UNASSIGNED: Engaging nursing students in transdisciplinary learning and collaborative activities will prepare them for future roles in promoting global health knowledge and cultural competence. The purpose of this study was to describe undergraduate nursing students\' experiences of participating in collaborative virtual seminars intended to promote global health knowledge and increase cultural competence between a university in Sweden and a university in Somaliland.
UNASSIGNED: A qualitative descriptive study using semi-structured individual interviews and focus group discussions was conducted. Notably, 27 nursing students who participated in a collaborative virtual seminar were included. Data were analyzed using inductive qualitative content analysis.
UNASSIGNED: Nursing students reported having gained profound comprehension of and a broadened perspective on global health, cultural awareness, and curiosity crucial for their roles as future global nurses.
UNASSIGNED: Fostering global health knowledge and cultural competence among nursing students through collaborative virtual seminars is advantageous as it enhances their cultural competence in nursing.

As an important enterprises\' practice in implementing the UN 2030 sustainable development, environmental, social, and governance (ESG) performance has drawn escalating attention from government, business and academia. This focus substantially impacts internationalization of enterprises. This paper tries to provide quantitative evidence of the impact of ESG performance of Chinese A-share listed companies on their international operation from 2009 to 2021. The results show that: (i) the ESG performance of listed enterprises exercise a significant positive impact on the internationalization operation. (ii) The effect of ESG performance on enterprises internationality is driven by increasing total factor productivity, enterprise reputation, and green innovation, as well as by mitigating financing constraint. (iii) Good ESG performance significantly boosts enterprise internationalization for non-heavy polluting, large-scale enterprises. This effect is also pronounced for enterprises with local government reports featuring a high frequency of environmental terms or those in high-tech industries.

UNASSIGNED: This paper identifies the determinant factors of Portuguese investment in Poland, Hungary, and the Czech Republic. We assume that investment abroad is motivated by business opportunities, and the quality-price ratio of the workforce.
UNASSIGNED: To this end, we used a qualitative methodology composed of 6 case studies, based on interviews and surveys with the managers of the Portuguese firms investing in those three economies.
UNASSIGNED: Despite the business opportunities, Portuguese investment directed towards these economies is negligible, due, in part, to the geographic and cultural distance. However, the economic and political stability, combined with market size and growth potential are undeniable attraction factors for Portuguese investors. Small and medium enterprises (SMEs), due to their flexible conditions that allow changes in the activity, and the strong trend towards outsourcing, to the detriment of the manufacturing industry, are the primary focus of international investment. This trend, although common to several sectors, has shown greater dynamism in the banking and financial sector.
UNASSIGNED: The results suggest market-oriented investments aiming at growth and expansion. The vast Polish market is the one that most attracted Portuguese investors. The hybrid feature of some strategies can align with the cautious attitude towards the investment translated into cooperation agreements with financial institutions for funding, the market learning process, and the training of the personnel. The anticipation of the installation over potential competitors, the experience in production and international markets, the price-quality ratio, the capacity of product adaptation and the design were considered important sources of competitive advantage that motivated the investment. The greatest difficulties during this process were language and the complexity of legislation.

Internationalization in higher education is essential, and although active learning methodologies are increasing and allow students to develop transversal skills, most still have a very local scope. In this context, the Collaborative Online International Learning (COIL) methodology is an interesting approach to benefit the students\' development. It consists of an online program that involves creating multicultural teams to develop a specific learning project. Although this methodology is expanding, its use in physiology is still scarce. This paper aims to show an example of applying COIL methodology in physiology topics to enhance higher-education students\' innovation and business skills. Our example project developed a sports-assessment service concept focused on physiology and biomechanics assessments. The program involved teams from Brazil, Germany, and Spain, comprising undergraduate and master students. Over 7 weeks, these teams, mentored by professors and researchers, engaged in workshops covering COIL methodology, business model design, executive summary planning, economic analyses, and communication techniques. Key outcomes included learning new concepts, developing soft skills, building confidence in innovative solution proposals, and experiencing diverse cultures. Challenges faced were language barriers, scheduling, task complexity, and logistical issues. This experience confirms the effectiveness of incorporating programs using COIL methodology into educational curriculums. Doing so exposes physiology students to innovation, entrepreneurship, and business creation while strengthening their professional connections and opening up postgraduation opportunities.NEW & NOTEWORTHY Although the Collaborative Online International Learning (COIL) methodology is expanding, its use in physiology is still scarce. Our example COIL project of 7 weeks developed a sports-assessment service concept focused on physiology and biomechanics assessments. The program involved teams from Brazil, Germany, and Spain, comprising undergraduate and master\'s students. Students perceived extracurricular activities in this format as beneficial. Coaches also expressed positive views about such initiatives, noting benefits for students and their development.

This paper explores the main drivers of firms\' external competitiveness in times of crisis. We focus on the aftermath of the Great Recession (2008-2015) and present evidence based on a comprehensive survey of Italian companies (the MET dataset). Overall, our results highlight not only the strict correlation between internationalization and innovative activities but also a positive change of attitude of Italian firms towards these strategies. We show that, while structural factors play a key role for external competitiveness, other critical aspects trigger superior performances, especially strategic profiles, technological capabilities, and proactive behaviors such as innovativeness and R&D investment. Importantly, we document disproportionate effects of innovation for smaller and less productive companies. This points at dynamic strategies as a potential tool to fill the gap between larger/more productive companies and the set of less structured firms, a segment representing an ideal target for policy measures.
UNASSIGNED: The online version contains supplementary material available at 10.1007/s11187-021-00453-0.

COVID-19 presented a range of challenges to the delivery of school psychology services in countries around the world. The current study aimed to investigate the practices of school psychologists from the United States of America, Australia, Germany, Canada, and the United Kingdom, including changes to practice and exploration of the factors that supported the delivery of school psychology services during the pandemic. Quantitative and qualitative data were collected from 1,030 school psychologists and analyzed using a mixed methods, multiple case study design. Differing impacts of the pandemic on the working hours of school psychologists were reported across countries. Participants in all countries reported a shift to online working, with an increased focus on consultation and intervention and a reduction in psychoeducational assessments. School psychologists from all nations emphazised the importance of self-care strategies, social connections and physical activity and the role of support via supervision or professional networks. Access to appropriate technology and responsive workplace policies and procedures were also identified as important. Results have implications for the internationalization of the school psychology profession and can inform international school psychology planning in response to future crises.

OBJECTIVE: To extend and form the \"Grading of Recommendations Assessment, Development and Evaluation in Traditional Chinese Medicine\" (GRADE-TCM).
METHODS: Methodologies were systematically reviewed and analyzed concerning evidence-based TCM guidelines worldwide. A survey questionnaire was developed based on the literature review and open-end expert interviews. Then, we performed expert consensus, discussion meeting, opinion collection, external examination, and the GRADE-TCM was formed eventually.
RESULTS: 265 Chinese and English TCM guidelines were included and analyzed. Five experts completed the open-end interviews. Ten methodological entries were summarized, screened and selected. One round of consensus was conducted, including a total of 22 experts and 220 valid questionnaire entries, concerning 1) selection of the GRADE, 2) GRADE-TCM upgrading criteria, 3) GRADE-TCM evaluation standard, 4) principles of consensus and recommendation, and 5) presentation of the GRADE-TCM and recommendation. Finally, consensus was reached on the above 10 entries, and the results were of high importance (with voting percentages ranging from 50 % to 81.82 % for \"very important\" rating) and strong reliability (with the Cr ranging from 0.93 to 0.99). Expert discussion meeting (with 40 experts), opinion collection (in two online platforms) and external examination (with 14 third-party experts) were conducted, and the GRADE-TCM was established eventually.
CONCLUSIONS: GRADE-TCM provides a new extended evidence-based evaluation standard for TCM guidelines. In GRADE-TCM, international evidence-based norms, characteristics of TCM intervention, and inheritance of TCM culture were combined organically and followed. This is helpful for localization of the GRADE in TCM and internationalization of TCM guidelines.

BACKGROUND: Abroad medical electives are recognized as high-impact practice and considered a necessity to provide global health training. As of recently, the COVID-19 pandemic and its related travel restrictions prohibited most international elective activities. Another important barrier to abroad electives that received comparably little attention is elective and application fees, which - combined - may be as high as $5000 per month, and may prevent students with limited financial resources from applying for an international elective. Elective fees have never been systematically analyzed and trends in teaching and application fees have rarely been subject to dedicated scientific investigations.
METHODS: Using data from two large elective reports databases, the authors addressed this gap in the literature. The authors analyzed trends in abroad elective fees within the last 15 years in some of the most popular Anglo-American elective destinations among students from Germany, including the United States of America, Australia, New Zealand, the Republic of South Africa, Ireland and the United Kingdom.
RESULTS: The authors identified n = 726 overseas elective reports that were uploaded between 2006 and 2020, of which n = 438 testimonies met the inclusion criteria. The United Kingdom and Australia were the most popular elective destinations (n = 123 and n = 113, respectively), followed by the Republic of South Africa (n = 104) and the United States of America (n = 44). Elective fees differed substantially-depending on the elective destinations and time point. Median elective fees were highest in the United States of America (€ 1875 for a 4-week elective between 2018-2020), followed by the Republic of South Africa (€ 400) and Australia (€ 378). The data also suggests an increasing trend for elective fees, particularly in the United States.
CONCLUSIONS: Rising fees warrant consideration and a discussion about the feasibility of reciprocity and the bidirectional flow of students in bidirectional exchange programs.

This paper describes the implementation of tools to support multiple language variants of the clinical information models that are used to define a model-driven EHR system. Beyond that, it describes how a complete EHR system can be created with multiple language variants, using the example of an EHR for clinical management of patients in a Fracture Liaison Service. A clinical information model, represented as ontology, was developed in the English language. This model was translated into Spanish and Mandarin, and the modeling tools were refined, on the basis of the experience gained. A workshop was then held, where participants used the EHR tools to create additional language variants in German, French, Portuguese, Arabic, Farsi, Urdu and Somali. The results from the workshop are presented here, with a brief summary of the lessons learned; further work will focus on improving the tools in response to those lessons.

Scientometric analyses characterize the output of research publications using quantitative methods. While it has been reported that the number of publications in anesthesiology has been increasing for years, the global research activity in pediatric anesthesiology and its landscape is largely unknown.
To examine the activity, developmental dynamics, and collaboration landscape of research publications in pediatric anesthesiology over the past two decades.
PubMed and WebOfScience were searched for pediatric anesthesiology publications published between 2001 and 2020. The identified publications were exported into a database, matched, curated, and then assigned to one or more countries according to their affiliation field(s). The primary outcome was the publication activity and its growth rate. Secondary outcomes included the geographical distribution, the evolution of international collaborations (as indicated by articles affiliated with more than one country), and the main sources.
Thirty-four thousand, three hundred and forty-three pediatric anesthesiology publications were retrieved. The compound annual growth rate over the study period was +7.6%. The highest annual growth rate was +20.6% from 2019 to 2020. Corresponding authors were most often affiliated with USA (32.5%), Germany (5.5%), and China (5.5%). China (+22.9%), Iran (+21.7%), and India (+16.1%) had the highest compound annual growth rates. 6001 (17.5%) articles involved international collaboration, with a compound annual growth rate of +13.1%. The most frequent collaboration was between USA and Canada (716 articles together). The most prominent source was Pediatric Anesthesia (10.0%).
Publication activity in pediatric anesthesiology has increased from 2001 to 2020 and has become more geographically diverse. With the volume of international collaborations even outpacing this growth, it is hoped that this will gradually lead to a larger evidence base in pediatric anesthesia.