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Work-integrated learning (WIL) has been suggested as a potentially beneficial addition to modern doctoral education. However, there is little research outlining the specificities of WIL aimed at PhD students. This paper explores the range of WIL opportunities available to PhD students through a review of secondary data. The findings indicate that WIL opportunities are non-homogenous and vary widely across their structure and implementation. Patterns emerge to indicate that WIL opportunities tend to be optional, paid, short-term, focused on horizontal learning development, and provide opportunities for boundary crossing outside of academia. These findings imply that WIL has the potential to complement doctoral education by providing opportunities to experience cross-sector or cross-discipline learning and development. However, higher education institutes might consider becoming more involved in the design and implementation of WIL for PhD students. Additional research is required to understand how WIL opportunities fit into doctoral education and to evaluate existing WIL opportunities.

The aim of this study is to investigate the effects of countries' development level in sports medicine, exercise and sports performance on their success in Olympic Games. Within this purpose, 1027 papers that were published between 2010 and 2018 in the journal of Sports Medicine, of which impact factor was 7.074 in 2017, were examined in analytical and correlational terms considering the first author and total author numbers. Pearson Correlation was utilized to find out the relationships between the papers from various countries and their success at Olympic Games. Regarding the number of medals won by the countries in the 2016, 2012 and 2008, Olympic Games were found significantly correlated with the number of first author (r = 0.73) and total author (r = 0.74).

The COVID-19 crisis has led to widespread temporary school closures and a deep economic recession. School closures have threatened children's ability to learn and later return to school well prepared. The impact of the economic recession is going to be even more devastating: first for students, but also for the ability of some Catholic schools to maintain their enrollment and remain sustainable financially in countries where they do not benefit from government support. This paper, the first in a set of two, looks at some of the likely impacts of the COVID-19 crisis on Catholic Schools in developed countries with a particular focus on the United States, a country not only hard hit by the crisis but also where Catholic schools are especially vulnerable to downturns. While Catholic schools may be able to respond to the immediate challenge of school closures among others through distance learning options, their ability to maintain enrollment during the economic downturn is less clear. How schools will respond to the twin challenges of ensuring learning during school closures and beyond, and remaining affordable for families at a time of economic stress, may affect whether they are able to maintain their comparative advantage. A key aim of the paper is to make Catholic school teachers and leaders aware of some of the discussions on how to respond to the crisis, and provide links to online resources that may be useful. [For Part II of the series, see EJ1278501.]

Across the world, numerous students are being bullied at school. Bullying is often caused by a power imbalance between students. Therefore, identifying potential sources of such a power imbalance can prevent school bullying from happening. Based on the labelling theory, we expect that grade retention can lead to such a power imbalance and, therefore, increase the likelihood of being bullied at school. Hence, this study examines the association between grade retention and self-reported victimisation. We also expect that retainees will be less likely to become a victim of school bullying in schools and countries with a high number of other retainees. If true, this would signal a moderating effect of both school- and country retention composition on the association between grade retention and victimisation. The contextualised impact of grade retention upon victimisation is assessed by cross-national multilevel analyses on PISA2018 data (25 countries; 8,039 schools; 159,412 students). Overall, our findings indicate that being retained in primary and/or secondary education is associated with higher levels of victimisation, while retainees suffer from more victimisation in countries with a low number of other retainees. In contrast to our expectations, however, we did not find such a moderation effect of school retention composition.

This study examines the perspectives and experiences of older lifelong participants in outdoor education/recreation. 32 participants, women (11) and men (21), aged 60-84 provided narratives of their lifelong engagements in the outdoors in nature-based activities. They were invited to write freely on their early experiences and their current engagements in the outdoors. The purpose was to explore and understand why and how serious lifelong older participants continued with their outdoor activities. This paper considers participants' current embodied engagements. The evidence suggests that as they age, their bodies become less able to deal with discomfort. Yet, the participants, as a consequence of their lifelong knowledge and experience, manage injuries and ill-health, choosing to adapt in various ways to enable their continued engagement/enjoyment in being active in nature. The study stresses the significance of lifelong engagement in the outdoors and the necessity for opportunities for outdoor nature-based experiences throughout the lifespan.

This study aims to review the scientific papers on Early Childhood Education for Sustainability (ECEfS) published between 2008 and 2020 and reveal changes in the area. This systematic review was carried out in two stages. In the first stage, a systematic review of papers on ECEfS was conducted according to the specified criteria, and all identified studies were evaluated descriptively. In the second stage, interventional research was evaluated, and their results were reviewed. It was seen that qualitative research methods were mostly preferred in the reviewed studies and most of them were conducted with children. It was determined that the most frequently discussed pillar is environmental. Moreover, the number of interventional research studies is limited. The research findings, it is thought that there is a need for future studies that use interventional, experimental and action research methods, holistically addressing pillars of sustainability

While internationalization is among the top strategic priorities of universities and colleges globally, research into the expanse of internationalization in the kinesiology discipline is not well researched. Given this gap, critical consideration of the state and status of the phenomenon is needed. Knowing more about what is being done in the name of internationalization within kinesiology and reflecting on how those actions and outcomes are aligned, or not, with key theoretical guidance is necessary in order to plan for improvement accordingly. For these reasons, this paper first provides a primer on internationalization in higher education, including how the phenomenon has come to be defined as well as key contemporary critiques associated with it. In particular, we highlight Beck's (2012) theoretical concept of 'eduscape' to critically consider the influences of globalization on internationalization within higher education kinesiology as well as Khoo, Taylor, and Andreotti's (2016) principles of intelligibility, dissent, and solidarity to consider the ways kinesiology scholars engage critically with internationalization processes. Presented next is a review of the kinesiology literature that is explicitly focused on internationalization. Then, the results of a pilot survey into the views of National Association for Kinesiology in Higher Education (NAKHE) members and other Western kinesiology scholars on internationalization is reported next. The paper concludes with recommendations as to how NAKHE and the broader community of Western kinesiology scholars might best navigate internationalization moving forward. We recommend the complexity-informed and principle-driven approach of inclusive leadership as a means of pursuing cognitive justice in the 21st century.

Results of international achievement surveys such as the Programme in International Student Assessment have consistently reported an achievement gap between immigrant and non-immigrant student populations around the world. This paper unpacks this persistent achievement gap by examining key characteristics that influence the performance of first- and second-generation immigrant students as well as the policies and practices that are associated with enhanced educational outcomes. A multi-layered framework is proposed to help policymakers juxtapose key characteristics of their immigrant students' achievement against individual, family, school, community, and host society characteristics and policies. The discussion also underscores the importance of connecting this multi-layered framework with other important sectors within governments such as those responsible for the economy, health, social protection, and immigration. This paper also examines limitations with current large-scale data sets and the implications for research and policy analysis.

Science, technology, engineering and mathematics (STEM) education and research are globally recognised as engines of growth and development and indicators of citizens' well-being. Studies have continuously highlighted the unequal access and participation in STEM higher education based on class, caste, gender, disability and other markers of identity. This research paper investigates the underrepresentation of women in STEM at the Indian Institute of Technologies (IITs) in India. IITs are India's top elite institutions that open window of opportunities to students across the world. The study uses the data available from the All India Survey of Higher Education (AISHE), the Council of Indian Institute of Technology and the websites of the IITs. The findings indicate a significant gap between males and females in faculty positions at IITs. Furthermore, the study finds that the underrepresentation of women faculty differs across the STEM disciplines at IITs in India. It needs more gender-just affirmative action policies such as intersectional reservation for women in STEM academic careers, funding, legal protection against harassment, and representation of women in various committees and leadership positions.

Much research has been made in recent years on the effect of over and under education on earnings. In this paper, I examine the validity of the assumption that the return to over (under) education is independent of the level of education. I use data from the PIAAC survey to estimate the return to education. The findings show that while this assumption might be valid for the return to under-education, it seems to be wrong for estimating the return to over-education. I offer an alternative model where the return to over-education or under-education is not linear and depends on the level of education.

Purpose: Since new digital micro-credential technologies emerged a decade ago, there has been a rapid rise in micro-credentials in the education landscape. Much has been promised about these educational technologies, yet there is much confusion by key stakeholders in the digital micro-credential ecosystem. This confusion has led to significant efforts globally to define micro-credentials to ensure quality learning and generate beneficial impacts to learners, employers, education providers and edtech organisations. Design/methodology/approach: This commentary reviews relevant literature on digital micro-credentials and other alternative credentials to determine how these educational technologies can meet the demands of the Fourth Industrial Revolution to nurture lifelong learning for working learners. Findings: Universities are being challenged to address the changing needs and uncertainty being introduced by the Fourth and Fifth Industrial Revolutions, particularly with implications for workforce upskilling and lifelong learning. To adapt, universities will need to rethink their roles and shift their institutional mindsets in how they may approach the challenges through mechanisms such as digital micro-credentials. Research limitations/implications: This paper focuses on the analysis of five policy statements about micro-credentials. While these policy statements represent a sample, there is a representation of Western education-related systems. Thus, they skew the findings towards Western education systems thinking. Practical implications: Understanding how micro-credentials are being positioned within education-related systems is useful for applying the educational technologies by, for example, universities, learners and employers. Social implications: Provides an overview of how these educational technologies may provide beneficial impacts for society as it plans to adapt to economic uncertainty and change. Originality/value: The commentary provides a policy context for the emerging use of micro-credential technologies to examine demands for workforce upskilling.

This paper uses data from the OECD's 2015 PISA and an endogenous treatment effects model to investigate the impact of different intensities of digital device use for academic purposes on science learning outcomes. When we do not differentiate the location of device use, we find that greater use can help students improve their science scores in most of the countries. When we consider school and outside-of-school use separately, we find the above positive results are driven by outside-of-school digital device use and that there are more negative results of increased device use at school.

This paper analyses the current state of postcolonial and decolonial science teaching, based on a systematic review of the literature, with a special focus on the European context. It shows that currently, a very narrow view on postcolonial science teaching prevails, limiting its scope to former colonies. A total of 227 articles published 2013-2022 were identified using meta-interpretation combined with systematic searches. 43 of these articles were selected for the sample and analysed. Included were only articles reporting on teaching practice in regular science classes in secondary school. The analysis identified as the main theme the question of how to coordinate Indigenous knowledge systems and Western science in the classroom. Further, translanguaging and pedagogy of justice are used as approaches toward decolonising science education. One striking finding in the analysis is the absence of de-/postcolonial approaches from European countries. This indicates that teaching practice in Europe might currently not undergo decolonisation. This contradicts Aimé Césaire's observation that both the colonised "and" the colonisers were decivilised during colonialism and need decolonisation [Césaire, A. (1955). "Discours sur le colonialisme" [Discourse on colonialism] (6th ed.). Présence Africaine]. In this article, the different approaches toward decolonisation and an outline of decolonial science teaching for the European context are presented.

The premise of this brief opinion piece is that the fundamental paradigm of education appeared with Plato. It is that there is a co-location in time and space of learners, teachers, and resources. The absence of any of these elements can lead to shortcomings in the meaning of the term "to be educated". Recent events such as COVID-19 demonstrate that the paradigm is subject to challenge but that its premises are firmly established. It is recognised that there are complex philosophical and theoretical arguments surrounding distance education debates. It is not possible in a short article like this to canvass all the possible philosophical positions that affect education. Pointers to these debates are referenced in the article. For the purpose of this article, "philosophy" is taken to mean that department of knowledge or study that deals with ultimate reality, or with the general causes and principles of things. More narrowly, it is the study of general principles of some particular branch of knowledge, experience, or activity--in this case, distance education or flexible learning. "Theory" is taken to mean a scheme or system of ideas or statements held as an explanation or account of a group of facts or phenomena.

Student learning outcomes assessment examines whether programs cover the material stated in their learning goals, whether students are learning the material, and the impact on student retention, graduation, post-graduation outcomes, and institutional accreditation, with the aim of providing faculty with data that can be used to help programs evolve or improve. While there is a plethora of research regarding effective methods of assessment used in the United States, little has been written regarding cross-national comparisons of assessment methodologies. This paper examines the current state of assessment in several nations and regions, and draws parallels in practices across countries. A literature search using the term "outcomes assessment" yielded 228 articles, of which, only 35 described practices outside the United States. Generally, searches on the terms "outcomes assessment" and "global" tend to return studies of outcomes assessment of teaching about global issues as it is practiced in the United States, rather than results about outcomes assessment practices used in other countries.

Purpose: The purpose of this study is to investigate the cross-cultural training (CCT) provided to European expatriate executives in New Zealand, and consequently add to the knowledge for human resource management in the Australasian region. Design/methodology/approach: The present qualitative research study is based on open-ended and in-depth interviews with 30 European expatriate executives who had been residing in New Zealand for the past year or more. Findings: The results indicate that at least some CCT was provided to all interviewees; however, the training content seemed to be strongly centered around professional work, with little focus on the culture of the host country. Moreover, there was no follow-up to the pre-departure CCT and very few expatriates in the sample received any training in New Zealand. Similarly, the family is considered a fundamental factor for the success of expatriates; however, in the sample, neither spouses nor children received any training before or after their arrival in New Zealand. Research limitations/implications: The research is limited by the sample small size. The study's inconclusive highlights the need for further research to explore the influences of local residents, colleagues and neighbors on expatriates' adjustment. Similarly, further studies are also required to ascertain the effectiveness of CCT in helping support expatriates' performance and adjustment in New Zealand. Practical implications: The present study suggests that opportunities do exist for multinational companies (MNCs) to better prepare their expatriates for assignments by integrating more effectively issues related to cultural awareness into their CCT. Specifically, experimental CCT methods that emphasize the host country's culture are most valuable. The CCT technique should be tailored to the cultural distance between the host nation and expatriates' country of origin and to the nature of their assignment. Originality/value: Given the existence of many MNCs in New Zealand, it is surprising that the issue of CCT in this context has received little research attention. The current study endeavors to address this gap. This paper hopes that the findings may also be useful for consultants and human resource managers in MNCs who are involved in preparing expatriates for foreign assignments in Australasia, especially New Zealand.

Due to the popularity of sport, the need to have sport management programs that properly train practitioners is justified (Pedersen & Thibault, 2014). However, with 505 sport management bachelors programs worldwide ("Degrees in Sports," n.d.) housed in various academic units, there is little consistency within the field of study. This paper strives to explore the field of sport management and to better understand sport management faculty members' perceptions of the discipline. Grounded in Foucault's (1971) theory of discourse, total of 154 sport management faculty members worldwide participated in the study. The data revealed there is a lack of consistency within the field regarding faculty members' perceptions of sport management. This study offers a vital, first step in an empirical examination of a critical phenomenon in the sport management academy.

Purpose: In education concerning environmental issues, there are two predominant currents in the world, environmental education (EE) and education for sustainable development (ESD). ESD is the formal commitment and therefore promoted by the United Nations, to ensure that countries achieve sustainable development. In contrast, EE was the first educational trend with an environmental protection approach. The purpose of this systematic review that seeks to show whether the migration from EE to ESD is being effective and welcomed by researchers and especially by universities is presented. With the above, a global panorama can be provided, where the regions that choose each model can be identified. In the same sense, it was sought to determine which of the two currents is more accepted within engineering education. Design/methodology/approach: The review followed the preferred reporting items for systematic reviews and meta-analyzes parameters for systematic reviews. In total, 198 papers indexed in Scopus, Science Direct, ERIC and Scielo were analyzed. With the results, the advancement of ESD and the state of the EE by regions in the world were identified. Findings: It was possible to categorize the geographical regions that host either of the two EE or ESD currents. It is important to note that ESD has gained more strength from the decade of ESD proposed by the United Nations Educational, Scientific and Cultural Organization. For its part, EE has greater historical roots in some regions of the planet. In turn, there is evidence of a limited number of publications on the design and revision of study plans in engineering. Originality/value: Through this systematic literature review, the regions of the world that are clinging to EE and those that have taken the path of ESD could be distinguished. Moreover, specific cases in engineering where ESD has been involved were noted.

The meta-analysis described in this paper evaluated the relationships between 11 types of leadership practices and 7 organizational, teaming, leader, and employee outcomes. A main focus of analysis was whether the leadership practices were differentially related to the study outcomes. Studies were eligible for inclusion if the correlations between leadership subscale measures (rather than global measures of leadership) and outcomes of interest were reported. The random effects weighted average correlations between the independent and dependent measures were used as the sizes of effects for evaluating the influences of the leadership practices on the outcome measures. One hundred and twelve studies met the inclusion criteria and included 39,433 participants. The studies were conducted in 31 countries in different kinds of programs, organizations, companies, and businesses. Ninety-six percent of the practice-outcome effect sizes were statistically significant where approximately half of the relationships were moderated by organizational types (for-profit, not-for-profit, education, healthcare, government, etc.). Results indicated that the 11 types of leadership practices were differentially related to the study outcomes even in the presence of considerable between study heterogeneity. Implications for leadership development are described.

The overarching assumption within popular approaches to global learning is that it takes place either in classrooms at home or in the case of study abroad, in experiential learning environments overseas. Policies and programs are carefully crafted to respond to particular institutional goals and objectives towards internationalization. These objectives have increasingly aligned with broader neoliberal reforms within universities that focus on the student as a global consumer. This places those responsible for designing and implementing international programs in a precarious position, often having to straddle a widening divide between critical educator and travel agent. While efforts are made to create programs that allow students to engage cross-culturally, internationally, and in meaningful ways, there also exists immense pressure to do so in the shortest amount of time and for the least amount of money. As more study abroad offices become self-funded, or financially self-sustaining, this often means prioritizing programs that are the most attractive to the student "consumer" as opposed to the student "academic." This competition between study abroad as academic endeavor and study abroad as business is illustrated in the bifurcation of the study abroad literature. One strand of the literature focuses squarely on the student experience, which includes questions of students' motivation for studying abroad and/or what they have gained from the experience. These studies often emphasize students' personal growth and development, their increased cross-cultural competence and understanding, as well as their changing conception of global citizenship. The second category of study abroad literature focuses on "best practices" and policies for the implementation of study abroad programs. This includes work on student and faculty recruitment strategies, program design, monitoring and evaluation tools, safety and risk management as well as re-entry programming for newly returned study abroad participants. What is largely missing from both sets of literature is an exploration of the global learning that takes place before a study abroad program begins; what are students learning about the world and their place within it when they visit a study abroad office website, thumb through a promotional pamphlet or attend a program recruitment event? To the knowledge of the author there has been no explicit acknowledgement in the study abroad literature of the hidden curriculum that presents itself through what she refers to as institutional study abroad portfolios (ISAPs), that is, the compilation of study abroad programs that a university promotes to its students that take place in particular locations focusing on specific academic disciplines. In this paper the author will argue that in looking at ISAPs as a unit of analysis we can uncover political complexity that is often obfuscated both by more macro level policy analysis (i.e. internationalization strategy) as well as more micro-level program evaluation.

Teacher agency (TA) has been increasingly supported as an influential factor for teacher professional learning, school improvement and sustainable educational change. Previous studies, however, feature a variety of discrepancies in their conceptualisation and approaches to examining teacher agency. A systematic review is essential to map the field, refine our understanding of the concept and inform relevant stakeholders of useful insights for policy making and further research. After being screened against a number of inclusion criteria, 104 empirical studies were selected to be included in this review. Thematic analysis was adopted for the data analysis of these papers. Findings indicate an imbalance in geographical, theoretical, methodological and thematic distributions in previous studies. Six major themes were identified from the literature: (1) TA enactment, (2) the role of teacher cognition, (3) influential factors, (4) implementing professional development interventions, (5) TA outcomes and (6) TA change trajectory. TA can be extrapolated in terms of its source, enactment and outcomes. Teachers' capacities, implementation strategies, and contextual factors jointly determine the achievement of their professional agency. A conceptual framework for accounting teacher agency holistically is proposed and implications for relevant stakeholders are discussed.

Digital technologies and the Internet are increasing in prominence in schooling systems. As schools and teaching evolve as a result of the integration of technologies teacher preparation will also change. This paper examines research exploring the preparation of teachers for the digital age through a systematic literature review of articles published between 2008 and 2018. The findings provide insight into what has and has not been studied across a range of literature and the alignment with the broader context of digital integration in schools. A focus on digital competencies was identified which was framed in three ways across the literature; generic digital competence, digital teaching competence and an emerging concept of professional digital competence. How student teachers learn to engage in the professional work of a teacher in a digitally infused education system should underpin future research. A model of professional digital competence is proposed.

A thematic content analysis of the seven issues (35 papers and two editorials) of the "International Research in Early Childhood Education" ("IRECE") journal published by Monash University in Melbourne, Victoria was conducted to explore the themes over its five years of publication. Publications were grouped into defined data chunks by year and Leximancer was used to discover concepts and themes. Five dominant themes emerged: children/s; childhood; learning; parent/s and teacher/s. Pathway analyses were then conducted to more fully understand and describe each theme. Data were used to visually represent the most frequently appearing terms to form a tag cloud, which in turn contributes to the development of a "folksonomy" for the journal. Finally, mentions of geographic regions were also explored which positively reflected on international focus of the journal.

Although health provider racial/ethnic bias has the potential to influence health outcomes and inequities, research within health education and training contexts remains limited. This paper reports findings from an anonymous web-based study examining racial/ethnic bias amongst final year medical students in Aotearoa/New Zealand. Data from 302 students (34% of all eligible final year medical students) were collected in two waves in 2014 and 2015 as part of the Bias and Decision Making in Medicine (BDMM) study. Two chronic disease vignettes, two implicit bias measures, and measures of explicit bias were used to assess racial/ethnic bias towards New Zealand European and Māori (indigenous) peoples. Medical students demonstrated implicit pro-New Zealand European racial/ethnic bias on average, and bias towards viewing New Zealand European patients as more compliant relative to Māori. Explicit pro-New Zealand European racial/ethnic bias was less evident, but apparent for measures of ethnic preference, relative warmth, and beliefs about the compliance and competence of Māori patients relative to New Zealand European patients. In addition, racial/ethnic bias appeared to be associated with some measures of medical student beliefs about individual patients by ethnicity when responding to a mental health vignette. Patterning of racial/ethnic bias by student characteristics was not consistent, with the exception of some associations between student ethnicity, socioeconomic background, and racial/ethnic bias. This is the first study of its kind with a health professional population in Aotearoa/New Zealand, representing an important contribution to further understanding and addressing current health inequities between Māori and New Zealand European populations. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to investigate which firm-level antecedent – resource-based capability or inter-organizational coordination – contributes to a firm's supply chain management (SCM) focus. Design/methodology/approach – A conceptual framework of antecedents of SCM focus and several research hypotheses posit that for a thorough understanding of the behavior of an organization in the supply chain, it is necessary to consider two sets of antecedents simultaneously. Hypotheses are tested using confirmatory factor analysis and multiple linear regression on a set of survey data collected in the USA, Europe and New Zealand. Findings – The analysis of survey data validates the major premise that inter-organizational coordination plays an important role in explaining the SCM focus of a firm. Research results validate the positive relationships between the proposed antecedents and a firm's SCM focus. Research limitations/implications – Although the research design incorporates extensive literature reviews, it does not capture every aspect of complex inter-organizational coordination. Future efforts should establish a valid, reliable instrument to measure the underlying constructs. Practical implications – This study shows that a firm possesses inimitable internal resource-based capabilities and external coordination mechanisms that are unique to each firm. Each of the resource-based capabilities helps to integrate the various internal functional areas within an organization to increase efficiency and reduce waste. The external coordination mechanisms help a firm to link its processes seamlessly with upstream and downstream supply chain members. The paper also shows that product innovation is the only resourced-based capability that predicts SCM focus when inter-organizational coordination mechanisms are considered. Originality/value – The paper contributes to the extant literature by integrating the traditional resource-based view of a firm with inter-organizational coordination to examine crucial factors that precede a firm's SCM focus. Both perspectives have considerable merit, so for a thorough understanding of a firm's SCM focus, it is necessary to consider these factors simultaneously. [ABSTRACT FROM AUTHOR]

Objective This paper examines how negative experiences with the health-care system create a lack of confidence in receiving medical care in seven countries: Australia, Canada, Germany, the Netherlands, New Zealand, the United Kingdom, and the United States. Methods The empirical analysis is based on data from the Commonwealth Fund International Health Policy Survey 2007, with nationally representative samples of adults aged 18 and over. For the analysis of the experience of cost barriers and confidence in receiving medical care, we conducted pairwise comparisons of group percentages as well as country-wise multivariate logistic regression models. Results Individuals who have experienced cost barriers show a significantly lower level of confidence in receiving safe and quality medical care than those who have not. This effect is most pronounced in the United States, where people who have foregone necessary treatment because of costs are four times as likely to lack confidence as individuals without the experience of cost barriers (adjusted odds ratio 4.00). In New Zealand, Germany, and Canada, individuals with the experience of cost barriers are twice as likely to report low confidence compared with those without this experience (adjusted odds ratios of 1.95, 2.19 and 2.24, respectively). In the Netherlands and UK, cost barriers are only a marginal phenomenon. Conclusions The fact that the experience of financial barriers considerably lowers confidence indicates that financial incentives, such as private co-payments, have a negative effect on overall public support and therefore on the legitimacy of health-care systems. [ABSTRACT FROM AUTHOR]

Although in vitro fertilization (IVF) has offered hope to those struggling with infertility, it has also had some unintended consequences, including the fate of embryos that may be “surplus” to requirement following IVF treatment. The number of embryos in storage across the world is high, creating a dilemma for patients who need to make disposal decisions, as well as presenting an administrative and practical dilemma for clinics. Research has suggested that patients’ views of the status of their embryo/s may affect their disposal decisions, and yet the nature of the links between views of the embryo and decisions to either donate or discard remain unclear. In this article, we engage in a discursive analysis of literature on disposal decisions. We discuss the range of ways in which embryos may be constructed, and demonstrate how these discourses make available or constrain particular action possibilities, and offer particular subject positions for patients. The analysis highlights the complexity of the relationship between embryo status and decision making, and may assist clinicians in supporting and guiding patients’ decisions. [ABSTRACT FROM AUTHOR]