National Expert Survey Research Articles

Divergent approaches in the vaccination of recently arrived migrants to Europe: a survey of national experts from 32 countries, 2017.

BackgroundMigrants within the European Union and European Economic Area (EU/EEA) may be underimmunised and lack documentation on previous vaccinations. We investigated approaches to vaccination in recently arrived adult and child migrants, and guideline availability and implementation. Methods: Between March and May 2017, a national vaccination expert from every EU/EEA country and Switzerland completed an electronic questionnaire. We used descriptive analyses to calculate percentages, and framework analysis to synthesise free-text responses. Results: We approached 32 countries (response rate 100%). Although 28 experts reported vaccination guidance at national level, specific guidelines for recently arrived migrants were only available in six countries and not consistently implemented. Twenty-three countries administered vaccinations during on-arrival health checks. Most experts recommended multiple vaccination opportunities be made available: at point of entry (n = 13) or at holding level (reception centres, migrant camps, detention centres) (n = 21). In 30 countries, child migrants without evidence of previous vaccination were re-vaccinated according to the national schedule. Diphtheria-pertussis-tetanus and polio vaccinations were given to migrant children in all countries, measles-mumps-rubella (MMR) in 31 countries, hepatitis B vaccination in 25. Low levels of catch-up vaccination were reported in adult migrants, with only 13 countries offering MMR and 10 countries charging fees. Conclusion: Existing guidance is often not migrant-specific and may not be applied in practice; clarification is needed on which vaccines should be given. Strategies are needed specifically for catch-up vaccination in adult migrants. Vaccinations should be offered in multiple settings, free of charge, with sufficient guidance and training provided to front-line healthcare professionals.

Access to and delivery of acute ischaemic stroke treatments: A survey of national scientific societies and stroke experts in 44 European countries.

IntroductionAcute stroke unit care, intravenous thrombolysis and endovascular treatment significantly improve the outcome for patients with ischaemic stroke, but data on access and delivery throughout Europe are lacking. We assessed best available data on access and delivery of acute stroke unit care, intravenous thrombolysis and endovascular treatment throughout Europe.MethodsA survey, drafted by stroke professionals (ESO, ESMINT, EAN) and a patient organisation (SAFE), was sent to national stroke societies and experts in 51 European countries (World Health Organization definition) requesting experts to provide national data on stroke unit, intravenous thrombolysis and endovascular treatment rates. We compared both pooled and individual national data per one million inhabitants and per 1000 annual incident ischaemic strokes with highest country rates. Population estimates were based on United Nations data, stroke incidences on the Global Burden of Disease Report.ResultsWe obtained data from 44 European countries. The estimated mean number of stroke units was 2.9 per million inhabitants (95% CI 2.3–3.6) and 1.5 per 1000 annual incident strokes (95% CI 1.1–1.9), highest country rates were 9.2 and 5.8. Intravenous thrombolysis was provided in 42/44 countries. The estimated mean annual number of intravenous thrombolysis was 142.0 per million inhabitants (95% CI 107.4–176.7) and 72.7 per 1000 annual incident strokes (95% CI 54.2–91.2), highest country rates were 412.2 and 205.5. Endovascular treatment was provided in 40/44 countries. The estimated mean annual number of endovascular treatments was 37.1 per million inhabitants (95% CI 26.7–47.5) and 19.3 per 1000 annual incident strokes (95% CI 13.5–25.1), highest country rates were 111.5 and 55.9. Overall, 7.3% of incident ischaemic stroke patients received intravenous thrombolysis (95% CI 5.4–9.1) and 1.9% received endovascular treatment (95% CI 1.3–2.5), highest country rates were 20.6% and 5.6%.ConclusionWe observed major inequalities in acute stroke treatment between and within 44 European countries. Our data will assist decision makers implementing tailored stroke care programmes for reducing stroke-related morbidity and mortality in Europe.

Entrepreneurial ecosystem conditions and gendered national-level entrepreneurial activity: a 14-year panel study of GEM

Scholars note the importance of the entrepreneurial ecosystem in promoting new venture activity. Yet to date, limited focus has been given to its impact on female venturing. Accordingly, our study investigates if the entrepreneurial ecosystem influences the prevalence of male and female entrepreneurship over time. We analyze the effect of entrepreneurial ecosystems in 75 countries between 2001 and 2014 on the rates of entrepreneurship for men and women using aggregate data from the Global Entrepreneurship Monitor Adult Population Survey and National Expert Survey. Findings indicate that the prevalence in entrepreneurship is highest for women when the entrepreneurial ecosystem features low barriers to entry, supportive government policy towards entrepreneurship, minimal commercial and legal infrastructure, and a normative culture that supports entrepreneurship. Conversely, we find that prevalence rates for men are highest when there is supportive government policy but weak government programs aimed towards business creation.

The impact of entrepreneurship framework conditions in total early-stage entrepreneurship activity: an international approach

The original global entrepreneurship monitor model predicts that the business activity at the national level varies with the general national framework conditions, while entrepreneurial activity varies with the entrepreneurial framework conditions (Reynolds et al., 2005). The aim of the national expert survey is to provide a general diagnostic approach to the entrepreneurship institutions that can be applied to any territorial level: as nation, region, city or others. It selects a representative sample of experts and asks them to make valuations on the target territory, using questionnaires. The global entrepreneurship monitor also provides the total early-stage entrepreneurship activity for the studied countries which is the percent of working age population both about to start an entrepreneurial activity, and that have started one from a maximum of three years and half. Therefore, this paper examines data collected from the Global Entrepreneurship Monitor 2011 National Expert Survey Global Individual Level Data in order to assess the impact of the environmental variables on entrepreneurship. Results show that the variables entrepreneurial level of education at vocational, professional, college and university, research and development level of transference, physical infrastructures and services access and cultural, social norms and society support, have more impact in the total early-stage entrepreneurship activity.

Impact of 'fund of funds' and other initiatives in building entrepreneurial economy of emerging India: a comparison with China

Entrepreneurship is increasingly recognised as double edged sword that provides self-employment and creation of employment for others. Moreover, entrepreneurial Startups are considered as the next great economic force that Indian needs today. Though, the country is seen as the youngest 'Startup Nation' in the world, the survival rate of startup is miserably low. Access to finance is one of the serious problems in the way of creation and sustaining business enterprises. Government of India has recognised this need and released corpus 'fund of funds' (FoF) 10,000 crore in June 2016, which is in line with Start Up India Action Plan. This huge corpus is expected to generate employment for 18,00,000 persons on full deployment. This paper is an attempt to gauge impact of such initiatives by government of India taken since 2014 specifically, to build entrepreneurial economy. Also a comparison of two emerging economies - India and China is done in the same context. Data from global entrepreneurship monitor - adult population survey (APS) and national expert survey (NES) is taken and analysed.

Impact of 'fund of funds' and other initiatives in building entrepreneurial economy of emerging India: a comparison with China

Entrepreneurship is increasingly recognised as double edged sword that provides self-employment and creation of employment for others. Moreover, entrepreneurial Startups are considered as the next great economic force that Indian needs today. Though, the country is seen as the youngest 'Startup Nation' in the world, the survival rate of startup is miserably low. Access to finance is one of the serious problems in the way of creation and sustaining business enterprises. Government of India has recognised this need and released corpus 'fund of funds' (FoF) 10,000 crore in June 2016, which is in line with Start Up India Action Plan. This huge corpus is expected to generate employment for 18,00,000 persons on full deployment. This paper is an attempt to gauge impact of such initiatives by government of India taken since 2014 specifically, to build entrepreneurial economy. Also a comparison of two emerging economies - India and China is done in the same context. Data from global entrepreneurship monitor - adult population survey (APS) and national expert survey (NES) is taken and analysed.

Cooperative entrepreneurship in Puerto Rico

The existing entrepreneurship literature shows that research on commercial venture creation is quite broad, whereas research on cooperative startups is rather limited. This article focuses on the entrepreneurial framework conditions (EFCs) for cooperative entrepreneurship in Puerto Rico. The authors base their analysis on data obtained from the 2013 National Experts Survey (NES) conducted as part of the Global Entrepreneurship Monitor (GEM). This exploratory study reveals that experts in the cooperative sector believe that the majority of the existing EFCs need improvement, even though Puerto Rico has a comprehensive framework for the support and development of the cooperative sector. Among the four conditions evaluated by the experts as the worst, three are in areas in which there exist specific organisations and legal framework: 1) education and training in cooperative entrepreneurship in primary and secondary levels; 2) financial support; and 3) commercial and legal infrastructure (legal and professional support in the process of cooperative startups).

Institutional theory and global entrepreneurship: exploring differences between factor- versus innovation-driven countries

Using the lenses of institutional theory, this study examines several Entrepreneurial Factor Conditions (National Experts Survey database) while focusing on potential differences of several institutional dimensions between factor- (or production) and innovation-driven countries. This study therefore examines first the extent to which several Scott’s institutional variables (normative, regulative, and cultural-cognitive) differ according to the economic structure of countries participating in NES-GEM. Results indicate that the relevance of both regulative and cultural-cognitive dimensions differ between the group of countries driven by factor (or production) versus innovation, with a single exception, the normative dimension. Second, the study fine tunes the analysis and examines the extent to which the relevance of the aforementioned dimensions differs in two distinct institutional contexts (Portugal and Angola). Results show that the relevance of all institutional variables is different except one, the basic education and training. A possible explanation for these results may be associated to the lack of and fragility of several institutions and the absence of norms and regulations needed for a well-functioning economy, particularly in what concerns the factor (or production)-driven countries. In terms of originality, the study addresses an area of the GEM model that is under-researched.

Definitions of urban areas feasible for examining urban health in the European Union.

As part of the EU-funded project, European Urban Health Indicator System (EURO-URHIS), a definition of urban areas (UAs) and of urban populations was needed to be able to identify comparable UAs in all member states. A literature review on existing definitions, as well as those used by other relevant projects, was performed. A survey of national experts in public health or land planning was also conducted. An algorithm was proposed to find UAs, which were feasible for the focus of EURO-URHIS. No unique general definition of UAs was found. Different fields of research define UAs differently. None of the definitions found were feasible for EURO-URHIS. All of them were found to have critical disadvantages when applied to an urban health project. An ideal definition for this type of project needs to provide a description of the situation without recourse to administrative boundaries yet inform the collection of routine data for urban health monitoring. These requirements were found to contradict each other and were not met in any existing definition. An algorithm was developed for the definition of UAs for the purpose of this study whereby national experts would select regions which are urban as an agglomeration or as a metropolitan area and which are potentially interesting in terms of public health; identify the natural boundaries, where countryside ends and residential or commercial areas of the region begin (e.g. by aerial photos); identify local government boundaries or other official boundaries used for routine data collection purposes which approximate the natural UA as closely as possible and list all administrative areas which are contained in the larger UA. The aggregation of all administrative areas within the original region formed the UA which was used in the project.

International classification of functioning, disability and health categories for spinal cord injury nursing in China

Purpose: To explore a set of International Classification of Functioning, Disability and Health (ICF) categories that cover the spinal cord injury (SCI) nursing practice in China through a national expert survey. Methods: An internet-based email survey was used. An original set of ICF categories specifically for SCI nursing has been developed from the preliminary studies based on an international perspective. For cultural adaptation in China, a national expert survey was conducted with Chinese experts on SCI nursing to identify the ICF categories that were specifically for SCI nursing in China. The ICF categories which received more than 80% support from the experts would be reported. Results: Twenty-nine Chinese experts on SCI nursing participated. There were 81 ICF categories which received more than 80% agreement among the experts, including 33 Body Functions categories, eight Body Structures, 24 Activities and Participation, six Environmental Factors and 10 Personal Factors items. Conclusions: A set of ICF categories that cover the SCI nursing practice in China was identified. It reflects the main issues that Chinese nurses focus on in caring SCI patients. These categories can facilitate Chinese nurses to use the ICF in multidisciplinary teamwork and improve the participation of nurses in the team.Implications for RehabilitationIn China, nurses lack of an effective model or tool to communicate with the other health professionals in the rehabilitation team for spinal cord injury (SCI) patients.International Classification of Functioning, Disability and Health (ICF) is a tool for multidisciplinary use, which can promote the communication and collaboration in the healthcare team by establishing a common language across different disciplines and sectors.This set of ICF categories developed from this study can serve as a roadmap for important items for use in clinical practice of Chinese SCI nursing.

Senior Entrepreneurship in the Perspective of European Entrepreneurial Environment

This paper studies the relationship between senior entrepreneurship propensity (entrepreneurship of the elderly) and national entrepreneurial context, in the European countries that exhibit either high or low levels of senior entrepreneurship. We focus on European countries that participated in Global Entrepreneurship Monitor (GEM) in 2013. We use GEM data as the main data source for our analysis. Firstly, we analyse the propensity of senior entrepreneurship on the national level, in order to create two clusters (high and low ones) based on the senior entrepreneurial activity. These clusters are then studied separately, compared and analysed based on their entrepreneurial environment. In order to assess the state of the national entrepreneurial environment, we use the GEM evaluation of key Entrepreneurial Framework Conditions, which are evaluated by GEM National Expert Survey. We thereafter compare the quality and profile of entrepreneurial environment based on the framework conditions in each of the created clusters and study similarities and differences both within the clusters and between them. In the further analysis, we investigate which of the entrepreneurial conditions and to what extent might play the role in influencing the senior entrepreneurial activity propensity in both high-activity and low-activity clusters.

A Quantum of Solace? An Assessment of Fiscal Stimulus Packages by EU Member States in Response to the Economic Crisis

This ETUI Working Paper analyses the fiscal stimulus packages implemented by EU Member States against the background of the on-going economic crisis. Alongside the overall volume of the packages, the study, which is based on a survey of national experts, considers their content and also the involvement – or lack of it – of the social partners and particularly trade unions. Overall the packages offer only a ‘quantum of solace’ to Europe. Against this background the widespread self-satisfaction on the part of European and national policymakers about the response to the crisis, and an increasing focus on early exit strategies from fiscal stimulus are inappropriate. European governments, faced with the unprecedented scale of the crisis, have taken action to stimulate their economies. But the crisis has exposed weaknesses in economic governance in Europe that should be addressed as part of the reforms being planned to ensure that such crises are not repeated in future.

Development of a Swedish Comprehensive International Classification of Functioning, Disability and Health (ICF) Core Set for adult patients with attention-deficit hyperactivity disorder (ADHD)

Background: Attention-deficit hyperactivity disorder (ADHD) in adults is a phenomenon that attracts a lot of attention in society today. Advances in research have made it clear that many conditions that make people seek medical and psychiatric care may have pervasive deficits in attention, motor control and impulsivity at their roots. Since ADHD in adults is a relatively new and very versatile concept, there is a great need for systemized classification of the ramifications of the deficit that extends into every aspect of these patients’ lives. Aims: To develop a Swedish Comprehensive International Classification of Functioning, Disability and Health (ICF) Core Set for adult patients with ADHD. Methods: A national expert survey was conducted using the Delphi technique and a formal consensus conference. Forty-two experts from different professions and organizations, including psychiatrists and physicians, psychologists, occupational therapists, a counsellor, a specialist nurse, representatives from a patient organization and representatives from the Swedish Social Insurance Agency, participated in the Delphi process and 28 participants from the expert group attended the consensus conference. Results: At the formal consensus conference, 66 categories from the ICF were identified and included in the national Comprehensive Core Set for ADHD: 21 categories from the component body functions, 26 categories from the component activities and participation, and 19 categories from the component environmental factors. Conclusion: The Comprehensive Core Set for ADHD should be regarded as national and preliminary, and should be further tested and evaluated by experts in ADHD in clinical settings in Sweden.

Corporate Donor–Charitable Organization Partners

Using the coorientation model, this study examines the views of leading U.S. corporations and charitable organizations about types of relationships between corporate donors and charities that receive corporate contributions. Results of the national expert survey show that both corporate giving officers and senior fundraisers of charitable organizations perceive the relationship as more communal than either one-way patronizing or two-way exchange. Findings from the coorientation analysis illustrate that the two groups are in a state of consensus on the patronizing and communal relationship types while a state of false consensus exists on the exchange relationship type; that is, charities wrongly assume that corporate donors desire a relationship based on the dominant characteristic of solid exchange or quid pro quo.

Withdrawal Symptoms: An Assessment of the Austerity Packages in Europe

Based on a survey of national experts, this Working Paper evaluates from a European and national comparative perspective the austerity packages that the governments of EU member states have announced and implemented following the recent financial crisis and the Great Recession. The study raises serious doubts about the drive for austerity being embarked upon by EU countries. The simultaneous nature of the demand contraction, and the very limited offsetting impacts on demand via monetary policy and the exchange rate, mean that the output costs will be high. This, in turn, will drag out the consolidation period, possibly condemning Europe to a ‘lost decade’. Even if the aggregate growth and employment figures prove more favourable than in our assessment, the problem of the unbalanced nature of the European economy, especially that of the euro area, remains. Moreover, the Europe 2020 goals are highly unlikely to be achievable in a context of persistently sluggish growth and regressive distributional tax-and-spend policies and cutbacks in areas such as public investment, education and active labour market policy. It is widely believed in policymaking circles that austerity is necessary for consolidation, and consolidation necessary for growth and jobs. In contrast, we believe that Europe needs to grow out of its public-sector deficits and debts, which resulted from the spectacular failings of an unregulated private sector, especially in finance. To do that it needs to invest. And it should embark on that course without delay.

Exploring entrepreneurship policy in a Pacific context: the case of Tonga

In 2010, data was collected to explore entrepreneurship in a Pacific context. The preliminary conceptual model is based on the triangulation of findings from the national expert survey (NES) and adult population survey (APS) components of the Global Entrepreneurship Monitor (GEM). For the NES, 25 national experts were interviewed in order to understand the factors that constrain and promote entrepreneurial activity. The APS analysed the responses of 1,184 household members across Tonga regarding their actual experiences and perceptions of entrepreneurial activity. Our analysis uses grounded theory in tandem with this model because of the lack of tested theory regarding entrepreneurship in the Pacific. The NES data was initially used in the analysis, and the triangulated confirmatory findings from the APS were used once the emergent propositions had become clear. Seven new propositions are developed that extend our existing conceptualisation of entrepreneurship. The research implications and limitations are discussed.

Entrepreneurial opportunities in peripheral versus core regions in Chile

Governmental policies tend to support and boost entrepreneurship in peripheral regions in many countries. This research revives the debate about specific regional policies designed to foster local new business creation, and the entrepreneurial framework conditions needed at the regional level for emerging regions such as Latin America. We applied one of the Global Entrepreneurship Monitor’s methodologies, the National Experts Survey, to a sample of 695 key informants in Chile at eight regions of which six are classified as peripheral. Using non-parametric statistics we compared the differences between peripheral and core regions. The main results indicate that peripherally located entrepreneurship experts perceive their regions as in a worse position than centrally located experts in terms of finance access and physical infrastructure. On the other hand, the results indicate that peripheral entrepreneurship experts detect more market dynamism in their regions and surprisingly perceive general policy and government programs as supporting entrepreneurship although the Chilean government had not promoted many regional policies.

Environmental conditions and entrepreneurial activity: a regional comparison in Spain

PurposeThe main objective of this paper is to analyse the influence of environmental factors on entrepreneurship at the Spanish regional level, using institutional economics as the theoretical framework for the research. Additionally, this work aims to emphasize how environmental conditions have different effects according to the gender of entrepreneurs.Design/methodology/approachRegional panel data (19 Spanish regions and the 2006‐2009 period) from the Global Entrepreneurship Monitor (GEM), specifically from the Spanish National Expert Survey (NES) for environmental conditions and the GEM Adult Population Survey (APS) for entrepreneurial activity were analysed within a fixed effects model with panel corrected standard errors.FindingsThe main findings of the study indicate that both informal (cultural and social norms, perception of opportunities to start‐up and entrepreneur social image) and formal factors (intellectual property rights) influence entrepreneurship, but the informal are more determinant than the formal. Concerning the gender issues, informal and formal institutions are also determinant, but female entrepreneurship is significantly associated with the women's support to start‐up, whereas primary and higher education are associated only with male entrepreneurial activity.Research limitations/implicationsThe results of the research should be interpreted carefully, because the availability of data constrained the analysis to a time period that is not reflective of the economic cycle; on the contrary, the data correspond to a period of recession, and thus the results cannot be generalized. Also, the study could extend the analysed period and compare the obtained results with international data, considering the global number of participant countries in the GEM Project.Originality/valueThe study provides a methodology to analyse the environmental factors for new firm creation at a regional level, combining GEM data and institutional economics.

Identifying Common Elements of Evidence-Based Psychosocial Treatments for Children's Disruptive Behavior Problems

: Almost all of the efforts to study and implement evidence-based practice (EBP) have used individual treatments as the unit of analysis. A complementary approach using aggregated common elements of multiple individual evidence-based treatment programs has been introduced. The purpose of this article is to describe a new method for identifying common elements of EBP and to present common elements resulting from a systematic review of interventions for children with disruptive behavior problems and their parents. : We identified eight individual treatment programs with established efficacy for children ages 4 to 13 with disruptive behavior problems, reviewed all of the treatment materials thoroughly, identified core elements of each treatment, and determined which elements were common to at least half of the programs. The validity of these common core elements was confirmed through a survey of national experts using a modified Delphi technique. : We identified 21 treatment elements that were common to multiple evidence-based treatment programs. These included therapeutic content (e.g., principles of positive reinforcement, problem-solving skills training), treatment techniques (e.g., role-playing, assigning homework), aspects of the working alliance, and other parameters such as treatment duration. : Identification of common core elements of EBP has important implications for efforts to characterize practice, as well as therapist training and implementation of EBP in community-based service settings. Therapist training and ongoing supervision that builds on common elements of EBP could potentially improve the effectiveness of care overall. It could also build a strong foundation for targeted individual treatment implementation efforts by enhancing therapists' skills and attitudes about EBP.

A look back and ahead

Integrating recent theories of entrepreneurship with new institutional economics, we develop a multilevel model to deepen our knowledge of how micro-level entrepreneurs’ personality and motivational antecedents interact with macro-level home-country institutions in determining internationalization by early-stage entrepreneurial firms. Data were collected from Global Entrepreneurship Monitor Adult Population Survey, GEM National Expert Survey, and the World Economic Outlook Database for the year of 2014. The results show that the personality trait of entrepreneurial self-efficacy contributes positively to the degree of internationalization via mobilizing opportunity-motivated entrepreneurship and that home-country formal institutions strengthen the above relationship of such young entrepreneurial firms.