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Psychotropic medications are often used to treat problem behaviours in people with intellectual disability which not only occur frequently but also tend to persist over time. This study examined the pattern of prescription of such medications to manage problem behaviours for adults with intellectual disabilities in a specialist psychiatric unit in Hong Kong. Individuals aged 18 or above with problem behaviours and receiving psychotropic medication for treatment in hospital, outpatient and community settings were studied. Their demographic and clinical information was collected. The type and dosage of medications were retrieved from the computer database and analysed. Those with psychotic disorder and mood (affective disorder) were excluded. After screening, 236 patients met the inclusion criteria. People with moderate intellectual disability accounted for most of the cohort (46%). Autism spectrum disorder was the commonest psychiatric diagnosis (35%) and aggression the commonest problem behaviour (52%). Antipsychotics, mood stabilisers and antidepressants were prescribed to 96%, 20% and 13% of the subjects respectively. The profile of problem behaviour in the Chinese population with intellectual disability is consistent with the findings reported in the world literature. Antipsychotic drugs are the most commonly prescribed class of psychotropic medication used to treat such behaviours. Although the current evidence is not strong enough to support a clear‐cut recommendation on the use of medications, the dichotomous notion of ‘prescription’ or ‘no prescription’ for problem behaviours may be simplistic.

The 11th revision of the International Classification of diseases which sets global standards for defining, reporting and managing health conditions is under way. The International Classification of Diseases (ICD) underpinning principle of clinical utility is currently poor for persons with Disorders of Intellectual Development (DID) and mental disorders. This impedes access to healthcare resources; services and social inclusion thereby further aggravating their vulnerability. The purpose of this paper is to present a critical overview and evidence informed recommendations within the context of an international collaborative programme, undertaken by the Faculty of Psychiatry of Intellectual Disability, Royal College of Psychiatrists, UK with support from the World Health Organisation (WHO).

The authors carried out: first, a systematic review (SR) of literature, using PRISMA guidelines regarding the reliability, validity and utility of the ICD-10/Diagnostic and Statistical Manual of Mental Disorders (DSM) diagnostic criteria in people with DID (PWDID); second, a national and international consultation exercise with partners, stakeholders and experts; third, a multicentric survey of problem behaviours in PWDID; and finally, information dissemination/dialogues including presentations and workshops at key scientific events, consultation networking, data gathering and consensus building.

The SR revealed a dearth of robust studies – most consisting of weak research methodologies. Significant difficulties were highlighted regarding the application of diagnostic criteria in the current classificatory systems – particularly in people with severe/moderate DID. Recommendations supported the introduction WHERE APPROPRIATE of modifications based on observed phenomena (signs) in PWDID in lieu of reported symptoms to facilitate DIAGNOSIS AND better access to healthcare and the community. Heterogeneity precluded quantitative pooling and meta-analysis. The consensus building exercise globally revealed that problem behaviours were the commonest reasons for referral to healthcare services with significant numbers without a diagnosed mental disorder being prescribed psychoactive medication.

The consensus gathering exercise WAS SELECTIVE AND did not cover all of the 194 member states of WHO due to resource and time constraints and this constitutes the main limitation of our study. Based on the SR and expert consensus, the authors submitted evidence informed pragmatic proposals to the WHO aimed at addressing the shortcomings of the ICD-10. The key recommendations focused on improving clinical utility within the context of epistemic iteration which would consolidate and strengthen the future evidence base. It was also recommended that self-injurious behaviour should form a standalone sub category in view of its relevance for healthcare services and resources which underpin clinical utility.

The ICD-11 is a global, multidisciplinary and multilingual development for public health benefit with 70 per cent of the world's health expenditures assigned using this system for resource allocation. Currently mental disorders in PWDID can be misinterpreted, unrecognised and under reported resulting in barriers to access to treatment and healthcare resources. Conversely disorders may be over diagnosed when the inherent discrepancies between the chronological age and the developmental level of functioning are not considered. Conclusions and recommendations from this study will result in better diagnosis of mental disorders and healthcare resources in this population.

PWDID are a vulnerable sector of the population with an increased prevalence of mental health problems who are marginalised and discriminated by society. Early detection, treatment and management of these conditions will prevent further decompensation and stigmatisation.

To the best of the authors knowledge this is the first comprehensive, large-scale study which evaluates the ICD classificatory system within the context of clinical utility for PWDID, including experts and stakeholders from both lower/middle- and high-income countries. The international consultation/consensus building process culminating in the formulation of evidence informed recommendations, aimed at improving the clinical utility of the ICD-11 for this population, has the potential to improve access to appropriate healthcare and treatment and consequent enhancement of their quality of life.

Frequent food safety incidents caused widespread consumer concerns. Even though food safety is one of the weakest links in the fresh food supply chain and influences consumer food choice in ways different from the quality dimension, this factor is hardly proposed as one of the key traditional supplier selection criteria (e.g. quality, delivery, and price) in the literature. The purpose of this paper is to develop a business process decision model to assess the non-compensating food safety sub-criteria in order to disqualify fresh food suppliers that cannot reach the minimum threshold for low probable food safety failure. The preferred fresh food suppliers can minimize the risk of food safety failure and the associated huge food safety failure costs spanning from private consumer anguish to social distress that cause unbearable costs of sales loss and damage to brand image in business.

This study proposes a novel approach that combines several well-established multi-criteria decision making (MCDM) techniques, including fuzzy AHP (FAHP), TOPSIS, and ELECTRE, and innovatively apply to analyze supplier performance and prioritize potential fresh food suppliers. This hybrid business process model can enforce compliance to all the five non-compensatory sub-criteria of food safety. Since ELECTRE is a non-compensatory MCDM method, it is therefore particularly applicable for disqualifying high risk fresh food suppliers from further full scale supplier performance evaluation by FAHP and TOPSIS. This hybrid business process decision model is able to capitalize on the strengths of these MCDM methods and offset their deficiencies.

This study uses data of an international supermarket chain to validate feasibility of the proposed model. Results indicate that this model is able to assess the non-compensating food safety sub-criteria via the ELECTRE method in order to disqualify fresh food suppliers that cannot reach the minimum threshold for low probable food safety failure. Only the preferred suppliers with the required food safety capability can proceed to the second stage of the supplier selection process. Assessment via the TOPSIS method reveals the ranking order of those top performing suppliers according to their relative scores along all the supplier selection criteria. The TOPSIS ranking results with the selection of the suppliers C, E, A, and F are robust and consistent across all the different scenarios.

Application to the fresh food industry is possible with the aid of the MCDM methods. The contribution to the body of knowledge in this teaching and research field demonstrates the importance of first identifying the order qualifier for disqualifying those suppliers that do not satisfy the food safety requirements via the ELECTRE method. The proposed assessment procedure complies with the regulatory policy on food safety, and would influence public policy in applying the best practice of food safety regulation. Without first qualifying the potential suppliers on the basis of food safety, wrong decision can be made to select those high food risk suppliers that have relatively higher overall scores in other supplier selection criteria. Using the assessment results has positive economic and commercial impact on the purchasing managers to formulate appropriate purchasing and supplier development strategy to enhance supplier’s food safety performance, whilst maximizing the overall supplier portfolio performance. The improved supplier’s food safety performance will certainly benefit the society’s quality of life as well.

Based on the analytical MCDM methods of FAHP, TOPSIS, and ELECTRE, purchasing managers can operationalize the Hill’s framework of order qualifier and winner that has primarily been used in the literature and manufacturing industry. This study represents the first move to innovatively apply the FAHP, TOPSIS, and ELECTRE methods to operationalize the Hill’s framework of order qualifier and winner that has primarily been used in the literature and manufacturing industry. Application to the fresh food industry to validate the feasibility of the proposed model has been conceived and implemented in this study. Analysis of the data inputs of a supermarket chain via the three MCDM methods generate the results that fulfill the purpose of achieving the research objective of identifying and managing the supplier base that can deliver the best supplier performance, conditional on first passing the fresh food safety test.

Hong Kong's prominent position in international textiles and the clothing trade will continue to shift under the transition of the Multifibre Arrangement (MFA). To provide a better understanding of the relationships between the local clothing manufacturers' generic marketing strategies and their deployment for future challenges, some 33 industrialists were interviewed. The results reveal no difference between the marketing‐oriented firms and the less marketing‐oriented firms in relation to the adoption of strategic actions in response to the abolition of the MFA. The results also indicate that firms, irrespective of their marketing approaches, shared similar views regarding the perceptions of the impact of the MFA upon Hong Kong industry and the overall future prospects of the Hong Kong clothing industry. Nevertheless, an interesting finding was that there might be a relationship between a firm's marketing approaches and its attitude to experimenting with strategies under different business environments. Less marketing‐oriented firms are found to be less proactive towards future uncertainties than the more marketing‐oriented firms.

The industrialisation of Hong Kong evolved in the late 1940s with the establishment of the textile and clothing industry. Following the practice of the textile pioneers, Hong Kong clothing entrepreneurs initiated foreign direct investment (FDI) as early as the late 1950s in order to evade the quantitative limitations on clothing exports into developed country markets. In‐depth literature search, survey and interviews have identified that the Hong Kong clothing industry is now in its fourth stage of migratory expansion. The search for export quotas or privileged access to developed countries has delineated the locations for offshore clothing production of Hong Kong firms.

Immigrants are a part of America’s founding and history. Until this study, it was unclear how immigrants have been historically portrayed in youth American trade books. Utilizing a discourse analysis approach, this study offered a critical and comparative examination of the portrayal of first-generation immigrants, the authors’ perspectives, and the historical evolution of American trade books written during two peak United States immigration eras (1880-1930s and 1980-2010s). After examining 98 books written over 100 years, findings indicated in both peak immigration eras, immigrants faced similar problems; first-generation immigrants were insensitively criticized and viewed as subpar individuals by Americans. As a whole, books were mostly tales of assimilation and mistreatment in the United States. Since youths’ ideas of people and cultural groups are formed by what they learn from not only social interaction but also the media, it is important for books to provide meaningful representations of immigrants.

The aim of this paper is to demonstrate how an imaginative sourcing policy can be used to provide a competitive advantage for clothing manufacturers based in high‐cost countries. The paper shows how Chorus Line Corporation implemented their sourcing mix, through a combination of production in different regions, to maintain and develop their competitive position in the womenswear market in the USA. The company's basic data and decisions are outlined as an example of how one privately owned company views the sourcing and production decision. In this way the paper will help firms to develop their own global production strategies with balanced sources to meet their business and market strategies.

One of the main concerns in human resource management around the world is how education is encouraging the understanding of global issues, cultures, technological changes and social trends to make appropriate decisions in firm management. This chapter will aim to illustrate the main issues in international business (IB) theory and practice that need to be considered in configurating a global-minded curriculum that is able to produce global-minded human resources. Hence, to determine what inputs must be considered in building an exceptional curriculum and successful educational strategies, the author observe the assertions from three perspectives: first, the contributors to the IB and the multinational enterprise theory; second, the author explores the stakeholders’ perspective, who see the benefits and assume the consequences of education in the field; and third, the author reviews the researchers who in recent years have studied the problems and trends of the discipline.

This study aims to investigate the impact of equity ownership structure (i.e. CEO ownership, board chair ownership and institutional ownership) on internationalization of firms. The moderating role of international experience of board chairs is also examined.

This study uses Compustat-Capital IQ data from Standard &Poor’s. The sample of this study includes 309 US multinational corporations representing different sectors. The parameters were estimated by using the ordinary least squares regression with the SPSS statistical package.

The finding of this study suggests that CEO ownership and board chair ownership have a significant, positive impact on the degree of internationalization of firms, whereas institutional ownership has a negative impact. The predicted moderating role of international experience of board chairs has found mixed results.

This study contributes to the literature by taking a holistic approach to examine the impact of equity ownership types (i.e. CEO ownership, board chair ownership and institutional ownership) on firms’ degree of internationalization. To the best of the authors’ knowledge, this research is also the first to investigate the impact of independent board chairs’ equity ownership and international experience on internationalization.