This article lays out the argument that we may best cope with the unfolding of the future by learning from the past. Here, the past represented by Niccolo Machiavelli's world and thoughts are juxtaposed with the questions and issues raised by postmodern organization theorists. Machiavelli's thoughts contributed to the creation of the world that concerns postmodern theorists and us. Both Machiavelli and postmodern organization theorists address change and strategies for dealing with change, including looking to needs and emotions for working with individuals in change situations and the importance of widespread involvement in governance structures. Building a better future requires learning to deal with human social realities that have been and will be shaped by past philosophers. Consciousness of past philosophers should help in that endeavor.

Our world is very culturally and ethnically diverse. Although there is so much beauty in the diversity of our world, the multiplicity of cultures can be very challenging when working to evoke change. Therefore, in an effort to better serve the realities of our environment, this article examines the question, "Is there a need for a different awareness on the part of researchers and/or intervention strategists when working to evoke change within diverse cultures, organizations, and/or communities?" And, equally important, how do we gain this awareness as we engage in change processes? Within the contextual framework of this question, this article also discusses the consequences that can and do emerge when one uses intervention strategies that may be grounded in generalized theory and practice when working within culturally and ethnically diverse populations. It concludes with a posit that suggests the need to evoke a more culturally sensitive approach to change, which is built on the use of discourse strategies that address the individualities of the environments, giving privilege to the diversity and culture.

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als in 14 countries to access unpublished information and assess the acceptability of different MEA types across Europe. Outputs were developed into a vaccines specific MEA framework and guidance for implementation. Results: To date, there is very little experience with vaccine MEAs in Europe; however, interesting value-added service examples were identified (e. g. educational campaign support). The vaccine-specific MEA framework developed (aligned with current taxonomy) focused on financial schemes (e. g. staggered entry approaches, volume-based discounts, price-volume agreements), coverage with evidence development and value-added services (e. g. vaccination implementation support). Pay-for-performance MEAs were less applicable. Budget holder feedback in selected countries confirmed their interest in co-creating such MEA/service approaches with vaccine companies. ConClusions: To enable decision makers to continue investing in innovative vaccines that address public health needs, a shift towards new value-based acquisition models is key. A broader, more flexible approach to vaccines access, including MEAs, can address the needs of budget holders and other external stakeholders as well as manufacturers.

on hourly labour costs is used for productivity costs per working day/hour. RESULTS: Vacancy durations estimated in 2009 for The Netherlands, Belgium, Germany, France, the UK, Norway and Sweden range between 40-80 days. Regression analysis of the vacancy durations shows that, there is a strong negative relationship between vacancy durations and unemployment rates. When unemployment increases, vacancy durations and hence friction period decline. We also find that an increase in the vacancy rate (the ratio of the stock of vacancies to total labor force) has a positive effect on vacancy durations which can be explained by the congestion provoked by the increase in the number of vacancies competing in the labor market. CONCLUSIONS: This paper provides estimates on vacancy durations, friction periods and the price component in order to calculate the friction costs. For seven European countries, we present empirical estimates to use the friction cost method in a practical way which can improve more uniform analysis of productivity costs in economic evaluations of diseases. Our regression results confirm the validity of estimated vacancy durations which are necessary to calculate the length of friction period and friction costs.