Cross-country Comparisons Research Articles

Sociotechnical Cross-Country Analysis of Contextual Factors That Impact Patients' Access to Electronic Health Records in 4 European Countries: Framework Evaluation Study.

The NORDeHEALTH project studies patient-accessible electronic health records (PAEHRs) in Estonia, Finland, Norway, and Sweden. Such country comparisons require an analysis of the sociotechnical context of these services. Although sociotechnical analyses of PAEHR services have been carried out in the past, a framework specifically tailored to in-depth cross-country analysis has not been developed. This study aims to develop and evaluate a method for a sociotechnical analysis of PAEHRs that advances a framework for sociotechnical analysis of eHealth solutions first presented by Sittig and Singh. This first article in a series presents the development of the method and a cross-country comparison of the contextual factors that enable PAEHR access and use. The dimensions of the framework for sociotechnical analysis were thoroughly discussed and extended in a series of workshops with international stakeholders, all being eHealth researchers focusing on PAEHRs. All countries were represented in the working group to make sure that important national perspectives were covered. A spreadsheet with relevant questions related to the studied services and the various dimensions of the sociotechnical framework was constructed and distributed to the 4 participating countries, and the project participants researched various national sources to provide the relevant data for the comparisons in the 10 sociotechnical dimensions. In total, 3 dimensions were added to the methodology of Sittig and Singh to separate clinical content from features and functions of PAEHRs and demonstrate basic characteristics of the different countries regarding national and regional steering of health care and information and communications technology developments. The final framework contained the following dimensions: metadata; hardware and software computing infrastructure; features and functions; clinical content shared with patients; human-computer interface; people; workflow and communication; the health care organization's internal policies, procedures, and culture; national rules, regulations, and incentives; system measurement and monitoring; and health care system context. The dimensions added during the study mostly concerned background information needed for cross-country comparisons in particular. Several similarities were identified among the compared countries, especially regarding hardware and software computing infrastructure. All countries had, for example, one national access point, and patients are provided a PAEHR automatically. Most of the differences could be identified in the health care system context dimension. One important difference concerned the governing of information and communications technology development, where different levels (state, region, and municipality) were responsible in different countries. This is the first large-scale international sociotechnical analysis of services for patients to access their electronic health records; this study compared services in Estonia, Finland, Norway, and Sweden. A methodology for such an analysis was developed and is presented to enable comparison studies in other national contexts to enable future implementations and evaluations of PAEHRs.

Does arts and cultural group participation influence subsequent well-being? A longitudinal cross-country comparison of older adults in Japan and England

IntroductionArts engagement is a positive health behaviour that could support the mental and social well-being of ageing populations globally. However, research is predominantly from Western countries, leaving it unclear whether...

Early Career Teachers’ Professional Agency in the Classroom and Socio-contextual Burnout: A Cross-country Comparison

This study examines early career teachers’ (ECT) professional agency in relation to socio-contextual burnout in four European countries: the UK, the Netherlands, Finland, and Sweden. Teachers’ professional agency has been shown to be related to their work-related well-being. However, we know little about the societal, cultural and contextual conditions facilitating the sense of professional agency that ECTs have in terms of active and intentional learning in the classroom and how ECTs experience burnout across countries. The aim of this study was to find out if these experiences of agency and burnout vary between countries and if they are interrelated. A total of 3814 ECTs responded to the survey, and the data were analysed using structural equation modelling. We found that the scales of teachers’ professional agency and socio-contextual burnout were invariant and related to each other across the countries. In particular, the aim of ECTs to build a collaborative environment and transform classroom practices with students were found to hold potential to tackle burnout in the four countries examined.

Walking the line of the double bind: A cross-country comparison on women and men politicians’ self-presentations on social media

Abstract Political leaders play a crucial role in shaping societal perceptions and citizens’ expectations of gender roles. Through their self-presentation on social media, political leaders have the power to either reinforce or challenge existing gender stereotypes, thereby influencing how citizens perceive and interpret gender norms. However, research on how women and men politicians present themselves on social media is scarce. This comparative study contributes to remedying this research gap by content analysing the official Facebook and Instagram pages of 18 political leaders during the 2021 national election campaigns in Germany and Norway. In contrast to earlier research on gendered presentations of politicians in the news, we did not find strong evidence of gendered self-presentations in either country, neither in terms of personalisation nor in terms of gender issue ownership. This could be because gender roles in Germany and Norway have become more fluid, or because the successful politicians we have analysed have been successful due to their ability to “walk the double bind” of needing to conform to both masculine and feminine gender expectations. Our study calls for more comparative research into this field, including studies of lower profile politicians and politicians in countries with lower degrees of gender equality.

Measuring sexual behavior stigma among cisgender men who have sex with men: an assessment of cross-country measurement invariance.

Globally, cisgender men who have sex with men experience sexual stigma, but limited investigation of cross-population scale performance hinder comparisons. As measurement invariance is a necessary but seldom-established criterion of valid cross-cultural comparisons, we assessed invariance in scales of stigma related to sexual behavior across 9 countries. This secondary analysis used data collected from adult (mean age=29.6, standard deviation=12.5) cisgender men who have sex with men (n=8,669) in studies from 6 West African, 2 Southern African, and 1 North American country from 2012-2016. A common item set assessed 2 sexual behavior stigma domains. A sequential process was used to test the factor structure and measurement invariance, which included multigroup confirmatory factor analyses (CFA). Individual countries, items, living with HIV, and disclosure were explored as possible sources of noninvariance. Goodness-of-fit statistics indicated adequate fit of the same 2-factor model in 7 of the 9 countries. The chi2 difference test comparing a constrained and unconstrained 7-country model in which loadings and thresholds were freely estimated was significant (p<0.001), indicating metric and scalar noninvariance, but removing the US provided evidence of invariance and freeing certain items led to a finding of partial invariance. Sexuality disclosure exhibited a direct relationship with select stigma items in several countries. Our findings point to the utility of the two stigma scale dimensions in making cross-country comparisons, but also to the necessity of assessing invariance with explicit attention to several factors including differential disclosure of sexuality across contexts to ensure valid comparisons.

Unlocking the Potential: An In-Depth Analysis of Factors Shaping the Success of Smart and Bidirectional Charging in a Cross-Country Comparison

The increasing utilisation of the distribution grid caused by the ramp-up of electromobility and additional electrification can be eased with flexibility through smart and bidirectional charging use cases. Implementing market-oriented, grid-, and system-serving use cases must be tailored to the different national framework conditions, both in technical and regulatory terms. This paper sets out an evaluation methodology for assessing the implementation of smart and bidirectional charging use cases in different countries. Nine use cases are considered, and influencing factors are identified. The evaluation methodology and detailed analysis are applied to Austria, the Czech Republic, Denmark, Finland, France, Germany, Italy, the Netherlands, Spain, and Sweden. In every country, the implementation of vehicle-to-home use cases is possible. Realising market-oriented use cases is feasible in countries with a completed smart meter rollout and availability of tariffs with real-time pricing. Grid-serving and ancillary service use cases depend most on country-specific regulation, which is why no clear trend can be identified. Use cases that require direct remote controllability are the most distant from implementation. The overarching analysis provides orientation for the design of transnational products and research and can serve as a basis for a harmonisation process in regulation.

Factors shaping network emergence: A cross-country comparison of quality of care networks in Bangladesh, Ethiopia, Malawi, and Uganda.

The Quality-of-Care Network (QCN) was conceptualized by the World Health Organization (WHO) and other global partners to facilitate learning on and improve quality of care for maternal and newborn health within and across low and middle-income countries. However, there was significant variance in the speed and extent to which QCN formed in the involved countries. This paper investigates the factors that shaped QCN's differential emergence in Bangladesh, Ethiopia, Malawi, and Uganda. Drawing on network scholarship, we conducted a replicated case study of the four country cases and triangulated several sources of data, including a document review, observations of national-level and district level meetings, and key informant interviews in each country and at the global level. Thematic coding was performed in NVivo 12. We find that QCN emerged most quickly and robustly in Bangladesh, followed by Ethiopia, then Uganda, and slowest and with least institutionalization in Malawi. Factors connected to the policy environment and network features explained variance in network emergence. With respect to the policy environment, pre-existing resources and initiatives dedicated to maternal and newborn health and quality improvement, strong data and health system capacity, and national commitment to advancing on synergistic goals were crucial drivers to QCN's emergence. With respect to the features of the network itself, the embedding of QCN leadership in powerful agencies with pre-existing coordination structures and trusting relationships with key stakeholders, inclusive network membership, and effective individual national and local leadership were also crucial in explaining QCN's speed and quality of emergence across countries. Studying QCN emergence provides critical insights as to why well-intentioned top-down global health networks may not materialize in some country contexts and have relatively quick uptake in others, and has implications for a network's perceived legitimacy and ultimate effectiveness in producing stated objectives.

Dark triad personality, motivational dynamics and nascent entrepreneurs entrepreneurial intentions: cross-country comparison

This research explores the relationships between the dark triad, motivational dynamics, and entrepreneurial intentions, as well as the moderating effect of the country on these relationships. Using a cross-sectional design, the study utilizes a sample of 701 new entrepreneurs from Turkey (n = 368) and Kosovo (n = 333). The findings indicate that narcissism positively influences entrepreneurial intentions. Additionally, psychopathy and Machiavellianism negatively impact motivational dynamics, while narcissism has a positive effect. Furthermore, the positive effects of motivational dynamics on entrepreneurial intentions have been confirmed. Mediation analysis reveals that individual motivations partially mediate the relationship between the dark triad and entrepreneurial intentions. Finally, the research results show that the country plays a moderating role in the relationships between narcissism and entrepreneurial intentions, personal attitudes and entrepreneurial intentions, psychopathy, and perceived behavioral control, and the need for achievement and narcissism with personal attitudes. Our study provides theoretical contributions as well as policy and managerial implications in the emerging field of entrepreneurship.

A text-mining analysis of Latin America Universities’ mission statements from a ‘Third Mission’ perspective

ABSTRACT University Mission Statements (UMS) were born by imitating a common practice in the business world, where private organisations state their core values and main purposes. Recently, there has been growing interest in analysing UMS through the lens of the Third Mission (TM) of universities. Despite the increasing attention to UMS analysis of TM at the national level, there remains a dearth of research that conducts international comparisons of UMS across various countries utilizing a TM perspective. In this study, we adopt a text mining approach commonly employed in Natural Language Processing studies to categorize 1304 UMS from 19 Latin American countries based on generalized social and economic orientations of TM. By eschewing classifications reliant on specific TM aspects and activities, our analysis aims to facilitate meaningful regional and cross-country comparisons. On average, the orientation of UMS from Latin American countries is 82% social and 55% economic, significant variations observed across countries reflecting the particularities of each Higher Education System. Our results are comparable to previous research analysing single-country UMS, utilizing interpretive content analysis and a Third Mission lens. This evidence offers a quantitative perspective that aligns with existing regional narratives, enriching our understanding of the Third Mission across Latin America.

Identifying the Careless Responders: A Cross-Country Comparison on PISA 2018 Dataset

Careless responding (CR) is one of the major concerns in self-report measures since it affects the quality of collected data. In this research, it was aimed to examine the dataset in terms of CR, to investigate the effects of CR on the psychometric properties of data, and to examine the effectiveness of CR detection methods in a cross-cultural context. Specifically; response time, outlier and long-string indices were used to flag CR and efficiency of using these were compared on PISA 2018 reading related attitude scales for Singapore and Turkey. As a result, it was indicated that the amount of CR was higher for Singapore than Turkey at long-string and response time methods. Furthermore, after removal of CR from dataset, enjoyment level of reading, perception of competence and perception of difficulty of PISA tests scores increased. Another result was that long-string and response time analyses provided significant improvement in model fit and long-string had the highest improvement level. Moreover, removing respondents according to outlier analyses didn’t provide any improvement on model-data fit. In general, results illustrated that careless responding behavior may have important effects on psychometric properties of self-report and screening the data for CR is strongly suggested in future studies.

Perceptions of misinformation salience: a cross-country comparison of estimations of misinformation prevalence and third-person perceptions

ABSTRACT Against the backdrop of mounting concerns about misinformation's destabilizing impact paired with growing distrust in established news, this study explores how people estimate misinformation salience in their news environment when engaging in comparative risk assessment with other countries. The study derives from two opposite lines of reasoning on risk perceptions: While research indicating the relative scarcity of misinformation might imply an overestimation of its significance within people's own information environments, the literature on third-person perceptions could counteract this perspective, suggesting a tendency toward underestimating the relative personal risk of misinformation exposure. A survey in seven countries (N = 2,979; the USA, the UK, The Netherlands, Germany, France, Poland, India) showed how perceptions of misinformation salience are not characterized by a systematic underestimation of relative personal risks, but rather reflect a general concern regarding news landscapes being undermined by misinformation. These findings highlight the importance of understanding and studying how audiences themselves make sense of misinformation salience, as these perceptions determine how people navigate a news environment that is perceived to be disrupted by the omnipresence of misinformation.

Sustainable development perspectives in Nordic physical education curricula: a cross-country comparison of the status and pre-conditions

ABSTRACT In the present study, we present a cross-country comparison of the status and condition of sustainable development (SD) in the Nordic physical education (PE) curricula. The aim of the study was to increase knowledge of how SD perspectives are represented and conceptualised in the Nordic PE curricula. An expert-driven research approach was used where representatives from Denmark, Finland, Iceland, Norway, and Sweden provided country overviews and completed surveys to elaborate on the status, pre-conditions, prospect/future, and research initiatives in relation to SD in PE. The study shows that SD perspectives seldom are explicitly mentioned in the Nordic PE curricula, and that little is known regarding how PE teachers understand SD in relation to PE goals and content in their countries. Suggestions on specific SD goals to focus on in Nordic PE, as well as suggestions on future research are provided and discussed in the paper.

The interrelationship between global mindedness and global awareness in explaining variability in global self-efficacy: a cross-country comparison

Recognition and understanding of the interconnectedness of the world and the complex web of global issues can have a positive effect on an individual’s belief in their ability to navigate and make a positive impact on global issues. However, past literature is not clear about how this relationship may be affected by a mindset characterized by openness, empathy, and respect for diverse perspectives and cultures. This study fills this gap in the literature by examining the interactive relationship of global mindedness and global awareness in explaining variation in global self-efficacy. Our results suggest a strong, robust, and positive interactive effect in some but not all countries with our empirical models explaining as much as two-fifths of the total variation in global self-efficacy. Educational implications and suggestions for future research are discussed.

Cross-Country Comparison of Risk Factors in Public–Private Partnerships in Infrastructure Development: Evidence from Colombia, Kazakhstan, and Ghana

Cross-Country Comparison of Risk Factors in Public–Private Partnerships in Infrastructure Development: Evidence from Colombia, Kazakhstan, and Ghana

627 Epidemiology, Admissions Outcomes, and Mortality for Geriatric Trochanteric Fractures. A Major Trauma Centre Study

Abstract Aim Femur trochanteric fractures are very debilitating injuries yet are under investigated in orthopaedic literature. We study the epidemiology, hospital admission factors, and mortality for elderly patients with trochanteric fractures. Method All patients over 65 years old at a level-1 trauma-centre with a trochanteric hip fracture from January-2015 to June-2021 were included. Fractures were subdivided with AO/OTA subclassifications into intertrochanteric (31-A1,A2,A3) and subtrochanteric (32-A1,A2) sub-types. Patient demographics, preadmission mobility, time-to-surgery, length-of-surgery, surgical fixation used, inpatient rehabilitation/mobilisation, and post-operative mortality at 1,3,6 and 12 months, were collected. Patients were followed up for minimum of 2-years. Statistical significance was p&amp;lt;0.05. Results A total of 1101 patients were included. The AO/OTA classification was: 31-A1(123), 31-A2(491), 31-A3(105), 32-A1(221), 32-A2(161). Average age was 84.9, with 72.8% patients being female. Average admission-to-surgery, surgery-time, and surgery-to-discharge-time was 21.6hours, 1.2hours, and 15.5days respectively. Overall mortality was 7.2%(1-month), 15.4%(3-months), 20.4%(6-months) and 27.1%(12-months). There were no statistically significant associations of type of fracture, operative method, or surgery-within-36hours, with mortality at any scale. Post-operative mobilisation within 24-hours, with or without physiotherapist aid, was associated with lower mortality on all investigated time scales, compared to no mobilisation (p&amp;lt;0.05). Conclusions Our study presents a large and detailed cohort of patients with trochanteric fractures classified with AO/OTA, the first in the UK, and investigated the associations with inpatient admission and mortality outcomes. Our detailed analysis and high-resolution data will allow for cross region and country comparisons and inform guideline and quality improvement efforts.

Decoding Scholarly Publication Dynamism in Oman Using Data Mining Exploration

The purpose of this study is to understand and analyze the quantitative data on the trend of academic publications produced by researchers across all disciplines, from science to humanities using bibliometric analysis affiliated with the Sultanate of Oman. During the study, a cross-country comparison was also conducted in order to determine and gage the contributions of various higher education institutions with a special focus on Oman. For the extraction of bibliometric data between January 1970 and November 2021, databases like Web of Science (WoS) and Scopus were taken into consideration. The results indicate the highest productivity years between 2012 and 2015, with elevated citation scores earned in the year 2012. Sultan Qaboos University in Oman emerged as the most notable contributor among higher education institutions in the Sultanate. Thus, this exhaustive bibliometric research depicts and abridges over 50 years of research work. This paper also outlines active higher education institutions in Oman involved in research and publication, the citations on their work, and productive years with respect to scholarly publications.

Health Inequity and Dietary Data Gaps: Cross-Country Comparison of Sodium Intake in the United States and China, 1989–2018

Health Inequity and Dietary Data Gaps: Cross-Country Comparison of Sodium Intake in the United States and China, 1989–2018

The cost of typhoid illness in low- and middle-income countries, a scoping review of the literature.

Typhoid fever is responsible for a substantial health burden in low- and middle-income countries (LMICs). New means of prevention became available with the prequalification of typhoid conjugate vaccines (TCV) by the World Health Organization (WHO) in 2018. Policymakers require evidence to inform decisions about TCV. The economic burden related to typhoid fever can be considerable, both for healthcare providers and households, and should be accounted for in the decision-making process. We aimed to understand the breadth of the evidence on the cost of typhoid fever by undertaking a scoping review of the published literature. We searched scientific databases with terms referring to typhoid fever cost of illness to identify published studies for the period January 1st 2000 to May 24th 2024. We also conferred with stakeholders engaged in typhoid research to identify studies pending completion or publication. We identified 13 published studies reporting empirical data for 11 countries, most of them located in Asia. The total cost of a typhoid episode ranged from $23 in India to $884 in Indonesia (current 2022 United States Dollar [USD]). Household expenditures related to typhoid fever were characterized as catastrophic in 9 studies. We identified 5 studies pending completion or publication, which will provide evidence for 9 countries, most of them located in Africa. Alignment in study characteristics and methods would increase the usefulness of the evidence generated and facilitate cross-country and regional comparison. The gap in evidence across regions should be mitigated when studies undertaken in African countries are published. There remains a lack of evidence on the cost to treat typhoid in the context of increasing antimicrobial resistance. Decision-makers should consider the available evidence on the economic burden of typhoid, particularly as risk factors related to antimicrobial resistance and climate change increase typhoid risk. Additional studies should address typhoid illness costs, using standardized methods and accounting for the costs of antimicrobial resistance.

Measurement invariance of subjective social status: The issue of single-item questions in social stratification research

Measures of objective and subjective social status are commonly used in social stratification research. While objective measures have been extensively examined for cross-national comparability, subjective indicators have received less attention. This study aims to address this research gap by investigating the measurement invariance of the three most commonly used single-item measures of subjective social status across many countries. Using a Bayesian approximation approach, we analysed data from three waves of the International Social Survey Programme conducted between 1999 and 2019. The analyses showed that our composite measure is a relatively reliable and stable construct when compared internationally. However, some single-item measures were not invariant across countries or survey rounds, suggesting that the average of a given single measure of subjective status or the relationship between it and other variables should not be compared across countries. Finally, the study showed that a subjective status item with a 10-step numerical ladder seems to be more appropriate for cross-country comparisons, showing low variation across countries. To improve the validity of future research, we recommend that at least three questions measuring subjective social status be included in international questionnaires and that subjective status be used as a latent construct whenever possible and appropriate.

The Role of Digitalisation in Shaping a Country's Image

The objective of this study is to examine the complex role played by digital technologies in shaping a country's image on the global stage. In recent times, with the rapid evolution of digital communication platforms, developing nations have increasingly turned to digital technologies to project their cultural, economic, and political narratives to an international audience. This paper examines the relevant literature relating to how digital technologies contribute to the creation and dissemination of a country's image, impacting the opinions and views of global stakeholders. It so doing, the paper reviews the challenges and opportunities arising from the integration of digital tools in country branding efforts, including misinformation concerns, digital diplomacy, cybersecurity, and the democratization of narrative-building. The paper then puts forward a provisional conceptual framework for primary research in Nigeria that will examine the interplay of digitalisation and country image. The paper concludes that digitalisation has a significant influence on a country's image, affecting perceptions of technological advancement, economic development, access to information, social transformation, and global competitiveness, and suggests that the framework put forward here may act as a model for cross-country comparisons in subsequent studies.