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National contributions to science are influenced by a number of factors, including economic capacity, national scientific priorities, science policy, and institutional settings and cultures. Nations do not have equal opportunities to access the global scientific market, and therefore, often seek out international partners with complementary resources and expertise. This study aims at investigating national collaboration strategies, with a focus on research leadership—measured through corresponding authorship—and its relationship with scientific impact. Results show that countries with higher R&D investments are more scientifically independent, and confirm that international collaboration is positively related to citation impact. However, leadership in international collaboration is inversely related with a countries’ share of international collaboration and there is a very little relationship between citation impact and international leadership. For instance, most countries—and particularly those that have fewer resources—have higher scientific impact when they are not leading. This suggests that, despite increasing global participation in science, most international collaborations are asymmetrical, and that the research system remains structured around a few dominate nations. [ABSTRACT FROM AUTHOR]

Economic crises carry a substantial impact on population health and health systems, but little is known on how these transmit to health workers (HWs). Addressing such a gap is timely as HWs are pivotal resources, particularly during pandemics or the ensuing recessions. Drawing from the empirical literature, we aimed to provide a framework for understanding the impact of recessions on HWs and their reactions. We use a systematic review and best-fit framework synthesis approach to identify the relevant qualitative, quantitative and mixed-methods evidence, and refine an a priori, theory-based conceptual framework. Eight relevant databases were searched, and four reviewers employed to independently review full texts, extract data and appraise the quality of the evidence retrieved. A total of 57 peer-reviewed publications were included, referring to six economic recessions. The 2010-15 Great Recession in Europe was the subject of most (52%) of the papers. Our consolidated framework suggests that recessions transmit to HWs through three channels: (1) an increase in the demand for services; (2) the impacts of austerity measures; and (3) changes in the health labour market. Some of the evidence appeared specific to the context of crises; demand for health services and employment increased during economic recessions in North America and Oceania, but stagnated or declined in Europe in connection with the austerity measures adopted. Burn-out, lay-offs, migration and multiple jobholding were the reactions observed in Europe, but job opportunities never dwindled for physicians during recessions in North America, with nurses re-entering labour markets during such crises. Loss of motivation, absenteeism and abuse of health systems were documented during recessions in low-income countries. Although the impacts of recessions may vary across economic events, health systems, labour markets and policy responses, our review and framework provide an evidence base for policies to mitigate the effects on HWs. [ABSTRACT FROM AUTHOR]

The adoption of the shared prosperity goal by the World Bank in 2013 and Sustainable Development Goal 10, on inequality, by the United Nations in 2015 should strengthen the focus of development interventions and cooperation on the income growth of the bottom 40 percent of the income distribution. This paper contributes to the incipient literature on within-country allocations of development institutions and assesses the geographic targeting of World Bank projects to the bottom 40 percent. Bivariate correlations between the allocation of project funding approved over 2005–14 and the geographical distribution of the bottom 40 as measured by survey income or consumption data are complemented by regressions with population and other potential factors affecting the within-country allocations as controls. The correlation analysis shows that, of the 58 countries in the sample, 41 exhibit a positive correlation between the shares of the bottom 40 and World Bank funding, and, in almost half of these, the correlation is above 0.5. Slightly more than a quarter of the countries, mostly in Sub-Saharan Africa, exhibit a negative correlation. The regression analysis shows that, once one controls for population, the correlation between the bottom 40 and World Bank funding switches sign and becomes significant and negative on average. This is entirely driven by Sub-Saharan Africa and not observed in the other regions. Hence, the significant and positive correlation in the estimations without controlling for population suggests that World Bank project funding is concentrated in administrative areas in which more people live (including the bottom 40) rather than in poorer administrative areas. Furthermore, capital cities receive disproportionally high shares of World Bank funding on average. [ABSTRACT FROM AUTHOR]

Are public officials more responsive to requests from affluent or poor constituents? A growing body of evidence suggests that lawmakers are more responsive to the rich when they craft policy. However, some scholars theorize that officials also exhibit a corresponding bias in favor of the poor when they handle casework, essentially giving policy to the rich and services to the poor. In this paper, we test this casework prediction using four experiments in which confederates sent simple requests to state or local officials. In each, our confederates’ reported social classes were randomly assigned and signaled with a brief introductory statement mentioning the sender’s occupation or economic situation. Across our samples, we find precisely-estimated null effects of social class biases: the officials we studied were equally likely to respond regardless of the constituent’s class. These findings raise doubts about whether casework is really a class-biased process. [ABSTRACT FROM AUTHOR]

Urban transport policies are characterized by a wide range of impacts, and trade-offs and conflicts among these impacts. The task of integrating and reconciling these impacts poses challenges, because they are incommensurable, and they affect different groups differentially. Further, impacts such as those related to social equity are hard to define and measure. In this paper we address two inter-related questions: How is social equity conceptualized, operationalized, and prioritized relative to environmental and other objectives; and how might social equity be more effectively integrated in urban transportation plans in North America? We critically analyze how social equity is incorporated into transportation plans in 18 large North American metropolitan areas, in terms of the quality of the related objectives, how meaningfully their achievement is assessed through the choice of performance measures or indicators, and their prioritization relative to other objectives. We observe that social equity goals and objectives are in many cases not translated into clearly specified objectives, and appropriate measures for assessing their achievement in a meaningful, disaggregated manner are often lacking. At the same time, there are good examples of social equity objectives and measures in several plans. In general, there is a stronger focus on the local environment (and congestion reduction) than on social equity in the plans. We end the paper with a discussion related to considerations for generating objectives and measures for better integrating social equity into urban transportation plans. [ABSTRACT FROM AUTHOR]

• An outlook toward the cullet collection, marketing, and applications was provided. • Several cullet end markets from construction to ceramics industries were discussed. • Restricting cullet landfilling applications should be encouraged by governments. • Selecting a dual-stream system makes cullet processing stage more cost-effective. • Developing stable high-demand markets benefits both end consumers and recyclers. Waste glass cullet (WGC) recovered from almost all waste streams is contaminated with mixed-color sources of variable compositions. Consequently, over 60% of the cullet is discarded in landfills in North America. The present work provides an overview of the potential end markets for the cullet with a focus on collection systems, marketing strategies, safety and environmental issues as well as the economics of the target applications. Cullet can find major applications in construction industry as a substitute to natural aggregates integrated with different proportions of concrete to build pavements, and roads Cullet could be widely used in different applications due to its desirable physical, mechanical, and chemical properties. This makes cullet an appropriate alternative for natural resources. Although various applications discussed in this paper have well-established markets, low proportion of cullet has been implemented in those applications. This could be attributed to the higher preprocessing cost of cullet compared to the natural aggregates. Different measures are required by the governments to continue to develop the potential post-consumer markets for recycled cullet such as encouraging recycling of WGC and restricting the use of landfilling activities for WGC. [ABSTRACT FROM AUTHOR]

This paper begins with a review Mexico's vital statistics, and some past and recent economic and political highlights. Mexico is assuming a larger and more prominent role in the global economy because of its abundant energy resources, its favorable demographics, its proximity to the large -- and rich -- North American market, and its openness to trade. Using a well-known framework that assesses the performance of a national economy that participates in the wider global economy, I identify the strengths and weaknesses of the Mexican economy that should be exploited or addressed to the end of enhancing the future performance of the economy. [ABSTRACT FROM AUTHOR]

This review paper discusses the program called Worldwide Opportunities on Organic Farms (WWOOF), in North America, as an example of a subset of the care economy in which volunteers contribute to farm care. Human care is partly direct (some childcare, kitchen duties and other housework), but mostly indirect, in that farm families get time off. This review expands on previous work that considered farms in Ontario, Canada as spaces of care and farmwomen as the carers. It critiques other research that claims WWOOFers do not replace local labor and that WWOOF represents an idealistic and ethical space potentially corrupted by tourists. [ABSTRACT FROM AUTHOR]

Achieving cleaner water for rural and suburban communities in a sustainable way requires approaches tailored to the unique socioeconomic, ecological, and historic contexts embedded in a particular community and place. Water quality trading (WQT) is a payment for ecosystem services style policy that is currently popular across North America as a mechanism to reduce water pollution from rural communities. Yet this approach is failing to generate markets with enough trades to measurably improve waterways. Some failures are attributed to poor program design and others to stakeholder communities who are averse to the premise or morality of WQT. However, rural communities are not homogenous and many are in fact amenable to payment for ecosystem services policies such as WQT. Although our case study identified Tennessee watersheds as "feasible" locations, we present evidence that the typical program design parameters would fail, despite having a willing population of farmers. We argue that identifying amenable communities or feasible locations simplifies the agency of stakeholders and is ultimately insufficient to make ecosystem services programs work unless the design and implementation phases of the programs include local stakeholders. [ABSTRACT FROM AUTHOR]

Threatened species are increasingly dependent on conservation investments for persistence and recovery. Information that resource managers could use to evaluate investments–such as the public benefits arising from alternative conservation designs–is typically scarce because conservation benefits arise outside of conventional markets. Moreover, existing studies that measure the public benefits of conserving threatened species often do not measure the benefits from partial gains in species abundance that fall short of official recovery, or the benefits from achieving gains in species abundance that happen earlier in time. We report on a stated preference choice experiment designed to quantify the non-market benefits for conservation investments aimed at threatened Pacific Coho salmon (Oncorhynchus kisutch) along the Oregon Coast (OC). Our results show that a program aimed at increasing numbers of returning salmon can generate sizable benefits of up to $518 million/y for an extra 100,000 returning fish, even if the species is not officially declared recovered. Moreover, while conservation investment strategies expected to achieve relatively rapid results are likely to have higher up-front costs, our results show that the public attaches substantial additional value of up to $277 million/y for achieving conservation goals quickly. Our results and approach can be used to price natural capital investments that lead to gains in returning salmon, and as inputs to evaluations of the benefits and costs from alternative conservation strategies. [ABSTRACT FROM AUTHOR]

With the advent of continuous antiretroviral therapy, HIV has become a complex chronic, rather than acute, condition. The Chronic Care Model (CCM) provides an integrated approach to the delivery of care for people with chronic conditions that could therefore be applied to the delivery of care for people living with HIV. Our objective was to assess the alignment of HIV care settings with the CCM. We conducted a mixed methods study to explore structures, organization and care processes of Canadian HIV care settings. The quantitative results of phase one are published elsewhere. For phase two, we conducted semi-structured interviews with key informants from 12 HIV care settings across Canada. Irrespective of composition of the care setting or its location, HIV care in Canada is well aligned with several components of the CCM, most prominently in the areas of linkage to community resources and delivery system design with inter-professional team-based care. We propose the need for improvements in the availability of electronic clinical information systems and self-management support services to support better care delivery and health outcomes among people living with HIV in Canada. [ABSTRACT FROM AUTHOR]

Downscaled climate projections need to be linked to downscaled projections of population and economic growth to fully develop implications for land, natural resources, and ecosystems for future scenarios. We develop an empirical spatiotemporal approach for jointly projecting population and income at the county scale in the United States that is consistent with neoclassical economic growth theory and overlapping labor markets and that accounts for labor migration and spatial spillovers. Downscaled projections generated for the five Shared Socioeconomic Pathways used to support global scenario analysis generally show growth focused around relatively few centers especially in the southeast and western regions, with some areas in the Midwest and northeast experiencing population declines. Results are consistent with economic growth theory and with historical trends in population change and convergence of per capita personal income across US counties. [ABSTRACT FROM AUTHOR]

Residential segregation into spatial neighborhoods and boroughs is a well-known spatial dynamic process that characterise complex urban environments. Existing models of segregation, including the pioneering Schelling ones, often do not consider all the factors that can contribute to this process. Segregation as well as aggregation emerges from local interactions among individuals, and is rooted in the complexity of social, economic and environmental interactions. The main objective of this study is to develop and implement a geospatial agent-based model to simulate the decision-making process of location of new household for incoming immigrant populations. Particularly this study aims to simulate and analyse the dynamics of the new immigrant populations arriving in the bilingual cities and boroughs of the island of Montreal. The model was implemented in NetLogo software, using real geospatial datasets. The obtained simulation results indicate realistic spatial patterns of spatial composition of the ethnographic fabric on the island of Montreal. The proposed model has the potential to be used as part of the city planning purposes. [ABSTRACT FROM AUTHOR]

The participation of diverse demographics in higher education has risen over the last half-century; meanwhile, different political and social tiers have been assigning a more active role to institutions in terms of equality and social justice. This change in circumstances has led to the roll out of processes to institutionalise diversity outreach. This study was conducted for the clear purpose of assessing the current institutionalisation status of diversity outreach in 127 key universities from the Academic Ranking of World Universities based on the opinions of diversity outreach managers and the information published on institutional websites, in turn measuring compliance with various indicators. A qualitative analysis of the institutional statements, the goals sought through strategic plans and the definitions of diversity itself was also conducted. The evidence reveals the early stage of the institutionalisation process in universities on account of the low percentage obtained for the proposed indicators. Furthermore, the study failed to exhibit significant differences in this process in terms of the institutional ownership or position held in the ranking; however, more prominent progress was noted in the North-American region when geographical differences were taken into account, likely as a result of the historical background in the advocacy for equal opportunities. Lastly, a change of approach to the conceptualisation of diversity is suggested in favour of equality and social justice. [ABSTRACT FROM AUTHOR]

Objective: Multidisciplinary vascular anomaly clinics (VACs) offer important value to pediatric patients with complex vascular anomalies whose care overlaps specialties. These clinics are labor intensive and costly to operate since providers see fewer patients compared to their individual specialty clinic. Our North American tertiary care institution's VAC specialists include a pediatric otolaryngologist, pediatric surgeon, pediatric plastic surgeon, pediatric dermatologist, and interventional radiologist. To assess financial feasibility, we conducted a cost analysis of our VACs comprised of 2 half-day multidisciplinary physician attended clinics (5 specialists at our main campus and 2 specialists at a satellite clinic) and a half-day nurse practitioner clinic. Method: Assessment of net revenue based on net collections for clinic, professional, operative, hospital setting, and facility charges generated during 12 consecutive monthly VACs beginning July 1, 2015. Expense calculations included provider and staff salaries, benefits, supply costs, and clinic leasing costs. Results: There were 469 clinic visits, of which 202 were new patient evaluations. Sixty-eight patients underwent 93 procedures under general anesthesia, including procedures performed by our interventional radiologist, most commonly sclerotherapy or embolization (n = 37), surgical interventions including endoscopy (n = 36), or laser procedures (n = 20). Three patients were admitted. Fifty-seven patients received a new diagnosis different from that for which they were referred. Gross revenue was $1 810 525, and net revenue was 42.5%, or $783 152. Expenses totaled $453 415 for a net positive revenue of $329 737. Conclusion: When including direct downstream revenue, particularly from operative procedures, our VAC program operates on a net positive margin, making the program financially feasible. [ABSTRACT FROM AUTHOR]

Objective: To systematically review the literature on women’s experiences traveling for abortion and assess how this concept has been explored and operationalized, with a focus on travel distance, cost, delays, and other barriers to receiving services. Background: Increasing limitations on abortion providers and access to care have increased the necessity of travel for abortion services around the world. No systematic examination of women’s experiences traveling for abortion has been conducted; this mixed-methods review provides a summary of the qualitative and quantitative literature on this topic. Methods: A systematic search was conducted using PubMed, Embase, Web of Science, Popline, and Google Scholar in July 2016 and updated in March 2017 (PROSPERO registration # CRD42016046007). We included original research studies that described women’s experiences traveling for abortion. Two reviewers independently performed article screening, data extraction and determination of final inclusion for analysis. Critical appraisal was conducted using CASP, STROBE, and MMAT checklists. Results: We included 59 publications: 46 quantitative studies, 12 qualitative studies, and 1 mixed-methods study. Most studies were published in the last five years, relied on data from the US, and discussed travel as a secondary outcome of interest. In quantitative studies, travel was primarily conceptualized and measured as road or straight-line distance to abortion provider, though some studies also incorporated measures of burdens related to travel, such as financial cost, childcare needs, and unwanted disclosure of their abortion status to others. Qualitative studies explored regional disparities in access to abortion care, with a focus on the burdens related to travel, the impact of travel on abortion method choice, and women’s reasons for travel. Studies generally were of high quality, though many studies lacked information on participant recruitment or consideration of potential biases. Conclusions: Standardized measurements of travel, including burdens associated with travel and more nuanced considerations of travel costs, should be implemented in order to facilitate comparison across studies. More research is needed to explore and accurately capture different dimensions of the burden of travel for abortion services on women’s lives. [ABSTRACT FROM AUTHOR]

Based on the entire population of Nobel laureates in science from 1901 to 2017, we show that North America’s rise as global power in science started in the 1920s. Following a transition period (1940s to 1960s), its scientific hegemony was consolidated in the 1970s. Yet since the 2000s, North America’s global leadership in science has come under pressure. In that time, its share of laureates across disciplines dropped, although it has retained its attractiveness as a destination for future laureates from Europe and the Asia-Pacific region. In addition, we find that North America has become apparently less effective since 2010 in transferring capacities for conducting ground-breaking research from one generation of scientists to another. Furthermore, both Europe and the Asia-Pacific region have similarly high shares of newcomer organizations with regard to where prize-winning work is conducted, indicating that these two regions are very active in the inter-organizational competition for scientific talent. Despite this competition, however, we find no support for the rise of a new global center of science. [ABSTRACT FROM AUTHOR]

Identifying and measuring the land value uplift (LVU) impacts of rapid transit are important for a number of reasons. However, despite the general notion that rapid transit does confer positive LVU benefits, our comprehensive and critical review of more than 130 analyses across 60 studies completed in North America over the past 40 years finds significant heterogeneity in research outcomes, leaving many significant questions unanswered. Beyond high-level differences in study inputs, we argue that a fundamental source of variability is a lack of empirical specificity from the use of proximity as the dominant way in which LVU benefits are captured. This use of a proxy leads to the potential for omitted variables and unobserved relationships, and exposes previous work to the potential for misvalued results. To overcome this issue, we outline recommendations for future research, namely a recognition of relative accessibility and the possibility of LVU impacts from transit-oriented development. Incorporating measures related to these factors into LVU models can reveal their implicit prices, resulting in research that is more theoretically inclusive, empirically comprehensive, comparable, and able to provide important information to inform policy analysis and prescription. [ABSTRACT FROM AUTHOR]

Treatment of metastatic soft tissue sarcoma ( mSTS) commonly includes multiple lines of chemotherapy, until a decline in performance status precludes further treatment. The primary objective of this study was to describe the lifetime healthcare resource utilisation and cost among mSTS patients with favourable response to chemotherapy. SABINE was a multi-centre ( n = 25), multi-country ( n = 9) retrospective chart review study of mSTS patients with favourable response to chemotherapy following 4 cycles. Healthcare resource utilisation was collected from first line until death or end of follow-up. Costs were analysed by health states (defined by treatment line, chemotherapy use and disease progression) and estimated by multiplying the mean weekly cost per health state by the expected number of weeks spent in each health state. Expected per-patient lifetime medical cost was €65 616 (95% CI: €51 454-€85 003); comprised of IV chemotherapy (31.7%), inpatient care (24.8%), concomitant medication (11.0%), oral chemotherapy (8.9%), outpatient visits (8.8%), radiotherapy (6.3%), hospice (4.0%), imaging (3.7%) and laboratory (0.7%). Weekly costs were 280-330% higher during chemotherapy treatment periods than off-chemotherapy, especially after disease progression. Per-patient costs were highest in the USA and lowest in the Netherlands and UK. The economic burden of mSTS is considerable and the amount of resources devoted to its treatment varies across countries. [ABSTRACT FROM AUTHOR]

This study investigates the biophysical impacts of human-induced land use change (LUC) on the regional climate of North America, using the fifth generation Canadian Regional Climate Model (CRCM5). To this end, two simulations are performed with CRCM5 using different land cover datasets, one corresponding to the potential vegetation and the other corresponding to current land use, spanning the 1988-2012 period, driven by European Centre for Medium-RangeWeather Forecasts Re-Analysis (ERA)-Interim at the lateral boundaries. Comparison of the two suggests higher albedo values, and therefore cooler temperatures, over the LUC regions, in the simulation with LUC, in winter. This is due to the absence of crops in winter, and also possibly due to a snow-mediated positive feedback. Some cooling is observed in summer for the simulation with LUC, mostly due to the higher latent heat fluxes and lower sensible heat fluxes over eastern US. Precipitation changes for these regions are not statistically significant. Analysis of the annual cycles for two LUC regions suggests that the impact of LUC on two meter temperature, evapotranspiration, soil moisture and precipitation are present year round. However, the impact on runoff is mostly restricted to the snowmelt season. This study thus highlights regions and variables most affected by LUC over North America. [ABSTRACT FROM AUTHOR]

According to the U.S. Energy Information Administration, shale gas will provide half of the United States' domestic gas by 2035. The United States has already moved from being one of the world's largest importers of gas to being self-sufficient in less than a decade, bringing hundreds of thousands of jobs and attracting back companies that long ago left America in search of cheap manufacturing costs. But the increase in shale gas extraction has also had an environmental cost. There is clear scientific evidence of leaking shale gas wells and induced earthquakes, and in some areas a population increasingly turning against the industry. The technology of horizontal drilling and hydraulic fracturing that was developed in the United States is now being tried outside the United States, including in Europe, Argentina, and China. There are clear reasons why shale gas might be attractive to Europe. It may offer security of energy supply to some countries particularly dependent on Russian gas; it could stimulate growth and jobs; and it could supply a cleaner fuel than coal in power stations. However, prospective shale often underlies areas of high population density in Europe, and moreover, populations that are unfamiliar with onshore gas operations. The main challenge in Europe therefore is not mainly technological but for the industry to achieve a 'social license' and for Government and regulations to be manifestly protecting the public and property. [ABSTRACT FROM AUTHOR]

In Fall 2011, the University of Nevada-Las Vegas School of Architecture's David G. Howryla Design-Build Studio began development of the university's entry into the U.S. Department of Energy Solar Decathlon 2013--an international, university-based competition to design solar-powered housing prototypes. The design team's primary goal was not the creation of a workable engineering model; instead, the team explored how technology can be a tool that assists people to reconnect with materiality, texture, light, and time, creating opportunities for memorable experiences. Students who have participated in design-build programs across the United States have cited them as critical formative experiences in their development as design professionals. Additionally, as a competition that requires collaboration among engineering, architecture, interior design, marketing, and communications, the Solar Decathlon is an effective tool for simulating teamwork on real projects. As the only university located in the Mojave Desert--one of the most extreme environments in North America--UNLV's inclusion in this competition offers a unique opportunity to demonstrate leadership in developing innovative responses to arid climates, and finishing in 2nd-place underscored the team's abilities. The Design-Build Studio's process of creating the Solar Decathlon House is instructive in understanding this success. [ABSTRACT FROM AUTHOR]

We adopt a physics-guided, data-driven method to predict the most likely future production from the largest tight oil and gas deposits in North America, the Permian Basin. We first divide the existing 53,708 horizontal hydrofractured wells into 36 spatiotemporal well cohorts based on different reservoir qualities and completion date intervals. For each cohort, we fit the Generalized Extreme Value (GEV) statistics to the annual production and calculate the means to construct historical well prototypes. Using the physical scaling method, we extrapolate these well prototypes for several more decades. Our hybrid, physico-statistical prototypes are robust enough to history-match the entire production of the Permian mudstone formations. Next, we calculate the infill potential of each sub-region of the Permian and schedule the likely future drilling programs. To evaluate the profitability of each infill scenario, we conduct a robust economic analysis. We estimate that the Permian tight reservoirs contain 54–62 billion bbl of oil and 246–285 trillion scf of natural gas. With time, Permian is poised to be not only the most important tight oil producer in the U.S., but also the most important tight gas producer, surpassing the giant Marcellus shale play. [ABSTRACT FROM AUTHOR]

Introduction and Aims: The practice and adverse consequences of pre-drinking have been documented within a dozen countries, but little remains known about the differences between countries or the country-specific determinants of pre-drinking. This study aims to estimate the percentage of pre-drinkers in different countries and the impact of country-level indicators such as the price of alcohol and the prevalence of drinkers and of heavy drinkers.Design and Methods: Using data from the Global Drug Survey, the percentage of pre-drinkers was estimated for 25 countries from 65 126 respondents. Bivariate and multivariate multilevel models were used to model the impact of the on-premise/off-premise drinks price ratio, the prevalence of current drinkers and of heavy drinkers on the percentage of pre-drinkers.Results: The estimated percentage of pre-drinkers per country ranged from 17.7% (Greece) to 85.4% (Ireland). Across all countries, the higher the prevalence of current drinkers, the higher the percentage of pre-drinkers. In addition, an interaction between the prevalence of heavy drinkers and the price ratio was found. In countries with a low price ratio, the higher the prevalence of heavy drinkers, the higher the percentage of pre-drinkers. The opposite effect was observed in countries with high price ratios.Discussion and Conclusions: Pre-drinking appears to be a worldwide phenomenon. The significant effects of all three indicators demonstrate the role of country-level determinants underpinning the prevalence of pre-drinking across countries. Policy makers could use the reported findings for initiating campaigns to reduce pre-drinking behaviour. [Labhart F, Ferris J, Winstock A, Kuntsche E. The country-level effects of drinking, heavy drinking and drink prices on pre-drinking: An international comparison of 25 countries. [ABSTRACT FROM AUTHOR]