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Business Traveller Middle East gives Fredrik Blomqvist, general manager of Six Senses Southern Dunes, The Red Sea, five minutes to pitch his property to prospective guests 'A slice of paradise [...]

THE C.D. HOWE INSTITUTE'S COMMITMENT TO QUALITY, INDEPENDENCE AND NONPARTISANSHIP The C.D. Howe Institute's reputation for quality, integrity and nonpartisanship is its chief asset. Its books, Commentaries and E-Briefs undergo [...]

Canadian drug prices are higher than in many peer countries. What's the remedy? Rather than regulation, we propose relying on the new Canadian Drug Agency to achieve lower prices through [...]

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In this study, we investigate the aggregation dynamics of colloidal silica by generating simulated structures and comparing them to experimental data gathered through scanning transmission electron microscopy (STEM). More specifically, diffusion-limited cluster aggregation and reaction-limited cluster aggregation models with different functions for the probability of particles sticking upon contact were used. Aside from using a constant sticking probability, the sticking probability was allowed to depend on the masses of the colliding clusters and on the number of particles close to the collision between clusters. The different models of the sticking probability were evaluated based on the goodness-of-fit of spatial summary statistics. Furthermore, the models were compared to the experimental data by calculating the structures’ fractal dimension and mass transport properties from simulations of flow and diffusion. The sticking probability, depending on the interaction with multiple particles close to the collision site, led to structures most similar to the STEM data.

Rather than abandon its experiments with an enrolment-based approach--using capitation--for paying primary care physicians, Ontario should continue and extend its efforts. THE C.D. HOWE INSTITUTE'S COMMITMENT TO QUALITY, INDEPENDENCE AND [...]

Drug prices and R&D spending vary greatly in developed countries, with the US ranking highest on both counts. How can Canada avoid being a 'free rider' on the US while [...]

ABSTRACTThe Swedish sports movement has gained an increasingly profound role in addressing social issues. One such issue is migrant youths’ social inclusion in underserved areas, and the underlying assumption is that sports clubs fulfill an important function here. However, retaining migrant youths in organized sports in these areas is difficult, and sports clubs often struggle with the resources to satisfy social policies. This paper explored the practices of 12 experienced Swedish sports clubs to illuminate the strategies deployed to recruit and retain migrant youths in underserved areas. Sports clubs were conceptualized as local development-initiatives according to Rothman’s community work classification, and the results were analysed with Bronfenbrenner’s Person-Process-Context-Time framework. The results show that sports clubs are run by compassionate and locally embedded individuals, but that the representatives’ different forms of capital and sensitivity differentiate their success. Three processes are stressed as essential. Clubs need to establish robust relationships with migrant youths’ parents. Secondly, since clubs are contingent on driven, but strained, individuals, it is imperative to recruit and utilize (migrant) youth trainers. Finally, sports clubs must work in tandem with important institutions, such as the school. In summary, sports clubs must adopt creative strategies, and have resilience, time, and support. These findings indicate that enabling migrant youths’ inclusion into sports requires holistic solutions.

Lack of access to even urgent dental care is a problem for the poor and other population groups in Canada. Their numbers are due to swell as babyboomers retire and [...]

International surveys reveal a troubling amount of inefficiency in terms of how well public funds are spent on Canadian healthcare relative to our peers. More effective healthcare delivery could be [...]

This article examines the establishment of the legal framework that led to the destruction and elimination of Jewish communities in Croatia and Romania during World War II. It argues that both regimes, supported by domestic fascist ideologies, evolving antisemitism, and inspired by the Nazi regime, promulgated anti-Jewish legal norms to present and establish new political, ideological, and social values and categories to their citizens. This article employs the theoretical framework of norms developed by Paul Morrow, whereby norms are seen as practical prescriptions, permissions or prohibitions. We argue that these destructive norms served as guidelines for individuals within the fascist new worldview and new reality. As such, these norms received state authorisation and implementation, serving as the ‘legal’ basis for the institutional destruction of unwanted citizens. This gave local and state actors a ‘legal’ pretext for the persecution and murder of Jews, who were stripped of their rights, assets, properties and right to life. The article concludes that the two legal frameworks enacted the process by which Jewish communities in Croatia and Romania faced a devastation of unseen proportions, which testifies to the importance and impact of legal norms on individuals, be they victims, bystanders or perpetrators.

THE INSTITUTE'S COMMITMENT TO QUALITY C.D. Howe Institute publications undergo rigorous external review by academics and independent experts drawn from the public and private sectors. The Institute's peer review process [...]

Anthracycline–taxane chemotherapy for early-stage breast cancer substantially improves survival compared with no chemotherapy. However, concerns about short-term and long-term side-effects of anthracyclines have led to increased use of taxane chemotherapy without anthracycline, which could compromise efficacy. We aimed to better characterise the benefits and risks of including anthracycline, and the comparative benefits of different anthracycline–taxane regimens.

As lifespans lengthen, more elderly Canadians will need long-term care (LTC). With the boomer generations retiring, there will already be great pressure on younger taxpayers, so now is not the [...]

Developing new healthcare technology is a risky business for drug firms, medical researchers and makers of diagnostic equipment. Health Technology Assessment provides decisionmakers with a tool to ensure the benefits [...]

Making buildings more energy efficient is an important part of achieving the European Union’s energy and climate goals, which several directives, policies, and measures has addressed over the years. This paper aims to study changes over a 10-year period in perception on barriers to and drivers for energy efficiency in the Swedish building sector and identifying success factors. The data collection consists of surveys conducted in 2010 and 2020 among organizations that mainly build, own, and manage multi-dwelling buildings. Besides the overall result, special focus is given to changes depending on type of ownership, size of organization, and organizational hierarchy.

While most hospital-based specialist doctors are paid for procedures by provincial insurance plans, most hospital funding comes through a separate pipe, in the form of lump-sum amounts not linked to [...]

Policy reforms in long-term care will require methods to contain costs, to fairly divide these costs between care recipients and taxpayers, and to get more value for money in a [...]

Primary care doctors today act more as patient managers within the health system--they diagnose, prescribe and refer, but deliver less direct services than in the past. This role fits better [...]

Canada would benefit form a serious look at European countries' efforts to align incentives with their health systems to better performance THE STUDY IN BRIEF Modern health systems, like Canada's, [...]

BackgroundTraditional prognostic factors for survival and treatment response of patients with breast cancer do not fully account for observed survival variation. We used available genotype data from a previously conducted twostage, breast cancer susceptibility genome-wide association study (ie, Studies of Epidemiology and Risk factors in Cancer Heredity [SEARCH]) to investigate associations between variation in germline DNA and overall survival. Methods We evaluated possible associations between overall survival after a breast cancer diagnosis and 10621 gerreline single-nucleotide polymorphisms (SNPs) from up to 3761 patients with invasive breast cancer (including 647 deaths and 26978 person-years at risk) that were genotyped previously in the SEARCH study with highdensity oligonucleotide microarrays (ie, hypothesis-generating set). Associations with all-cause mortality were assessed for each SNP by use of Cox regression analysis, generating a per rare allele hazard ratio (HR). To validate putative associations, we used patient genotype information that had been obtained with 5' nuclease assay or mass spectrometry and overall survival information for up to 14096 patients with invasive breast cancer (including 2303 deaths and 70019 person-years at risk) from 15 international case-control studies (ie, validation set). Fixed-effects meta-analysis was used to generate an overall effect estimate in the validation dataset and in combined SEARCH and validation datasets. All statistical tests were two-sided. Results In the hypothesis-generating dataset, SNP rs4778137 (C>G) of the OCA2 gone at 15q13.1 was statistically significantly associated with overall survival among patients with estrogen receptor-negative tumors, with the rare G allele being associated with increased overall survival (HR of death per rare allele carried = 0.56, 95% confidence interval [CI] = 0.41 to 0.75, P = 9.2 x [10.sup.-5]). This association was also observed in the validation dataset (HR of death per rare allele carried = 0.88, 95% CI = 0.78 to 0.99, P = .03) and in the combined dataset (HR of death per rare allele carried = 0.82, 95% CI = 0.73 to 0.92, P= 5 x [10.sup.4]). Conclusion The rare G allele of the OCA2 polymorphism, rs4778137, may be associated with improved overall survival among patients with estrogen receptor-negative breast cancer. DOI: 10.1093/jnci/djq057

Purpose: This retrospective, practice-based study investigates behaviour management problems (BMPs) in dental care among Finnish children with operated congenital heart disease (CHD). Methods: All the heart-operated children born between the years 1997 and 1999 were identified in the national ProCardio database (n= 570). Primary dental care records were requested from this population and were eventually received from 211 patients. Information on gender, diagnosis, number of heart operations and perioperative care were collected from the ProCardio database, and the CHDs were categorised as shunting/stenotic/complex/other defects. Data on BMP/dental fear, oral conscious sedation, dental general anaesthesia (DGA) and past and present caries indices at 6, 12 and 15 years (d/D, dmft/DMFT) were assessed. Results: Notes on behaviour management problems or dental fear were found in 19% of the study population. BMPs in dental care were more frequent among boys. Children with re-operations, longer post-operative intensive care stay and hospitalisation, and complications had not more BMP than others. Those children diagnosed with syndromes had more BMP often than the rest. Past and present caries experience were significantly associated with BMP, need of oral conscious sedation and DGA. Oral conscious sedation, nitrogen oxide sedation and dental general anaesthesia were used in 17/211, 2/221 and 24/211 CHD patients, respectively. Conclusion: Dental caries remains a main factor associated with BMP in the CHD population. Need for oral conscious sedation and DGA were rather common. To maintain a good oral health and to avoid development of BMP, CHD children benefit from focus in health promotion and preventive care.

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.respol.2008.04.015 Byline: Mona Weck (a), Kirsimarja Blomqvist (b) Keywords: Inter-organizational relationships; Inventor; Knowledge; Patent; Telecommunications Abstract: This paper examines the role of various inter-organizational relationships in patent development, and how these relationships contribute to patent competitiveness. It takes the perspective of individual inventors and describes how they utilize external knowledge in the development of patents. Based on a case study of a European telecom operator, we found interaction with R&D consortia, suppliers and customers to support inventors in the development of new ideas for patents and in solving related problems. In terms of patent competitiveness, buyer-seller relationships were more valuable for an operator than R&D consortia relationships, as they reduced the market and technology uncertainty related to the patent. Author Affiliation: (a) Helsinki University of Technology, Department of Industrial Engineering and Management, PL 5500, 02015 TKK, Finland (b) Professor of Knowledge Management, Lappeenranta University of Technology, School of Business & Technology Business Research Center, PO BOX 20, 53851 LAPPEENRANTA, Finland Article History: Received 18 June 2006; Revised 11 January 2008; Accepted 21 April 2008

The shortcomings of the health care system have been front and center in the American debate over social policy for decades. Canadians are also preoccupied with health care policy, but [...]

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.indmarman.2005.09.003 Byline: Risto Seppanen (a), Kirsimarja Blomqvist (a), Sanna Sundqvist (b) Keywords: Inter-organizational trust; Conceptualization; Operationalization; Measurement; Review Abstract: This study reviews empirical research on inter-organizational trust. Since the early 1990s, researchers on inter-organizational relationships have consistently argued that mutual trust is an essential factor of relationship quality and performance. The purpose of the study was to evaluate the advancements and setbacks in current empirical research in terms of measuring inter-organizational trust. This paper analyzes the theoretical approach, the conceptualization and operationalization, and the measurement issues covered in studies on inter-organizational trust conducted from 1990 to 2003. Although trust has emerged as an important factor in inter-organizational relationships, there are still major conceptual and methodological challenges to be met in studying this complex concept. The results show major inconsistencies in conceptualization, operationalization, and measurement of trust. The paper concludes with suggestions for further empirical research. Author Affiliation: (a) Lappeenranta University of Technology, Department of Business Administration and Technology Business Research Center, P.O. Box 20, FI-53851 Lappeenranta, Finland (b) Department of Business Administration and Technology Business Research Center, University of Technology, P.O. Box 20, FI-53851 Lappeenranta, Finland Article History: Received 6 September 2004; Revised 22 April 2005; Accepted 13 September 2005

Sulfatide (3'-sulfo-β-galactosyl ceramide) is a glycosphingolipid present in mammalians in various fatty acid isoforms of which the saturated 16 carbon-atom length (C16:0) is more abundant in pancreatic islets than in neural tissue, where long-chain sulfatide isoforms dominate. We previously reported that sulfatide isolated from pig brain inhibits glucose-induced insulin secretion by activation of ATP-sensitive [K.sup.+] channels ([K.sub.ATP] channels). Here, we show that C16:0 sulfatide is the active isoform. It inhibits glucose-estimulated insulin secretion by reducing the sensitivity of the [K.sub.ATP] channels to ATP. (The half-maximal inhibitory concentration is 10.3 and 36.7 µmol/l in the absence and presence of C16:0 sulfatide, respectively.) C16:0 sulfatide increased whole-cell [K.sub.ATP] currents at intermediate glucose levels and reduced the ability of glucose to induce membrane depolarization, reduced electrical activity, and increased the cytoplasmic free [Ca.sup.2+] concentration. Recordings of cell capacitance revealed that C16:0 sulfatide increased [Ca.sup.2+]-induced exocytosis by 215%. This correlated with a stimulation of insulin secretion by C16:0 sulfatide in intact rat islets exposed to diazoxide and high [K.sup.+]. C24:0 sulfatide or the sulfatide precursor, β-galactosyl ceramide, did not affect any of the measured parameters. C16:0 sulfatide did not modulate glucagon secretion from intact rat islets. In βTC3 cells, sulfatide was expressed (mean [± SD] 0.30 ± 0.04 pmol/µg protein), and C16:0 sulfatide was found to be the dominant isoform. No expression of sulfatide was detected in αTC1-9 cells. We conclude that a major mechanism by which the predominant sulfatide isoform in β-cells, C16:0 sulfatide, inhibits glucose-induced insulin secretion is by reducing the [K.sub.ATP] channel sensitivity to the ATP block., Sulfatide is a glycosphingolipid present in mammalian organisms (1). The fatty acids of the ceramide moiety vary in chain length and saturation and may also be hydroxylated (2). In neural [...]

Determining treatment status is an important issue in natural-history research about alcohol problems. When examining pathways to change, it is essential to be able to identify those who recovered with [...], Aim: To assess what it means when respondents say they have received treatment on population surveys. Method: Former heavy drinkers recruited through a random digit dialing telephone survey were asked about the type, time, and amount of treatment they had received. Results: When respondents indicated that they had received treatment, it appeared that they had a specific treatment in mind, that they completed the treatment program, and that, for the majority, treatment occurred at roughly the same time as their successful change from heavy drinking. The congruence between age of change and age of treatment use appeared greater among respondents with abstinent versus reduced-drinking recoveries. Key words: Natural history, alcohol, representative survey, treatment use.

Elevated circulating fatty acid concentration is a hallmark of insulin resistance and is at least in part attributed to the action of adipose tissue-derived tumor necrosis factor-[alpha] (TNF-[alpha]) on lipolysis. Cell death-inducing DFFA (DNA fragmentation factor-[alpha])-like effector A (CIDEA) belongs to a family of proapoptotic proteins that has five known members in humans and mice. The action of CIDEA is unknown, but CIDEA-null mice are resistant to obesity and diabetes. We investigated CIDEA in adipose tissue of obese and lean humans and mice. The mRNA was expressed in white human fat cells and in brown mouse adipocytes. The adipose mRNA expression of CIDEA in mice was not influenced by obesity. However, CIDEA expression was decreased twofold in obese humans and normalized after weight reduction. Low adipose CIDEA expression was associated with several features of the metabolic syndrome. Human adipocyte depletion of CIDEA by RNA interference stimulated lipolysis and increased TNF-[alpha] secretion by a posttranscriptional effect. Conversely, TNF-[alpha] treatment decreased adipocyte CIDEA expression via the mitogen-activated protein kinase c-Jun N[H.sub.2]-terminal kinase. We propose an important and human-specific role for CIDEA in lipolysis regulation and metabolic complications of obesity, which is at least in part mediated by cross-talk between CIDEA and TNF-[alpha]., Obesity is an excess of body fat that develops from a combination of genetic and environmental factors, leading to a disturbed balance between energy intake and energy expenditure (1). The [...]

In today's knowledge-based global competitive climate, both large and small firms attempt to leverage external knowledge by collaborating with companies with complementary knowledge and resources. Academics and practitioners agree that in the global network era knowledge has become a key resource for continuous innovation and competitiveness. The issues of trust, social capital and the management of intellectual property have also attracted more attention in terms of knowledge creation. However, trust, intellectual property and contracts are seldom discussed simultaneously. This paper focuses on the roles of trust and contracts in asymmetric R&D collaboration. We begin by reviewing the state-of-the-art literature on these roles in interfirm collaboration, and continue by examining the potential for balancing trust and contracting in a case study in which a small firm collaborates with a large, global machinery and equipment supplier. We conclude that an understanding of the roles and dynamics of contracts and trust is critical for R&D collaboration. Contracts as such cannot guarantee successful collaboration, but the contracting process may be used purposefully to increase mutual understanding and learning, and to build up trust. We also offer some managerial recommendations on how to balance trust and contracting in asymmetric R&D collaboration. Keywords: Trust; Contract; Asymmetry; R&D; Collaboration

The results of postmarketing surveys of patients with rheumatoid arthritis treated with etanercept between 1999 and 2003 in Sweden are examined.

The role of human resources (HR) management and marketing departments of an organization in promoting the brand name is discussed. The importance of both the departments working in collaboration with each other to achieve goals in HR and marketing management of the organization is also discussed.

The networked research and development management approach emphasizes external and internal collaboration networks as key success factors for firms operating in a dynamic environment. The Finnish information technology services company Sonera Corp. is used as an example.

Natural-history research has encompassed a wide range of topics. The seminal studies explored factors associated with change in untreated samples of recovered drinkers (reviewed in: Blomqvist, 1996; Blomqvist, 1999). Such [...], This study explored the factors associated with reduction from heavy drinking among three groups: current abstinent, moderate, and reduced drinkers. A random-digit-dialing telephone survey was conducted of 3,006 respondents in Ontario, Canada. Of these, 470 respondents (46% female) met criteria as former heavy drinkers (99 abstinent; 237 moderate; 134 reduced but not moderate drinkers). Quantitative and qualitative questions were used to explore current and past drinking, use of treatment, and reasons for change. Qualitative items were tape-recorded and transcribed. Respondents in the abstinent group had more severe problems prior to resolution as compared with those in the moderate group. Reduced drinkers displayed a prior alcohol severity at a level between these two other groups. The most common reasons for change in all groups were new responsibilities, maturation, and health concerns. This study serves as a useful adjunct to other natural-history research, exploring the reasons for change in a representative sample of former heavy drinkers. KEY WORDS: Natural history, alcohol, representative survey.

Background: Ankylosing spondylitis (AS) is a chronic inflammatory joint disease which may lead to extraarticular complications. The disease associated cancer risk has been poorly explored. Recently, tumour necrosis factor α [...]

This paper analyzes dyadic partnership formation between asymmetric buyers and specialized suppliers. In the first part of the paper different economics of organization-based approaches are evaluated. Their basic implications concerning the rise of partnerships are derived. In the second part a dynamized transaction cost and benefit model is introduced to analyze the most critical elements of a typical partnership decision. The final part is based on insights from practice and in-depth interviews among 12 specialized suppliers and their four large incumbent partners in the Information and Telecommunications Industry. Keywords: Transaction costs and benefits; Theory of the firm; Partnership; Supply management; Trust

This article compares Finnish and Swedish attitudes towards aged automobile drivers' crash risk. Topics include patient-doctor relations, drug use, and health screening.

ObjectivesPhysical inactivity and sedentary behaviour are associated with higher breast cancer risk in observational studies, but ascribing causality is difficult. Mendelian randomisation (MR) assesses causality by simulating randomised trial groups using genotype. We assessed whether lifelong physical activity or sedentary time, assessed using genotype, may be causally associated with breast cancer risk overall, pre/post-menopause, and by case-groups defined by tumour characteristics.MethodsWe performed two-sample inverse-variance-weighted MR using individual-level Breast Cancer Association Consortium case-control data from 130 957 European-ancestry women (69 838 invasive cases), and published UK Biobank data (n=91 105–377 234). Genetic instruments were single nucleotide polymorphisms (SNPs) associated in UK Biobank with wrist-worn accelerometer-measured overall physical activity (nsnps=5) or sedentary time (nsnps=6), or accelerometer-measured (nsnps=1) or self-reported (nsnps=5) vigorous physical activity.ResultsGreater genetically-predicted overall activity was associated with lower breast cancer overall risk (OR=0.59; 95% confidence interval (CI) 0.42 to 0.83 per-standard deviation (SD;~8 milligravities acceleration)) and for most case-groups. Genetically-predicted vigorous activity was associated with lower risk of pre/perimenopausal breast cancer (OR=0.62; 95% CI 0.45 to 0.87,≥3 vs. 0 self-reported days/week), with consistent estimates for most case-groups. Greater genetically-predicted sedentary time was associated with higher hormone-receptor-negative tumour risk (OR=1.77; 95% CI 1.07 to 2.92 per-SD (~7% time spent sedentary)), with elevated estimates for most case-groups. Results were robust to sensitivity analyses examining pleiotropy (including weighted-median-MR, MR-Egger).ConclusionOur study provides strong evidence that greater overall physical activity, greater vigorous activity, and lower sedentary time are likely to reduce breast cancer risk. More widespread adoption of active lifestyles may reduce the burden from the most common cancer in women.

In an international comparison, alcohol treatment in Sweden stands out as rather singular with regard to its total per capita expenditure, its location within the municipal social services system, and [...], The paper describes and analyzes the development of prevention and care of alcohol problems in Sweden, from the emergence of the temperance issue as a public concern at the turn of the 19th century to the economic and ideological changes that seem to challenge the 'Swedish model' of dealing with alcohol problems 100 years later. By applying an analytical model that transcends the common 'badness-illness' dualism and provides a bridge between a social-political and a clinically oriented perspective, an attempt is made to relate the historical succession of dominant approaches to alcohol problems to the changing roles of the welfare state. The paper concludes by discussing the future prospects in Sweden of the type of community approach to handling alcohol problems that was first launched at the beginning of the century in Ivan Bratt's pioneer work but still awaits a major breakthrough in practice.

AbstractThis study investigates how the transition to remote work during the coronavirus disease 2019 pandemic is experienced by employees. We investigate to what extent perceived work stressors relate to psychological strain through perceptions of social support, work–life conflict, and adjustment to remote work. The findings expound the mechanisms underlying psychological strain in the context of sudden organizational change. Specifically, this study shows that both challenge stressors and hindrance stressors have negative impact on adjustment to remote work, whereas hindrance stressors are more strongly negatively related to social support. The study further demonstrates that there is hardly any buffering impact of job control, work structuring, and communication technology use on the implications of these work stressors. These findings contribute to our theoretical understanding and provide actionable implications for organizational policies in facilitating employees' adaptation to remote work.

Background. Results of surgical treatment of cutaneous malignant melanoma (CMM) have been highly variable, probably because of patient selection. Therefore, a study of representative patients with this disease was performed. Methods. In a defined area of Sweden, 581 patients were analyzed. Clinical records and histopathologic findings were reviewed. The minimum follow-up time was 7 years. Prognostic factors were evaluated by the Cox proportional hazards model. Results. Evaluation of sex distribution, age, and anatomic site of the primary tumor showed that the patients were representative of all Swedish patients with CMM of the head and neck. The mean patient age at diagnosis was 64 years for both sexes. Fifty-three percent of the patients were women. Female patients had more tumors of the face than did male patients, whereas male patients were overrepresented among patients with tumors of the auricle-external ear canal and scalp-neck area. Localization to the face was observed in 68%, which is an overrepresentation of three to four times when skin surface is taken into consideration. Twenty-four percent of the patients had lentigo maligna melanoma. Only 33% of the patients had superficial spreading melanoma. In univariate analyses, sex, anatomic site of the primary tumor, histogenetic type, Clark level of invasion, and tumor thickness had prognostic power. In a multivariate analysis, tumor thickness, anatomic site of the primary tumor, and sex of the patient were independent prognostic factors. Conclusions. In representative patients with CMM of the head and neck, tumor thickness, anatomic site of the primary tumor, and sex of the patients were independent prognostic factors. Cancer 1993; 71:751-8.

THE INSTITUTE'S COMMITMENT TO QUALITY C.D. Howe Institute publications undergo rigorous external review by academics and independent experts drawn from the public and private sectors. The Institute's peer review process [...]