Challenges of network interaction in managing sustainable development projects in developing countries: case of an international consulting company

Purpose This study aims to explore the challenges and complexities of interaction in international stakeholder networks within the context of projects focused on the implementation of sustainable development goals (SDGs). In particular, it examines the challenges faced by stakeholders in a network from a developed country during interaction in the context of a developing country. Design/methodology/approach Using a qualitative approach, this study analyses interview data collected from the key managers of an international consulting company in charge of a water supply and sanitation project in Nepal. The primary data is triangulated with secondary data, such as project reports and related academic articles. Findings This study illustrates how interaction in international stakeholder networks affects and is interrelated with SDGs, as well as how aiming to achieve one specific goal can stimulate the implementation of other sustainable goals. Further, this research shows how project managers from a developed country had to adapt to the specifics of the developing country context and how their sustainability project influenced the well-being of local communities by improving environmental and social sustainability. Research limitations/implications The research suggests that challenges in stakeholder interaction may arise because of differences in process management methods used by the international stakeholders involved in the project and country-context specifics, such as corruption, imperfect national regulations, cultural specifics, effects of climate change, etc. Originality/value The paper contributes to the literature on international multi-stakeholder interaction between actors from developed and developing countries. Furthermore, it adds to the literature on stakeholder networking by highlighting the importance of engaging in a dialogue with local communities during the conceptualisation stages of both sustainability and SDG implementation because of diverging worldviews and practices.

The impact of digital transformation on the economic security of Ukraine

The article is devoted to the study of the impact of digital transformations on the economic security of Ukraine. The article examines the essence of the digital economy, defines the features of the functioning of the economy in the context of digitalization. Based on the indicators of the international consulting company McKinsey and the World Bank, the authors analyzed the impact of digitalization on the economy, highlighted the main advantages and disadvantages of functioning in the digital economy, systematized the problems of economic security in the digital economy and highlighted systemic, structural and industry problems, as well as businesses and individuals. The main issues of economic security include the problems of "digital inequality", the lack of their own element base, changes in the labour market, industrial espionage, manipulation of personal data and others. The authors also identified a tool for monitoring the development of a networked digital society – the Network Readiness Index. The practical contribution was the development of a mechanism to smooth the impact of digital transformation on the economic security of Ukraine.

Infrastructure Shaming and Consequences for Management of Urban WEF Security Nexus in China and India

Worldwide, consumption of resources such as water, energy and food continues to rise exponentially despite environmental and climatic change related challenges. Centralized sewerage systems continue to be implemented worldwide despite being very water and energy intensive, and although this is not always the best option for regions facing water scarcity. Deploying the Water-Energy-Food (WEF) Nexus approach, particularly through alternative technology options that can support decentralized water reclamation with integrated resource recovery, can enable resource conservation and more effective management of the WEF security Nexus for local governments with limited capacities. However, a certain pattern of “business as usual” infrastructure development and investment linked to infrastructure shaming continuously reinforces implementation of centralized sewerage systems, thereby hampering deployment of alternative technology options. This study uses two typical case study towns, Shaxi in China and Leh in India, to describe this pattern. The study finds that alternative technology approaches were in place in both towns. Yet after international consulting companies got involved, centralized sewerage systems were implemented despite limited water availability and large segments of the population not having flush toilets. This study discusses management of the WEF security Nexus implications thereof in the context of cities worldwide and a systemic socio-technical transition to a circular economy.

The Various Scenarios of Stock Exchange Development in Uzbekistan: in the Context of COVID-19

With increasing volatility in stock markets, the investment expectations of various market participants remain unclear. This study examines the short-term market development scenarios provided by international consulting companies. Inertial and optimistic scenarios of the national stock market are also presented as a result of the author's research. Several factors influencing the market index were also studied using a regression model, and as a result, the impact of factors such as market turnover, number of transactions, inflation rate on market capitalization was presented.

Functional Status and Therapy for Older Patients with Diffuse Large B-Cell Lymphoma (DLBCL): A Population-Based Study

Background: DLBCL is a potentially curable lymphoma, yet up to 25% of older Medicare beneficiaries with DLBCL do not receive any therapy (Hamlin et al, Oncologist, 2014). Older adults with DLBCL may have vulnerabilities and require care from home health agencies. Functional impairment may compromise DLBCL therapy, but data are lacking about treatment and outcomes of home health services (HHS) recipients. There is ongoing need for accurate and efficient tools to assess function and guide therapy in geriatric patients with DLBCL, as inaccurate assessment may lead to under- and over-treatment with suboptimal outcomes. Medicare beneficiaries who receive HHS periodically undergo functional assessments using the standardized Outcome and Assessment Information Set (OASIS). OASIS scores have been recently linked to SEER-Medicare data, and can offer insights into the role of functional status in DLBCL treatment. We examined the association of functional status, measured in OASIS, and treatments and outcomes in DLBCL. Methods: From SEER-Medicare, we selected beneficiaries diagnosed with DLBCL in 2011-2015, and identified HHS recipients who had OASIS assessments within 3 months before diagnosis or treatment. OASIS instrument measures functional status as a linear score ranging from 0 to 40; higher scores represent worse functioning. We classified the scores as mild (OASIS 0-9), moderate (10-16), and severe (17-40) impairment by tertiles of the population distribution. We examined the following outcomes: receipt of therapy (including standard [RCHOP-like] and non-standard [bendamustine, rituximab monotherapy, etc.] regimens), and among treated patients: mortality, ED visit, hospitalization, and ICU admission within 30 days from first chemotherapy. We used logistic models, reporting odds ratios (OR) with 95% confidence intervals (CI). We additionally compared overall survival (OS) between groups receiving standard and non-standard regimens in each functional category using adjusted hazard ratios (aHR) derived from Cox models. All models were adjusted for age, sex, race, DLBCL stage, and comorbidity index. Results: Among 8,914 beneficiaries with DLBCL, 1,317 had OASIS assessments. Their characteristics included: median age 80 years, 46% men, 83% White, 53% stage 3/4 DLBCL. Median OASIS score was 13 (interquartile range, 7-18). Chemotherapy was administered to 63% of HHS recipients, compared with 75% of other beneficiaries (OR, 0.66; 95%CI, 0.57-0.76). HHS recipients were significantly more likely to experience 30-day ED visit, hospitalization, ICU admission, and mortality after chemotherapy (OR 1.24-1.52), and have shorter OS compared with other beneficiaries with DLBCL (7 vs 40 months, aHR, 1.55, 95% CI, 1.44-1.67; Fig. A). Severe functional impairment was associated with lower odds of receiving any therapy, as well as higher rates of acute mortality, hospitalization, and ICU admission. Patients with moderate impairment had an increased risk of 30-day ED visit and ICU admission after chemotherapy (Table). OS was worse with severe functional impairment, even after adjusting for other clinical factors (aHR, 1.64, 95% CI, 1.24-2.17; Fig. B). Functional status was not significantly associated with the use of standard or non-standard regimen, and OS was better with RCHOP-like therapy in all functional groups (aHR, 0.50-0.56, P for interaction: 0.85; Fig. C). Conclusions: In this novel population-based study using OASIS assessments to examine function as a predictor of cancer therapy, functional impairment was an independent predictor of treatment and outcomes in geriatric patients with DLBCL. We observed that a substantial proportion of patients on HHS did not receive any therapy, and worse survival in those who received attenuated regimens, independent of their functioning. Our results highlight the need for novel, less toxic strategies in this population, supporting research on emerging chemotherapy-free approaches. Clinicians should consider a dedicated functional assessment (such as a comprehensive geriatric assessment) to optimize treatment selection in DLBCL. OASIS assessments for HHS recipients are easily available to clinicians and could be incorporated into pre-chemotherapy evaluation to improve patient selection for intensive therapies, potentially avoiding under-treatment with attenuated regimens Disclosures Panagiotou: International Consulting Associates, Inc: Other: personal fees from International Consulting Associates, Inc. outside the scope of the submitted work. Olszewski:TG Therapeutics: Research Funding; Adaptive Biotechnologies: Research Funding; Spectrum Pharmaceuticals: Research Funding; Genentech, Inc.: Research Funding.

Comparison of End-of-Life Care Quality Outcomes and Indicators of Palliative Needs between Medicare Beneficiaries with Solid and Hematologic Malignancies

Background: Patients (pts) with hematologic malignancies (HM) are thought to have suboptimal hospice utilization and receive more aggressive end of life (EOL) care than those with solid tumors (ST), including high rates of EOL chemotherapy use, ICU admissions, and inpatient deaths (Egan, Blood Adv, 2020). Barriers to equitable EOL care outcomes for pts with HM may include difficulty identifying the "terminal phase" of disease, the potential for curative stem cell transplant that lingers even after failure of multiple therapies (Odejide, JCO, 2016), and specificity of palliative needs in HM, like transfusion dependence (Leblanc, Blood, 2018), that are not met by the current hospice benefit. However, direct comparison of EOL outcomes between HM and ST in a population-based setting has not been conducted. Our objective was to compare EOL care quality measures, hospice utilization, and indicators of palliative needs between Medicare beneficiaries with HM and ST. Methods: From the linked SEER Medicare database (covering ~30% of the US population), we identified beneficiaries with common ST (breast, prostate, lung, and colorectal cancer) and HM (leukemia, myeloma, lymphoma, myelodysplastic syndrome [MDS], and myeloproliferative neoplasms [MPN]) who died between 2011-2015, and whose cause of death was cancer. We ascertained claims-based indicators of EOL care quality: hospice use before death, duration of hospice length of stay (LOS), death in an acute care hospital, receipt of (oral or parenteral) chemotherapy in the last 14 days of life (DOL), ICU admission in the last 30 DOL, Medicare spending, and inpatient days in the last 30 DOL. We also explored indicators of palliative needs: opioid use, transfusion use, and number of physician office visits in the last 30 DOL. We compared binary outcomes in multivariable robust Poisson (reporting adjusted relative risk, adj RR), counts in negative binomial, and costs in log-gamma models, reporting estimates with 95% confidence intervals (CI). Models were adjusted for age, sex, race, marital status, Medicaid co-insurance (indicator of low socio-economic status), prevalent poverty, comorbidity index, performance status indicator, calendar year, and survival from diagnosis. Results: Characteristics of the 18,185 patients with HM and 59,352 with ST are listed in Table. HM pts were, on average, older, and more likely to be male and married. HM pts were less likely than ST pts to enroll on hospice (58% vs 67%, adjusted RR 0.85,CI 0.84-0.86), had a shorter hospice LOS (median 9 vs 14 days, adj means ratio RR 0.81, CI 0.79-0.83), and were more likely to spend < 3 days on hospice (adj RR 1.29, CI 1.24-1.35) (see Figure). HM pts were more likely to die in an acute care setting (32% vs 23%, adj RR 1.4, CI 1.36-1.44), have an ICU admission in the last 30 DOL (39% vs 30%, adj RR 1.32, CI 1.29-1.35), and receive chemotherapy in the last 14 DOL (12% vs 5%, adj RR 2.73, CI 2.55-2.93). Median Medicare spending in the last 30 DOL was higher in HM than in ST (17.8k vs 11.9k, adj means ratio 1.52, CI 1.49-1.56), as was the median number of inpatient days (4 vs 2, adj means ratio 1.55, CI 1.52-1.59). The results were consistent when examined by specific subtypes of HM and ST. Pts with HM were less likely to use opioids at the EOL (adj RR 0.81, 95% CI, 0.79-0.84), but had more transfusions (adj RR 4.34, 95% CI, 4.11-4.58) and more physician office visits (adj RR 1.11, 95% CI, 1.09-1.14). Furthermore, trends in EOL care quality indicators differed between HM and ST. While the use of hospice services increased for both populations, the hospice LOS has steadily lengthened over time in ST (from median 10 days in 2011 to 14 days in 2015, P<.001), but it did not change significantly in HM (P=.077). Discussion: To our knowledge, this is the first population-based study demonstrating that, adjusting for socio-demographic characteristics and baseline health status, pts with HM have inferior EOL care quality outcomes than those with ST. These disparities are consistent across all established EOL care quality outcomes and across all histologies, supporting the notion of a fundamental difference between EOL care in HM and ST. Furthermore, our data challenge the assumption that HM pts do not have significant palliative care needs; rather, their needs may differ from those of ST patients, and may be less easily met by the current hospice benefit (as other literature suggests). Novel care models are needed to improve EOL care for pts with HM. Disclosures Panagiotou: International Consulting Associates, Inc: Other: personal fees from International Consulting Associates, Inc. outside the scope of the submitted work. LeBlanc:AstraZeneca: Research Funding; Agios, AbbVie, and Bristol Myers Squibb/Celgene: Speakers Bureau; UpToDate: Patents & Royalties; American Cancer Society, BMS, Duke University, NINR/NIH, Jazz Pharmaceuticals, Seattle Genetics: Research Funding; AbbVie, Agios, Amgen, AstraZeneca, CareVive, BMS/Celgene, Daiichi-Sankyo, Flatiron, Helsinn, Heron, Otsuka, Medtronic, Pfizer, Seattle Genetics, Welvie: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees. Olszewski:Adaptive Biotechnologies: Research Funding; Spectrum Pharmaceuticals: Research Funding; Genentech, Inc.: Research Funding; TG Therapeutics: Research Funding.

ESPORTS TOURNAMENTS AS A FORM OF STRATEGIC PROMOTION OF PRODUCTS AND SERVICES

The article is dedicated to eSports as a new and promising sector of the world economy that provides businesses with effective integration scenarios. This contributes to the development of cooperation of private and public investors with eSports holdings, as well as to the involvement of the generation Z audience in promising consumption of interested companies’ products. The article examines the current trends in the development of the eSports market using analytical studies of international consulting companies. The official data characterizing the state of the eSports market in Russia are also represented. The article provides information about the model of monetization of eSports and its perspective directions. In conclusion, the article makes the necessary inferences to assess the prospects of such areas of the economy as eSports, both for the industry of interactive entertainment and for representatives of other market sectors.