Country-level Factors Research Articles

Housing Hardship Among Older Adults Living Alone: The Protective Roles of Aging and Housing Policies.

This study investigates the association between living arrangements and housing hardship among older adults across 21 high-income countries. Using data from the Gallup World Poll (2016-2020) and OECD databases, we employ multilevel regression models that can assess how individual- and country-level factors, including public spending on pensions and housing policies such as social housing stock and rent control, moderate these associations. Older adults living alone experience significantly higher rates of housing hardship compared to their counterparts, even after adjusting for demographic and economic factors. Public spending on old age pensions attenuates housing hardship for older adults living alone. While public spending on housing shows limited effectiveness, social housing availability and rent control emerge as protective measures, reducing housing hardship among older adults living alone by providing stable and affordable housing options. This study emphasizes the need for targeted interventions to support independent living.

Exploring support for return-to-work: A comparative analysis of firm and country-level factors

Abstract Background Employers are important stakeholders in efforts to facilitate the return-to-work (RTW) of employees after sick-leave, but the available data reveal large variation in employer support for RTW across European countries and firms. This paper explores in a comparative perspective what factors at the country level and at the firm level can explain these differences. Methods Employer support for RTW is examined using microdata covering 31 countries from the Third European Survey of Enterprises on New and Emerging Risks (ESENER), conducted in 2019 (N = 9,775). These data are integrated with country-level indicators to capture national differences in economic incentives and institutional provisions concerning the management of sick-leave. Two-level mixed-effects logit models with random intercepts are used to estimate the impact that different firm characteristics and country-level factors have on the propensity to provide RTW support. Results The empty model has an intraclass correlation coefficient (ICC) of 0.345, indicating that a substantial share of the observed variation across European firms is determined at the country level. Larger establishments and those with workplace health risks are more likely to provide RTW support. Including firm-level indicators does however not reduce the observed between-country variance. Institutional differences in the economic costs of sick leave for employers, on the other hand, explain about 15% of this variance. The ICC drops more strongly after including in the model policy indicators that capture activating elements in the social security system and the existence of national policies targeting RTW. The full model explains almost two thirds (62.8%) of the observed between-country variance. Conclusions The findings highlight that only in few European countries employers are systematically involved in RTW support and strengthen the case for comprehensive policy strategies to engage employers in worker activation. Key messages • Employer characteristics, such as firm size, impact the propensity to provide RTW support, but they do not explain the large between-country variation that we observe across Europe. • Comprehensive national policy strategies and institutional incentives are crucial to engage employers systematically in RTW efforts.

Long COVID prevalence differences across 27 European countries that participated in the 2021 Survey of Health, Ageing and Retirement in Europe

Abstract The COVID-19 pandemic caused a significant burden in Europe, with over 60% of infected individuals developing Long COVID symptoms. Variations in Long COVID prevalence across countries are linked to individual-level factors, but the influence of population-based country-level characteristics remains unclear. Thus, our objective was to assess how country-level characteristics related to: (i) the way European countries responded to the COVID-19 pandemic, (ii) their population-level health status, (iii) provision and access to healthcare services, (iv) human development, governance, and environmental risk factors, are associated with Long COVID. We used a sample of 4,004 middle-aged and older adults from 27 European countries who, in summer 2021, participated in Corona Survey 2 (from Survey of Health, Ageing and Retirement in Europe) and who reported COVID-19 infection one year prior to the survey. To assess the potential role of country-level characteristics, while controlling for key individual-level factors, we estimated three sequential multilevel random intercept logistic regression models. Approximately 70% of respondents who had COVID-19 also experienced Long COVID symptoms and there were significant cross-country differences in Long COVID rates, ranging from 32% to 89%. About 13% of the total variance in the risk of having Long COVID can be attributed to cross-country differences and the remaining 87% to individual-level factors. The individual-level characteristics also accounted for 6% of the observed cross-country differences in Long COVID rates (compositional effects) while the country-level characteristics further reduced this variance by over 50%. Both individual and country-level factors influence Long COVID occurrence, emphasizing the need for tailored recovery plans, healthcare planning and resource allocation at the national level to address this condition.

Retail franchise ecosystem dynamics: Insights from countries of varied development levels

This study explores the influence of entrepreneurial ecosystems on international franchise expansion. We understand franchising as a part of retailing and reflect on various country-level factors that impact the international franchise growth in 52 developed and emerging markets. We classify developed and emerging markets based on the Human Development Index (HDI). Employing an entrepreneurial ecosystem framework initially applied to new business growth in cities, we investigate how cultural, institutional, economic, and infrastructure factors affect franchise growth. Our findings indicate that well-developed infrastructure, economic freedom, and supportive laws contribute to franchise expansion, while locations with high crime rates are less attractive to franchise expansion. Surprisingly, increased internet access or higher spending on research and development does not consistently further franchise expansion. Countries with higher levels of human development tend to have franchises that are expand more rapidly. However, we found little difference between countries with very high development and those with high development standards. This study helps us understand what makes franchise business expansion work and how they can succeed in different countries. Implications for businesses and governments looking to support franchise growth are explained. Finally, the results reflect the importance of understanding the unique dynamics of emerging markets and offers actionable insights for businesses and policymakers aiming to foster retail ecosystems and franchise on these specific markets entrepreneurship globally.

The impact of corporate social responsibility on employee outcomes in the hospitality industry: A multi-motive and cross-cultural meta-analysis

Corporate social responsibility (CSR) in the hospitality industry has received increased attention from both practitioners and researchers in the past two decades, due in part to growing concerns regarding hospitality operations' impact on the environmental, social, and economic well-being of their communities. While research has enhanced our understanding of CSR's influence on hospitality employees, an integrated literature synthesis is still needed. Leveraging the multi-motive CSR framework, we aim to (1) synthesize CSR's impact on hospitality employee outcomes (i.e., performance, job satisfaction, and organizational identification); (2) investigate how the instrumental, relational, and moral motives of employees mediate the CSR–employee performance relationship; and (3) test how country-level factors moderate the relationship between CSR employee outcomes. Meta-analytic results using 87 studies, 33,567 individuals, and 160 effect sizes show a positive relationship between CSR and employee outcomes. Further exploring the multi-motive framework, meta-analytic structural equation modeling (MASEM) results show that instrumental, relational, and moral motives fully mediated the CSR–employee performance relationship. Additionally, results of subgroup tests indicate that the CSR–employee outcome relationship was stronger for employees working in highly developed countries and horizontal-individualistic cultures. Our findings highlight how CSR enhances employee performance through underlying psychological mechanisms, with implications for theory and practice.

Climate change mitigation policy for planetary health equity? An automated content analysis of countries’ nationally determined contribution reports

Abstract Introduction This study examines the extent to which national governments discuss the social determinants of planetary health equity (SDPHE) within their Nationally Determined Contribution reports (NDCs) to the UN Framework Convention on Climate Change. This is assessed relative to the frequency of discussion of economic factors and health outcomes, and how this varies between countries based on political, economic, and environmental factors.
Methods Using natural language processing, a dictionary-based automated content analysis was conducted of the frequency of terms within these reports. Correlation analyses examined the relationship between the frequency of dictionary categories and political, economic, and environmental variables to ascertain the role of contextual factors.
Results Overall, NDCs were found to feature a greater proportion of economic language compared to health outcome and SDPHE terms. Among the SDPHE, equity- and gender-related terms occurred most frequently. Correlations were identified primarily among high-income countries, that suggest moderate positive associations between levels of CO2 emissions per capita and per dollar of GDP and the use of economic terms, and a negative association of economic language with levels of democracy. Democracy was also positively associated with language related to social norms such as equity and justice, indicating potential scope for impact through democratic pressures.
Conclusion The relatively frequent use of economic frames in NDCs suggests that economic issues may receive more attention compared to the SDPHE. This analysis identifies potential enabling and constraining country-level factors for greater attention to the SDPHE in NDCs and more progressive climate change mitigation policymaking.

Founders’ Characteristics and Startups’ Funding Opportunities Around the Globe

In this paper, I investigate the eleven largest startup markets in the world to uncover whether female founders have a disadvantage in the amount of funding received by their respective startups. I am also interested in whether country-level factors such as the level of development and quality of formal and informal institutions can impact the results. Moreover, I research founders with formal technical education to show if they have any advantage while funding their startups. I investigate more than 3,500 international startups during the period of 2017-2022 while utilizing CrunchBase database. I uncover that female founders are at a disadvantage in funding for their startups in all 11 countries of interest. Such results are more pronounced in developed countries, those with better functioning formal institutions and more individualistic populations. The disparity between male and female-led startups’ funding is especially pronounced in debt financing as well as seed round of equity financing. The technical education of male and female founders does not provide any advantage in terms of the funding opportunities.

The determinants of MNE foreign subsidiaries’ performance: a systematic literature review and future research agenda

PurposeForeign subsidiaries of multinational enterprises (MNEs) operate in complex and competitive international environments, implement market and non-market strategies, manage resources and value-added activities and contribute to the overall performance of their parent firms. Thus, the research question on the determinants of MNE foreign subsidiaries’ performance is of interest to managers and academic researchers. The empirical literature has flourished over the recent decades; however, the domains are fragmented, and the findings are inclusive. The purpose of this study is to systematically review, analyse and synthesize the empirical articles in this area, identify research gaps and suggest a future research agenda.Design/methodology/approachThis study uses the qualitative content analysis method in reviewing and analysing 150 articles published in 24 scholarly journals during the period 2000–2023.FindingsThe literature uses a variety of theoretical perspectives to examine the key determinants of subsidiary performance which can be grouped into six major domains, namely, home- and host country-level factors; distance between home and host countries; the characteristics of parent firms and of subsidiaries; and governance mechanisms (the establishment modes and ownership strategy, subsidiary autonomy and the use of home country expatriates for transferring knowledge from the headquarters and controlling foreign subsidiaries). A range of objective and subjective indicators are used to measure subsidiary performance. Yet, the research shows a lack of broader integration of theories and presents inconsistent theoretical predictions, inconclusive empirical findings and estimation bias, which hinder our understanding of how the determinants independently and jointly shape the performance of foreign subsidiaries.Originality/valueThis study provides a comprehensive, nuanced and systematic review that synthesizes and clarifies the determinants of subsidiary performance, offers deeper insights from both theoretical, methodological and empirical aspects and proposes some promising avenues for future research directions.

Underweight and associated factors among children under age of five in low and lower-middle income African countries: hierarchical analysis of demographic and health survey data.

Globally, nearly half of all deaths among children under the age of five are linked to undernutrition. These tragic outcomes are most prevalent in low- and middle-income countries. The far-reaching impact of malnutrition affects not only individuals but also their families, communities, and entire nations. By examining underweight, we gain valuable insights into the intricate network of factors influencing child health. Therefore, this study aims to assess underweight prevalence and its associated factors among under-five children in low and lower-middle-income African countries. We conducted a secondary analysis of standard demographic and health surveys in 30 low and lower-middle-income African countries spanning from 2012 to 2022. Our analysis included a total sample of 200,655 children under the age of 5 years. We employed a three-level hierarchical model to assess the determinants of underweight among children in this age group. Measures of association were evaluated using adjusted odds ratios with a 95% confidence interval. Explanatory variables with a p-value less than the level of significance (0.05) were considered statistically significant. The pooled prevalence of underweight among children under the age of five in low and lower-middle income African countries was estimated at 17.60%, with a 95% confidence interval (CI) ranging from 17.44 to 17.77%. The hierarchical analysis identified several factors significantly associated with underweight, including male gender, birth size, maternal body mass index, maternal educational level, household wealth index, antenatal care (ANC) visits, community poverty level, and income level of countries. The high prevalence of underweight among children under the age of five in low and lower-middle income African countries underscores the need for targeted interventions. By addressing individual, community, and country-level factors, we can work toward improving child nutrition and well-being.

Variability in forgoing life-sustaining treatment practices in critically Ill patients with hospital-acquired bloodstream infections: a secondary analysis of the EUROBACT-2 international cohort

BackgroundThe decision to forgo life-sustaining treatment in intensive care units (ICUs) is influenced by ethical, cultural, and medical factors. This study focuses on a population of patients with hospital-acquired bloodstream infections (HABSI) to investigate the association between patient, pathogen, center and country-level factors and these decisions.MethodsWe analyzed data from the EUROBACT-2 study (June 2019–January 2021) from 265 centers worldwide, focusing on non-COVID-19 patients who died in the hospital or within 28 days after HABSI. We assessed whether death was preceded by a decision to forgo life-sustaining treatment, examining country, center, patient, and pathogen variables. To assess the association of each potentially important variable with the decision to forgo life-sustaining treatment, univariable mixed logistic regression models with a random center effect were performed.ResultsAmong 1589 non-COVID-19 patients, 519 (32.7%) died, with 191 (36.8%) following a decision to forgo life-sustaining treatment. Significant geographical differences were observed, with no reported decisions to forgo life-sustaining treatment in African countries and fewer in the Middle East compared to Western Europe, Australia, and Asia. Once a center effect was considered, only health expenditure (Odds ratio 1.79, 95%CI: 1.45–2.21, p < 0.01) and age (Odds ratio 1.02, 95%CI: 1.002–1.05, p = 0.03) were significantly associated with decisions to forgo life-sustaining treatment, while other patient and pathogen factors were not.ConclusionEconomic and regional disparities significantly impact end-of-life decision-making in ICUs. Global policies should consider these disparities to ensure equitable end-of-life care practices.

Quality leadership, technology integration and patient care quality across countries: moderating roles of national culture and infrastructure development

PurposeTo better understand the nature and effective delivery of quality health-care globally, this paper aims to study the role of quality leadership on patient care quality (PCQ) delivered in hospitals, including the intervening role of technology integration and two country-level factors – national culture and infrastructure development – in North America (Canada, Mexico and the USA).Design/methodology/approachPCQ comprises four facets: interpersonal, technical, environmental and administrative quality. Using survey data and interdisciplinary theoretical support (e.g. quality management and the Global Leadership and Organizational Behavior Effectiveness Project [GLOBE] model of national culture), this paper tested for moderated mediation between hospital quality leadership and the four-facet PCQ model with technology integration as the mediator and national culture and infrastructure development as moderators.FindingsResults show that technology integration partially mediates the relationship between hospital quality leadership and PCQ and that national culture and infrastructure development shape the role of hospital quality leadership on PCQ. Hence, these national factors must be considered holistically to understand the impact of hospital quality leadership on patient care.Practical implicationsTo improve PCQ, hospital leaders should broaden their understanding of quality health-care to include technology integration and an awareness of cultural and institutional differences across nations.Originality/valueThis paper used primary data from hospital quality leaders and the four-facet PCQ conceptualization across three large North American nations, offering a more global understanding of service quality in health-care.

Socio-economic inequalities in the use of flu vaccination in Europe: a multilevel approach

BackgroundThe European-wide statistics show that the use of flu vaccination remains low and the differences between countries are significant, as are those between different population groups within each country. Considerable research has focused on explaining vaccination uptake in relation to socio-economic and demographic characteristics, health promotion and health behavior factors. Nevertheless, few studies have aimed to analyze between-country differences in the use of flu vaccination for the EU population. To address this gap, this study examines the socio-economic inequalities in the use of influenza vaccination for the population aged 15 years and over in all 27 EU Member States and two other non-EU countries (Iceland and Norway).MethodsUsing data from the third wave of European Health Interview Survey (EHIS) 2019, we employed a multilevel logistic model with a random intercept for country, which allows controlling simultaneously the variations in individuals’ characteristics and macro-contextual factors which could influence the use of flu vaccination. In addition, the analysis considers the population stratified into four age groups, namely adolescents, young adults, adults and elderly, to better capture heterogeneities in flu vaccination uptake.ResultsThe main findings confirm the existence of socio-economic inequalities between individuals in different age groups, but also of significant variation between European countries, particularly for older people, in the use of influenza vaccination. In this respect, income and education are strong proxy of socio-economic status associated with flu vaccination uptake. Moreover, these disparities within each population group are also explained by area of residence and occupational status. Particularly for the elderly, the differences between individuals in vaccine utilization are also explained by country-level factors, such as the type of healthcare system adopted in each country, public funding, personal health expenditure burden, or the availability of generalist practitioners.ConclusionsOverall, our findings reveal that vaccination against seasonal influenza remains a critical public health intervention and bring attention to the relevance of conceiving and implementing context-specific strategies to ensure equitable access to vaccines for all EU citizens.

Intimate partner violence against adolescent girls: regional and national prevalence estimates and associated country-level factors

Intimate partner violence is a serious public health problem and negatively affects short-term and long-term health, development, and wellbeing of adolescent girls. Global estimates from WHO have shown that adolescent girls aged 15-19 years experience high rates of intimate partner violence. We aimed to estimate the lifetime and past-year prevalence and patterns of physical or sexual intimate partner violence against adolescent girls by male partners across 161 countries and areas, and to examine the country-level factors, including the prevalence of child marriage, associated with the lifetime and past-year prevalence of intimate partner violence in this age group. These analyses used the 2018 global, regional, and country estimates on intimate partner violence published by WHO and economic, social, and political metadata from subject-specific databases. Drawing on data from the WHO Global Database on Prevalence of Violence Against Women, we used hierarchical Bayesian modelling techniques to estimate lifetime and past-year prevalence of physical or sexual (or both) intimate partner violence against adolescent girls aged 15-19 years by country. Linear regression methods were used to examine contextual social, economic, and political factors associated with intimate partner violence against adolescent girls in the 101 countries (lifetime prevalence) and 105 countries (past-year prevalence) for which these metadata were available. The estimated global prevalence of physical or sexual intimate partner violence against ever-partnered adolescent girls aged 15-19 years was 24% (95% uncertainty interval 21-28) in their lifetime and 16% (14-19) in the past year. Prevalence varied greatly across countries and regions, with lifetime prevalence ranging from 6% (3-11) in Georgia to 49% (35-64) in Papua New Guinea. Overall, the prevalence of both lifetime (154 countries) and past-year (157 countries) intimate partner violence against adolescent girls was higher in low-income and lower-middle-income countries and regions than in high-income countries and regions. Countries with higher rates of female secondary school enrolment and those with inheritance laws that are more gender-equal had lower prevalence of intimate partner violence against adolescent girls. Lower-income countries and societies with a high prevalence of child marriage had higher prevalence of physical or sexual intimate partner violence against adolescent girls. Our findings highlight the widespread prevalence of intimate partner violence against adolescent girls across the globe and its relationship with country-level contextual factors. They emphasise the need for promoting and ensuring policies and programmes that increase and ensure gender equality. Countries should strive to provide secondary education for all girls, ensure equal property rights for women, eliminate discriminatory gender norms, and address harmful practices such as child marriage. UN Women-WHO Joint Programme on Strengthening Violence Against Women Data funded by the UK Foreign and Commonwealth Development Office and the UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development, and Research Training in Human Reproduction.

Potential Drivers for the Spatiotemporal Patterns of the Global Burden of Chronic Obstructive Pulmonary Disease Attributable to Ambient Ozone, 1990-2019.

To identify the long-term spatiotemporal trend of ozone-related chronic obstructive pulmonary disease (COPD) burden by sex and country and to explore potential drivers. We retrieved data of ozone-related COPD death and disability adjusted life year (DALY) from the Global Burden of Disease 2019. We used a linear regression of natural logarithms of age-standardized rates (ASRs) with calendar year to examine the trends in ASRs and a panel regression to identify country-level factors associated with the trends. Global ozone-attributable COPD deaths increased from 117,114 to 208,342 among men and from 90,265 to 156,880 among women between 1990 and 2019. Although ASRs of ozone-related COPD death and DALY declined globally, they increased in low and low-middle Socio-demographic Index (SDI) regions, with faster rise in women. Elevated average maximum temperature was associated with higher ozone-attributable COPD burden, while more green space was associated with lower burden. More efforts are needed in low and low-middle SDI regions, particularly for women, to diminish inter-country inequality in ozone-attributable COPD. Global warming may exacerbate the burden. Expanding green space may mitigate the burden.

Addressing health workforce shortages as a precursor to attaining universal health coverage: A comparative policy analysis of Nigeria and Ghana

There is a critical shortage of health professionals globally which is affecting the possibility of attaining universal health coverage. Developing countries in sub-Saharan Africa such as Ghana and Nigeria are disproportionately affected and the shortfall in health professionals is envisaged to worsen over the next decade. Countries have responded differently in addressing this shortage. To understand the differing response to the same policy issue in two countries that share similar characteristics in terms of geolocation, socioeconomic indices and disease burden, this paper offers a comparative policy analysis of the two countries using the 3-I framework and punctuated equilibrium theory as comparative policy analysis tools. The analysis identified the ideas, interests, and institutions at play and how they have led to different policy outcomes in both countries. The analysis also shows the interaction between subsystems, policy images and policy venues and how this interaction led to policy change, in the case of Ghana and lag in the case of Nigeria. Our findings show four critical areas in addressing health workforce shortages in both countries – a general approach to addressing the issue, welfare and remuneration, workforce autonomy and career progression, and financing for workforce improvement. For Ghana, there has been significant policy change including implementing strategies for increasing the production of health professionals and addressing remuneration and welfare issues. For Nigeria, there has been seems to be a lag in policy change. While the findings show that Ghana's approach has seemingly put them on a good path toward universal health coverage, applying any lessons should, however, be contextual, considering other country-level and health systems factors that are relevant to addressing health workforce shortages.

The effects of individual and cultural factors on digital inclusion in European countries: a two-level regression analysis

PurposeWith digitisation, a new kind of inequality has emerged in society between people and groups of people. A lack of digital inclusion creates challenges for the economic and social development of society and citizen participation. This study analyses how the country-level cultural factors defined by Hofstede are associated with citizens' digital skills and internet usage and how they moderate the effects of age, gender, educational level and income level.Design/methodology/approachThis comparative cross-sectional study examines digital inclusion in 22 European countries. Data from the European Social Survey (N = 37,602) are analysed using a two-level regression analysis.FindingsThe study found significant effects of demographic and socio-economic factors and country-level indulgence on digital skills and internet usage. In addition, the study shows that a high value on the indulgence index moderates the negative effect of age.Originality/valueThe digital divide has been studied widely with regard to individual-level influencing factors and international comparisons. The significance of Hofstede’s cultural dimensions in terms of digitisation and digital divides has also been confirmed in previous studies. However, there is a lack of analysis combining the effects of country-level culture and individual-level demographic and socio-economic factors on citizens' digital skills and internet usage. Generally, the research emphasises the significance of national culture in digital inclusion and especially in supporting the digital inclusion of older adults.

Do pregnant persons want influenza vaccines? Knowledge, attitudes, perceptions, and practices toward influenza vaccines in 8 low- and middle-income countries.

While vaccination is the most effective way to prevent influenza infection and adverse outcomes, and despite WHO recommendations to vaccinate pregnant persons, access to seasonal influenza vaccines remains low. We explored knowledge, attitudes, and practices of pregnant persons about seasonal influenza vaccines to inform actions to improve vaccine uptake among this priority population. We pooled individual-level data from cross-sectional surveys assessing pregnant persons' attitudes toward seasonal influenza vaccines in eight low- and middle-income countries during 2018-2019. The eight countries used a standard protocol and questionnaire to measure attitudes and intents toward influenza vaccination. We stratified by country-level (presence/absence of a national influenza vaccination program, country income group, geographic region) and individual-level factors. Our analysis included 8,556 pregnant persons from eight low- and middle-income countries with and without seasonal influenza vaccination programs. Most pregnant persons (6,323, 74%) were willing to receive influenza vaccine if it was offered for free. Willingness differed by presence of an existing influenza vaccination program; acceptance was higher in countries without influenza vaccination programs (2,383, 89%) than in those with such programs (3,940, 67%, p < 0.001). Most pregnant persons in middle-income countries, regardless of influenza vaccination program status, were willing to be vaccinated against influenza if the vaccine was provided free of charge. National investments in influenza vaccination programs may be well-received by pregnant persons, leading to averted illness both in pregnant persons themselves and in their newborn babies. US Centers for Disease Control and Prevention.

Abortion Attitudes Across Cultural Contexts

Abstract: We explored between-country and within-country variability in abortion attitudes, using country-level factors (e.g., gender equality) and individual-level factors (e.g., gender role attitudes) as predictors. Participants from Mexico ( N = 215), India ( N = 215), the United States ( N = 215), and the United Kingdom ( N = 206) were recruited via Qualtrics Panels. Regression models and ANOVAs were used to assess whether estimates of gender inequality, gender role attitudes, motherhood norms, belief in big/moralizing gods, and sexual strategy were associated with abortion attitudes. As predicted, individuals living in countries with greater gender inequality, and more restrictive abortion policy, reported more restrictive abortion attitudes and stronger support for banning abortion. Furthermore, individuals who endorsed more traditional gender role ideologies, who reported belief in big/moralizing gods and who used long-term sexual strategies also reported more restrictive abortion attitudes and stronger support for banning abortion. Exploratory analyses highlight how these relationships vary as a function of cultural context. We can conclude that both contextual factors (e.g., local abortion legislation and gender inequality) as well as individual factors (e.g., gender role attitudes and religious/spiritual belief) shape people’s attitudes toward abortion. Implications regarding the bidirectional relationship between attitudes and policy in reproductive health are discussed.

Risk factors of peritoneal dialysis-related peritonitis in the Japan Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS).

Peritoneal dialysis (PD)-related peritonitis is a major complication of PD. Wide variations in peritonitis prevention, treatment strategies and consequences are seen between countries. These between-country differences may result from modifiable risk factors and clinical practices. A total of 1225 Japanese PD patients were included and prospectively followed in the Peritoneal Dialysis Outcomes and Practice Patterns Study phase 1 (2014-2018) and phase 2 (2018-2022). Associations between PD-related peritonitis and various risk factors were assessed by Cox proportional hazards survival models. During follow-up (median 1.52years), 539 peritonitis episodes were experienced by 364 patients. The country crude peritonitis rate was 0.27 episodes/patient-year. In the fully adjusted model, noticeable patient-level factors associated with experiencing any peritonitis included age {hazard ratio [HR] 1.07 per 5-year increase [95% confidence interval (CI) 1.01-1.14]}, serum albumin level [HR 0.63 per 1g/dl higher (95% CI 0.48-0.82)] and continuous ambulatory peritoneal dialysis (PD) [HR 1.31 versus automated PD (95% CI 1.05-1.63)]. The adoption of antibiotic prophylaxis practice at the time of PD catheter insertion [HR 0.63 (95% CI 0.51-0.78)] or when having complicated dental procedures [HR 0.74 (95% CI 0.57-0.95)] or lower endoscopy [HR 0.69 (95% CI 0.54-0.89)] were associated with lower hazards of any peritonitis, while a routine facility practice of having more frequent regular medical visits was associated with a higher hazard. Identification of risk factors in Japan may be useful for developing future versions of guidelines and improving clinical practices in Japan. Investigation of country-level risk factors for PD-related peritonitis is useful for developing and implementing local peritonitis prevention and treatment strategies.

Heterogeneity in the integration of ESG measures in executive compensation: Determinants, contracting details and outcomes

Corporate social responsibility (CSR) contracting incorporates environmental, social, and governance (ESG) related measures in executive compensation plans. Current research on this practice is limited to a US setting, despite global adoption. We investigate heterogeneity in CSR contracting using data from 59 countries between 2002 and 2019. We find that besides firm-level past ESG performance and the industry-level adoption rate, country-level ESG regulations have significant explanatory power in firms’ tendencies to adopt CSR contracting. Hand-collected data reveal significant cross-country differences in CSR contracting details. Finally, CSR contracting is positively associated with subsequent financial performance only in countries with more stringent ESG regulations and stronger legal enforcement. In contrast, CSR contracting is associated with subsequent ESG performance regardless of country-level factors.