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General Data Protection Regulation (GDPR) of the European Union (EU) was passed to protect data privacy. Though the GDPR intended to address issues related to data privacy in the EU, it created an extra-territorial effect through Articles 3, 45 and 46. Extra-territorial effect refers to the application or the effect of local laws and regulations in another country. Lawmakers around the globe passed or intensified their efforts to pass laws to have personal data privacy covered so that they meet the adequacy requirement under Articles 45–46 of GDPR while providing comprehensive legislation locally. This study aims to analyze the Malaysian and Saudi Arabian legislation on health data privacy and their adequacy in meeting GDPR data privacy protection requirements.

The research used a systematic literature review, legal content analysis and comparative analysis to critically analyze the health data protection in Malaysia and Saudi Arabia in comparison with GDPR and to see the adequacy of health data protection that could meet the requirement of EU data transfer requirement.

The finding suggested that the private sector is better regulated in Malaysia than the public sector. Saudi Arabia has some general laws to cover health data privacy in both public and private sector organizations until the newly passed data protection law is implemented in 2024. The finding also suggested that the Personal Data Protection Act 2010 of Malaysia and the Personal Data Protection Law 2022 of Saudi Arabia could be considered “adequate” under GDPR.

The research would be able to identify the key principles that could identify the adequacy of the laws about health data in Malaysia and Saudi Arabia as there is a dearth of literature in this area. This will help to propose suggestions to improve the laws concerning health data protection so that various stakeholders can benefit from it.

The purpose of this paper is to illuminate the ethical concerns associated with the use of artificial intelligence (AI) in the medical sector and to provide solutions that allow deriving maximum benefits from this technology without compromising ethical principles.

This paper provides a comprehensive overview of AI in medicine, exploring its technical capabilities, practical applications, and ethical implications. Based on our expertise, we offer insights from both technical and practical perspectives.

The study identifies several advantages of AI in medicine, including its ability to improve diagnostic accuracy, enhance surgical outcomes, and optimize healthcare delivery. However, there are pending ethical issues such as algorithmic bias, lack of transparency, data privacy issues, and the potential for AI to deskill healthcare professionals and erode humanistic values in patient care. Therefore, it is important to address these issues as promptly as possible to make sure that we benefit from the AI’s implementation without causing any serious drawbacks.

This paper gains its value from the combined practical experience of Professor Elhassan gained through his practice at top hospitals worldwide, and the theoretical expertise of Dr. Arabi acquired from international institutes. The shared experiences of the authors provide valuable insights that are beneficial for raising awareness and guiding action in addressing the ethical concerns associated with the integration of artificial intelligence in medicine.

This study aims to reveal the travel insurance behavior of digital nomads systematically. For this purpose, the habits and preferences of digital nomads for travel and health insurance were investigated based on the problems they experience during their travels.

Within the scope of multimethod qualitative research, the insurance behaviors of digital nomads were investigated in depth by using both interview and content analysis techniques for social media comments. In the first stage of the study, the interview technique was used to describe the main factors underlying the insurance behaviors of digital nomads. In the second stage, the comments of digital nomads on social media platforms were evaluated by content analysis and themes regarding the insurance behaviors of digital nomads were reached.

The inadequacies of the current global system and national order determine the travel insurance behavior of digital nomads, who are generally opposed to the existing order and tend to escape from authority and routine. It was found that digital nomads care about the speed at which insurance companies meet their demands, the coverage of insurance policies (medical and travel-related components of insurance) and the cost of insurance behavior.

This study aims to provide a new perspective to the literature by conducting multimethod qualitative research within the scope of the risks experienced by digital nomads and their travel insurance behavior. The study shows that digital nomads cannot escape from national regulations. They have to take out insurance in countries with low cost of living due to problems with the health system and security, and in some countries, it is due to country regulations. In practice, the study provides conclusions and recommendations for current and potential digital nomads, insurance companies and governments regarding the insurance behavior of digital nomads. In particular, the study concludes with recommendations for insurance companies in terms of insurance product development and the use of social policy tools for governments.

This study offers a perspective on the key factors underlying the travel insurance behavior of digital nomads.

Providing high-quality and cost-efficient care of older people is an important development priority for many health and social care systems in the world. This paper suggests a shift from acute, episodic and reactive hospital-centered care toward longitudinal, person-centered and proactive home-centered care. The purpose of this paper is to contribute to the knowledge of a comprehensive development strategy for designing and providing home-centered care of older people.

The study design is based on qualitative research with an inductive approach. The authors study development initiatives at the national, regional and local levels of the Swedish health and social care system. The data collection methods included interviews (n = 54), meeting observations (n = 25) and document studies (n = 59).

The authors describe findings related to policy actions and system changes, attempts to achieve collaboration, integration and coordination, new forms of care offerings, characteristics of work settings at home and differences in patients' roles and participation at home and in the hospital.

The authors suggest home-centered care as a solution for providing person-centered and integrated care of older people and give examples of how this can be achieved.

The authors outline five propositions for research and development related to national policies, service modularity as a solution for customized and coordinated care, developing human resources and infrastructure for home settings, expanding services that enable older people living at home and patient co-creation.

Inflation and federal monetary efforts to control it with interest rate hikes have very real and overwhelmingly negative consequences on US local governments following the onset of COVID-19. This study explores the post-pandemic inflationary environment of US local governments; examines the impacts of inflation and high interest rates on local government revenue, operating costs, capital costs, and debt service; reviews local government inflation management strategies, including the use of intergovernmental revenue; and assesses ongoing threats to local government financial health and financial resilience.

This study uses trend and literature analysis to comment on current issues local governments face.

The study finds that the growth of property values and resulting stability of property tax revenue has been important to local government revenues; that local governments bear very real burdens as operating and capital costs increase; and that the combination of high inflation and interest rates affects local government debt issuance by negatively affecting credit quality and interest costs, leading to municipal market contraction. Local governments have benefitted tremendously from intergovernmental revenue, but would be ill-advised to rely on it.

Vulnerabilities owing from revenue mismatch with the economy; inadequate affordable housing, inequality, and social issues; a changing workforce and tight labor market; climate change; and federal fiscal contraction—all of which are exacerbated by high inflation and interest rates—require local governments to act strategically, boldly and collaboratively to achieve fiscal health and financial resilience, and to realize positive returns of investments in people and capital.

This work is unique in addressing the post-pandemic impact of inflation and interest rates on local governments.

The purpose of this paper is to analyze to what extent and in what ways signaling theory has been explored within the field of international marketing. This paper systematically reviews the use of signaling theory in the field of international marketing. Communication is a core aspect of the international marketing process. Research in this field has explored effective and unique ways of improving the communication flow to reduce the asymmetry of information between international consumers and the firm. This notion is adopted, enhanced and strengthened by signaling theory. Signaling theory has recently received the attention of international marketing scholars.

The systematic review methodology was applied for the purpose of identifying the relevant studies. We extracted academic articles over the last 23 years from the domain of international marketing that directly contribute to signaling theory based on 57 journal articles extracted through the systematic review process.

Based on systematic research the results reveal that the topic has grown and continues to expand within the broader international marketing field. We offer a theoretical conceptual framework to better understand signaling theory in the context of international marketing.

The authors map and critically evaluate the use of signaling theory in international marketing. Relevance of signaling theory in international marketing is growing and authors present an integrative framework that organizes the existing literature, and provides scholars to further expand on emerging themes of the domain. The paper offers some useful future research directions.

Sharing patient health information (PHI) among hospitals has been much slower than the adoption of health record systems. This paper aims to investigate if privacy regulation (PR) or security measures (SMs) influence hospitals’ use of health information exchange (HIE) to share PHI with other providers (e.g. physicians, labs, hospitals). The study specifically focuses on how multiple PRs can impede and a strong national security infrastructure (NSI) can support HIE.

The study uses secondary data from a multi-national and multi-hospital survey administered by the European Union. The multi-level structure of the cross-sectional panel data is used to test the influence of both hospital-level (e.g. PR) and national-level variables (e.g. NSI) on HIE. A total of nine types of HIE, three types of PRs, nine SMs and other relevant control variables are considered. This study uses a two-level random intercept generalized linear model to test the hypothesis proposed in the study.

The study finds that national-level PRs (NLPR) have the strongest positive influence on HIE in comparison to regional (RLPR) and hospital-level (HLPR) PRs. Moreover, the study finds evidence that the presence of RLPR and HLPR, on average, decreases the positive impact of NLPR by 264%. The SMs also have a significant and positive impact on HIE. Adoption of an additional SM can increase the odds of engaging in a certain type of HIE between 21% and 61%. On the other hand, a strong NSI can also amplify the positive impact of SM on certain types of HIE.

This study extends prior research on the role of PRs in enabling HIE by considering the complexities brought up by adopting multiple PRs. NLPRs have the strongest impact on HIE in comparison to RLPRs or HLPRs. Moreover, public infrastructure initiatives such as those related to secure communications can also complement SMs adopted by the providers by encouraging HIE.

The purpose of this study is to examine the determinants of the level of indebtedness in the health sector in Portugal, taking into account the effects of the COVID-19 pandemic. At the same time, an attempt is made to understand whether the effect of a pandemic crisis is similar to that of a financial crisis.

To achieve this aim, two subperiods were analyzed: a global period between 2011 and 2020 that includes the pandemic crisis and the period between 2011 and 2014, designated as the financial assistance period by the “Troika” in Portugal. For a sample of 514 companies belonging to the NACE code: 86100 – activities of the health sector with hospitalization, the panel data methodology was applied, specifically, the generalized method of moments system proposed by Arellano and Bover (1995) and Blundell and Bond (1998).

The results of the study are in line with the Pecking-order explanatory theory, demonstrating that companies in this sector follow a financing hierarchy, preferentially resorting to internally generated funds and external debt. Additionally, the results reveal that the capital structure of companies has changed due to the COVID-19 pandemic. As for the period of financial assistance, there are no major differences in evidence when the total debt ratio is considered. The results suggest different impacts when it comes to a bear market period caused by a health crisis or a period of growing economic slowdowns.

As far as we know, this is the first study that analyses the debt levels in the context of the health sector in a country with a financial system based on the bank sector, using short- and long-term debt ratios, taking into account the particularities of two different moments considered to be bear market that may eventually be useful for comparison with other bear market moments in other macroeconomic environments.

El objetivo principal de este estudio es examinar los determinantes del nivel de endeudamiento en el sector de la salud en Portugal, teniendo en cuenta los efectos de la pandemia de COVID-19. Al mismo tiempo, se intenta comprender si el efecto de una crisis pandémica es similar al de una crisis financiera.

Para lograr este objetivo, se analizaron dos subperíodos: un período global entre 2011 y 2020 que incluye la crisis pandémica y el período entre 2011 y 2014, designado como el período de asistencia financiera por la “Troika” en Portugal. Para una muestra de 514 empresas pertenecientes al código NACE: 86100 – actividades del sector de la salud con hospitalización, se aplicó la metodología de datos de panel, específicamente, el método generalizado de momentos (GMM)-sistema propuesto por Arellano y Bover (1995) y Blundell y Bond (1998).

Los resultados del estudio están en línea con la teoría explicativa del “Pecking-order”, demostrando que las empresas en este sector siguen una jerarquía de financiamiento, recurriendo preferentemente a fondos generados internamente y deuda externa. Además, los resultados revelan que la estructura de capital de las empresas ha cambiado debido a la pandemia de COVID-19. En cuanto al período de asistencia financiera, no hay diferencias significativas en la evidencia cuando se considera la proporción total de deuda. Los resultados sugieren impactos diferentes cuando se trata de un período de mercado bajista causado por una crisis de salud o un período de crecimiento económico más lento.

Hasta donde sabemos, este es el primer estudio que analiza los niveles de deuda en el contexto del sector de la salud en un país con un sistema financiero basado en el sector bancario, utilizando ratios de deuda a corto y largo plazo, teniendo en cuenta las particularidades de dos momentos diferentes considerados como momentos de mercado bajista que eventualmente pueden ser útiles para comparar con otros momentos de mercado bajista en otros entornos macroeconómicos.

O principal objetivo deste estudo é examinar os determinantes do nível de endividamento no setor de saúde em Portugal, levando em consideração os efeitos da pandemia de COVID-19. Ao mesmo tempo, tenta-se compreender se o efeito de uma crise pandêmica é semelhante ao de uma crise financeira.

Para atingir esse objetivo, foram analisados dois subperíodos: um período global entre 2011 e 2020, que inclui a crise pandêmica, e o período entre 2011 e 2014, designado como o período de assistência financeira pela “Troika” em Portugal. Para uma amostra de 514 empresas pertencentes ao código NACE: 86100 – atividades do setor de saúde com hospitalização, foi aplicada a metodologia de dados em painel, especificamente o método generalizado de momentos (GMM)-sistema proposto por Arellano e Bover (1995) e Blundell e Bond (1998).

Os resultados do estudo estão de acordo com a teoria explicativa da ordem de preferência (“Pecking-order”), demonstrando que as empresas neste setor seguem uma hierarquia de financiamento, recorrendo preferencialmente a fundos gerados internamente e dívida externa. Além disso, os resultados revelam que a estrutura de capital das empresas mudou devido à pandemia de COVID-19. No que diz respeito ao período de assistência financeira, não há diferenças significativas na evidência quando se considera a proporção total de dívida. Os resultados sugerem impactos diferentes quando se trata de um período de mercado em baixa causado por uma crise de saúde ou um período de desaceleração econômica.

Até onde sabemos, este é o primeiro estudo que analisa os níveis de dívida no contexto do setor de saúde em um país com um sistema financeiro baseado no setor bancário, utilizando índices de dívida de curto e longo prazo, levando em consideração as particularidades de dois momentos diferentes considerados como momentos de mercado em baixa que eventualmente podem ser úteis para comparação com outros momentos de mercado em baixa em outros ambientes macroeconômicos.

The Astroworld concert tragedy is used as an example of crisis (mis)management and the potential utility of the 4R model. Although the 4R model has been implemented in high-risk emergency management situations, it is useful in the PR field because of its actionable approach, creating a way for practitioners to prepare for and manage crisis situations.

This is an analysis of the crisis that occurred at Astroworld, spanning preparation, day-of events, casualties and enduring reputational impact. The paper applies the 4R method to the Astroworld tragedy to show how it could have lessened or even prevented the tragedy. Finally, the SCCT model is used to explain why the official post-crisis statements were ineffective.

Social media has heightened the importance of a quick and effective organizational response to risk and crisis situations because poor responses can go viral quickly. However, social media also provides intelligence and crowd sourced information that can inform PR practitioners of emerging crisis scenarios. It is also an underutilized tool for two-way communication during crises.

The 4R approach is beneficial to general practitioners as it simplifies crisis best-practices, something essential for quick action. As our world changes and becomes less predictable, practitioners must have a clear plan to protect their organizations and the public surrounding them. This approach includes reduction, readiness, response and recovery, which are all essential in crisis communication.

The 4R method has not been explored or applied in the PR field. This paper highlights how the model has been utilized in the emergency management field and illustrates the way 4R can serve the PR field.

The rise of emerging economies in the innovation landscape has often been attributed to the positive spillovers of innovation capabilities from multinational corporations (MNCs). However, it is less certain that their innovative capabilities imported from the home country function effectively in the host country from the outset. This study examines the performance of the innovation capabilities of MNC subsidiaries in emerging economies over time by considering the gradual process of their learning about host countries.

We employed stochastic frontier analysis to measure innovation capabilities, our focal construct. For regression analysis, we applied the Mundlak estimator, a variant of the fixed-effects panel estimator, to a sample comprising subsidiaries of MNCs from technologically advanced nations operating in Korea between 2006 and 2016.

Our results indicate that the innovation capabilities of MNC subsidiaries initially underperform those of local firms but improve over time, eventually surpassing the capabilities of their local counterparts. Furthermore, our findings reveal that institutional distance amplifies the underperformance of the innovation capabilities of MNC subsidiaries.

This study contributes to the literature by extending both theoretical development and empirical measurement of innovation capabilities in cross-national settings. Additionally, it deepens our understanding of whether and how MNC subsidiaries adapt their innovation capabilities to the local market environment.