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The aim of this study is to identify the most prolific countries in the field of special education and to discuss the widespread impact of their papers by taking into account the country's h-index. Through a bibliometric analysis, the data were collected in the Web of Science Core Collection category "Education, Special" in the Social Science Citation Index during 2011-2020. The 25 most prolific countries in the field of special education were determined in terms of paper productivity, and it was seen that the leading country was undisputedly the USA (54.42%). Meanwhile, a strong positive correlation was found between the h-index and the number of papers published by the countries (r=0.864). On the other hand, when the ranking in terms of the number of papers was reconfigured by the h-index, it was relatively changed. The possible reasons for this change for the countries with the most changing rankings were discussed by considering some definitive criteria such as the journal quartiles, the percentage of international and domestic, and the percentage of open access papers. This study reports a positive correlation between the quality and quantity in the field of special education for the publications of countries. It has been shown that where the positive correlation deviates, then especially, the journal quartiles, the percentage of international collaboration and the percentage of open access papers have a significant effect. The bibliometric findings may be useful to enrich the discussion about the widespread impact of papers and debate whether the use of h-index is acceptable for cross-national comparisons.

The study of variables related to the use of ICT in the classroom is a topic of interest that has been frequently researched. In this paper, after examining the importance of teacher training in explaining the use of ICT in the classroom, we focused on analysing the weight of variables related to teaching practices and the organisational context of schools, which are variables that are less frequently addressed in the literature. To do so, a secondary analysis was carried out using data provided by the Teaching and Learning International Study (TALIS 2018). Specifically, we worked with a sample of 3,918 principals and 64,899 teachers from a total of 3921 schools in 21 countries. A multilevel binary regression model with random intercept, fixed coefficients and a two-level structure with teachers at level 1 and schools at level 2 was used. The results indicate that the presence of ICT in the classroom is associated with self-efficacy in teaching and the cognitive activation of students and with the organisational aspects of the school, which are scarcely addressed by the existing literature on this topic of interest, such as school climate, educational innovation and cooperation among teachers. Based on these results, we reflect on possible ways to promote the use of ICT in the classroom.

Background: The value of a life is regularly monetised by government departments for informing resource allocation. Guidance documents indicate how economic evaluation should be conducted, often specifying precise values for different impacts. However, we find different values of life and health are used in analyses by departments within the same government despite commonality in desired outcomes. This creates potential inconsistencies in considering trade-offs within a broader public sector spending budget. We provide evidence to better inform the political process and to raise important issues in assessing the value of public expenditure across different sectors. Methods: Our document analysis identifies thresholds, explicitly or implicitly, as observed in government-related publications in the following public sectors: health, social care, transport, and environment. We include both demand-side and supply-side thresholds, understood as societies' and governments' willingness to pay for health gains. We look at key countries that introduced formal economic evaluation processes early on and have impacted other countries' policy development: Australia, Canada, Japan, New Zealand, the Netherlands, and the United Kingdom. We also present a framework to consider how governments allocate resources across different public services. Results: Our analysis supports that identifying and describing the Value of a Life from disparate public sector activities in a manner that facilitates comparison is theoretically meaningful. The optimal allocation of resources across sectors depends on the relative position of benefits across different attributes, weighted by the social value that society puts on them. The value of a Quality-Adjusted Life Year is generally used as a demand-side threshold by Departments of transport and environment. It exceeds those used in health, often by a large enough proportion to be a multiple thereof. Decisions made across departments are generally based on an unspecified rationing rule. Conclusions: Comparing government expenditure across different public sector departments, in terms of the value of each department outcome, is not only possible but also desirable. It is essential for an optimal resource allocation to identify the relevant social attributes and to quantify the value of these attributes for each department. [ABSTRACT FROM AUTHOR]

Information communication and technology (ICT) has been used in various fields. The use of teleconference for teaching and learning activities is currently not a new topic in global world. In Indonesia, through IMHERE Program from Directorate of Higher Education, some universities have been connected with a network of teleconference as a medium of disseminate knowledge. However, when compare to university, the use of teleconference is not yet well-known in schools in Indonesia. This paper aims at presenting the experiences on the use of Teleconference as a medium of teaching secondary school pupils new information on different subjects they discovered in international learning environment. This activity is carried out by Indonesian students who study abroad e.g. students who study in Germany, Japan, Canada, Australia and USA. This paper will also analyse the feedback from the beneficiaries of the teleconference program, to gather opinion about the prospect, challenges in the administration, organisation, and the pedagogy implication of the use of information communication and technology in schools in Indonesia. The author will also give suggestions or recommendations on the best strategies of improving the use of information technology in schools. This is important to further promote and establish the e-Global-learning-system in Indonesia.

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]

Background. To date, there has been no attempt to describe or compare physical therapy as practiced globally, nor any evidence that an international data set exists to support this effort. It is known that research evidence can be used in strategic and tactical ways, especially within the highly politicized context of the policy arena. The International Private Practitioners Association recognized the potential value a global evidence base could have in influencing policy and supporting professional development in a number of countries, yet it lacked a mechanism to achieve these aims. Objectives. The purposes of this study were: (1) to identify and test an international data set, definitions, and means of data collection and (2) to establish views in relation to the value of international collaborations. Design. A mixed, prospective design was used in the study. Method. Phase 1 (2006-2007) involved the development of a data set, definitions, and Web-based and paper-based data collection options involving 98 physical therapists from 68 physical therapy practices in 7 countries. Phase 2 (2008-2009) involved testing of the data set in 34 practices involving 3,195 patient episodes and included physical therapist feedback of experience, local relevance of the data set, and value of international collaborations. Results. Testing confirmed the relevance and reliability of the data set and definitions and a preference for Web-based data collection (74.0%). Physical therapist feedback supported these findings. Most respondents (60.0%-100.0%) reported the value of further international collaborations for their profession nationally or internationally. Limitations. Although a true international collaboration, the limited sample size should be recognized. Conclusions. It is possible to develop an agreed-upon international data set and means of data collection. Testing appears to support its acceptability and relevance for use in practice. Participants highly valued the opportunity to undertake international collaborations that may benefit their profession nationally and internationally. Further testing and use of the data set are advocated before final validation is sought. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic was managed in Aotearoa New Zealand (NZ) by a COVID-19 elimination policy, involving border closure and an initial national lockdown. This was different to most other countries including Northern Ireland (NI) and the Netherlands (NED). We quantify the effect of these policies on the diagnosis of three major cancers, comparing NZ with these two European countries. Method: Data from NED, NZ and NI population-based cancer registries were used to assess trends in all pathologically diagnosed (PD) lung, breast, and colorectal cancers from March to December 2020 (pandemic period) and compared to the similar pre-pandemic period (2017–2019). Trend data were also collated on COVID-19 cases and deaths per 100,000 in each population. Results: Comparing the pre-pandemic period to the pandemic period there were statistically significant reductions in numbers of lung (↓23%) and colorectal (↓15%) PD cancers in NI and numbers of breast (↓18%) and colorectal cancer (↓18.5%) diagnosed in the NED. In NZ there was no significant change in the number of lung (↑10%) or breast cancers (↑0.2%) but a statistically significant increase in numbers of colorectal cancer diagnosed (↑5%). Conclusion: The impact of COVID-19 on cancer services was mitigated in NZ as services continued as usual reflecting minimal healthcare disruption and protected cancer services linked with the elimination approach adopted. The reduction in PD cases diagnosed in NED and NI were linked with higher COVID-19 rates and reflect societal restrictions which resulted in delayed patient presentation to primary and secondary care, disruption to screening and healthcare services as a result of COVID-19 infections on staff and the need to shift intensive care to COVID-19 patients. Reductions in PD cancers in NI and the NED and in particularly lung cancers in NI, highlight the need for targeted public health campaigns to identify and treat 'missing' patients. Protecting cancer services should be a priority in any future pandemic or systemic healthcare system disruption. [ABSTRACT FROM AUTHOR]

Seamless learning has a significance that has been increasing in recent years, and an increasing number of studies on the subject in the literature draws attention. This study aimed to examine the research on seamless learning between 1996 and 2020 with the bibliometric analysis method. The Scopus database was used in the collection of the data. After various screening processes, a total of 389 publications were included in the analysis. Descriptive analysis and bibliometric analysis were used in the analysis of the data. The distribution of publications by years, types of publications, sources, and languages were analyzed in the research. Additionally, visual maps were created with analyses of co-author, cocitation, and co-word. At the end of the study, it was seen that there has been an increase in the number of publications from the past to the present, articles and papers were predominant, and that most of the studies were carried out in English. As a result of bibliometric analysis, it was concluded that the most efficient countries in seamless learning were the United Kingdom, the United States, and Singapore. Also, it has been determined that the National Institute of Education, Center for International Education and Exchange, and Kyushu University institutions are dominant. The most frequently mentioned authors cited in studies in many different fields are M. Sharples, L.-H. Wong, and H. Ogata. According to the co-word analysis, the keywords seamless learning, mobile learning, ubiquitous learning, and mobile-assisted language learning stand out in the field of seamless learning.

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.

Seeking ethics committee approval for research can be challenging even for relatively simple studies occurring in single settings. Complicating factors such as multicentre studies and/or contentious research issues can challenge review processes, and conducting such studies internationally adds a further layer of complexity. This paper draws on the experiences of the LINNAEUS Collaboration, an international group of primary care researchers, in obtaining ethics approval to conduct an international study investigating medical error in general practice in six countries. It describes the ethics review processes applied to exactly the same research protocol for a study run in Australia, Canada, England, the Netherlands, New Zealand, and the US. Wide variation in ethics review responses to the research proposal occurred, from no approval being deemed necessary to the study plan narrowly avoiding rejection. The authors' experiences demonstrated that ethics committees operate in their own historical and cultural context, which can lead to radically different subjective interpretations of commonly-held ethical principles, and raised further issues such as 'what is research?'. This first LINNAEUS study started when patient safety was a particularly sensitive subject. Although it is now a respectable area of inquiry, patient safety is still a topic that can excite emotions and prejudices. The LINNAEUS Collaboration now extends to more countries and continues to pursue an international research agenda, so reflection on the influences of history, social context, and structure of each country's ethical review processes is timely. [ABSTRACT FROM AUTHOR]

The article deals with the recent widespread increase in marriage rates in the Western world. A convenient method of studying aspects of the recent history of marriage is provided by easily available data regarding the proportion of single persons at various dates. The article uses these data to disentangle two effects in the marriage boom: the extent to which the cohorts whose marriages have formed the main contribution to the marriage boom are marrying more, i.e. whether the proportion who will ultimately remain single is likely to be lower than in previous generations, the extent to which the mean age at marriage of these generations is likely to fall below that of their predecessors. The raw material for the computations to be presented consists of the proportions single at two recent dates for each of thirteen countries used in the study. The countries included in the study are Czechoslovakia, Denmark, England and Wales, France, Ireland, Luxembourg, the Netherlands, Norway, Sweden, Switzerland, Australia, New Zealand, and the U.S. The study from the proportion single shows that both reduction in the age at marriage and an increase in the proportion marrying at least once in the course of their lives is occurring in several countries.

The paper looks at part-time higher educational services for students in the educational systems of Australia, Canada, Germany, France, Italy, Japan, The Netherlands, New Zealand, Spain, Sweden, the United Kingdom, and the United States. A comparative examination of the nature and importance of part-time higher education is then presented. (DB)

This article focuses on the book "Generational Accounting Around the World," edited by Alan J. Auerbach, Laurence J. Kotlikoff and Willi Leibfritz. This book contains twenty-one papers which introduces generational accounting, a method of long term fiscal analysis and planning. Papers discuss the limitations of traditional fiscal analysis, generational accounts for Belgium, generational accounting in Brazil, Canada on the road to fiscal balance, public debt, welfare reforms, and the intergenerational distribution of tax burdens in Denmark, generational accounting for France, unification, aging, and the generational impacts of alternative fiscal policies in Germany, generational accounts for Italy, generational accounts for the Netherlands, generational accounting in New Zealand, generational accounting and depletable natural resources in Norway, generational accounts in Sweden.

In a recent paper, Reardon found that the relationship between family income and children's academic achievement grew substantially stronger in the 1980s and 1990s in the United States. We provide an international context for these results by examining the income-achievement association in 19 other Organisation for Economic Co-operation and Development countries using data from the Progress in International Reading Literacy Study and the Programme for International Student Assessment. First, we calculate and compare the magnitude of "income achievement gaps" across this sample of countries. Second, we investigate the association between the size of a country's income achievement gap, its income inequality, and a variety of other country characteristics. We find considerable variation across countries in income achievement gaps. Moreover, the U.S. income achievement gap is quite large in comparison to this sample of countries. Our multivariate analyses show that the income achievement gap is positively associated with educational differentiation, modestly negatively associated with curricular standardization, and positively associated with national levels of poverty and inequality.

By investigating how educational practitioners participate in activities around open educational practices (OEP), this paper aims at contributing to an understanding of open practices and how these practitioners learn to use OEP. Our research is guided by the following hypothesis: Different social configurations support a variety of social learning activities. The social configuration of OEPs is investigated by an operationalization into the dimensions (1) practice, (2) domain, (3) collective identity, and (4) organization. The results show how practitioners of six different OEPs learn, while acting and collaborating through a combination of offline and online networks. The findings of our study lead to practical implications on how to support participation in OEP, and thereby stimulate learning in (online) networks of OEP.

This paper studies the link between school facilities (buildings and grounds) and student achievement in eight countries using data from the TIMSS 2003 database. The results indicate a negative relationship, but the estimated coefficients are mainly insignificant. Interestingly, the coefficients differ heavily across countries. Whereas there seem to be adverse consequences from poor facilities in Australia, The Netherlands and Japan, there is no significant effect in the remaining five countries. It remains an open question for future research why facilities seem to play such a different role across countries. The main lesson to be learnt from the present investigation is that school facilities seem to have different impact across countries.

In a period of student loan scandals and U.S. financial market instability impacting on the cost and availability of student loans, this paper looks at alternative models of higher education funding. In this context, it also considers the level of financial support that the government should provide to higher education.

This article presents the authors' critique of lessons proposed by the Partnership for 21st Century Skills (P21). The authors initiate a discussion about content that they hope will play out in schoolhouses and statehouses across the country. They take on a different task: they present a handful of lesson ideas from P21 that could enhance studies of academic content. They present examples of content-rich education in which they hope P21 will use as models to revise its current skills maps. (Contains 11 endnotes.)

In this paper, we report on the results of a series of e-mail interviews with statistics educators around the world, focusing on their views of the nature of teaching statistics as a "service" subject. What do they think are the important aspects of statistics to focus on in such servicing teaching? What do they think are the characteristics of good teachers? And how do they go about developing themselves as statistics teachers? We analyse their responses to these and other questions using a phenomenographic approach to identify an outcome space for their conceptions of teaching service statistics. We examine the centralities and tensions that emerged from their responses and discuss the implications--insights on agency and reflective practice. The study contributes to a research framework for understanding the nature of pedagogical awareness in contexts beyond the setting for this study and aims to stimulate discussion about teaching service courses.

Aim: Concerns have been raised about the impact of alcohol sports sponsorship on harmful consumption, with some countries banning this practice or considering a ban. We review evidence on the relationship between exposure to alcohol sports sponsorship and alcohol consumption. Methods: Search of electronic databases (PubMed, Cochrane Library, Google Scholar and International Alcohol Information Database) supplemented by hand searches of references and conference proceedings to locate studies providing data on the impact of exposure to alcohol sports sponsorship and outcomes relating to alcohol consumption. Results: Seven studies met inclusion criteria, presenting data on 12,760 participants from Australia, New Zealand, the UK, Germany, Italy, Netherlands and Poland. All studies report positive associations between exposure to alcohol sports sponsorship and self-reported alcohol consumption, but the statistical significance of results varies. Two studies found indirect exposure to alcohol sports sponsorship was associated with increased levels of drinking amongst schoolchildren, and five studies found a positive association between direct alcohol sports sponsorship and hazardous drinking amongst adult sportspeople. Conclusion: These findings corroborate the results of previous systematic reviews that reported a positive association between exposure to alcohol marketing and alcohol consumption. The relationship between alcohol sports sponsorship and increased drinking amongst schoolchildren will concern policymakers. Further research into the effectiveness of restrictions on alcohol sports sponsorship in reducing harmful drinking is required. [ABSTRACT FROM AUTHOR]

Objective: To assess the mean package size and manufacturer-recommended serving size of sweet beverages available in four high-income countries: Australia, Canada, the Netherlands and New Zealand.Design: Cross-sectional surveys.Setting: The two largest supermarket chains of each country in 2012/2013.Subjects: Individual pack size (IPS) drinks (n 891) and bulk pack size (BPS) drinks (n 1904).Results: For all IPS drinks, the mean package size was larger than the mean serving size (mean (sd)=412 (157) ml and 359 (159) ml, respectively). The mean (sd) package size of IPS drinks was significantly different for all countries (range: Australia=370 (149) ml to New Zealand=484 (191) ml; P<0·01). The mean (sd) package size of Dutch BPS drinks (1313 (323) ml) was significantly smaller compared with the other countries (New Zealand=1481 (595) ml, Australia=1542 (595) ml, Canada=1550 (434) ml; P<0·01). The mean (sd) serving size of BPS drinks was significantly different across all countries (range: Netherlands=216 (30) ml to Canada=248 (31) ml; P<0·00). New Zealand had the largest package and serving sizes of the countries assessed. In all countries, a large number of different serving sizes were used to provide information on the amount appropriate to consume in one sitting.Conclusions: At this point there is substantial inconsistency in package sizes and manufacturer-recommended serving sizes of sweet beverages within and between four high-income countries, especially for IPS drinks. As consumers do factor serving size into their judgements of healthiness of a product, serving size regulations, preferably set by governments and global health organisations, would provide consistency and assist individuals in making healthier food choices. [ABSTRACT FROM AUTHOR]

Background: Low fruit and vegetable consumption is a risk factor for poor health. Studies have shown consumption varies across neighbourhoods, with lower intakes in disadvantaged neighbourhoods. However, findings are inconsistent, suggesting that socio-spatial inequities in diet could be context-specific, highlighting a need for international comparisons across contexts. This study examined variations in fruit and vegetable consumption among adults from neighbourhoods of varying socioeconomic status (SES) across seven countries (Australia, Canada, Netherlands, New Zealand, Portugal, Scotland, US). Methods: Data from seven existing studies, identified through literature searches and knowledge of co-authors, which collected measures of both neighbourhood-level SES and fruit and vegetable consumption were used. Logistic regression was used to examine associations between neighbourhood-level SES and binary fruit and vegetable consumption separately, adjusting for neighbourhood clustering and age, gender and education. As much as possible, variables were treated in a consistent manner in the analysis for each study to allow the identification of patterns of association within study and to examine differences in the associations across studies. Results: Adjusted analyses showed evidence of an association between neighbourhood-level SES and fruit consumption in Canada, New Zealand and Scotland, with increased odds of greater fruit intake in higher SES neighbourhoods. In Australia, Canada, New Zealand and Portugal, those residing in higher SES neighbourhoods had increased odds of greater vegetable intake. The other studies showed no evidence of a difference by neighbourhood-level SES. Conclusions: Acknowledging discrepancies across studies in terms of sampling, measures, and definitions of neighbourhoods, this opportunistic study, which treated data in a consistent manner, suggests that associations between diet and neighbourhood-level socioeconomic status vary across countries. Neighbourhood socioeconomic disadvantage may differentially impact on access to resources in which produce is available in different countries. Neighbourhood environments have the potential to influence behaviour and further research is required to examine the context in which these associations arise. [ABSTRACT FROM AUTHOR]

A comparison of developments in part-time work in New Zealand, the Netherlands and Denmark shows three very different trends. The Dutch are moving towards a‘part-time economy’, the decline in Danish part-time employment confounds the common expectation of rising atypical employment, while the New Zealand case illustrates some of the negative employment outcomes often associated with part-time employment and provides a contrast to the negotiated, tripartite solutions found in the Netherlands and Denmark. Overall, the diversity in part-time work patterns raises important theoretical and public policy questions, such as the interaction between institutional and preference changes, gender patterns and union strategies. [ABSTRACT FROM AUTHOR]

Theories of democratic government traditionally have relied on a model of organization in which officials act impartially, accept clear lines of accountability and supervision, and define their day-to-day activities through rules, procedures, and confined discretion. In the past 10 years, however, a serious challenge to this ideal has been mounted by critics and reformers who favor market, network, or "mixed-economy" models. We assess the extent to which these new models have influenced the work orientations of frontline staff using three alternative service types—corporate, market, and network—to that proposed by the traditional, procedural model of public bureaucracy. Using surveys of frontline officials in four countries where the revolution in ideas has been accompanied by a revolution in methods for organizing government services, we measure the degree to which the new models are operating as service-delivery norms. A new corporate-market hybrid (called "enterprise governance") and a new network type have become significant models for the organization of frontline work in public programs. [ABSTRACT FROM AUTHOR]

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.)

Background: Despite significant investments to support primary care internationally, income-based inequities in access to quality health care are present in many high-income countries. This study aims to determine whether low- and middle-income groups are more likely to report poor quality of primary care (PC) than high-income groups cross-nationally. Methods: The 2011 Commonwealth Fund Telephone Survey of Sicker Adults is a cross-sectional study across eleven countries. Respondents were recruited from randomly selected households. We used data from surveys conducted in Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, the United Kingdom, and the United States. We identified all questions relating to primary care performance, and categorized these into five dimensions: 1) access to care, 2) coordination 3) patient-centered care, and 4) technical quality of care. We used logistic regression with low and middle-income as the comparison groups and high-income as the referent. Results: Fourteen thousand two hundred sixty-two respondents provided income data. Countries varied considerably in their extent of income disparity. Overall, 24.7% were categorized as low- and 13.9% as high-income. The odds of reporting poor access to care were higher for low- and middle-income than high-income respondents in Canada, New Zealand and the US. Similar results were found for Sweden and Norway on coordination; the opposite trend favoring the low- and middle-income groups was found in New Zealand, United Kingdom, and the United States. The odds of reporting poor patient-centered care were higher for low-income than high-income respondents in the Netherlands, Norway, and the US; in Australia, this was true for low- and middle-income respondents. On technical quality of care, the odds of reporting poor care were higher for the low- and middle-income comparisons in Canada and Norway; in Germany, the odds were higher for low-income respondents only. The odds of reporting poor technical quality of care were higher for high-income than low-income respondents in the Netherlands. Conclusion: Inequities in quality PC for low and middle income groups exist on at least one dimension in all countries, including some that in theory provide universal access. More research is needed to fully understand equity in the PC sector. [ABSTRACT FROM AUTHOR]

Background: Disparities in access to primary care (PC) have been demonstrated within and between health systems. However, few studies have assessed the factors associated with multiple barriers to access occurring along the care-seeking process in different healthcare systems. Methods: In this secondary analysis of the 2016 Commonwealth Fund International Health Policy Survey of Adults, access was represented through participant responses to questions relating to access barriers either before or after reaching the PC practice in 11 countries (Australia, Canada, France, Germany, Norway, the Netherlands, New Zealand, Sweden, Switzerland, the United Kingdom, and United States). The number of respondents in each country ranged from 1000 to 7000 and the response rates ranged from 11% to 47%. We used multivariable logistic regression models within each of eleven countries to identify disparities in response to the access barriers by age, sex, immigrant status, income and the presence of chronic conditions. Results: Overall, one in five adults (21%) experienced multiple barriers before reaching PC practices. After reaching care, an average of 16% of adults had two or more barriers. There was a sixfold difference between nations in the experience of these barriers to access. Vulnerable groups experiencing multiple barriers were relatively consistent across countries. People with lower income were more likely to experience multiple barriers, particularly before reaching primary care practices. Respondents with mental health problems and those born outside the country displayed substantial vulnerability in terms of barriers after reaching care. Conclusion: A greater understanding of the multiple barriers to access to PC across the stages of the care-seeking process may help to inform planning and performance monitoring of disparities in access. Variation across countries may reveal organisational and system drivers of access, and inform efforts to improve access to PC for vulnerable groups. The cumulative nature of these barriers remains to be assessed. [ABSTRACT FROM AUTHOR]

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.

Background: As the role of the physician assistant/associate grows globally, one question is: what is the level of patient satisfaction with PAs? Driven by legislative enactments to improve access to care, the PA has emerged as a ready and able medical professional to address workforce shortages. The aim of this study was to review the literature on patient satisfaction of PAs., Objectives: The basis for this review was to clarify working definitions, synthesize the evidence, and establish conceptual boundaries around the topic of patient satisfaction with PAs. The intent was to identify gaps in the literature and offer suggested undertakings for more clarification on the subject., Methods: A scoping review was undertaken. Literature from 1968 to 2019 was searched and filtered for eligibility. Those that met criteria were categorized by date, method, geography, themes, and design., Results: In total, there were 987 papers or reports that were identified through bibliography database searching. Additional articles found through snowball methodology-reviewing references (n = 11). Only English language articles emerged for analysis. From this effort, 25 articles surfaced from the filtering process for final inclusion. Most (72%) of the articles came from the United States of America, three from the United Kingdom, and one each from Ireland, the Netherlands, and New Zealand. Most articles were descriptive in nature. Some variations in methods emerged., Conclusion: PAs are operational in 15 nations; their acceptance appears successful and satisfaction with their care largely indistinguishable from physicians. Findings from this analysis highlight one theory that when patient's needs are met, satisfaction is high regardless of the medical provider. Areas for further research are identified.

From previous work, we know that medical practice varies widely, and that unwarranted variation signals low value for patients and society. We also know that public reporting helps to create awareness of the need for quality improvement. Despite the availability of rich data, most Western countries have no routine surveillance of the geographic distribution of utilization, costs, and outcomes of healthcare, including trends in variation over time. This paper highlights the role of transparent public reporting as a necessary first step to spark change and reduce unwarranted variation. Two recent examples of public reporting are presented to illustrate possible ways to reduce unwarranted variation and improve care. We conclude by introducing the Value Improvement Cycle, which underscores that reporting is only a necessary first step, and suggests a path toward developing a multi-stakeholder approach to change.