International Setting Research Articles

The Future of HSR Program Evaluation: A European Perspective

Abstract There is a long tradition of program evaluation in public health, due to the influence of medical approaches and the development of evidence-based medicine. Health services research have thus provided substantial evidence and built itself partially on the evaluation of organizational innovations over time in various international healthcare settings. What is new here? What is the future of HSR from an evaluation perspective? Since the turn of the century, two main shifts in the resources and methods available to public health researchers could provide a significant leap for HSR research in Europe, and in France especially. First, more data are being produced and made available to researchers. Most healthcare systems in Europe have implemented DRGs and for doing so, information systems have been developed incidentally. This led to the routine production of data initially used for payment schemes, that are now increasingly being used for research. Although this is similar to what happened in the US, the main difference with European healthcare systems lies in the generalized approach of the welfare system to the whole population. Second, evaluation methods recently evolved towards the framework of what is known as “realist evaluation” based on the causal analysis of programs or public policies while incorporating contextual effects and a theoretical perspective to explain rather than merely measure the effect - or lack thereof. To conclude, we shall argue that the future of HSR program evaluation may bring together researchers, health professionals and policymakers to discuss, explore, experiment and implement innovative actions in healthcare to address the challenges to come.

In different states of indifference: movement, friction, and resistance

In different states of indifference: movement, friction, and resistance

Teachers’ Awareness and Management of the Social, Cultural, and Political Indexicalities of Translanguaging

ABSTRACT Translanguaging scholars have debated whether dismantling boundaries between “named” languages is necessary for social justice in education. To explore this issue, we examined teachers’ reported use of named languages or translanguaging in classroom activities. We used a survey as an interview protocol to compare the extent to which four primary teachers in different international settings implemented two types of bi/multilingual practices with a recently taught class: translanguaging to learn without regard for boundaries between named languages, and symbolic valuation of students’ (named) home languages and languages of affiliation. Using the sociolinguistic construct of “indexicality” as a lens of analysis, we found that only sometimes do teachers describe attaching positive indexicalities (social, cultural, or political meanings) to dynamic translanguaging or to named languages, and only sometimes are these indexicalities egalitarian—suggesting that the answer to the debate lies in positionings teachers create while marshalling translanguaging or named languages to manage classroom identities.

Sustainability efforts in healthcare simulation and clinical learning: An international survey

BackgroundLittle is known about international environmental sustainability practices in healthcare simulation education. Understanding these practices can elucidate current differences in practice, promote sharing of current practices, and establish baseline efforts for improving sustainability practices globally. Therefore, an electronic survey was undertaken targeting international healthcare simulation centers to acquire a more comprehensive understanding of healthcare simulation education sustainability practices in differing international settings. ResultsOnly 40 % of respondents had a written sustainability plan, but 68.75 % indicated their center purchased environmentally preferable supplies, 100 % endorsed supply reuse, 60.4 % endorsed supply recycling, and 37.5 % endorsed sustainable supply disposal. Most participants cited “environmental consciousness” motivated these efforts. Comparison analyses found significant differences between the U.S. and Canada for recycling (p = 0.0065) and disposal (p = 0.0074), and between Canada and international countries for recycling (p = 0.01395). ConclusionCanadian simulation centers implement more waste reduction practices than any other country surveyed. Further research should investigate factors contributing to variability and perceptions of sustainability efforts, as well as differences in international waste reduction capabilities. Countries with the most successful waste reduction efforts should advertise and expand them. In addition, healthcare simulation centers must be aware of current options for plastic reuse and embed those practices into healthcare simulation centers. Embedded practices should be taught to all simulation educators and students, with the ultimate goal of students translating these ideas into practice. The summation of improving these sustainability efforts in healthcare simulation education can have a positive global impact.

The paradoxical (post-)politics of scale: exploring authoritarian state environmental policymaking in Brunei

ABSTRACT This article argues how the politics of scale is paradoxically used by the Bruneian state in environmental policymaking to legitimate its internal authoritarian regime. The literatures on post-politics, green authoritarianism and green as ‘spectacle’ are used in conjunction with personal observation findings on forestry protection and climate change policymaking processes, and triangulation with global environmental performance indices, to explore this paradox. The Bruneian state must justify a strong environmental policy implementation rhetoric, whilst simultaneously having to maintain its domestic authoritarian functioning that relies on fossil fuel extraction and exportation. It does this by engaging in a ‘consensual’ neoliberal post-politics that uses supra-national and international environmental policy frameworks and settings that are liberal democratic and polycentric in nature, through a ‘post-politics of scale’. This article contributes to the wider territory, politics and governance literature by illustrating how internal enviro-political tensions are remedied, inculcated across, and discursively influenced by, wider geographical spaces and politics beyond individual states, regardless of their political regime type.

The TT-AT trauma protocol piloted in different international settings: Zambia, UK, Italy

ABSTRACT Background Art therapists have worked with traumatised individuals from the very beginning. Nevertheless, the effectiveness of art therapy in the treatment of Post Traumatic Stress Disorder (PTSD) and Complex Post Traumatic Stress Disorder (C-PTSD) is not yet evidence-based. Studies suggest innovative treatments should describe clearly both the intervention, in order to facilitate replication, and the treatment targets, in order to facilitate assessment and research. Context In the ‘Trauma Treatment through Art Therapy’ (TT-AT) protocol, the intervention is described clearly, and the treatment targets are the six client symptom clusters listed by the International Society for Traumatic Stress Studies (ISTSS): (1) emotion regulation; (2) relationships with others; (3) relationship with self; (4) awareness of trauma; (5) distancing; (6) resources. The intervention consists of six sessions, one for each symptom and related need. Approach The TT-AT protocol – that was developed and piloted in Tanzania – is now being applied in three other countries (Zambia, the UK and Italy). Outcomes The group participants in the three countries followed the six themes easily. Some shared the history of traumas, even though verbal sharing was optional, and sometimes for the first time hidden traumas of the past. After the intervention they described being able to leave the past in the past, feeling stronger in the present, and more hopeful about their future. Conclusions and implications for research The TT-AT protocol can be replicated easily and it has clear treatment targets. This makes it suitable for use in research. Plain-language summary This article reports on the implementation of an innovative trauma treatment intervention (the TT-AT protocol) in three countries: Zambia, the UK and Italy. The format is group art therapy and all the participants are women with a history of traumatic experience presenting with a variety of PTSD and C-PTSD symptoms. The six art therapy workshops addressed the six symptoms listed by the International Society of Traumatic Stress Studies (ISTSS). The groups are: (a) a group of six medical students in Zambia; (b) a group of five in a community mental well-being project in the UK; (c) a group of four private practice clients in Italy. The article illustrates the art therapy process in each group. The participants moved through three stages, from the initial strengthening phase to the stage of becoming more aware of their trauma, to the final stage of trusting their own resources. Feedback shows improvements in dealing with their past and in coping with present life challenges. This report suggests that the protocol is suitable to be applied to diverse countries and cultures.

Implementing digital mental health interventions at scale: one-year evaluation of a national digital CBT service in Ireland

BackgroundIn recent years, exponential growth in digital innovations and internet access has provided opportunities to deliver health services at a much greater scale than previously possible. Evidence-based technology-enabled interventions can provide cost-effective, accessible, and resource-efficient solutions for addressing mental health issues. This study evaluated the first year of a supported digital cognitive behavioral therapy (CBT) service provided by the national health service in Ireland, which has been accessible to individuals who receive a referral from one of five referring groups: General Practitioners, Primary Care Psychology, Counselling Primary Care, Community Mental Health, and Jigsaw (a nationwide youth mental health service).MethodsA retrospective, observational study examining data from the service between April 2021 to April 2022 was conducted. Descriptive statistics on referrals, account activations, user demographics, program usage, and user satisfaction were extracted, and pre-to-post clinical outcomes for depression measured by the Patient Health Questionnaire-9 and for anxiety measured by the Generalised Anxiety Disorder-7 were analysed using linear mixed effect models.ResultsThere were 5,298 referrals and 3,236 (61%) account activations within the year. Most users were female (72.9%) and aged between 18 and 44 years (75.4%). The CBT programs were associated with significant reductions in both depression (β = 3.34, 95% CI [3.03, 3.65], p < 0.001) and anxiety (β = 3.64, 95% CI [3.36, 3.93], p < 0.001), with large effect sizes (Cohen’s d > 0.8). Time spent using the programs was also found to be a predictor of the variability in these clinical outcomes (p < 0.001), and accounting for this resulted in significantly better model fits (p < 0.001). User satisfaction ratings were also very high, exceeding 94%.ConclusionsEfforts to improve the representation of male and older adult users are warranted. However, overall, the results demonstrate how digital CBT can be provided at scale and lead to symptom reductions with large effect sizes for patients seeking help for depression and anxiety. The findings substantiate the continued use and expansion of this service in Ireland and the more widespread implementation of similar services in other international public healthcare settings.

Mood seasonality around the globe

This paper examines the existence of mood seasonality, documented by Hirshleifer et al. (2020, JFE) for the cross-section of US equity returns, in an international setting. First, we confirm the results of the original study. Next, we extend these findings to non-US markets and show that they are not sample-specific. A stock's relative historical seasonal returns are positively correlated with its relative future seasonal returns during similar or congruent mood periods and negatively related with its relative future seasonal returns during dissimilar or non-congruent mood periods. Moreover, both regression and portfolio analyses indicate that mood beta, the sensitivity of equity returns to aggregate investor mood, helps explain these mood seasonality effects.

Debunking the Production Predicaments among the Motor and Pump Exporters in the Coimbatore Region: Upside-down Approach of O-L-I Framework

We explore the unplumbed dimension of the O-L-I specific advantage of the firm in this research by shifting the focus from the entry mode of MNEs to problems faced by home-based manufacturer exporters, which is unique from its original concept. The proposed approach transposes the idea and implication of the eclectic paradigm in an international trade setting. To test the upside-down approach of the O-L-I framework, various challenges were identified through EFA and CFA, and in the final phase, the impact of ownership, location and internalization has been measured (using path analysis) on production problems faced by these manufacturer exporters. We used a structured questionnaire to collect the data from 220 motors and pump manufacturer exporters from January to September 2021. Moreover, the Coimbatore city wears the crown of ‘Pump City of Asia’, which makes the spot an ideal place for generalization of research and optimization of desired results. The research outcome illustrates the significant impact of location and internalization on the production problems encountered by the manufacturer exporters. The novelty of the study is substantiated by extending the application of O-L-I specific advantage for FDI to home-based exports, which we labelled as the ‘up-side-down approach’ of the O-L-I framework.

Real Earnings Management during Economic Downturns

ABSTRACT This study examines the impact of economic downturns on real earnings management activities in an international setting. Using a sample of 27 countries between 1988 and 2016, I find that the extent of real earnings management increases and that the substitution relation between real earnings management and accrual-based earnings management becomes stronger during economic downturns. Managers tend to rely on real earnings management to avoid the threat of greater scrutiny during economic downturns. The effect of an economic downturn on real earnings management is stronger for firms with high earnings management incentives, such as to avoid reporting earnings decreases and losses, to just meet or beat analysts’ earnings forecasts, and to facilitate the success of seasonal equity offerings. The findings suggest that real earnings management comes at a high cost. Firms sacrifice future performance when engaging in real earnings management. Data Availability: Data are available from the public sources cited in the text. JEL Classifications: G14; G28; G39; M41.

A Novel and Efficient Digital Pathology Classifier for Predicting Cancer Biomarkers Using Sequencer Architecture

In digital pathology tasks, transformers have achieved state-of-the-art results, surpassing convolutional neural networks (CNNs). However, transformers are usually complex and resource intensive. This study developed a novel and efficient digital pathology classifier called DPSeq to predict cancer biomarkers through fine-tuning a sequencer architecture integrating horizontal and vertical bidirectional long short-term memory networks. Using hematoxylin and eosin-stained histopathologic images of colorectal cancer from two international data sets (The Cancer Genome Atlas and Molecular and Cellular Oncology), the predictive performance of DPSeq was evaluated in a series of experiments. DPSeq demonstrated exceptional performance for predicting key biomarkers in colorectal cancer (microsatellite instability status, hypermutation, CpG island methylator phenotype status, BRAF mutation, TP53 mutation, and chromosomal instability), outperforming most published state-of-the-art classifiers in a within-cohort internal validation and a cross-cohort external validation. In addition, under the same experimental conditions using the same set of training and testing data sets, DPSeq surpassed four CNNs (ResNet18, ResNet50, MobileNetV2, and EfficientNet) and two transformer (Vision Transformer and Swin Transformer) models, achieving the highest area under the receiver operating characteristic curve and area under the precision-recall curve values in predicting microsatellite instability status, BRAF mutation, and CpG island methylator phenotype status. Furthermore, DPSeq required less time for both training and prediction because of its simple architecture. Therefore, DPSeq appears to be the preferred choice over transformer and CNN models for predicting cancer biomarkers.

Inclusive education policies – objects of observance, omission, and obfuscation: ten years on …

ABSTRACT This article draws upon a critical policy analysis approach to examine the state of inclusive education policy in Global North settings over the past decade. Building on an earlier paper on this topic ten years ago, this updated article seeks to explore whether and how inclusion and inclusive education have been understood in varied international, national and sub-national policy settings over time. While it might be anticipated that schooling systems should be more aware and proactive in supporting inclusion within their policies, our findings reveal mixed results. At times, there appears to have been regression in some settings, stagnation in others, as well as moderate progress in other settings in relation to support and advocacy for inclusion in educational policies. In an era of increased attention to a range of issues of inclusion more broadly over the past decade (e.g. marriage equality, gender fluidity, Black Lives Matter, #StopAsianHate), our article cautions against assuming that such movements have somehow led to a more ‘inclusive’ conception of students’ identities and wellbeing in schooling policy. Whether and how teachers can be expected to be more inclusive in their practices in such a variegated policy environment is an area for continued inquiry.

Correlation of immediate prevalence of cervical squamous cell precancers and cancers with HPV genotype and age in women with LSIL cytology: A retrospective analysis of 1617 cases.

To evaluate the immediate risk of cervical squamous cell precancers and cancers in women with low-grade squamous intraepithelial lesion (LSIL) cytology according to different high-risk human papillomavirus (hrHPV) results and age stratification. The study included 1617 women with LSIL cytology and underwent simultaneous Aptima HPV genotyping (E6/E7 mRNA test) followed by cervical biopsy. Among 1317 hrHPV positive cases, other 11 types of hrHPV were the most frequent (68.8%), followed by HPV16 (11.1%), HPV18/45 (4.1%), and HPV16/HPV18/45 (0.5%). Compared to other groups, HPV18/45 positive group and other 11 types of hrHPV group showed significantly higher prevalence of intraepithelial neoplasia grade (CIN)1 (p < .0001), while HPV16 positive and HPV16/HPV18/45 dual positive groups showed significantly higher prevalence of CIN2/3 (p < .0001). In addition, hrHPV positive, 25-39 years-old age group showed a significantly higher prevalence of CIN1 (p = .032) than the other age groups. Furthermore, CIN1 prevalence was significantly higher in patients under 40 or 50 years of age than in those over 40 or 50 years of age (p = .005 and p = .011, respectively). However, there was no significant difference among the different age groups in CIN2/3 prevalence in women with LSIL cytology. In southern Chinese women population, LSIL cytology carries very low immediate risk of high-grade squamous intraepithelial lesions (HSIL) (CIN2/3) in general. However, HPV16 positive and HPV16/HPV18/45 dual positive indicated a higher immediate risk of high-grade squamous intraepithelial lesions (HSIL) (CIN2/3). Age is not an immediate risk factor in this patient population for high-grade squamous lesions or SCC. These results are similar to data from cytology laboratories in the United States and other international settings, therefore strongly support the usage of ASCCP guidelines in this patient population.

A descriptive analysis of the contents of Care Response, an international data set of patient-reported outcomes for chiropractic patients

BackgroundDatabases have become an important tool in understanding trends and correlations in health care by collecting demographic and clinical information. Analysis of data collected from large cohorts of patients can have the potential to generate insights into factors identifying treatments and the characteristics of subgroups of patients who respond to certain types of care. The Care Response (CR) database was designed to capture patient-reported outcome measures (PROMs) for chiropractic patients internationally. Although several papers have been published analysing some of the data, its contents have not yet been comprehensively documented. The primary aim of this study was to describe the information in the CR database. The secondary aim was to determine whether there was suitable information available to better understand subgroups of chiropractic patients and responsiveness to care. This would be achieved by enabling correlations among patient demographics, diagnoses, and therapeutic interventions with machine learning approaches.MethodsData in all available fields were requested with no date restriction. Data were collected on 12 April 2022. The output was manually scanned for scope and completeness. Tables were created with categories of information. Descriptive statistics were applied.ResultsThe CR database collects information from patients at the first clinical visit, 14, 30, and 90 days subsequently. There were 32,468 patient responses; 3210 patients completed all fields through the 90 day follow up period. 45% of respondents were male; 54% were female; the average age was 49. There was little demographic information, and no information on diagnoses or therapeutic interventions. We received StartBack, numerical pain scale, patient global impression of change, and Bournemouth questionnaire data, but no other PROMs.ConclusionsThe CR database is a large set of PROMs for chiropractic patients internationally. We found it unsuitable for machine learning analysis for our purposes; its utility is limited by a lack of demographic information, diagnoses, and therapeutic interventions. However, it can offer information about chiropractic care in general and patient satisfaction. It could form the basis for a useful clinical tool in the future, if reformed to be more accessible to researchers and expanded with more information collected.

Foreign institutional investors and the value of excess cash holdings: international evidence

Purpose Using a comprehensive sample from developed and emerging economies, this study aims to examine whether foreign institutional investors (FIIs) enhance the value of excess cash by constraining the potential self-appropriating managerial propensity related to its inefficient utilization. Design/methodology/approach This study uses a large panel data set of firms from 32 non-US countries from 2007 to 2018. Using data from COMPUSTAT Global and S&amp;P Capital IQ, this study uses ordinary least squares regression with year- and firm-fixed effects for the baseline analysis. In addition, two-stage least squares with instrumental variable regression and propensity score matching approaches were used to address the potential endogeneity. Findings This study shows that FIIs significantly increase the value of excess cash holdings. The authors also found that the positive impact of FIIs is more significant when investors come from common-law countries with better governance and investor protection. Furthermore, in countries and firms with weaker governance controls, the relationship between FIIs and the value of excess cash is stronger, consistent with the institutional monitoring hypothesis. Collectively, the findings imply that FIIs are advantageous to investees because they effectively promote the efficient deployment of corporate resources. Practical implications Collectively, the findings of this study imply that FIIs are advantageous to investees because they effectively promote the efficient deployment of corporate resources. Originality/value This study offers new evidence on how FIIs impact the value of excess cash in an international setting. In addition, it highlights the significance of the legal origin of institutional investors’ home country and the governance quality of host countries and investee firms in influencing the effect of foreign institutional monitoring on the value of excess cash.

The International Association for the Study of Lung Cancer Thymic Epithelial Tumor Staging Project: A Re-Assessment of the International Thymic Malignancy Interest Group/International Association for the Study of Lung Cancer Lymph Node Map for Thymic Epithelial Tumors for the Forthcoming Ninth Edition of the TNM Classification of Malignant Tumors

IntroductionA lymph node map is the pillar on which accurate assignment and documentation of nodal classification stands. The International Thymic Malignancy Interest Group created the first map for thymic epithelial malignancies in conjunction with the eighth edition of the TNM classification, representing the first official TNM classification of thymic epithelial malignancies. The map was based on clinical experience and published studies, but it was largely empirical because of limited available data. Dissemination of the map and implementation of a standard thymic stage classification across the world in 2017 have provided more consistent and granular data. MethodsMore than twice as many cases of node involvement are available for analysis in the current database compared with that of the eighth edition database, allowing validation of many aspects of the eighth edition map. This article details the process and considerations for refinement of the thymic map for the ninth TNM used by the Thymic Domain of the Staging and Prognostic Factors Committee of the International Association for the Study of Lung Cancer. The committee evaluated a large international collaborative data set, published anatomical and clinical studies pertaining to lymph node spread from thymic epithelial tumors, in conjunction with the analysis underlying refinements of the TNM components for the ninth edition TNM classification. ResultsThe node map boundaries of the N1 and N2 categories remain unchanged. Visual clarifications have been added to the nomenclature of nodal stations within these regions. ConclusionsOn the basis of the recommendation to keep the N component unchanged for the ninth edition TNM classification, the lymph node map remains unchanged as well; however, clarifications have been added to facilitate clinical use.

Factorial validity and comparability of the six translations of the Rivermead Post-Concussion Symptoms Questionnaire translations: results from the CENTER-TBI study

BackgroundComparison of patient-reported outcomes in multilingual studies requires evidence of the equivalence of translated versions of the questionnaires. The present study examines the factorial validity and comparability of six language versions of the Rivermead Post-Concussion Symptoms Questionnaire (RPQ) administered to individuals following traumatic brain injury (TBI) in the Collaborative European NeuroTrauma Effectiveness Research (CENTER-TBI) study.MethodsSix competing RPQ models were estimated using data from Dutch (n = 597), English (n = 223), Finnish (n = 213), Italian (n = 268), Norwegian (n = 263), and Spanish (n = 254) language samples recruited six months after injury. To determine whether the same latent construct was measured by the best-fitting model across languages and TBI severity groups (mild/moderate vs. severe), measurement invariance (MI) was tested using a confirmatory factor analysis framework.ResultsThe results did not indicate a violation of the MI assumption. The six RPQ translations were largely comparable across languages and were able to capture the same construct across TBI severity groups. The three-factor solution comprising emotional, cognitive, and somatic factors provided the best fit with the following indices for the total sample: χ2 (101) = 647.04, {chi }^{2}/df= 6.41, p < 0.001, CFI = 0.995, TLI = 0.994, RMSEA = 0.055, CI90%[0.051, 0.059], SRMR = 0.051.ConclusionThe RPQ can be used in international research and clinical settings, allowing direct comparisons of scores across languages analyzed within the full spectrum of TBI severity. To strengthen the aggregated applicability across languages, further analyses of the utility of the response scale and comparisons between different translations of the RPQ at the item level are recommended.

The Spillover of U.S. Regulatory Oversight to Foreign Markets: Evidence from the Effect of PCAOB International Inspections on Executive Compensations

We examine the spillover effect of the Public Company Accounting Oversight Board (PCAOB) international inspection program on improving the contracting role of accounting numbers in executive compensations in an international setting. For a sample of non-U.S.-listed foreign public firms with PCAOB-inspected foreign auditors, we find a significant increase in the sensitivity of their executive cash compensations to earnings after the release of the first inspection reports on their auditors by the PCAOB, relative to those without PCAOB-inspected foreign auditors. Such a result suggests that the compensation committees of firms with PCAOB-inspected auditors infer that the quality of earnings as a performance measure for determining executive compensations improves due to the PCAOB’s inspections of their auditors. We also find that a clean inspection report issued to the firm’s auditor has an incremental effect on increasing earnings pay-for-performance sensitivity. Our findings provide novel evidence on the effectiveness of U.S. regulatory oversight in foreign markets and should interest the PCAOB and local audit regulators around the world.

MetaBelgica Project

Trustworthy metadata about entities related to cultural heritage is important to correctly identify bibliographic meta-data, attribute works, identify works of public domain (based on contributors’ date of death), or to support Named Entity Linking (NEL) for digitised documents. However, in Belgium such data is currently dispersed between numerous institutions, modelled with different ontologies, represented in different formats and curated in different languages. GLAM institutions would profit from data about Belgian entities to correctly annotate their collections.Furthermore, this would facilitate research in Belgium and abroad. The current situation does not only complicate data exchange in a national and international setting, but also leads to duplicate data curation efforts and data quality issues, negatively impacting the users’ experience. This paper introduces the MetaBelgica project, coordinated by KBR - The Royal Library of Belgium with the Royal Museums of Fine Arts, the Royal institute for Cultural Heritage, and the Royal Museum of Art and History, to improve the status quo. The aforementioned Federal Scientific Institutes (FSIs), belonging to the Belgian Science Policy Office (BELSPO), joined forces to develop a shared Linked Data platform for managing shared entities. This platform, based on Wikibase (the technology behind Wikidata), aims to ensure FAIR data about persons, organisations, time/events and locations related to Belgian cultural heritage. We will integrate data about millions of Belgian entities from the four participating FSIs into a Wikibase instance and make it accessible by using Persistent Identifiers. This will not only professionalize our own data management and improve data quality, but according to received project support letters, also impact other regional, national and European institutions.

How LinkedIn can boost SMEs’ Digital Marketing Strategies on International Markets: A Case Study of an Apulian Tech-Intensive company

The use of digital marketing tools, especially social media, could support small and medium-sized enterprises (SMEs) achieving a sustainable competitive advantage. Business-to-business (B2B) SMEs have discovered the potential of social media in identifying new business opportunities and building quality business contacts especially in international settings. LinkedIn, in particular, seems to be a valuable tool for lead generation and networking, thanks to knowledge and insights coming from structured and unstructured data. Despite the growing interest in adopting LinkedIn for marketing purposes, a significant gap persists in terms of the benefits coming from the adoption of digital marketing within B2B firms and SMEs. To address this gap, this study aims to examine how a social network can support a SME’s internationalisation process in technology-intensive niche sectors. The study adopts an exploratory method based on a case study of an Apulian company operating in the field of aerospace, which provides services to vertical markets. The study employs the action research methodology, using structured interviews and direct observation for data collection, and an inductive and iterative approach for data analysis. Findings demonstrate that an effective strategy utilising LinkedIn can be a game-changer for high-tech SMEs. This strategy sees the implementation of a data-driven approach that relies on the analysis of data and knowledge from buyer personas to predict their expectations, which are crucial for identifying the ideal target audience. The proposed roadmap composed by several maturity steps to lead the company in the process of potential customer identification, lead generation till customer engagement, provides a useful guideline for company managers involved into a structured and standardised innovative digital marketing strategy. Indeed, by integrating the various digital tools and strategic communication on LinkedIn, SMEs have the opportunity to create a data-driven marketing strategy that can lead them to internationalisation and finally to company growth.