The debate on the standardization and adaptation of marketing strategy is not new, but the researchers not yet came to an agreement that which strategy is better to serve the international market.
Obstructive sleep apnea Pulmonary diseases e.
Aetna considers the gastric emptying breath test GEBT experimental Standardization versus adaptation investigational for gastroparesis and for all other indications because of insufficent evidence of its effectiveness.
Aetna considers exhaled breath temperature experimental and investigational for lung diseases and all other indications because its effectiveness has not been established. Background Exhaled breath tests are noninvasive techniques designed to be utilized as markers for airway inflammation.
Though the tests were introduced primarily for the management of asthma, exhaled breath tests have been proposed for use to evaluate other respiratory disorders that have an inflammatory component such as chronic obstructive pulmonary disease COPDcystic fibrosis, pulmonary hypertension and are Standardization versus adaptation suggested for gastrointestinal GI use.
Marker identification is purported to be useful for physicians to verify a diagnosis, adherence to anti-inflammatory therapy or for predicting upcoming exacerbations in individuals.
Gastric emptying breath testing GEBT and hydrogen breath testing are examples of tests used to diagnose certain gastrointestinal conditions.
Nitric oxide NO is normally produced by the human respiratory tract mucosa lining and is supposedly a powerful mediator involved in airway inflammation. It has been suggested that elevated levels of NO in exhaled air, referred to as fractional exhaled NO FeNOcould serve as markers of airway inflammation.
Exhaled nitric oxide testing involves breathing through a mouthpiece that is connected to a computer by a tube. The individual begins by breathing in nitric oxide free air to total lung capacity.
Air is then slowly exhaled into the mouthpiece. The computer screen immediately displays the nitric oxide concentration. Examples of nitric oxide testing systems include, but may not be limited to: A number of studies have investigated the relationship between exhaled nitric oxide NO and airway inflammation in asthma.
These studies have found that levels of exhaled NO are elevated in people with asthma who are not taking inhaled glucocorticosteroids compared to people without asthma, yet these findings are not specific for asthma.
Exhaled NO is thought to reflect eosinophilic airway inflammation in asthma. Levels of exhaled NO have been suggested as non-invasive markers of airway inflammation in asthma, as an alternative to invasive methods such as examination of spontaneously produced or hypertonic-saline induced sputum for eosinophils and metachromatic cells.
Measurement of exhaled NO may prove to be useful in diagnosing asthma, assessing adherence to treatment with inhaled corticosteroids, or in the identification of patients in whom respiratory symptoms are associated with eosinophilic airway inflammation.
A number of methods have been developed to measure exhaled NO, including laser spectroscopy and chemiluminescence. Current studies on exhaled NO in asthma have focused on the technical feasibility of measurement and correlations with pulmonary function and invasive methods of assessing airway inflammation.
The evidence for assessment of exhaled NO for other pulmonary conditions is more limited. However, well-designed, long-term studies are needed to evaluate whether the addition of exhaled NO measurements to clinical and lung function assessment results in improved asthma control.
An assessment on a NO measurement system NIOX for monitoring response to asthma treatment prepared by the Canadian Coordinating Office for Health Technology Assessment CCOHTA Hailey, concluded that no information was found on the extent to which the use of this device improves patients' compliance with medication use or ensures appropriate prescribing.
Comparative studies to obtain such measures of efficacy would be desirable. This is in agreement with the observation of Zeidler et al who stated that exhaled NO may be a useful parameter for monitoring asthmatic inflammation, adjusting therapy, and diagnosing asthma, although prospective longitudinal trials investigating the correlation between exhaled NO and clinical outcomes are necessary to determine its utility.
The TEC assessment found that available evidence does not permit the conclusion that use of FENO monitoring to guide treatment decisions in asthma leads to improved outcomes.
The assessment stated that the 7 studies that evaluated the predictive ability of FENO, and its potential to provide prognostic information that could influence management decisions, had considerable methodologic limitations and variability in study methodology that precluded synthesis of their results and definitive conclusions.
The assessment explained that each study reported different benefits that have not been reproduced. The assessment noted that differences in the control management strategy raise questions about the optimal management strategy to which FENO monitoring should be compared.
Patients were followed for 12 months. The rates of exacerbation were 0. The authors reported no significant differences in other markers of asthma control, use of oral prednisone, pulmonary function, or levels of airway inflammation sputum eosinophils. Earlier studies, however, have demonstrated that control can be maintained through a standardized approach involving a uniform dose reduction.
It is also unclear what effects multiple medications may have on the relationship between asthma control and FENO measurements. There is a need for clinical studies showing the merits and limitations of different methodologies, to standardize measurements of fractional FENO in infants, and to obtain normal reference values for this age group.
Turner stated that over a relatively short time FENO has become recognized as an useful objective tool for diagnosing and monitoring asthma. However, more clinical studies are needed in order for FENO to become fully established in the diagnosis and management of asthma.
Participants were assessed monthly for 4 months and then every 2 months for a further 8 months.Standardization versus Adaptation in International Marketing Introduction The most challenging decision that a company may face in internationalization is the degree of standardization or adaptation .
Standardization vs. Adaptation The first view is the standardization standpoint (as proposed by Jain, ; Levitt, ). According to these authors, supporters of standardization believe that there is a union of cultures with similar environmental and customer demand around the globe.
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Abstract. Scales with evidence of validity and reliability are important to evaluate child development. In Brazil, there is a lack of standardized instruments to evaluate young children. The product standardization has been one of the major issues in this standardization versus adaptation debate.
Consumer nondurables (CND) needs more adaptation than consumer durables (CD) because of the influence of local culture.
This essay represents a critical analysis of standardisation vs. adaptation in international marketing in the twenty first century.
The essay starts with.