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We identify nine categories of clauses in Host Government Instruments (HGIs, ie licences, concessions, production sharing contracts (PSCs), etc.) that potentially affect the Fair Market Value of petroleum exploration and production rights, in addition to the clauses quantifying the fiscal terms. The categories comprise state participation, performance bonds and penalties for failing to perform minimum work programmes, local content, decommissioning, natural gas terms, stabilization, assignment and change of control, renewals and extensions and governance issues. For each category, we review and summarize global practice in the top 50 oil-producing countries. We quantify our analysis using statistics from a data set of 55 representative HGIs, including contemporary alternative types for five countries. The age of each HGI used varies, guided by the history of oil production in each country. Texts are available for 53 HGIs and published summaries are available for the other two. The discussion provides a checklist for use in negotiating new HGIs or performing due diligence for transactions involving existing HGIs. Our choice of representative HGIs and our characterizations of some clauses are both in part subjective. Nevertheless, we suggest the statistics provide a useful guide to trends in global practice.

Objectives To use a pharmacist-managed short-acting beta agonist (SABA) service (1) to determine the patient's rationale for SABA refill requests, (2) to assess adherence to current controller therapy and current level of disease control, and (3) to characterize the pharmacist's recommendations made in response to a patient's SABA refill request. Setting An academic-based general pediatric clinic. Practice Description SABA overuse is a marker of increased morbidity and mortality in children with asthma. This article describes a pharmacist-managed SABA refill telephone service. Practice Innovation The pediatric ambulatory care pharmacy team assessed and authorized (or denied) all SABA refill requests, provided education, and facilitated appropriate follow-up using a telephone service. Interventions Upon receiving a patient-requested SABA refill, the pharmacist identified the reason for the SABA request, assessed asthma control, and determined adherence to daily controllers or spacer use, if applicable. Education was also provided. Data obtained were used to determine SABA refill approval. Evaluation Primary reasons for SABA refill request were for (1) current symptom management and (2) no refills remaining in the absence of symptoms. Forty-two (50%) SABA refill requests were eligible for refill per the clinic algorithm, yet 70% actually received a refill after assessment by the pharmacist. Asthma control was assessed as 26% well controlled, 38% not well controlled, and 36% very poorly controlled. Forty-eight percent of patients prescribed daily controller medications were deemed adherent. Spacers were used in 43 of 76 (56%) patients using metered dose inhalers. Education was provided to 82% of caregivers. Pharmacists facilitated asthma follow-up visits in 41 of 84 (49%) patients contacted, and 61% of those appointments were kept. Conclusions Pharmacist management of a SABA refill telephone service provides an additional means for delivery of asthma education, facilitates follow-up asthma care, helps to identify patients at risk for increased morbidity and mortality due to the overuse of SABAs, and provides another mechanism for medication refills.

Magnetic Resonance Imaging (MRI) and Ultrasound (US) imaging are both routinely used in the assessment of rotator cuff pathology. Factors influencing the frequency of use of the respective technologies include access to equipment, provider preference, and cost. The purpose of our study was to compare the accuracy of in clinic ultrasound with that of MRI in diagnosing pathology of the rotator cuff in a large sample size with limited exclusionary criteria. 500 patient profiles assessed by each imaging type, MRI and ultrasound, who then proceeded to arthroscopic surgery were gathered and analyzed for interobserver agreement between the image interpretation and the surgical observations. While ultrasound displayed slightly higher sensitivity and specificity ratings in the diagnosis of full tears (0.90 and 0.92 vs. 0.86 and 0.91), MRI had a higher sensitivity (0.87 vs. 0.80) and Ultrasound had a higher specificity (0.86 vs. 0.76) for general cuff damage. The Weighted Kappa Values for both MRI (0.699) and Ultrasound (0.668) both indicate a substantial strength of agreement between the image interpretation and surgical findings. While there was a balanced distribution of errors observed in the MRI category, the most common error made in the Ultrasound assessment was a false negative assessment of a partial tear. The data indicate that in a clinical setting Ultrasound imaging is a cost-effective and accurate alternative to MRI and can be a valuable addition to the diagnostic assessment of rotator cuff injury and pathology.

Background: Flu-like symptoms (FLSs) and injection-site reactions (ISRs) have been reported with interferon beta treatments for multiple sclerosis (MS). We sought to obtain consensus on the characteristics/management of FLSs/ISRs in patients with relapsing-remitting MS based on experiences from the randomized, placebo-controlled ADVANCE study of peginterferon beta-1a.Methods: ADVANCE investigators with a predefined number of enrolled patients were eligible to participate in a consensus-generating exercise using a modified Delphi method. An independent steering committee oversaw the development of two sequential Delphi questionnaires. An average rating (AR) of 2.7 or more was defined as consensus a priori.Results: Thirty and 29 investigators (ie, responders) completed questionnaires 1 and 2, respectively, representing 374 patients from ADVANCE. Responders reported that the incidence/duration of FLSs/ISRs in their typical patient generally declined after 3 months of treatment. Responders reached consensus that FLSs typically last up to 24 hours (AR = 3.17) and have mild/moderate effects on activities of daily living (AR = 3.34). Patients should initiate acetaminophen/nonsteroidal anti-inflammatory drug treatment on a scheduled basis (AR = 3.31) and change the timing of injection (AR = 3.28) to manage FLSs. Injection-site rotation/cooling and drug administration at room temperature (all AR ≥ 3.10) were recommended for managing ISRs. Patient education on FLSs/ISRs was advocated before treatment initiation.Conclusions: Delphi responders agreed on the management strategies for FLSs/ISRs and agreed that patient education is critical to set treatment expectations and promote adherence.

To date, most export performance studies have focused on providing business practitioners with set ‘prescriptions’ for export success. However, this approach has resulted in overwhelmingly inconsistent findings, so there is a need for alternative approaches. One alternative is through contingency theory, which posits that each firm's export performance is dependent on the context in which the firm operates. This study therefore uses contingency theory to establish if there is a relationship between export performance and the level of ‘fit’ between a firm's strategic orientation and its context. This study focused on exporting firms in the apparel industry in New Zealand. Firms were categorised as to whether they were entrepreneurial or conservative in their strategic orientation. The results showed that entrepreneurial firms could operate successfully in hostile or benign external environments, by using either organic or mechanistic export channel structures. But when entrepreneurial and conservative firms have a strategic orientation and channel structure that matches their external environment then there are no real performance advantages for entrepreneurial firms.

In their article, “Examining the Potential Exploitation of UNOS Policies,” Zink, Wertlieb, Catalano, and Marwin (2005) appeal to familiar intuitions of utility and equity to argue against the curre...