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Background The orally administered small molecule drug pan-Jak inhibitor tofacitinib (TFB) appears to be effective in the treatment of ulcerative colitis (UC), however, available real world studies are limited by the cohort size. In addition, TFB may also be efficacious in patients with acute severe colitis (ASUC) as a rescue therapy. We aimed to conduct an international cohort study, to investigate the efficacy and safety of TFB in patients with moderate to severe colitis and ASUC. Methods This was a retrospective, international multi-centre, cohort study including 23 tertiary referral centres. UC patients with at least 6 weeks of TFB treatment were included. Physicians categorized the indication as rescue therapy (RT) and chronic activity (CA). Baseline demographic and clinical data, clinical/endoscopic activity indexes, laboratory parameters (including CRP, faecal calprotectin, liver enzymes, lipids, iron homeostasis), adverse events, and hospitalization/colectomy rates were collected at w0, w2-6, w8-14, w22-30 and w48-56 intervals. Steroid-free remission, colectomy rates, primary non-response (PNR) and loss-of response (LOR) rates, and safety was studied. Results A total of 391 UC patients (mean age: 39.2±14.1 years, male/female ratio 208/183; mean follow-up period 33.7±18.1 weeks) were included. 107 patients (27.4%) received TFB as a rescue therapy. Most of the patients received it as a third line treatment (37.4%). Steroid-free remission (SFR) rates were 21.3% (RT: 25.0%, CA: 22.3%) at w14, and 40.1% (RT: 32.5%, CA: 42.2%) at w52. In total, baseline pMayo (OR: 0.856; p=0.007) was negatively associated with w12 SFR, while line of treatment (OR: 0.749; p=0.047) and age (OR: 1.022; p=0.038) influenced the w52 SFR in the CA group. The w12 colectomy rate was 5.1%, and no difference was observed between groups (RT: 8.5%; CA: 3.8%), however, w52 colectomy rate was higher in the RT group (19.2% compared to 5.9%; p Conclusion TFB is effective in both moderate to severe UC, and in patients with ASUC as a rescue therapy. TFB treatment resulted in high rates of SFR and mucosal healing in short- and long term even after anti-TNF and vedolizumab failure. Higher baseline disease activity and number of previous biological therapies negatively influenced efficacy. Serious adverse events were rare.

In this study, we explore how, and to what extent, home country effects on HR practice in hotel industry MNEs might diminish when host country institutional mediation is weak or uneven. This study ...

Solidarity behaviour (SB) among employees is important in building a sense of community in organizations, particularly within a crisis context where adverse working conditions prevail. However, we have limited knowledge concerning how SB develops. Using the lens of social exchange theory, this study examines how top-down communication and employee voice relate to horizontal (employee to emplCoyee) SB. We conducted two comprehensive studies during the Greek economic crisis and found that the relationship between top-down employee communication and horizontal SB is mediated by employee voice. The paper extends our existing knowledge in the fields of management and human resource management by advancing our understanding of horizontal SB, highlighting the role of top-down employee communication as an effective human resource practice and delineating the role of employee voice in fostering workplace camaraderie in small and medium-sized enterprises under crisis.

Background The use of biosimilar adalimumab (ADA) is effective and safe in inflammatory bowel disease (IBD), although clinical data on switching between ADA biosimilars is still rare. At the end of 2020, a non-medical switch to biosimilar ADA became mandatory in Hungary due to reimbursement policy changes of the National Health Insurance Fund of Hungary (NEAK). The aim of the present study was to evaluate short- and medium term clinical efficacy, drug sustainability and safety comparing non-medical switches from the originator to biosimilar ADA, and between ADA biosimilars. Methods 246 consecutive patients on maintenance ADA therapy (n=181 Crohn’s disease [CD] and n=65 ulcerative colitis [UC], male/female: 44%/56%, median disease duration: 10years(y) (IQR: 10–16)) were included from 4 IBD centers between September 2019 and December 2020. Data on clinical efficacy, using Crohn’s Disease Activity Index (CDAI) and partial Mayo Score (pMayo), laboratory parameters (C-reactive protein – CRP) and adverse events were collected at 8–12 weeks prior switch, at baseline, and 8–12 weeks, 20–24 weeks after switch. Drug sustainability following the switch was evaluated after a median of 41 weeks (IQR: 35–42) follow-up time. Results A total of 246 IBD patients (n=153 patients [115CD/38UC, median age: 38y(IQR: 27–45)] and n=93 patients [66CD/27UC, 32y(IQR: 26–40.5)] underwent a non-medical switch from the originator to a biosimilar, and biosimilar to biosimilar. Clinical disease activity based on CDAI and pMayo scores are presented in Figures 1 and 2. No significant difference was found in the proportion of patients in clinical remission at week 8–12 prior switch / switch / week 8–12 and week 20–24 in either patients switched from originator to biosimilar (86.8% / 88.2% / 86.0% / 85.0%; p=0.87 among groups) or biosimilar to biosimilar (72.0% / 77.4% / 84.9% / 77.6%; p=0.21). 89.2% and 83.1% of patients who were in clinical remission at switch/baseline sustained clinical remission up to week 20–24 in the first and second cohorts. Mean CRP levels were also unchanged during follow-up in both cohorts (p=0.71 and p=0.94). Drug survival was similar between originator to biosimilar and biosimilar to biosimilar switch cohorts, with a probability of 90.6% (SE: 2.4) and 85.8% (SE:3.7) to stay on drug after 40 weeks (log-rank: p=0.271). Figure 3. Two cases of skin reactions were registered as adverse events, one leading to treatment discontinuation. Conclusion Clinical remission was sustained following non-medical switch from originator or biosimilar adalimumab to a biosimilar in IBD patients. Medium-term drug sustainability following the switch was high, and comparable between patients with an originator to biosimilar and a biosimilar to biosimilar switch.

We explore two historically different, yet regionally connected, countries and the way that their weak institutional foundations and long-term economic turbulence have made them unable to overcome crises, leading to the institutionalisation of adverse working conditions. We focus on the outcomes of the systemic crisis in Greece and the transition crisis in Serbia using semi-structured interviews and focus groups with managers and employees in small and medium-sized enterprises (SMEs) in two time periods. We argue that, although the crisis has different origins in the two countries, in both it has led to adverse working conditions becoming institutionalised in organisations and, therefore, less likely to change. Our research explores the institutionalisation of adverse working conditions and offers an understanding of the lived reality of institutions in the way they are experienced by individuals, examining variations in the origins, pressures and outcomes of different types of crises on business practices from an individual perspective.

Background Anti-tumor necrosis factor alpha treatments are effective and safe as first line therapy, however, their long-term efficacy is limited by primary (PNR) and secondary non-response (LOR) resulting in treatment discontinuation in approximately, 40–50% of cases. Vedolizumab (VDZ) and ustekinumab (UST) therapy could be good alternative in patient with anti-TNF failure, however, no direct comparison has been made. This study aimed to assess treatment persistence and long-term efficacy of VDZ and UST as second- and third line biological therapies in Crohn’s disease (CD) patients refractory to anti-TNF therapy. Methods In this multicentre study, CD patients on VDZ or UST maintenance therapy were enrolled. We analysed data of medical history retrospectively in case of both agents. Demographic and clinical data at baseline and one-year were obtained. Clinical (CDAI Results 200 UST and, 96 VDZ-treated patients were included in the study. After exclusion of confounders, 162 UST and, 77 VDZ-treated patients were completed the follow-up. Mean age was, 41,1 (±16,5) and, 37,9 (±11,3) years at both agents at baseline. Steroid-free clinical and biochemical remission rates did not differ between VDZ and UST groups at one year (73% vs, 73% and, 67% vs., 51%). Kaplan-Meyer analysis revealed superiority of UST during follow up (86,5% vs., 62,9%, p Conclusion We confirmed that VDZ and UST are effective and safe alternatives to CD patients who have failed to anti-TNF therapy. UST has a superiority in drug persistence compared to VDZ. Second compared to third line of sequential therapy results in better outcome in drug persistence in case of both agents, however, head-to-head comparison of both agents are needed to verify our data.

In this chapter, we highlight some of the most influential approaches to understanding variations in HRM policy and practice, and draw out the implications of recent theoretical developments. Although the different comparative approaches vary in the relative attention they accord to the specific details of HRM practice, they all make broad predictions as to the impact of context on the relative attention accorded to a firm’s employees and whether they are treated primarily in instrumental cost‒benefit terms.

This paper analyzes the effects of remittances and foreign direct investments (FDI) on economic growth, gross fixed capital formation (GFCF), and inflation in Albania through a vector error correct...

PurposeThe purpose of this paper is to explore and theorize the process of managerial feedback in relation to change in small and medium enterprises (SMEs).Design/methodology/approachThis research embraces a qualitative methodology in the context of manufacturing SMEs. Drawing on 30 in-depth interviews, and observations conducted with various managers in six SMEs operating in three countries, it is argued that managers benefit more by using daily, ongoing, feedback as a trigger of change in their organizations.FindingsThe findings suggest that there is an overall view that managers appear to be reluctant to change existing processes using formalized feedback mechanisms, which runs counter-intuitive to the literature. In contrast, informal methods of feedback work better in enhancing organizational change. Moreover, another two features of feedback enhance this process, namely, benefits oriented and confidence oriented. As such, this study contributes to existing knowledge and practice by proposing a three-fold form of feedback through which managers expand their perspectives of feedback from feeding-back to feeding-forward thereby enhancing the opportunities of triggering change.Research limitations/implicationsFeedback should merely be considered as a dynamic and socially constructed managerial practice. A practice where actors not only exchange information and share knowledge, but also act, react and interact with each other as they constantly rethinking the change process. The proposed aspect of feedback emphasizes knowledge therapeutically and in combination with the dialogical discourse (practical illustration) that increases the odds for capturing change as a natural, rather than exceptional.Practical implicationsPractitioners, as such, may wish to consider the terminology used when it comes to studying change and its implementation in a crisis context. Using deformalized managerial feedback mechanisms to tackle a formal phenomenon like “change” could help avoid employees perceiving a negative connotation, causing resistance or confusion and feeling threatened. Therefore, the authors suggest that practitioners, during development initiatives on modernizing or altering organizational processes, consider replacing the term “change” as a formal concept.Originality/valueIt is an investigation from an exploratory perspective in studying and understanding the causes, factors and modalities that trigger managerial feedback toward organizational change in manufacturing SMEs.

Background Although efficacy and safety of ustekinumab (UST) in the treatment of inflammatory bowel disease have been demonstrated through randomized trials, data from real-life prospective cohorts are still of great interest. Our aim was to evaluate the clinical efficacy, drug sustainability, frequency of dose intensification, and results from therapeutic drug monitoring in UST treated Crohn’s disease (CD) patients using a prospective, nationwide, multicenter cohort from Hungary. Methods Patients were consecutively enrolled in this cohort between 2019 January and 2020 May from 5 academic centers and 5 county hospitals. Data from patient demographics, disease phenotype, treatment history (surgical history, prior and present medical therapies), clinical disease activity (using the Crohn’s Disease Activity Index (CDAI), Harvey Bradshaw Index (HBI)), biomarkers (C-reactive protein – CRP), and therapeutic drug monitoring were captured. Evaluations were performed at week8 (post-induction), w16-20, w32-36, and w52-56 follow-up visits. Results N=142 CD patients were included with a median follow-up time of 60 weeks (IQR:47.5–79.5w) [57.4% female; age 38.4±13.0 years]. Based on the Montreal classification, complicated disease behavior (B2orB3) was 48.2%, whereas ileocolonic disease location(L3) 55.7%. Perianal manifestation was present in 46.8% of the patients. Previous anti-TNF exposition was 97.2%, while previous vedolizumab failure was 25.5%. 66.2%/ 66.9% of the patients had moderate-to-sever clinical disease activity at baseline (CDAI>220/HBI>7). Clinical response and remission rates were 78.1% and 57.7% using CDAI, and 82.5% and 51.8% based on HBI scores after induction treatment (w8). One year clinical remission rates were 58% / 57.3% (CDAI/HBI) Composite clinical and biomarker remission (CDAI Conclusion Ustekinumab showed good drug sustainability and clinical efficacy in a population with severe disease phenotype and high rates of previous anti-TNF failure, however frequent and early dose intensification was required.

Purpose – The purpose of this paper is to study particular structural and organisational factors affecting the formality of human resource management (HRM) practices in small and medium-sized enterprises (SMEs) in South-Eastern European (SEE) post-communist countries, in particular Serbia, Romania, Bulgaria and the Former Yugoslav Republic of Macedonia in order to understand the antecedents of formalization in such settings. Design/methodology/approach – Adopting a quantitative approach, this study analyses data gathered through a survey of 168 managers of SMEs from throughout the region. Findings – The results show that HRM in SMEs in the SEE region can be understood through a threefold framework which includes: degree of internationalisation of SMEs, sector of SMEs and organisational size of SMEs. These three factors positively affect the level of HRM formalisation in SEE SMEs. These findings are further attributed to the particular political and economic context of the post-communist SEE region. Research limitations/implications – Although specific criteria were set for SME selection, the authors do not suggest that the study reflects a representative picture of the SEE region because the authors used a purposive sampling methodology. Practical implications – This paper provides useful insights into the factors which influence HRM in SMEs in a particular context. The findings can help business owners and managers understand how HRM can be applied in smaller organisations, particularly in post-communist SEE business contexts. Originality/value – HRM in SMEs in this region has hardly been studied at all despite their importance. Therefore, this exploratory research seeks to expand knowledge relating to the application of HRM in SMEs in SEE countries which have their business environments dominated by different dynamics in comparison to Western European ones.

This paper reviews the existing evidence base on the practice of people management in the context of post-state socialist countries of Asia. The focus is on Asian successor states of the Soviet Union and those under direct Soviet domination. In an undeniably diverse region, in all the countries under review there appears to be a disarticulation between liberal market reforms, economic progress, the ability to attract FDI and the development and persistence of a formal employment base. Extended informal networks of support often play an important role, inter alia, in informing recruitment, although clan based networks appear as quite impermeable to outsiders. Regulatory coverage is uneven but in many instances job protection is high. Drawing on the available research base, this paper consolidates and extends the existing state of knowledge on people management within the institutional contexts examined and draws out the implications for theorising and practice. The study highlights how reforms in one area may lead to counter-movements in others, shoring up existing modes of people management. Again, whilst clans and middle classes both have channels for political advocacy, there are fewer opportunities for workers and their representatives; this means that there is little impetus for legislation to promote better practice, workplace inclusivity and equity.

Solidarity behavior among employees is important to the effective functioning of organizations, particularly within the context of a crisis where adverse working conditions prevail. There is, howev...

The economic crisis has undermined the foundations of trust-based relationships, creating a trust gap between organizations and their stakeholders and threatening business practice. The purpose of ...

1. Introduction (David G. Collings and Geoffrey Wood) Section 1: The Context of HRM 2. HRM in Changing Organizational Contexts (Phil Johnson) 3. Strategic HRM: A Critical Review (Jaap Paauwe and Corine Boon) 4. HRM and Organizational Performance (Stephen Wood) 5. HRM: An Ethical Perspective (Mick Fryer) 6. Organizational Outsourcing and the Implications for HRM (Richard Haines) 7. The Socio-Cultural Aspects of Knowledge Management and the Links to HRM: A Critical Perspective (Donald Hislop) 8. HRM in Small and Medium-Sized Enterprises (SMEs) (Tony Dundon and Adrian Wilkinson) Section 2: The Practice of HRM 9. Recruitment and Selection (Rosalind Searle) 10. HR Planning: Institutions, Strategy, Tools and Techniques (Zsuzsa Kispal-Vitai and Geoffrey Wood) 11. Performance Management (Anthony McDonnell and Patrick Gunnigle) 12. Reward Management (Suzanne Richbell and Geoffrey Wood) 13. Human Resource Development (Irena Grugulis) 14. Industrial Relations and Human Resource Management (Gilton Klerck) Section 3: The International Context of HRM 15. Human Resource Management in Emerging Markets (Frank M. Horwitz and Kamel Mellahi) 16. Comparative HRM: The Debates and the Evidence (Chris Brewster and Wolfgang Mayrhofer) 17. International Human Resource Management (David G. Collings, Hugh Scullion and Deirdre Curran)

Meetings, convention, and exhibition tourism is a growing and relatively high value segment of the industry. As a result, it is often put forth as a strategic focus to enhance overall tourism revenues, particularly in the tourism off-season. Professional meeting planners play a major role in this sector, given their critical intermediary position and function which enable them to influence, and often determine, location choice. Therefore, knowing their views of various competitive destinations and the dimensions on which they base their evaluation can be important information for marketers engaged in destination branding and promotion. This study evaluates the perceptions of professional meeting planners concerning the relative importance of destination choice attributes and the images of selected convention destinations in Greece. Research instruments from earlier tourism studies are used and enhanced by scales from the related literature on product–country image effects on product choice, where place image is also important. The findings support those of earlier studies but also point to factors related to places and their people, which may be more effective differentiators for convention destinations than traditional tourism factors. Implications for research and practice and potentially interesting areas for future studies are discussed.

This study uses an interdisciplinary view informed by two related streams of research that have evolved independently of each other, “Tourism Destination Image” and “Product Country Image”, to research the place image construct. A theoretical model is applied to simultaneously measure image dimensions from both streams in order to better understand relationships between them. Australia, a country that has a strong “general country” and “tourism destination” image but a weaker “product” image, is used as the study target. We use comparative cross-national data from culturally similar (Canada) and dissimilar (South Korea) countries and a mixed method analysis culminating in a LISREL-tested, two-country, three-dimensional structural equation model.

Purpose The purpose of this paper is to understand how reverse resource exchanges and resource dependencies are managed in the service supply chain (SSC) of returnable transport packaging (RTP). Design/methodology/approach A single case study was conducted in the context of automotive logistics focusing on the RTP SSC. Data were collected through 16 interviews, primarily with managers of a logistics service provider (LSP) and document analysis of contractual agreements with key customers of the packaging service. Findings Resource dependencies among actors in the SSC result from the importance of the RTP for the customer’s production processes, the competition among users for RTP and the negative implications of the temporary unavailability of RTP for customers and the LSP (in terms of service performance). Amongst other things, the LSP is dependent on its customers and third-party users (e.g. the customer’s suppliers) for the timely return of package resources. The role of inter-firm integration and collaboration, formal contracts as well as customers’ power and influence over third-party RTP users are stressed as key mechanisms for managing LSP’s resource dependencies. Research limitations/implications A resource dependence theory (RDT) lens is used to analyse how reverse resource exchanges and associated resource dependencies in SSCs are managed, thus complementing the existing SSC literature emphasising the bi-directionality of resource flows. The study also extends the recent SSC literature stressing the role of contracting by empirically demonstrating how formal contracts can be mobilised to explicate resource dependencies and to specify, and regulate, reverse exchanges in the SSC. Practical implications The research suggests that logistics providers can effectively manage their resource dependencies and regulate reverse exchanges in the SSC by deploying contractual governance mechanisms and leveraging their customers’ influence over third-party RTP users. Originality/value The study is novel in its application of RDT, which enhances our understanding of the management of reverse exchanges and resource dependencies in SSCs.

As Brewster (1995) notes, organizational level HR practices are intimately bound up with context. Hence Sparrow and Hiltrop (1997) and Ignjatovic and Svetlik (2003) suggest that the distinctiveness of Human Resource Management (HRM) in Europe reflects institutional factors including legislation, informal regulation and the nature of state intervention, as well as associated cultural dynamics.

Fang Lee Cooke Professor of HRM and Chinese Studies Department of Management Monash University 26 Sir John Monash Drive Caulfield East Melbourne, VIC 3145 Australia Fang.cooke@monash.edu Geoffrey Wood Professor of HRM School of Management University of Sheffield 9 Mappin St Sheffield, S1 4DT United Kingdom g.t.wood@sheffield.ac.uk Alexandros G. Psychogios Senior Lecturer CITY College, An International Faculty of the University of Sheffield 3 Leontos Sofou St. Thessaloniki 546-26 Greece a.psychogios@city.academic.gr Leslie T. Szamosi Senior Lecturer CITY College, An International Faculty of the University of Sheffield 3 Leontos Sofou St. Thessaloniki 546-26 Greece szamsoi@city.academic.gr

This paper reports new empirical findings in relation to the impact of feedback on organizational routines. The analysis based on forty-two (42) in-depth semi- structured interviews with a cross-se...

PurposeThe purpose of this paper is to introduce the employment relations context in South Eastern Europe from a variety of capitalism perspectives. Particular attention is accorded to the uneven nature of change at both the levels of institutions and practice. This is followed by a review of the individual papers that make up this special issue.Design/methodology/approachThis paper is primarily a theoretical one, providing a review of the papers that make up this special issue and giving an overview of the foundation being provided.FindingsWhile the term “transitional” has often been deployed to describe employment relations across the region, the process has been an extremely protracted one. There is little doubt that the nature and form of employment relations in the countries encompassed in this review is still coalescing, with further ruptures likely as a result of the 2009 depression. At the same time, the papers in this special issue point to long‐standing continuities with employment.Research limitations/implicationsWhile the papers that make up this special issue may present the most recent research in the region, they also point to future areas for research. First, there is particularly little research that has been undertaken on peripheral areas of a generally peripheral region. Not only do we know very little about, say, Albanian employment relations, but we know little about employment relations in peripheral areas of large countries such as Turkey. Second, the 2009 depression is likely to accelerate trends to downsizing and insecure work, in the short term at least. Finally, there is a growing consensus that a sustainable economic recovery from the current crisis will depend, at least in part, on new social compromises both globally and regionally.Practical implicationsEmployment relations in the region are undergoing an extended transition. In the short term, the most likely trend will be towards a further weakening of the bargaining position of employees, and towards more insecure working. However, a sustained recovery is likely to see a reversal of this, with employers being more likely to be forced to contemplate new social compromises.Originality/valueThis study applies the comparative capitalism literature to the South Eastern European region context. It also introduces some of the most recent applied research in the region.

The countries of South-Eastern Europe have begun attracting the interest of foreign investors as stability has begun to return to the region. For the purpose of this study, valuable information was collected regarding the determination of foreign direct investment (FDI) in Albania during the transition period 1989–2004. Its purpose was to identify the entry modes and the kind and type of motives and entry barriers for inward FDI that foreign firms have considered entering the country. This research has identified a variety of internal business conditions/factors (obstacles– motives/incentives) that have been examined by foreign enterprises. The study is part of a broader research agenda in the region based on previous FDI theories and follows Dunning's theory regarding the possible motives and entry barriers for foreign direct investment. A total of 51 foreign companies participated in this research representing the bulk of current, major FDIs into the country, providing a strong foundation upon which to ...

The purpose of this paper is to address the generic research question of the effects of the implementation of Total Quality Management (TQM) on managers' lives. In particular, this study focuses on TQM effects on middle managers' (MMs) autonomy. Through a multi-modal research approach based on a combination of quantitative and qualitative methods, it is argued that the implementation of TQM programmes has a positive impact on MMs' autonomy. Nevertheless, it is related mostly to the ‘hard’ rather than the ‘soft’ side of TQM. The strong impact of TQM practices on MMs' responses to aspects related to their work, as compared to the small impact of the ‘soft’ side, implies a pragmatic view of TQM. Managers perceive a somewhat linear road to quality improvement through the use of ‘hard’ management practices and giving less importance to concepts, such as empowerment and employee involvement.

This is a preliminary report on the benefit of a weekly low glycemic load (GL) diet intervention designed to positively effect body weight (BW) and body composition by reducing satiety in overweight/obese (BMI=28.38±5.86 kg m −2 ) pre-pubertal children over a 12-week period. Thirteen otherwise healthy (11.46±1.94 years) children participated in the study. The low GL diet intervention included attending a weekly nutrition consultation, exchanging of at least 50% of the high glycemic index (GI) foods with low GI foods in the diet and portion control. Dietary changes were made based on weekly 4-day food-diaries over the 12-weeks. There were significant reductions in BW (68.08±22.03 vs. 65.64±22.12 kg), body mass index (BMI; 28.38±5.86 vs. 27.09±6.2 kg m −2 ), fat mass (26.02±12.8 vs. 23.64±12.8 kg) % body fat (36.82±6.1 vs. 33.81±7.4), and circumference measurements; waist (95.73±14.01 vs. 90.76±14.26 cm); hip circumference (97.23±13.37 vs. 93.34±18.80 cm); thigh circumference (59.08±7.9 vs. 56.80±8.1 cm). T...

PurposeThe purpose of this paper is to review the effect of a cluster approach on SMEs' competitiveness. The primary objective is to examine the use of a cluster approach among SMEs as a tool for meeting their challenges related to globalisation and trade liberalisation, as well as investigating its contributing factor in the process of increasing their competitiveness.Design/methodology/approachThe methodology used for this paper is a literature review of published materials. The literature analysis was performed based on research objectivity, coverage and authority.FindingsThere is strong evidence to suggest that a cluster policy brings additional positive effect to existing SME policy in industrialised economies, but such effects have not been extensively researched in developing (transition) countries, particularly from the point of view of the SMEs, which are the main actors in the cluster development process, in relation to whether their performance has been improved as a result of cluster effects.Originality/valueThe findings from this research will assist business managers in making more informed decisions regarding the adoption of a cluster approach and entering into cluster‐based relations, as well as assisting policy makers in designing more efficient cluster policies. The academic value will be added in the context of expanding knowledge in relation to the impact of clusters on economic development in transition countries and as such contribute in filling gaps within the existing body of knowledge.

PurposeThis paper seeks to explore the Greek National Business System (NBS) in terms of management practices, organizational culture and public administration. Moreover, the need for modernization is analyzed with focus on total quality management (TQM) as the major issue on this agenda.Design/methodology/approachThis study utilizes a critical literature review approach to draw together and conceptualize the modernization agenda of the Greek NBS.FindingsThis paper supports the idea that there is a need to put promising management practices into the context of the Greek national business system and to study not only the market situation, the industrial relations history and the HR practices used, but also how these practices are understood and used by managers and employees who work in different employment sectors.Practical implicationsThe findings of this study may have a broader impact as Greece attempts to redefine itself as a hub for South‐East Europe.Originality/valueSince most academic studies concerning the application of promising management strategies like TQM have been conducted in Anglo‐Saxon countries, there is a need to remove the blinkers and explore these management initiatives in the context of other than Anglo‐Saxon NBSs.

PurposeThe paper seeks to determine what tomorrow's employees (i.e. graduates) are seeking from SMEs in terms of organizational satisfaction and value characteristics.Design/methodology/approachA survey of 55 university students who identified SMEs as their best opportunity for their career goals is shown. The survey utilized tested measures of organizational satisfaction and values.FindingsThe paper finds that Generations X and Y are seeking equivalent values and satisfaction outcomes from SMEs. It is seeking very caring, environmentally concerned, and sensitive SMEs. Tangible and intangible benefits, empowerment and respect, workplace involvement, concern for employee welfare and supportive management are critical.Research limitations/implicationsThe paper shows that when researching one can differentiate between what graduates are looking for from their SMEs as opposed to organizations in general. Future research could analyze SME versus MNC or other organizational forms.Practical implicationsThe paper implies that in the recruiting process SMEs need to focus on various outcomes that graduates seek in order to attract and retain the best potential employees. There appears to be little need to tailor the workplace for Generations X versus Y.Originality/valueA series of outcome variables has been specifically identified for graduates who want to work in SMEs.

The focus of this paper is on developing an understanding, and benchmarking, human resource management (HRM) issues in small and medium enterprises (SMEs) in South‐Eastern Europe. The importance of SME's in helping transition‐based economies develop is critical, but at the same time the research indicates that the movement toward westernized business systems has a dramatic impact on the human resources within such businesses. Toward addressing this linkage, critical HRM issues related to work outcomes, measures of satisfaction, and managerial support were studied with a sample of nearly 300 employees from 21 SMEs in a country in South‐Eastern Europe (the Former Yugoslav Republic of Macedonia). The data suggest that SMEs are not currently giving their employees what they want from their job (e.g. career development, participation in decision making) and that women are treated differently than men creating an imbalance within the workforce. From these data recommendations are drawn for SMEs on how to move forward as transition unfolds.

Background Several groups have reported high levels of antibodies against 60 kDa heat shock proteins (hsp) associated with coronary heart disease. Methods and results Complement activating (CA) antihsp60 autoantibodies were measured by the AtheroRisk kit (CardioPath Ltd, Alloa, UK), in parallel with IgG antibodies to human hsp60 and mycobacterial hsp65 by ELISA in 32 healthy children (18 boys, 14 girls, 11·8 ± 4·0 years). At least one of the parents of these children had a history of myocardial infarction before 55 years of age (high family risk (HFR) group). The control group consisted of 63 healthy children (31 boys, 32 girls, 9·0 ± 3·6 years) without known family history of coronary heart disease (CHD), hypertension, and diabetes mellitus. Concentrations of CA antihsp60 antibodies were significantly (P = 0·021) higher in the HFR group than in the control group. Also in the HFR group, significantly (P = 0·004) lower high-density lipoprotein cholesterol (HDL-C)-cholesterol (measured enzymatically) and significantly (P = 0·020) higher low-density lipoprotein cholesterol (LDL-C)-cholesterol levels (calculated by the Friedewald formula) were observed when compared with the controls. The difference in the CA antihsp60 antibody levels between the HFR and control groups remained significant even after adjustments for age, smoking, HDL-cholesterol, LDL-cholesterol levels, and white blood cell count. Children with high (in the highest quartile) CA antihsp60 antibody levels compared with those with normal levels of these antibodies also had adjusted odds ratios (OR) of 9·80 (2·15–44·58, P = 0·003), indicating high family risk. No significant difference in the IgG antihsp antibody levels was observed. Conclusions These findings indicate that high levels of CA autoantibodies against hsp60 can be considered to be a novel family risk factor of CHD, independent of HDL- and LDL-cholesterol levels.

Discusses the use of the act frequency approach methodology to develop and validate a measure of organizational support of revolutionary change. A total of nine unique behaviors, describing three constructs, were viewed by employees as supportive of revolutionary change; and 12 unique behaviors, describing two constructs, were perceived as being non‐supportive of revolutionary change. The measures developed were found to have high internal reliability. The measures were also found to be highly correlated with relevant individual and organizational outcome measures. These results provide empirical support for the idea that how an organization supports revolutionary change can have an impact on both the organization and its employees and that contextual variable may not influence perceptions.

This exploratory research investigates product-country images (PCI) within the turbulent environment of the former Yugoslavia, and points to geographic proximity, level of development, overall political orientation, and cultural affinity as potential correlates of product-country images.

A series of 1H-1,4-benzodiazepine-2,5-diones, which have been found to inhibit photosystem II electron transport, were evaluated for their herbicidal activity. Many of the analogues tested exhibited moderate to good herbicidal activity both preemergence and postemergence. The structure-activity relationships were probed by substitution in both the benzene and diazepine ring. Among the variations investigated, it was found that maximal herbicidal activity was obtained by substitution at C-7 and C-9 in the aromatic portion and by bulky aliphatic substitution at N-4 while leaving N-1, C-6, and C-8 unsubstituted.

Benzodiazepinediones, exemplified by AC 341775, are a new class of herbicides with excellent herbicidal properties. Results from variousin vitroandin vivotests indicate that benzodiazepinediones inhibit photosynthesis by blocking the photosystem II (PSII) electron transport. These compounds do not control triazine-resistant plants; therefore, benzodiazepinediones and triazine herbicides most likely share a common binding site on the D1 protein in PSII. Benzodiazepinediones could be used as molecular probes to understand the structure of PSII.

Threonine dehydratase, the first enzyme in isoleucine biosynthesis, catalyzes deamination and dehydration of threonine to produce 2-ketobutyrate and ammonia. An antimetabolite, 2-(1-cyclohexen-3(R)-yl)-S-glycine (CHG), inhibits the plant enzyme. CHG inhibits the growth of Black Mexican Sweet corn (Zea mays) cells and of Arabidopsis thaliana plants. The herbicidal effects of CHG can be reversed by 2-ketobutyrate, other intermediates of isoleucine biosynthesis, and by isoleucine itself. These results suggest that the herbicidal effects observed with CHG are a consequence of inhibition of threonine dehydratase. The enzyme could be a potential target site for an herbicide screening program.

Adalimumab is a fully human monoclonal antibody targeting tumour necrosis factor with proven efficacy in the treatment of Crohn's disease (CD).To investigate the predictors of medium-term clinical efficacy and mucosal healing during adalimumab therapy, in patients with CD, in specialised centres approved for biological therapy in Hungary.Data capture of the 201 CD patients was standardised and prospective (male/female: 112/89, median age: 33.0 years, duration: 8 years). Previous infliximab therapy had been administered in 48% of patients, concomitant steroids in 41%, azathioprine in 69% and combined therapy in 27% of patients.Overall clinical response and remission rates at 24 weeks were 78% and 52%, respectively; at 52 weeks were 69% and 44%, respectively. Endoscopic improvement and healing were achieved in 43% and 24% of patients. In a logistic regression model, clinical efficacy and CRP at week 12, need for combined immunosuppression at induction, shorter disease duration and smoking were identified as independent predictors for 12-month clinical outcome, whereas CRP at week 12, clinical remission at week 24, inflammatory parameters and nonsmoking were associated to endoscopic improvement/healing. Intensification to weekly dosing was needed in 16% of patients. Parallel azathioprine therapy and clinical remission at week 12 were inversely associated with dose escalation.Clinical efficacy and normalised CRP at week 12 (early deep clinical remission) are associated with medium-term clinical efficacy and mucosal healing during adalimumab therapy, whereas need for combined immunosuppression at induction and smoking status are predictors for non-response. Parallel azathioprine therapy may decrease the probability for dose escalation.

The Objective of this study was to determine the frequency of care reactive atherosclerosis risk factors in children of parents with premature coronary heart disease observed before their 45 years of age for the promotion of the effectivity of the preventive work started in childhood and adolescent ages.Height and weight was measured. Body mass index (BMI) was calculated. Fat analysis was performed in children with overweight. Blood pressure was measured and both 24 hour monitoring and fundoscopy were performed in cases with a blood pressure higher than 90 centile values. Fasting blood sugar (BS) level was measured. Oral glucose tolerance test was made in cases with a fasting BS level higher than 5 mmol/l. Serum total cholesterol (TC), HDL-cholesterol (HDLC) and total triglyceride (TT) levels were measured and LDL-cholesterol (LDLC) level was calculated. The plasma thiobarbituric acid reactive system (TBARS) was investigated. Statistical analyses were performed by chi2 and Student t-probes. Data of 1140 offsprings and 457 referents without any high atherosclerotic risk family history were analyzed.BMI of 87 offsprings was higher than the 90 centile value. The fat percent of the body of these children was higher than 40. The blood pressure of 311 children and adolescents was higher than the 90 centile value. Fasting BS level was higher than 5 mmol/l in 47 cases 17 of them showed a pathologic oral glucose tolerance test. High serum TC level was observed in 67 cases, high serum TT level was found in 8 cases. 245 offsprings had a low serum HDLC level. The plasma TBARS level was high in 241 cases. Data of referents differed significantly from those of offsprings. Their serum TC, LDLC levels and plasma TBARS level were lower, serum HDLC level was higher than that of children and adolescents with high risk atherosclerotic family history.Risk factors of atherosclerosis are detectable in children and adolescents of high risk families. The measurement of these factors may help the efficacy of the preventive work.

The screening and special management of high risk patient, is possible strategy to reduce the high morbidity and mortality of stroke. In the II. district of Budapest we examined high vascular risk patients cooperating with general practitioners. We let the severity of risk with arithmetic of the cumulative risk index. Significant relation was found between of high cumulative risk index and 50% or higher carotis stenosis, as well as the cumulative risk index and low Se HDL level. Increased blood pressure level has been found in among the treated hypertonic patient. Reduction of high blood pressure was documented in the 6 month control examination. Finally there was very low level of smoking in the high vascular risk patient group.

Threonine dehydratase (TD; EC.4.2.1.16) is a key enzyme involved in the biosynthesis of isoleucine. Inhibition of TD by isoleucine regulates the flow of carbon to isoleucine. We have identified two different forms of TD in tomato (Lycopersicon esculentum) leaves. One form, present predominantly in younger leaves, is inhibited by isoleucine. The other form of TD, present primarily in older leaves, is insensitive to inhibition by isoleucine. Expression of the latter enzyme increases as the leaf ages and the highest enzyme activity is present in the old, chlorotic leaves. The specific activity of the enzyme present in older leaves is much higher than the one present in younger leaves. Both forms can use threonine and serine as substrates. Whereas TD from the older leaves had the same Km (0.25 mM) for both substrates, the enzyme from the young leaves preferred threonine (Km = 0.25 mM) over serine (Km = 1.7 mM). The molecular masses of TD from the young and the old leaves were 370,000 and 200,000 D, respectively. High levels of the isoleucine-insensitive form of threonine dehydratase in the older leaves suggests an important role of threonine dehydratase in nitrogen remobilization in senescing leaves.