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Communication is an indispensable part of international cooperation and it requires managing different cultures. Being prepared to see and understand different values, trying to understand contrasting views in a consortium, can decrease the potential of misperception which otherwise may act as a real barrier to cooperation. This is why international cooperation necessitates negotiation across cultures. In the case of collaboration, parties come together for a joint work which itself may create common values/understanding, besides the set goals. This is because collaboration requires strong we-feeling and commitment. The purpose of this paper is to focus on cross-cultural communication and collaboration in the area of Open and Distance Learning (ODL), concentrating on the communication processes in project management. Cross-cultural studies point to different communicative behaviours of individuals in multinational work environments e.g. the cultural characteristics affect the preferences towards the use of the media. For the purposes of this paper, the authors make a phenomenological-oriented case study of project management based on interviews with partners of a multilateral Grundtvig (adult learning) project, affiliated with distance education institutions in eight different countries. The authors test their assumptions for constructive and cooperative communication in e-Learning projects; delineating the effects of different cultures as regards the expectations from (1) international projects and (2) communication media.

Auditors' liability is a hot topic nowadays. Due to the increased risks of auditors and the lack of appropriate insurance, a limitation of auditors' liability seems appropriate. Based on the economic study of the London Economics, the European Commission issued a consultation paper to discuss a European harmonization of auditors' liability. But to harmonize a liability cap on auditors, one needs to examine not only the economic implications, but also the legal restraints and differences of auditors' liability regimes within the European Union. This paper shows that there are large discrepancies concerning auditor's liability towards third parties within the legal systems of the European Union. In Belgium, an auditor is liable towards each interested party. However, the public role of an auditor is not acknowledged in the United Kingdom, the Netherlands and Germany. In those countries the purpose of audited statements is to fulfil the auditor's duty to the shareholders collectively and not to the stockholders as individual parties or third parties. In Germany, the Netherlands and the United Kingdom, an auditor has to encompass a special duty of care towards the third party to be liable. Only a special relationship of the auditor towards a third party could imply auditor's liability toward those parties. This element wasn't discussed in the London Economics Study. However, these findings could have a major impact on the debate to harmonize an auditor's liability cap because the more parties can pursue an auditor, the more damage can be claimed and the higher the liability cap needs to be fixed. [ABSTRACT FROM AUTHOR]

Background: Nursing competency frameworks describe the competencies; knowledge, skills and attitudes nurses should possess. Countries have their own framework. Knowledge of the content of professional competency frameworks in different countries can enhance the development of these frameworks and international collaborations. Objective: This study examines how competencies and task divisions are described in the current professional competency frameworks for registered nurses (RNs with a Bachelor's degree) in the Netherlands, Belgium, the United Kingdom (UK), Canada and the United States (US). Methods: Qualitative document analysis was conducted using the most recently published professional competency frameworks for registered nurses in the above-mentioned five countries. Results: All the competency frameworks distinguished categories of competencies. Three of the five frameworks explicitly mentioned the basis for the categorization: an adaptation of the CanMEDS model (Netherlands), European directives on the recognition of professional qualifications (Belgium) and an adapted inter-professional framework (US). Although there was variation in how competencies were grouped, we inductively identified ten generic competency domains: (1) Professional Attitude, (2) Clinical Care in Practice, (3) Communication and Collaboration, (4) Health Promotion and Prevention, (5) Organization and Planning of Care, (6) Leadership, (7) Quality and Safety of Care, (8) Training and (continuing) Education, (9) Technology and e-Health, (10) Support of Self-Management and Patient Empowerment. Country differences were found in some more specific competency descriptions. All frameworks described aspects related to the division of tasks between nurses on the one hand and physicians and other healthcare professionals on the other hand. However, these descriptions were rather limited and often imprecise. Conclusions: Although ten generic domains could be identified when analysing and comparing the competency frameworks, there are country differences in the categorizations and the details of the competencies described in the frameworks. These differences and the limited attention paid to the division of tasks might lead to cross-country differences in nursing practice and barriers to the international labour mobility of Bachelor-educated RNs. [ABSTRACT FROM AUTHOR]

Context: Existing studies have explored the association between workplace training and wages suggesting that training participation may have a positive association with wages. However, we still know very little about whether this association varies between men and women. Through its potential positive association with wages, training may balance wage differences between men and women. In addition, the gender wage gap varies across the wage distribution. Differences in the association between training participation and wages for men and women across the earnings spectrum may offer an explanation as to why the discrepancy in female/male earnings is larger at some point of the wage distribution compared to others. Approach: Using data from the Programme for International Assessment of Adult Competencies (PIAAC) and unconditional quantile regression, this paper examines whether the association between workplace training and wages differs between men and women at different points of the wage distribution across 14 European countries. To partly control for endogeneity in training participation, detailed measures of cognitive skills have been included in the models. Findings: Findings show gender differences in the association between training and wages across the wage distribution. In most countries, results indicate larger training coefficients for women than men at the lower end of the wage spectrum whereas they are larger for men at the top. This pattern holds across most countries with the only exception of Liberal ones, where women benefit less than men across the entire wage spectrum. Conclusions: The findings of this work reveal that distributional variations in returns to workplace training follow a similar pattern across industrialized countries, despite their different institutional settings. Moreover, differences in training coefficients of men and women at different parts of the wage distribution suggest that training could reduce gender wage differences among low earners and potentially widen the gap in wages among individuals at the top of the wage distribution.

In this paper, I examine whether generalized trust and education, as well as social security policies of welfare state institutions matter for cross-national differences in subjective well-being (SWB), because knowledge on this issue is still lacking. For this purpose I integrated the insights of two sociological theories: Social Function Production theory and Actor-Centred Institutionalism. Based on these theoretical notions we derived several hypotheses, which I tested using multilevel analysis of the data from the European Social Survey (2006), in a sample of 37,237 respondents from 22 European countries. My findings indicate that various extensiveness of social security policies matter for the level of SWB, and for the impact of education on SWB. I found negative impact of low education on SWB in all countries, except in Northern and Western European countries. This might suggest that social security policies of the latter countries have diminished the negative impact of low education on SWB. Moreover, my findings indicate positive relationship between individual education and generalized trust; as well as between generalized trust and SWB in countries with all five types of social security policies.

Cross-border higher education institutions are considered a main way to fulfill the educational internalization in Mainland China; to some extent they represent the attitude of entering the international market. In this paper, the history, status quo, and future of Chinese-foreign cooperatively-run schools are analyzed and discussed. Cross-border higher education institutions in Mainland China have experienced the process from accidental and disorder to a systematic and quality orientation.

Background: Obesity-related lifestyle behaviors usually co-exist but few studies have examined their simultaneous relation with body weight. This study aimed to identify the hierarchy of lifestyle-related behaviors associated with being overweight in adults, and to examine subgroups so identified. Methods: Data were obtained from a cross-sectional survey conducted across 60 urban neighborhoods in 5 European urban regions between February and September 2014. Data on socio-demographics, physical activity, sedentary behaviors, eating habits, smoking, alcohol consumption, and sleep duration were collected by questionnaire. Participants also reported their weight and height. A recursive partitioning tree approach (CART) was applied to identify both main correlates of overweight and lifestyle subgroups. Results: In 5295 adults, mean (SD) body mass index (BMI) was 25.2 (4.5) kg/m², and 46.0 % were overweight (BMI ≥25 kg/m²). CART analysis showed that among all lifestyle-related behaviors examined, the first identified correlate was sitting time while watching television, followed by smoking status. Different combinations of lifestyle-related behaviors (prolonged daily television viewing, former smoking, short sleep, lower vegetable consumption, and lower physical activity) were associated with a higher likelihood of being overweight, revealing 10 subgroups. Members of four subgroups with overweight prevalence >50 % were mainly males, older adults, with lower education, and living in greener neighborhoods with low residential density. Conclusion: Sedentary behavior while watching television was identified as the most important correlate of being overweight. Delineating the hierarchy of correlates provides a better understanding of lifestyle-related behavior combinations which may assist in targeting preventative strategies aimed at tackling obesity. [ABSTRACT FROM AUTHOR]

Objective: To systematically review the literature and map published studies on 4-8-year-olds' intake of discretionary choices against an ecological framework (ANalysis Grid for Environments Linked to Obesity; ANGELO). Design: Articles were identified through database searches (PubMed, PyscINFO®, Web of Science) in February and March 2014 and hand-searching reference lists. Studies were assessed for methodological quality and mapped against the ANGELO framework by environment size (macro and micro setting) and type (physical, economic, policy and socio-cultural influences). Setting: Studies were conducted in the USA (n 18), Australia (n 6), the UK (n 3), the Netherlands (n 3), Belgium (n 1), Germany (n 1) and Turkey (n 1). Subjects: Children aged 4-8 years, or parents/other caregivers. Results: Thirty-three studies met the review criteria (observational n 23, interventions n 10). Home was the most frequently studied setting (67% of exposures/strategies), with the majority of these studies targeting family policy-type influences (e.g. child feeding practices, television regulation). Few studies were undertaken in government (5·5%) or community (11%) settings, or examined economic-type influences (0%). Of the intervention studies only four were categorised as effective. Conclusions: The present review is novel in its focus on mapping observational and intervention studies across a range of settings. It highlights the urgent need for high-quality research to inform interventions that directly tackle the factors influencing children's excess intake of discretionary choices. Interventions that assist in optimising a range of environmental influences will enhance the impact of future public health interventions to improve child diet quality. [ABSTRACT FROM AUTHOR]

Background: The evidence that inspires and fosters communication skills, teaching programmes and clinical recommendations are often based on national studies which assume, implicitly, that patients' preferences towards doctors' communication style are not significantly affected by their cultural background. The cross-cultural validity of national results has been recognized as a potential limitation on how generally applicable they are in a wider context. Using 35 country-specific focus group discussions from four European countries, the aim of the present study is to test whether or not national cultures influence lay people's preferences towards doctors' style of communication.Methods: Lay people preferences on doctor's communication style have been collected in Belgium, the Netherlands, the United Kingdom and Italy. Each centre organized between eight and nine focus groups, where participants (n = 259) were asked to comment on a video of a simulated medical interview. The discussions were audiotaped, transcribed and coded using a common framework (Guliver Coding System) that allowed for the identification of different themes.Results: The frequency distribution of the topics discussed highlights lay people's generally positive views towards most part of doctors interventions. The regression model applied to the Guliver categories highlighted slight national differences and the existence of a cross-cultural appreciation, in particular, of five types of intervention: Doctors attitudes (both Task-Oriented and Affective/Emotional), Summarizing, Structuring and Providing solution.Conclusion: Lay panels valued doctors' communication style in a similar manner in the countries selected. This highlights the existence of a common background, which in the process of internationalization of heath care, might foster the implementation of cross-national teaching programmes and clinical guidelines. [ABSTRACT FROM AUTHOR]

The article presents a study which aims to listen to peoples' perspectives on what constitutes a good physician communication. The researchers detail the study design using videotaped standardized medical encounters to discuss their preferences in gender-specific focus groups. It implies that the physicians' affective attitude is most desired and appreciated by patients.

Objective:To (1) examine the opinions of medical staff working in spinal cord injury (SCI) centres (SCICs); (2) evaluate their knowledge, attitudes and practices towards obesity prevention and management; (3) report the number of beds and dietitians available at each SCIC.Methods:A 37-item questionnaire was sent to 23 SCICs in the UK, the Netherlands, Belgium and the Republic of Ireland between September 2012 and January 2013.Results:Eighteen SCICs returned the questionnaires for analysis. All respondents stated that they had an interest in obesity treatment but only 2.3% of the respondents received training in obesity management. Sixty-one percent of staff did not consider body mass index (BMI) to be appropriate for use in SCI patients and subsequently less than half of the respondents use BMI routinely. The majority of respondents reported that they are confident in dealing with overweight (74.5%) and obese (66.1%) SCI adults, less than half (44.1%) are confident in treating overweight and obese SCI children. Respondents also indicated the need for nationally adopted guidelines and a lack of physical activity provision. There were 17.5 whole-time equivalent (WTE) dietitians recorded in 22 SCICs, equivalent to 47.8 beds per WTE dietitians (range 10-420). Non-UK SCIC dietitians are significantly better resourced than in UK SCICs (beds per WTE dietitian: 36 vs 124, P=0.035).Conclusion:Medical staff expressed the need to participate in obesity prevention and management. Appropriate training should be considered for all medical staff and the development of specific weight management guidelines and dietetic provision should be considered. [ABSTRACT FROM AUTHOR]

Background Continuous sedation is increasingly used as a way to relieve symptoms at the end of life. Current research indicates that some physicians, nurses, and relatives involved in this practice experience emotional and/or moral distress. This study aims to provide insight into what may influence how professional and/or family carers cope with such distress. Methods This study is an international qualitative interview study involving interviews with physicians, nurses, and relatives of deceased patients in the UK, The Netherlands and Belgium (the UNBIASED study) about a case of continuous sedation at the end of life they were recently involved in. All interviews were transcribed verbatim and analysed by staying close to the data using open coding. Next, codes were combined into larger themes and categories of codes resulting in a four point scheme that captured all of the data. Finally, our findings were compared with others and explored in relation to theories in ethics and sociology. Results The participants' responses can be captured as different dimensions of 'closeness', i.e. the degree to which one feels connected or 'close' to a certain decision or event. We distinguished four types of 'closeness', namely emotional, physical, decisional, and causal. Using these four dimensions of 'closeness' it became possible to describe how physicians, nurses, and relatives experience their involvement in cases of continuous sedation until death. More specifically, it shined a light on the everyday moral reasoning employed by care providers and relatives in the context of continuous sedation, and how this affected the emotional impact of being involved in sedation, as well as the perception of their own moral responsibility. Conclusion Findings from this study demonstrate that various factors are reported to influence the degree of closeness to continuous sedation (and thus the extent to which carers feel morally responsible), and that some of these factors help care providers and relatives to distinguish continuous sedation from euthanasia. [ABSTRACT FROM AUTHOR]

Background: Older patients often experience sub-standard communication in the palliative phase of illness. Due to the importance of good communication in patient-centred end-of-life care, it is essential to understand the factors which influence older patients' communication with physicians. This study examines older patients' attitudes towards, and experiences of, patient-physician end-of-life (EoL) communication in three European countries. Methods: A secondary analysis of interviews from British, Dutch and Belgian patients over the age of 60 with a progressive terminal illness was conducted. Cross-cutting themes were identified using a thematic approach. Results: Themes from 30 interviews (Male n = 20, Median age 78.5) included: confidence and trust; disclosure and awareness; and participation in decision-making. Confidence and trust were reinforced by physicians' availability, time and genuine attention and hindered by misdiagnoses and poor communication style. Most participants preferred full disclosure, though some remained deliberately ill-informed to avoid distress. Patients expressed a variety of preferences for and experiences of involvement in medical EoL decision-making and a few complained that information was only provided about the physician's preferred treatment. Conclusions: A variety of experiences and attitudes regarding disclosure and participation in decision-making were reported from each country, suggesting that communication preferences are highly individual. It is important that physicians are sensitive to this diversity and avoid stereotyping. In regard to communication style, physicians are advised to provide clear explanations, avoid jargon, and continually check understanding. Both the 'informed' and the 'shared' patient-physician decision-making models assume patients make rational choices based on a clear understanding of treatment options. This idealized situation was often not reflected in patients' experiences. [ABSTRACT FROM AUTHOR]

Varying sets of items and constructs are a problem frequently encountered in cross-national and longitudinal studies in marketing. We discuss the use of multi-group latent variable models in this situation and describe a method that can be used to handle unequal sets of items and constructs across groups in such models. A simulation study based on cross-national marketing data from Belgium and Great Britain revealed that accurate estimates of differences between latent means can be obtained with this procedure with as few as two common items, although a fairly large sample size is required to obtain small standard errors of the estimates of latent mean differences. A substantive example involving a confirmatory factor model as well as a structural model is also provided, using longitudinal data concerning the quality image of a food product in the Netherlands. [ABSTRACT FROM AUTHOR]

To achieve efficient and effective quality improvement, European universities have gradually adopted organizational strategies, structures, technologies, management instruments, and values that are commonly found in the private business sector. Whereas some studies have shown that such managerialism is beneficial to the quality of job performances of university employees, others have argued that managerialism is largely counterproductive and that it results in lower performances. The latter situation is called a "managerialism contradiction". This paper tests two lines of reasoning underlying a potential contradiction governing the relationship between managerialism and job performances, while using university employee survey data from six European countries (Belgium, Finland, Germany, Netherlands, Sweden, UK). The results tend to support the assumption that managerialism, in these six countries at least, has a positive effect, albeit a modest one, on the quality of performances. The most important conclusion is therefore that there is no managerialism contradiction at work in European universities.

The evaluation of government-financed research has become increasingly important in the last few decades in terms of increasing the quality of, and payoff from, the research that is done, reducing the cost of doing it, and lending public credibility to the manner in which research is funded. But there are very large differences throughout the world in the extent to which systems used promote these results. This paper briefly presents the dimensional results of a study designed to comparatively evaluate the national-level research evaluation models in sixteen countries on five merit-defining dimensions. (Contains 6 figures.)

This paper reflects on the usefulness and applicability of comparative inquiry for policy and practice in education development projects involving universities within the EU or EEA (Socrates, Erasmus, etc.) and especially in technical aid and outreach programmes (Tempus etc.), using concrete examples, exploring the distinctions made in EU regulatory documents and funding frameworks between research and development. The tension is shown between overt political objectives such as the transfer of assumed know-how to solve immediate priority problems of common concern, and educational objectives of extending understanding among equal partners. It is suggested that the more a development project is a shared learning programme, the more applicable and fruitful are comparative methods. Experienced examples are considered of research investigation applied to development programmes from within, whether as practitioner research or by independent research commissioned by practitioners, to assist in pursuing development objectives; of surveys commissioned by the EC across programmes to evaluate the overall effectiveness of a scheme and identify best practice for the future; and of research undertaken independently, taking advantage of access to the project framework to explore questions which are not necessarily or exclusively instrumental. The need is identified to bring these into a coherent system, and recommendations are outlined for future policy.

This article presents seven reports on the interviews about reception and use of international indicators among respondents from Belgium, Denmark, France, Italy, The Netherlands, Spain and United Kingdom. The first report is based on interviews with 5 respondents occupied with different aspects of the macro level of the Flemish educational system. It focuses on the content of the interviews and is structured upon seven headlines referring to the BEQUAD interview schedule. The second report is based on six interviews with respondents placed at different levels of the Danish educational system. This report is written on the basis of the interviews and the structure of the report is built upon seven headlines referring to the guideline of interview headings including a summary and a conclusion. The third is based on six interviews conducted during the months of May and June, 2002, with a union representative with the SNES (secondary education teachers) (A), the Director of School Education (B), a Counsellor at the "Cour des Comptes" and Chairman of the Higher Council for School Assessment (C), a counsellor and Director of Programming and Development (D), a Senator (E) and a Deputy Director of Higher Education (F). Most of the interviewees expressed their views on the best-known publications by the OECD and French education system. All interviews give emphasis on the use of indicators to serve specific ends. The fourth is based on interviews with 6 people engaged in key positions in the Italian Educational system. The fifth is based on interviews with six people occupying different key positions in the Dutch educational system. The report summarises the content of the interviews and is based on the seven headings of the BEQUAD interview schedule. Next is a report based on interviews with 6 people occupying key positions in the Spanish educational scene. The interviews aimed at getting relevant information about their perceptions on the possible influences of international indicators to decision-making processes and public information. The last report is based on interviews with three groups of respondents in the UK. The report summarises the content of the interviews and the Department of Education and Skills (DFES) written response and is structured using the seven section headings of the BEQUAD interview schedule. (Contains 2 footnotes.)

Background: Obtaining a sample that is representative of the group of interest is of utmost importance in questionnaire studies. In a survey using a state authorized web-portal for citizen communication with authorities, we wanted to investigate the view of adult men on patient involvement in health care decision-making regarding Prostate-Specific Antigen test for prostatic cancer. In this paper, we report on sample characteristics and representativeness of our sample in terms of personality and baseline involvement preferences., Methods: We compared personality profiles (BFI-10) and baseline healthcare decision-making preferences (CPS) in our sample (n = 6756) to internationally available datasets. Pooled data from a) US, UK, Canada, Australia, and New Zealand (n = 1512), b) Germany, Netherlands, Switzerland, and Belgium (n = 1136), and c) Norway, Sweden, Finland, and Denmark (n = 1313) were used for BFI-10 comparisons. Regarding CPS, we compared our sample with three previous datasets relating to decision-making in cancer (n = 425, 387, and 199)., Results: Although statistically significant differences particularly appeared in large dataset comparisons, sample BFI-10 and CPS profiles mostly were within the range of those previously reported. Similarity was greatest in BFI-10 comparisons with group a) where no statistically significant difference could be established in factors 'agreeableness' and 'neuroticism' (p = .095 and .578, respectively)., Conclusion: Despite some variation, our sample displays personality and baseline preference profiles that are generally similar to those described in previous international studies. For example, this was the case with the BFI-10 'agreeableness' measure (incl. trust and fault-finding items), an important factor in healthcare decision-making.