Leveraging the Country-of-Origin Image by managing it at different levels

The study aims to articulate the Country-of-Origin Image (COI) at different levels (country, industry and firm levels) by advancing the knowledge and exploring ways to manage the COI at different levels underpinned on corporate brand and brand architecture strategies. For that, a mixed-methods approach was conducted where a qualitative study—looking into the case of the Brazilian Machinery Solutions Programme (BMS)—was carried out in combination with a quantitative survey held with a specific target country (Colombia). Data for the quantitative study were collected with 89 Colombian industrial buyers using Brazil as a manufacturer-supplier and country of reference. Findings indicate the relevance of managing the COI at different levels and highlight the development of the COI at the industry level. This demonstrates that nation-branding and COI literature should be developed and articulated using strategic marketing programmes and brand architecture elements. The study advances the body of knowledge in the COI literature by analysing it within three different levels and offers a framework to manage the COI using corporate brand and brand architecture elements, which is beneficial to institutions, governments, trade agencies, industry associations and firms to leverage the COI by understanding aspects of it transferrable to industry and firm levels

MRI biomarker assessment of neuromuscular disease progression: a prospective observational cohort study

BACKGROUND: A substantial impediment to progress in trials of new therapies in neuromuscular disorders is the absence of responsive outcome measures that correlate with patient functional deficits and are sensitive to early disease processes. Irrespective of the primary molecular defect, neuromuscular disorder pathological processes include disturbance of intramuscular water distribution followed by intramuscular fat accumulation, both quantifiable by MRI. In pathologically distinct neuromuscular disorders, we aimed to determine the comparative responsiveness of MRI outcome measures over 1 year, the validity of MRI outcome measures by cross-sectional correlation against functionally relevant clinical measures, and the sensitivity of specific MRI indices to early muscle water changes before intramuscular fat accumulation beyond the healthy control range. METHODS: We did a prospective observational cohort study of patients with either Charcot-Marie-Tooth disease 1A or inclusion body myositis who were attending the inherited neuropathy or muscle clinics at the Medical Research Council (MRC) Centre for Neuromuscular Diseases, National Hospital for Neurology and Neurosurgery, London, UK. Genetic confirmation of the chromosome 17p11·2 duplication was required for Charcot-Marie-Tooth disease 1A, and classification as pathologically or clinically definite by MRC criteria was required for inclusion body myositis. Exclusion criteria were concomitant diseases and safety-related MRI contraindications. Healthy age-matched and sex-matched controls were also recruited. Assessments were done at baseline and 1 year. The MRI outcomes-fat fraction, transverse relaxation time (T2), and magnetisation transfer ratio (MTR)-were analysed during the 12-month follow-up, by measuring correlation with functionally relevant clinical measures, and for T2 and MTR, sensitivity in muscles with fat fraction less than the 95th percentile of the control group. FINDINGS: Between Jan 19, 2010, and July 7, 2011, we recruited 20 patients with Charcot-Marie-Tooth disease 1A, 20 patients with inclusion body myositis, and 29 healthy controls (allocated to one or both of the 20-participant matched-control subgroups). Whole muscle fat fraction increased significantly during the 12-month follow-up at calf level (mean absolute change 1·2%, 95% CI 0·5-1·9, p=0·002) but not thigh level (0·2%, -0·2 to 0·6, p=0·38) in patients with Charcot-Marie-Tooth disease 1A, and at calf level (2·6%, 1·3-4·0, p=0·002) and thigh level (3·3%, 1·8-4·9, p=0·0007) in patients with inclusion body myositis. Fat fraction correlated with the lower limb components of the inclusion body myositis functional rating score (ρ=-0·64, p=0·002) and the Charcot-Marie-Tooth examination score (ρ=0·63, p=0·003). Longitudinal T2 and MTR changed consistently with fat fraction but more variably. In muscles with a fat fraction lower than the control group 95th percentile, T2 was increased in patients compared with controls (regression coefficients: inclusion body myositis thigh 4·0 ms [SE 0·5], calf 3·5 ms [0·6]; Charcot-Marie-Tooth 1A thigh 1·0 ms [0·3], calf 2·0 ms [0·3]) and MTR reduced compared with controls (inclusion body myositis thigh -1·5 percentage units [pu; 0·2], calf -1·1 pu [0·2]; Charcot-Marie-Tooth 1A thigh -0·3 pu [0·1], calf -0·7 pu [0·1]). INTERPRETATION: MRI outcome measures can monitor intramuscular fat accumulation with high responsiveness, show validity by correlation with conventional functional measures, and detect muscle water changes preceding marked intramuscular fat accumulation. Confirmation of our results in further cohorts with these and other muscle-wasting disorders would suggest that MRI biomarkers might prove valuable in experimental trials. FUNDING: Medical Research Council UK

Sex differences in CSF biomarkers for neurodegeneration and blood-brain barrier integrity.

INTRODUCTION: As cerebrospinal fluid (CSF) neurofilament light protein (NfL) and the CSF/serum albumin ratio (QAlb) are used in the clinical routine, the impact of demographic factors on these biomarkers is important to understand. METHODS: Participants were derived from two Swedish samples: the population‐based H70 Study (n = 308, age 70) and a clinical routine cohort (CSF NfL, n = 8995, QAlb, n = 39252, age 0 to 95). In the population‐based study, QAlb and NfL were examined in relation to sex, cardiovascular risk factors, and cerebral white matter lesions (WMLs). In the clinical cohort, QAlb and NfL sex differences were tested in relation to age. RESULTS: Men had higher QAlb and NfL concentrations and had higher QAlb and NfL concentrations from adolescence throughout life. NfL was not related to WML, but QAlb correlated positively with WMLs. DISCUSSION: The CSF NfL sex difference could not be explained by vascular pathology. Future studies should consider using different reference limits for men and women

Community exercise is feasible for neuromuscular diseases and can improve aerobic capacity

Objective: The aim of this phase 2 trial was to ascertain the feasibility and effect of community based aerobic exercise training for people with two of the more common neuromuscular diseases: Charcot-Marie-Tooth disease type 1A (CMT) and Inclusion Body Myositis (IBM). Methods: A randomised single blinded cross over trial design was used to compare a 12-week aerobic training programme using recombinant exercise bicycles compared to a control period. The training occurred three times per week in community gyms local to the participants. Support was available from trained gym staff and a research physiotherapist. The two disease groups were analysed separately. The primary outcome measure was peak oxygen uptake (VO2 peak) during a maximal exercise test, with secondary measures of muscle strength, function and patient reported measures. Results: Data from 23 people with CMT and 17 people with IBM was included in the analysis. Both disease groups had high levels of participation and demonstrated improvements in VO2 peak, with a moderate effect size in the CMT participants (Cohen’s d = 0.53) and a strong effect size in the IBM group (Cohen’s d = 1.72). No major changes were observed in the secondary outcome measures. Qualitative interviews revealed that participants valued the support of gym instructors and the research physiotherapists in overcoming challenges to participation. Conclusion: Twelve weeks of aerobic training in community gyms was feasible, safe and improved aerobic capacity in people with CMT and IBM. Classification of Evidence: This study provides Class II evidence that for patients with CMT type 1A and IBM, an aerobic training program increases aerobic capacity

(In)dependência funcional na dependente relação de homens tetraplégicos com seus (in)substituíveis pais/cuidadores

Objetivou-se identificar elementos da classificação internacional de funcionalidade, incapacidade e saúde, aplicáveis ao cuidado domiciliar de homens adultos tetraplégicos, com vistas à redução da dependência de ajuda de seus pais para as atividades da vida diária, e o autocuidado. Os dados foram coletados de junho de 2004 a março de 2005, a partir de entrevista semi-estruturada, realizada com 8 adultos acometidos de lesão medular alta, e com experiência de usuários do cuidado domiciliar. Optou-se pela análise de conteúdo, a partir das categorias de significados pautadas nos seguintes resultados: suporte familiar: segurança para as funções corporais do incapacitado; tecnologia assistiva: inventividades para promoção da qualidade do cuidado; medos, futuro incerto e perda dos pais: limiares e fragilidades humanas; e ganhos funcionais: respostas objetivas das funções corporais. Conclui-se que o apoio da família e, em especial, a presença dos pais, são fundamentais para enfrentar as limitações e reagir na busca de equilíbrio na deficiência, incapacidade, desvantagem e saúde dessa clientela, preparando-a para o alcance de gradativos ganhos funcionais e independência para atividades cotidianas e autocuidado.El estudio tuvo como objetivo identificar elementos de la clasificación internacional de funcionalidad, incapacidad y salud, aplicables al cuidado domiciliario de hombres adultos cuadripléjicos, con el fin de reducir la dependencia de la ayuda de sus padres en las actividades de la vida diaria y el autocuidado. Los datos fueron reunidos entre junio de 2004 y marzo de 2005, sobre la base de una entrevista semiestructurada efectuada a 8 adultos que sufrían de lesión medular alta y que recibían normalmente cuidado domiciliario. Se optó por el sistema de análisis de contenidos a partir de las categorías de significados pautados en los siguientes resultados: apoyo familiar: seguridad para las funciones corporales del discapacitado; tecnología de apoyo: soporte tecnológico para optimizar la calidad de los cuidados; miedos; futuro incierto y pérdida de los padres: los umbrales y las fragilidades humanas; y ganancias funcionales: respuestas objetivas de las funciones corporales. Se concluyó en que el apoyo familiar y, en particular, la presencia de los padres, son fundamentales para enfrentar las limitaciones y reaccionar en la búsqueda de equilibrios en la deficiencia, incapacidad, desventajas y salud de tales pacientes, preparándolos para alcanzar en forma gradual mejoras funcionales e independencia para realizar actividades diarias y ocuparse del autocuidado.The objective of this study was to identify elements of the international classification of functioning, disability and health, applicable to quadriplegic men's home care, to reduce the dependence on their parents' help for activities of daily living and self-care. Data were collected from June 2004 to March 2005. Semi-structured interviews were performed with eight adults with high spinal cord lesions who were being cared for at home . Content analysis was performed based on the categories of meaning extrapolated and the following themes were discovered : family support: safety for the corporal functions of the disabled; supporting technology: inventiveness to promote quality care; fears, uncertain future and parents' loss: thresholds and human fragilities; and functional gains: objective response of body functions. In conclusion, family support, and especially the presence of parents, is fundamental to facing limitations and to reacting in the search for balance with the deficiency, disability, disadvantage and health of that population, preparing them to achieve gradual functional gain and independence for daily activities and self-care

A Case-base Approach to Workforces’ Satisfaction Assessment

It is well known that human resources play a valuable role in a sustainable organizational development. Indeed, this work will focus on the development of a decision support system to assess workers’ satisfaction based on factors related to human resources management practices. The framework is built on top of a Logic Programming approach to Knowledge Representation and Reasoning, complemented with a Case Based approach to computing. The proposed solution is unique in itself, once it caters for the explicit treatment of incomplete, unknown, or even self-contradictory information, either in terms of a qualitative or quantitative setting. Furthermore, clustering methods based on similarity analysis among cases were used to distinguish and aggregate collections of historical data or knowledge in order to reduce the search space, therefore enhancing the cases retrieval and the overall computational process