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Zhang Li,1 Tiara Aninditha,2 Brahim Griene,3 Javier Francis,4 Paulo Renato,5 Alain Serrie,6 Indira Umareddy,7 Sebastien Boisseau,8 Yacine Hadjiat8 1Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, China; 2Mangunkusumo Hospital, Jakarta, Indonesia; 3Pierre and Marie Curie Centre, Algerie, Algeria; 4St. Luke’s Medical Center, Quezon City, Philippines; 5Anesthesiology Service and Clinical Oncological IOC Group Pain, Brazil; 6Hospital Lariboisiere, Paris, France; 7Kantar Health, Singapore, Singapore; 8Mundipharma Pte Ltd., Singapore, Singapore Abstract: Cancer pain is one of the most common, feared, debilitating, and often undertreated symptoms among cancer patients. It needs attention since it has a significant impact on the quality of life (QoL) of the patients. Also, since cancer has emerged as a major health problem in developing countries, there is a need to strengthen preventive strategies for effective cancer pain management and provide comfort to cancer patients. Nonetheless, various barriers limit developing countries toward optimal cancer pain management. To bridge the gap between adequate pain management and burden of cancer pain in developing countries, a comprehensive understanding of the limitations faced and the prevalence of cancer pain should be addressed.The aim of this literature review is to provide a deeper understanding on the factors associated with cancer pain as well as barriers toward optimal cancer pain management in developing countries. Some of the barriers addressed were administrative, judicial, economic, and professional barriers. Also, estimates on the prevalence of cancer pain and detrimental effects of pain on the QoL of cancer patients have been addressed. In summary, pain, which is one of the most debilitating symptoms of cancer, remains uncontrolled and undertreated in developing countries. It has a profound impact on the patient’s QoL and can have physical, psychological, and social consequences; therefore, it needs to be managed urgently and appropriately. Most importantly, optimal treatment of cancer pain should be highlighted as a priority in developing countries and concerted efforts should be made to eliminate different barriers discussed in this review for effective and humane care. Keywords: cancer, pain, health care, economic, quality of life, developing countries

Yacine Hadjiat,1 Alain Serrie,2 Richard Treves,3 Berangere Chomier,1 Laurent Geranton,4 Stephane Billon5 1Medical Department, Mundipharma SAS, Paris, 2Pain and Palliative Care Department, CHU Lariboisiere, Paris, 3Rheumatology Department, CHU Limoges, Limoges, 4Public Affairs Department, Mundipharma, 5Department of Health Economics, University Paris Dauphine, Paris, France Purpose: This study aimed to estimate the prevalence of pain among French adults and assess the impact of pain on health-related quality of life (HRQoL), activity impairment, and health care resource use (HRU).Patients and methods: Respondents from the 2015 France National Health and Wellness Survey (N=19,173) were categorized by self-reported pain (experienced pain in the past 12 months vs no pain) and compared on HRQoL (36-Item Short Form Health Survey version 2: Mental Component Summary, Physical Component Summary, and Short Form-6 Dimensions health utilities), activity impairment (Work Productivity and Activity Impairment questionnaire), employment status, and HRU (health care provider visits, emergency room visits, and hospitalizations). Bivariate analyses examined differences between pain groups stratified by age, sex, income, and Charlson comorbidity index (CCI) scores.Results: Pain prevalence was 20.2% (n=4007). Mean Physical Component Summary decrements with pain ranged from 3.4 to 8.1 points among those aged

Cross-cultural skills are a major criterion for success in the global business environment. For American managers in multinational organizations, this means learning to manage cultural difference at three levels: self, interpersonal, and organizational. Since literature indicates that training programs based on cross-cultural and learning theories are more effective, this paper examines a training program that Serrie first reported in a 1992 issue of JTIB. The five related and synergistic activities discussed in the paper give participants experience in dealing with and solving real-world problems in cross-cultural management at all three levels. The process is reassessed in terms of recent theory, and to confirm the efficacy of this approach, a pretest-posttest experiment was conducted with a treatment group and control groups. Results show that the treatment group was the only one to show a significant (at p less than 0.05) increase in intercultural expertise--a measure of cross-cultural skill. Limitations and implications are discussed. (Contains 7 tables.)

Cross-cultural skills are a major criterion for success in the global business environment. For students pursuing careers in international business, this means learning to manage cultural difference on three levels: self, interpersonal, and organizational. This paper describes five related and synergistic exercises that give college students experience in dealing with and solving real-world problems in cross-cultural management on all three levels. Anecdotal evidence suggests the exercises are a highly successful method for developing the cross-cultural skills of students. To confirm the efficacy of this process, a pre-test post-test experiment was conducted with a treatment-group and control-groups. Results show that the treatment group was the only one to show a significant (at p less than 0.05) increase in intercultural sensitivity--a measure of cross-cultural skill. (Contains 1 table.)