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Using a standardized dataset, this paper compares the differences in income mobility among four countries—Canada, the United States, Great Britain and Germany—during the 1990s and early 2000s. The results suggest that, in general, there exist diverse levels of income mobility across the four countries. Although the precise magnitudes of the differences are sensitive to the measurement method used, incomes in Britain are by far the most mobile. Our findings also reveal country-specific driving forces that underlie income mobility. The stabilizing effects of government transfers are most pronounced in Canada. In Germany, it is the progressive tax system that offsets earnings variations and results in smaller changes in longitudinal incomes. Moreover, we also discover that demographic factors provided only limited explanation of differences in income mobility. [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]

This article investigates the interdependence of stock returns and exchange rate changes within the same economy. Six countries were tested for volatility spillovers, namely the U.S., Great Britain, Japan, Germany, Canada and France. Evidence of spillovers from stock returns to exchange rate changes is found for all countries except Germany. These results suggest that the asset approach to exchange rate determination is valid when formulated in terms of the second moments of the exchange rate distribution for these countries. The spillovers from stock returns to exchange rate changes are symmetric in nature. Volatility spillovers from exchange rate changes to stock returns are insignificant for all countries.

This article looks at the development of a model, including both corporate and individual taxes, to determine the conditions under which preferred shares are issued and purchased in the U.S., Canada, Germany, Great Britain, France and Denmark prior to 1986. For each country examined, it is shown that there are conditions under which corporations are able to issue preferred shares that are profitable for the issuing corporations as well as attractive to investors. The model also produces specialized implications for each country. For example, the analysis suggests that there are stronger tax incentives to create a positive preferred stock equilibrium in Canada than in the U.S. This results from the existence of the dividend tax credit in Canada and from the higher dividend exclusion for corporate investors. The implication of the model for West Germany is that the ratio of new issues of preferred shares over bonds should be quite low because the condition for issuing preferred shares is only marginally satisfied. Individual investors and parent companies in France and Denmark are entitled to similar tax relief, but non-parent firms are in a less advantageous position than their Canadian counterparts.

Background: The resources used in treatment for sex offenders with intellectual disabilities have had much research attention, but less has been written about how participants are expected to respond (programme mechanisms). Methods: A realist evaluation of seven programmes from the UK, Canada, USA, Switzerland and Germany was conducted. In semi‐structured interviews, programme designers elucidated how they are intended to work. The data analysis was driven by the realist concern to expose programme mechanisms and intended outcomes. Results: Two main outcomes are increasing risk management capacities and cultivating prosocial identities. These are achieved through developing insights into a person's risks, work on (sexual) self‐regulation skills, sexual boundaries and personal values and by developing meaningful social roles and positive relationships. Conclusions: Over time, there have been changes to some of the treatment resources used. However, there were little differences in terms of the intended programme mechanisms and outcomes, which remained surprisingly consistent. [ABSTRACT FROM AUTHOR]

Background: The availability of costly safety measures against transfusion-transmissible infections forces Western countries to confront difficult ethical questions. How to decide about implementing such measures? When are such decisions justified? As a preliminary to addressing these questions, we assessed which concerns shape actual donor blood safety policymaking in five Western countries.Study Design and Methods: Our qualitative study involved determining which issues had been discussed in advisory committee meetings and capturing these issues in general categories. Appropriate documents were identified in collaboration with local decision-making experts in Canada, Germany, the Netherlands, the United States, and the United Kingdom. The introduction of hepatitis B virus nucleic acid testing and selected measures against variant Creutzfeldt-Jakob disease, West Nile virus, and Q-fever were chosen as cases representing decision-making on safety measures with high costs and low or uncertain added safety.Results: A broad inventory of concerns was established, including: 1) nine categories of advantages and disadvantages of candidate safety policies; 2) six kinds of difficulties in assessing risks and forecasting the effects of safety policies; 3) 13 decision-making principles; and 4) six kinds of practical barriers hampering the translation of candidate policies into decisions.Conclusion: Blood safety policymaking involves a wide variety of competing concerns, and approaches to reconcile these considerations are themselves contested. Developing a systematic decision-making approach requires ethical reflection on, among others, reasonable costs of safety and the value of transparency in public policy. [ABSTRACT FROM AUTHOR]

ACADEMIC EMERGENCY MEDICINE 2011; 18:1358-1370 © 2011 by the Society for Academic Emergency Medicine Abstract The maturation of emergency medicine (EM) as a specialty has coincided with dramatic increases in emergency department (ED) visit rates, both in the United States and around the world. ED crowding has become a public health problem where periodic supply and demand mismatches in ED and hospital resources cause long waiting times and delays in critical treatments. ED crowding has been associated with several negative clinical outcomes, including higher complication rates and mortality. This article describes emergency care systems and the extent of crowding across 15 countries outside of the United States: Australia, Canada, Denmark, Finland, France, Germany, Hong Kong, India, Iran, Italy, The Netherlands, Saudi Arabia, Catalonia (Spain), Sweden, and the United Kingdom. The authors are local emergency care leaders with knowledge of emergency care in their particular countries. Where available, data are provided about visit patterns in each country; however, for many of these countries, no national data are available on ED visits rates or crowding. For most of the countries included, there is both objective evidence of increases in ED visit rates and ED crowding and also subjective assessments of trends toward higher crowding in the ED. ED crowding appears to be worsening in many countries despite the presence of universal health coverage. Scandinavian countries with robust systems to manage acute care outside the ED do not report crowding is a major problem. The main cause for crowding identified by many authors is the boarding of admitted patients, similar to the United States. Many hospitals in these countries have implemented operational interventions to mitigate crowding in the ED, and some countries have imposed strict limits on ED length of stay (LOS), while others have no clear plan to mitigate crowding. An understanding of the causes and potential solutions implemented in these countries can provide a lens into how to mitigate ED crowding in the United States through health policy interventions and hospital operational changes. [ABSTRACT FROM AUTHOR]

Researchers are only beginning to understand how contextual variables such as date of birth and birthplace affect the development of elite athletes. This article considers the generality of birthplace and date-of-birth effects in varying sport contexts. The Study 1 examined how environmental factors associated with an athlete's date-of-birth and size of birthplace predict the likelihood of becoming an Olympic athlete in Canada, the United States of America, Germany, and the United Kingdom. Study 2 examined date-of-birth and birthplace effects among athletes playing in the first professional league in Germany. Study 2 also examined the validity of birthplace as a proxy for early developmental environment by comparing birthplace with the place of first sports club in four German sports leagues. Results from both studies showed no consistent findings for date of birth. Findings from Study 2 also suggested incongruence between birthplace and location of first sports club as proxies for early developmental environment. Although there was some consistency suggesting elite athletes are less likely to come from very small or excessively large communities, exceptions occurred both within and across sport contexts. These results suggest that any developmental effects of date and place of birth are buffered by broader socio-cultural factors. [ABSTRACT FROM AUTHOR]

Treatment with new and/or innovative drugs with uncertain safety and efficacy profile is associated with substantial ethical concerns. The main objective of this paper is to present guidance on the use of such drugs contained in: (i) major international codes and guidelines pertaining to medical ethics and biomedical research; (ii) national codes of medical ethics and professional conduct of the USA, Canada, Australia, New Zealand, the UK, Ireland, France and Germany. Out of the four international codes and guidelines analysed, only the Declaration of Helsinki addresses the question of the use of unproven drugs. Among national codes, only two (USA and New Zealand) explicitly allow for use of new or innovative drugs. Moreover, treatment with unproven drugs seems to be permissible under the French code, though this is not stated explicitly. The remaining codes do not contain any articles on the use of new and innovative drugs. An update of existing articles, as well as the addition of new guidelines to the codes, should be considered in view of the rapid pace of development and introduction to clinical practice of new drugs. This work is relevant to innovative off-label applications of approved drugs and expanded access to investigational drugs., (© 2018 The British Pharmacological Society.)