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This article summarizes an investigation to determine which areas in the training of U.S. expatriate engineers and constructors are viewed by foreign engineers and construction personnel as inadequate, and to provide information on the areas that are affecting the competitiveness of U.S. firms in the global marketplace. This paper presents information generated by a study of working relationships of foreign and U.S. engineering and construction professionals. The main objective is to quantify evaluations performed by foreign nationals from engineering and construction firms from three East Asian countries, who worked on joint venture projects, or as consultants to U.S. firms, and to determine whether the training that U.S. engineering and construction professionals receive prior to overseas assignments is adequate to prepare them to work in foreign environments. This study also addresses the issue of whether the perceptions of foreign nationals differ by their occupation, by working relationship with U.S. expatriates, and by the position of the U.S. expatriates.

This paper summarizes research that was undertaken to investigate the role of privatization as it is viewed by members of the construction and engineering industries. Several aspects of privatization are covered, including privatization issues, a history of privatization, objectives of privatization, international issues in privatization, national competitiveness and future trends in privatization, interview summary and results, and a discussion on the segments of the infrastructure that are implementing privatization policies. The information provided is based on research related to privatization that included an exploration of existing literature related to privatization; extensive personal interviews with executives from owner organizations, contractors, construction managers, engineers, and government agencies throughout the United States; and information gathered from a symposium and workshops held in Scottsdale, Ariz. The research was sponsored by the Construction Industry Institute (CII). The CII Construction 2000 Task Force assisted with setting up the industrial and government interviews. The research included participation by personnel from both CII member companies, nonCII companies, professional societies, academic institutions, and government agencies.

During the past two decades the global marketplace has changed, and U.S. engineering and construction firms have had to deal with many new competitors. This has created a need for understanding global dynamics and competition, developing new and innovative competitive strategies, and taking actions to maintain worldclass leadership. To investigate global competitiveness and provide clarification, the driving forces that help shape competition in the global engineering and construction marketplace were studied. This paper summarizes research on the factors that affect the competitiveness of engineering and construction firms that was sponsored by the Construction Industry Institute (CII) Construction 2000 Task Force. Historical and current trends were analyzed to help identify the driving forces that may shape the future of the engineering and construction industries. This research specifically addressed the following aspects as they relate to the future of competitiveness: the shaping of corporate capabilities; financing options; management, organization, and structure; work force characteristics; and technological issues.

During the 1980s U.S. engineering and construction firms have not been securing as many overseas contracts as they had been acquiring in the past. Ideas have developed during the past decade on what types of programs would help U.S. engineering and construction firms regain their dominant position in the world marketplace. This paper presents information pertaining to the lack of competitiveness U.S. firms are experiencing in overseas markets and discusses how crosscultural training of engineering professionals, before sending them on foreign assignments, relates to a firm's competitiveness. This paper discusses the merits and importance of crosscultural training programs for U.S. engineering professionals and the areas that need to be addressed by engineering managers.

OBJECTIVE: To identify potential predictors of undergraduate students who struggle during their medical training. Design Case-control study. Cases were students who had experienced academic or personal difficulties that affected their progression on the course ("strugglers"). Controls were selected at random from the corresponding year cohorts, using a ratio of four controls for each struggler. Setting University of Nottingham Medical School. Participants Students who entered the course over five consecutive years. MAIN OUTCOME MEASURES: Likelihood ratios for independent risk factors for struggling on the course RESULTS: 10-15% of each year's student intake were identified as strugglers. Significant independent predictors of students being in this category were negative comments in the academic reference (likelihood ratio 2.25, 95% confidence intervals 1.44 to 3.50), lower mean examination grade at A level (2.19, 1.37 to 3.51), and the late offer of a place (1.98, 1.19 to 3.30). Male sex was a less significant risk factor (1.70, 1.09 to 2.65) as was a lower grade at GCSE science (2.13, 1.12 to 4.05). In UK students whose ethnicity was known, not being white was a significant predictor of struggling (2.77, 1.52 to 5.05) but the presence of negative comments was not. Age at entry to the course and the possession of a previous degree were not predictive. CONCLUSIONS: Our results support retention of existing selection practices relating to academic achievement and critical review of students' references. We plan to undertake further investigation of the reasons why some students, including men, those with late offers and those from ethnic minority backgrounds, may do less well on the Nottingham course.

An interview with Katthy Kettler, an Inuit throatsinger from Canada, is presented. When asked about how she started throatsinging, she said she started throatsinging with her sister when she was about three or four years old. Her mother did not teach them and they learned throatsinging from friends.

This article summarizes an investigation to determine which areas in the training of U.S. expatriate engineers and constructors are viewed by foreign engineers and construction personnel as inadequate, and to provide information on the areas that are affecting the competitiveness of U.S. firms in the global marketplace. This paper presents information generated by a study of working relationships of foreign and U.S. engineering and construction professionals. The main objective is to quantify evaluations performed by foreign nationals from engineering and construction firms from three East Asian countries, who worked on joint venture projects, or as consultants to U.S. firms, and to determine whether the training that U.S. engineering and construction professionals receive prior to overseas assignments is adequate to prepare them to work in foreign environments. This study also addresses the issue of whether the perceptions of foreign nationals differ by their occupation, by working relationship with U.S. expatriates, and by the position of the U.S. expatriates.

During the 1980s U.S. engineering and construction firms have not been securing as many overseas contracts as they had been acquiring in the past. Ideas have developed during the past decade on what types of programs would help U.S. engineering and construction firms regain their dominant position in the world marketplace. This paper presents information pertaining to the lack of competitiveness U.S. firms are experiencing in overseas markets and discusses how cross‐cultural training of engineering professionals, before sending them on foreign assignments, relates to a firm's competitiveness. This paper discusses the merits and importance of cross‐cultural training programs for U.S. engineering professionals and the areas that need to be addressed by engineering managers.

This paper summarizes research that was undertaken to investigate the role of privatization as it is viewed by members of the construction and engineering industries. Several aspects of privatization are covered, including privatization issues, a history of privatization, objectives of privatization, international issues in privatization, national competitiveness and future trends in privatization, interview summary and results, and a discussion on the segments of the infrastructure that are implementing privatization policies. The information provided is based on research related to privatization that included an exploration of existing literature related to privatization; extensive personal interviews with executives from owner organizations, contractors, construction managers, engineers, and government agencies throughout the United States; and information gathered from a symposium and workshops held in Scottsdale, Ariz. The research was sponsored by the Construction Industry Institute (CII). The CII Construction 2000 Task Force assisted with setting up the industrial and government interviews. The research included participation by personnel from both CII member companies, non‐CII companies, professional societies, academic institutions, and government agencies.

During the past two decades the global marketplace has changed, and U.S. engineering and construction firms have had to deal with many new competitors. This has created a need for understanding global dynamics and competition, developing new and innovative competitive strategies, and taking actions to maintain world‐class leadership. To investigate global competitiveness and provide clarification, the driving forces that help shape competition in the global engineering and construction marketplace were studied. This paper summarizes research on the factors that affect the competitiveness of engineering and construction firms that was sponsored by the Construction Industry Institute (CII) Construction 2000 Task Force. Historical and current trends were analyzed to help identify the driving forces that may shape the future of the engineering and construction industries. This research specifically addressed the following aspects as they relate to the future of competitiveness: the shaping of corporate capabilities; financing options; management, organization, and structure; work force characteristics; and technological issues.

OBJECTIVE: To determine whether there are risk factors in a doctor’s time at medical school that are associated with subsequent professional misconduct. Design Matched case-control study. Setting Records from medical schools and the General Medical Council (GMC). Participants 59 doctors who had graduated from any one of eight medical schools in the United Kingdom in 1958-97 and had a proved finding of serious professional misconduct in GMC proceedings in 1999-2004 (cases); 236 controls (four for each case) were selected by systematic sampling from matching graduation cohorts. Case-control status was revealed by the GMC after completion of data entry. MAIN OUTCOME MEASURE: Odds ratios for being a "case," with multivariable conditional logistic regression of potential risk factors including pre-admission characteristics and progress during the course. These data were obtained from anonymised copies of the students’ progress files held by their original medical schools. RESULTS: Univariate conditional logistic regression analysis found that cases were more likely to be men, to be of lower estimated social class, and to have had academic difficulties during their medical course, especially in the early years. Multivariable analysis showed that male sex (odds ratio 9.80, 95% confidence interval 2.43 to 39.44, P=0.001), lower social class (4.28, 1.52 to 12.09, P=0.006), and failure of early or preclinical examinations (5.47, 2.17 to 13.79, P<0.001) were independently associated with being a case. CONCLUSIONS: This small study suggests that male sex, a lower socioeconomic background, and early academic difficulties at medical school could be risk factors for subsequent professional misconduct. The findings are preliminary and should be interpreted with caution. Most doctors with risk factors will not come before the GMC’s disciplinary panels.

OBJECTIVE:s To determine whether the UK Clinical Aptitude Test (UKCAT) adds value to the selection process for school leaver applicants to medical and dental school, and in particular whether UKCAT can reduce the socioeconomic bias known to affect A levels. Design Cohort study Setting Applicants to 23 UK medical and dental schools in 2006. Participants 9884 applicants who took the UKCAT in the UK and who achieved at least three passes at A level in their school leaving examinations (53% of all applicants). MAIN OUTCOME MEASURES: Independent predictors of obtaining at least AAB at A level and UKCAT scores at or above the 30th centile for the cohort, for the subsections and the entire test. RESULTS: Independent predictors of obtaining at least AAB at A level were white ethnicity (odds ratio 1.58, 95% confidence interval 1.41 to 1.77), professional or managerial background (1.39, 1.22 to 1.59), and independent or grammar schooling (2.26, 2.02 to 2.52) (all P<0.001). Independent predictors of achieving UKCAT scores at or above the 30th centile for the whole test were male sex (odd ratio 1.48, 1.32 to 1.66), white ethnicity (2.17, 1.94 to 2.43), professional or managerial background (1.34, 1.17 to 1.54), and independent or grammar schooling (1.91, 1.70 to 2.14) (all P<0.001). One major limitation of the study was that socioeconomic status was not volunteered by approximately 30% of the applicants. Those who withheld socioeconomic status data were significantly different from those who provided that information, which may have caused bias in the analysis. CONCLUSIONS: UKCAT was introduced with a high expectation of increasing the diversity and fairness in selection for UK medical and dental schools. This study of a major subgroup of applicants in the first year of operation suggests that it has an inherent favourable bias to men and students from a higher socioeconomic class or independent or grammar schools. However, it does provide a reasonable proxy for A levels in the selection process.

<$O_ST_ABS>AUTHORS SYNOPSIS<$C_ST_ABS>The technique of lower body negative pressure has been adapted for use with the anaesthetized rabbit. Exposure of the pelvis and hind limbs to suction causes a fall in cardiac output, which is linearly related to suction pressure, and also hypotension, which elicits vasopressor and cardiac reflex responses. The percentage of total blood volume pooled by this procedure in the rabbit appears to be of the same order as in man. The preparation appears to provide a satisfactory animal model for the study of the effects of blood pooling on cardiovascular haemodynamics.

<$O_ST_ABS>AUTHORS SYNOPSIS<$C_ST_ABS>Forearm blood flow was measured by venous occlusion plethysmography in normotensive subjects of various ages and in patients with treated or untreated hypertension. Brief exposure of one forearm to pressures below atmospheric was used to study the transient local changes in arterial inflow which occurred with changes in transmural pressure induced in this way. The increase in initial arterial inflow with such an exposure to suction in a group of young normotensive women was only slightly reduced in two groups of older women. However, a group of subjects with untreated hypertension showed a significantly smaller initial inflow during the suction. There was some indication that adequate treatment of high blood pressure might reverse this effect.