11 research outputs found
PERSPECTIVE ON FIRMS’ RESPONSES TO ECONOMIC CRISES
This paper analyzes how firms respond to emerging economic crises. A firm’s response to crisis is a mechanism for survival. It normally evolves out of the impact of the crisis, and it is linked to the strategic goals and operational objectives of the firm. Firms normally pursue one or more of three lines of responses to crises; retrenchment, investment and ambidextrous responses. Responses of firms to crisis are far from predictable or systematic and usually vary from firm to firm. They are predetermined by specific contexts of the firm’s existence. These contexts range from the firm’s size, ownership, sector of operation, history in business, country dynamics and resource capabilities. There is also a tendency for firms to move from one type of response to another during the course of the crisis. Retrenchment is the most preferred form of response, although investment responses tend to have long-term advantages. The study recommends that firms consider ambidextrous responses to realize the synchronized benefits of retrenchment and investment responses to crises. It is also recommended that studies on firms’ responses to crisis should examine firms on a case-to-case basis, identify the particularities of their responses
IMPACT OF ECONOMIC CRISES ON FIRMS: A LITERATURE REVIEW
This paper examines literature that analyzes how economic crises affect firms. Eighty-five studies were examined with the overall aim of finding out the impact of crises on firms. Studies published between 1805 and 2018 were sampled purposively through digital database searches, to establish the most recent literature on the impact of crises on firms. Consequently, the majority of the work assessed focuses on the global economic crisis of 2007 and its effect on firms in a different country and regional contexts. The literature demonstrates that economic crises affect firms negatively and positively with a tendency for crises to affect firms more negatively. Negative impacts include a decline in demand, fall in profitability, debt problems, operational challenges, bankruptcy, loss of goodwill or public image, uncertainty, and scale down of operations. Positive impacts comprise stimulation of efficiency, and improved performance for strategic firms The review further establishes that the impact of crises on firms varies from firm to firm, which requires that to examine the impacts of economic crises on firms requires that the firms are studied on a case-to-case basis.
Dolutegravir twice-daily dosing in children with HIV-associated tuberculosis: a pharmacokinetic and safety study within the open-label, multicentre, randomised, non-inferiority ODYSSEY trial
Background:
Children with HIV-associated tuberculosis (TB) have few antiretroviral therapy (ART) options. We aimed to evaluate the safety and pharmacokinetics of dolutegravir twice-daily dosing in children receiving rifampicin for HIV-associated TB.
Methods:
We nested a two-period, fixed-order pharmacokinetic substudy within the open-label, multicentre, randomised, controlled, non-inferiority ODYSSEY trial at research centres in South Africa, Uganda, and Zimbabwe. Children (aged 4 weeks to <18 years) with HIV-associated TB who were receiving rifampicin and twice-daily dolutegravir were eligible for inclusion. We did a 12-h pharmacokinetic profile on rifampicin and twice-daily dolutegravir and a 24-h profile on once-daily dolutegravir. Geometric mean ratios for trough plasma concentration (Ctrough), area under the plasma concentration time curve from 0 h to 24 h after dosing (AUC0–24 h), and maximum plasma concentration (Cmax) were used to compare dolutegravir concentrations between substudy days. We assessed rifampicin Cmax on the first substudy day. All children within ODYSSEY with HIV-associated TB who received rifampicin and twice-daily dolutegravir were included in the safety analysis. We described adverse events reported from starting twice-daily dolutegravir to 30 days after returning to once-daily dolutegravir. This trial is registered with ClinicalTrials.gov (NCT02259127), EudraCT (2014–002632-14), and the ISRCTN registry (ISRCTN91737921).
Findings:
Between Sept 20, 2016, and June 28, 2021, 37 children with HIV-associated TB (median age 11·9 years [range 0·4–17·6], 19 [51%] were female and 18 [49%] were male, 36 [97%] in Africa and one [3%] in Thailand) received rifampicin with twice-daily dolutegravir and were included in the safety analysis. 20 (54%) of 37 children enrolled in the pharmacokinetic substudy, 14 of whom contributed at least one evaluable pharmacokinetic curve for dolutegravir, including 12 who had within-participant comparisons. Geometric mean ratios for rifampicin and twice-daily dolutegravir versus once-daily dolutegravir were 1·51 (90% CI 1·08–2·11) for Ctrough, 1·23 (0·99–1·53) for AUC0–24 h, and 0·94 (0·76–1·16) for Cmax. Individual dolutegravir Ctrough concentrations were higher than the 90% effective concentration (ie, 0·32 mg/L) in all children receiving rifampicin and twice-daily dolutegravir. Of 18 children with evaluable rifampicin concentrations, 15 (83%) had a Cmax of less than the optimal target concentration of 8 mg/L. Rifampicin geometric mean Cmax was 5·1 mg/L (coefficient of variation 71%). During a median follow-up of 31 weeks (IQR 30–40), 15 grade 3 or higher adverse events occurred among 11 (30%) of 37 children, ten serious adverse events occurred among eight (22%) children, including two deaths (one tuberculosis-related death, one death due to traumatic injury); no adverse events, including deaths, were considered related to dolutegravir.
Interpretation:
Twice-daily dolutegravir was shown to be safe and sufficient to overcome the rifampicin enzyme-inducing effect in children, and could provide a practical ART option for children with HIV-associated TB
Neuropsychiatric manifestations and sleep disturbances with dolutegravir-based antiretroviral therapy versus standard of care in children and adolescents: a secondary analysis of the ODYSSEY trial
BACKGROUND: Cohort studies in adults with HIV showed that dolutegravir was associated with neuropsychiatric adverse events and sleep problems, yet data are scarce in children and adolescents. We aimed to evaluate neuropsychiatric manifestations in children and adolescents treated with dolutegravir-based treatment versus alternative antiretroviral therapy. METHODS: This is a secondary analysis of ODYSSEY, an open-label, multicentre, randomised, non-inferiority trial, in which adolescents and children initiating first-line or second-line antiretroviral therapy were randomly assigned 1:1 to dolutegravir-based treatment or standard-of-care treatment. We assessed neuropsychiatric adverse events (reported by clinicians) and responses to the mood and sleep questionnaires (reported by the participant or their carer) in both groups. We compared the proportions of patients with neuropsychiatric adverse events (neurological, psychiatric, and total), time to first neuropsychiatric adverse event, and participant-reported responses to questionnaires capturing issues with mood, suicidal thoughts, and sleep problems. FINDINGS: Between Sept 20, 2016, and June 22, 2018, 707 participants were enrolled, of whom 345 (49%) were female and 362 (51%) were male, and 623 (88%) were Black-African. Of 707 participants, 350 (50%) were randomly assigned to dolutegravir-based antiretroviral therapy and 357 (50%) to non-dolutegravir-based standard-of-care. 311 (44%) of 707 participants started first-line antiretroviral therapy (ODYSSEY-A; 145 [92%] of 157 participants had efavirenz-based therapy in the standard-of-care group), and 396 (56%) of 707 started second-line therapy (ODYSSEY-B; 195 [98%] of 200 had protease inhibitor-based therapy in the standard-of-care group). During follow-up (median 142 weeks, IQR 124–159), 23 participants had 31 neuropsychiatric adverse events (15 in the dolutegravir group and eight in the standard-of-care group; difference in proportion of participants with ≥1 event p=0·13). 11 participants had one or more neurological events (six and five; p=0·74) and 14 participants had one or more psychiatric events (ten and four; p=0·097). Among 14 participants with psychiatric events, eight participants in the dolutegravir group and four in standard-of-care group had suicidal ideation or behaviour. More participants in the dolutegravir group than the standard-of-care group reported symptoms of self-harm (eight vs one; p=0·025), life not worth living (17 vs five; p=0·0091), or suicidal thoughts (13 vs none; p=0·0006) at one or more follow-up visits. Most reports were transient. There were no differences by treatment group in low mood or feeling sad, problems concentrating, feeling worried or feeling angry or aggressive, sleep problems, or sleep quality. INTERPRETATION: The numbers of neuropsychiatric adverse events and reported neuropsychiatric symptoms were low. However, numerically more participants had psychiatric events and reported suicidality ideation in the dolutegravir group than the standard-of-care group. These differences should be interpreted with caution in an open-label trial. Clinicians and policy makers should consider including suicidality screening of children or adolescents receiving dolutegravir
A Thematic Review of the Efficacy of Firms' Responses to Economic Crises: a Ugandan Perspective
This paper is a thematic review of the efficacy of firms' responses to economic crises. The review seeks to answer the question of: how effective are firm's responses to economic crises? Basing on the three forms of response firms adopt during economic crises, the paper identifies the advantages and disadvantages of each response. From studies accessed, it was found that retrenchment responses may improve efficiency of the firm, and help the firm to survive. On the contrary, retrenchment may weaken the competitiveness of the firm, and might increase costs of the process in the long run. Investment responses are forward looking offering the best prospects of post-recovery performance. In the short term, they are good for developing innovative solutions during crises. The main disadvantage with investment response is the cost of getting it done. Ambidextrous responses are the most viable option, because they tap into the advantages of retrenchment and investment and assist the firms to tackle the disadvantages of each response. The review also found that the efficacy of each response is dependent on a web of other factors related to the firm. Thus, the efficacy of each response may vary from firm to firm because of their unique circumstances
A Systematic Review of Studies on Digital Migration and Coverage of Digital Television Services
This review systematically examines studies published on the relationship between digital migration and coverage of digital television broadcasting services. It was guided by four objectives: to examine the cost of digital migration and coverage of digital broadcasting services; to analyze consumer awareness and coverage of digital broadcasting services; to examinenbsp; subscription payments and coverage of digital broadcasting services; and to analyze special interactive services and coverage of digital television broadcasting services. The inclusion criteria were based on studies that linked to the objectives of the review. Effort was also made to sieve and select studies that were scholarly in nature. The review employed a longitudinal descriptive design covering studies published between 2010 and 2018. 35 studies were purposively sampled and classified into periodization (date of publication), geographical scope, content scope, and methodological orientation. It was found that most of the studies were published close to 2015 which was the International Telecommunications Union (ITU) deadline for member countries to migrate to digital television broadcasting. The studies were limited in geographical scope focusing on only 9 out of the 193 member countries of the ITU. Costs, customer awareness, subscription payments, and special interactive services were found to have a strong effect on coverage of digital television broadcasting services
A Historical Analysis of Media Reportage on the Sikh Genocide of 1984: Implications for National Security of the Indian State
This study critically examined the media reportage on the Sikh genocide of 1984. From the reports, the study drew inferences on the effect of the Sikh genocide on India's national security within the spectrum of the persistent agitation for self-determination by the Sikh people of Punjab. Despite the devastating implications of the crisis for India security architecture, much that is quite revealing has not been captured in extant body of literature on the subject of the Sikh genocide. This lacuna informs one of the major motivations for this treatise. Two main research questions were critical to this analysis: What was the effect of the Sikh genocide on the desire for self-determination of the Punjab people? What were the implications of the Sikh genocide of 1984 for the security architecture of the Indian State? To answer these questions, a content analysis of media reports on the subject matter was used as the primary method of data collection which was complemented by in-depth interviews of key stakeholders. Findings revealed that Sikh genocide of 1984 was the major catalyst for the call for self-determination and the resultant crisis that have erupted in the region since then. It was further revealed that the Sikh genocide of 1984 had negatively impacted on the security of lives and also on the perception of security by people in India and the Punjab state in particular. The study concluded that there is need for a permanent and acceptable solution to the issue of self-determination and mutual distrust in the Punjab State in the interest India's national security. It was recommended that a community based approach hinged on the principles of compromise and inclusiveness should be adopted towards resolving the crisis in the region
A Critical Analysis of Foreign Intervention in the Sikh Genocide of 1984
This study critically discussed the role played by foreign actors in the Sikh genocide and the resulting violence of 1984. A review of literature established a dearth of relevant literature on the subject matter and was a motivating factor for this study. One main research question was considered in this study and it was: “What role did foreign intervention play in mediating the relationship between the Sikh genocide of 1984 and the state of the Indian nation?”. To answer these questions, a content analysis of media reports on the subject matter was used as the primary method of data collection which was complemented by in-depth interviews of key stakeholders. The findings of this study showed an insignificant intervention (positive or negative) during the period and issue under review. It was recommended that the International community, including Amnesty International, need to do more to prevent the proliferation of arms into crisis-prone areas and to also support these affected communities by providing humanitarian aid to them