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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]

The construction of public problems has a lasting influence on implementation in a given policy subsystem. National and sociopolitical contexts influence issue definition differently across nations. However, the degree to which nation-specific issue definition takes place has been insufficiently explored. In recent years, the growing incidence of autism has led to a quest for causal factors. One hypothesis posits that the use of mercury in vaccines may be a culprit. This paper examines the definition of the mercury and autism issue in Australia, Canada, the United Kingdom, and the United States. Insights into the comparative elements of issue definition are suggested by the case. These insights are of particular importance to administrators, as agencies are deeply involved as objects and actors in the process of issue definition and are often responsible for implementing new and redefined policies. [ABSTRACT FROM AUTHOR]

Drawing on in-depth qualitative data, this article critically examines disability geography as a subfield where the personal is highly valued. The value and the risks inherent in this personal approach will be evaluated, including the usefulness of being an ‘insider’ and the difficulties of being reflexive and critically making use of one's positionality. The article concludes with reflections regarding how disability geography can confront its marginal status, appealing to researchers who claim no experience of disability while also supporting and encouraging those with personal experiences of disability to participate in the field. [ABSTRACT FROM AUTHOR]

Aim: To explore the health workforce responses to COVID‐19. Design: Analysis of job advertisements. Methods: We collected advertisements for healthcare jobs which were caused by and in response to COVID‐19 between 4 March–17 April 2020 for the United States, Canada, United Kingdom, Australia and New Zealand. We collected information on the date of the advertisement, position advertised and location. We categorized job positions into three categories: frontline, coordination and decision support. Results: We found 952 job advertisements, 72% of which were from the United States. There was a lag period between reported COVID‐19‐confirmed cases and job advertisements by several weeks. Nurses were the most advertised position in every country. Frontline workers were substantially more demanded than coordination or decision‐support roles. Job advertisements are a novel data source which leverages a readily available information about how workforces respond to a pandemic. The initial phases of the response emphasise the importance of frontline workers, especially nurses. [ABSTRACT FROM AUTHOR]

This study aimed to examine the association between breastfeeding and childhood obesity. A multinational cross‐sectional study of 4,740 children aged 9–11 years was conducted from 12 countries. Infant breastfeeding was recalled by parents or legal guardians. Height, weight, waist circumference, and body fat were obtained using standardized methods. The overall prevalence of obesity, central obesity, and high body fat were 12.3%, 9.9%, and 8.1%, respectively. After adjustment for maternal age at delivery, body mass index (BMI), highest maternal education, history of gestational diabetes, gestational age, and child's age, sex, birth weight, unhealthy diet pattern scores, moderate‐to‐vigorous physical activity, sleeping, and sedentary time, exclusive breastfeeding was associated with lower odds of obesity (odds ratio [OR] 0.76, 95% confidence interval, CI [0.57, 1.00]) and high body fat (OR 0.60, 95% CI [0.43, 0.84]) compared with exclusive formula feeding. The multivariable‐adjusted ORs based on different breastfeeding durations (none, 1–6, 6–12, and > 12 months) were 1.00, 0.74, 0.70, and 0.60 for obesity (Ptrend =.020) and 1.00, 0.64, 047, and 0.64 for high body fat (Ptrend =.012), respectively. These associations were no longer significant after adjustment for maternal BMI. Breastfeeding may be a protective factor for obesity and high body fat in 9‐ to 11‐year‐old children from 12 countries. [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]

The job description for legislators in western democracies includes constituency-focused activities such as casework and district visits. Unfortunately we have a limited theoretical and empirical understanding of the factors affecting legislators' constituency-oriented activities, in large part because most studies focus on single nations; even studies that are comparative do not span a variety of electoral systems. In this article we examine the constituency focus of MPs in six chambers that do provide such variance: the Australian House and Senate, Canadian House, Irish Dáil, New Zealand House, and the British House of Commons. We find that electoral considerations and incentives provided by different electoral systems, as well as other factors, affect the priority that MPs place on constituency service. [ABSTRACT FROM AUTHOR]

Severe disturbances in the financial markets in many countries during the 1980s and 1990s caused many stakeholders to examine whether commercial banks had adequate reserves for future loan losses. In the United States, bank regulators considered an adequate Allowance for Loan Losses a‘safety and soundness’ issue while the SEC became increasingly concerned over the possibility of banks using the Allowance as a method to‘manage earnings’. Both regulators demanded more rigorous calculations from banks to support their accounting entries. Also the FASB and the IASB have expressed concerns about a lack of harmonization and convergence in standards. An analysis of measurement standards in the United States, Canada, Japan, the United Kingdom and Australia, as well as by the Basel Committee on Banking Supervision and the IASB, reveals the partially conflicting goals for the Allowance: (a) promote harmonization (IASB), (b) increase transparency (SEC), (c) promote safety and soundness (bank regulators) and (d) maintain reasonable flexibility in recognition of the subjective aspects in determining an appropriate Allowance (bankers). The article offers a methodology which an individual bank may utilize to reconcile the conflicting goals of all interested parties. [ABSTRACT FROM AUTHOR]