: Data from the Myanmar Demographic and Health Survey 2015-16 were used in this analysis. In that survey, married women aged between 15 to 49 years were selected for interview using a multistage cluster sampling technique. The dependent variables were domestic violence and the decision-making power of women. Independent variables were age of the respondents, educational level, place of residence, employment status, number of children younger than 5 years of age and wealth index. MAIN OUTCOME MEASURES: Domestic violence and decision-making power of women. SAMPLE SIZE: 7870 currently married women. RESULTS: About 50% respondents were 35 to 49 years of age and the mean (SD) age was 35 (8.4) years. Women's place of residence and employment status had a significant impact on decision-making power whereas age group and decision-making power of women had a relationship with domestic violence. CONCLUSION: Giving women decision making power will be indispensable for the achievement of sustainable development goals. Government and other stakeholders should emphasize this to eliminate violence against women. LIMITATIONS: Use of secondary data analysis of cross-sectional study design and cross-sectional studies are not suitable design to assess this causality. Secondly the self-reported data on violence may be subject to recall bias. CONFLICT OF INTEREST: None

Subclinical Hypothyroidism & Infertility: A Review

Subclinical hypothyroidism (SCH) may be of greater clinical importance in women with “unexplained” infertility, especially when the luteal phase is inadequate, and such patients should be investigated for thyroid dysfunction in detail. To date, studies investigating the association between SCH and infertility are still based on the high serum thyroid stimulating hormone (TSH) levels while some older studies are based on the presence of an abnormal serum TSH after a thyrotropin releasing hormone (TRH) stimulation test. The recommendation in the current guidelines to treat subclinical hypothyroidism is based on minimal evidence and it is thought that with treatment the potential benefits outweigh the potential risks. Thyroxine-replacement therapy should be started in patients with SCH caused by conditions which are at high risk of progression to overt hypothyroidism. Ibrahim Med. Coll. J. 2014; 8(1): 17-2