The possibilities of using regional rail for intra-urban commuting in post-socialist cities in Central and Eastern Europe

Introduction: Ischemic stroke accounts for approximately 80% of all stroke cases and remains a major cause of morbidity and mortality among adults. At the beginning of the 21st century, the age-standardized incidence of stroke in Europe ranged from 95 to 290 cases per 100,000 population. Objective: Our aim was to examine trends in the incidence of ischemic stroke in Europe between 1991 and 2021, by country group, gender, and age group. Method: In our retrospective, quantitative study, we analyzed data from 44 countries in three European country groups (Eastern, Central, and Western Europe) per 100 000 people based on the Global Burden of Disease 2021 database. Descriptive statistics, time series analysis and Kruskal–Wallis test were performed. Results: Between 1991 and 2021, the age-standardized incidence per 100 000 population in men decreased from 206.7 to 147.1 (−28.8%) in Eastern Europe, from 172.1 to 123.8 (−28.1%) in Central Europe, and from 120.7 to 62.3 (−48.4%) (p<0.05) in Western Europe. In women, during the same period, it decreased from 169.8 to 113.9 (−32.9%) in Eastern Europe, from 142.4 to 106.0 (−25.6%) in Central Europe, and from 89.5 to 47.2 (−47.3%) in Western Europe (p<0.05). Significant differences were found between Eastern and Western European countries and between Central and Western European countries for both sexes (1991, 2001, 2011, 2021: p<0.05). The incidence was higher in men than in women every year, especially in the age groups over 55. The largest decrease for both sexes was observed in the 65–69 age group. Based on the analysis by country, the largest decrease was in Portugal (men: –71.1%; women: –69.9%), while in Montenegro, increases of +4.1% for men and +6.3% for women were observed. Conclusion: During the study period, the incidence of ischemic stroke decreased in all three country groups, but the improvement was greater in the Western European country group, which had lower (more favorable) baseline values, than in Central or Eastern Europe. Nevertheless, in 2021, the incidence in Eastern and Central Europe still exceeded the level measured in Western European countries in 1991. Orv Hetil. 2025; 166(42): 1642–1652.

In the last decade, substantial differences in the epidemiology of, antiretroviral therapy (ART) for, cascade of care in and support to people with HIV in vulnerable populations have been observed between countries in Western Europe, Central Europe (CE) and Eastern Europe (EE). The aim of this study was to use a survey to explore whether ART availability and therapies have evolved in CE and EE according to European guidelines. The Euroguidelines in Central and Eastern Europe (ECEE) Network Group conducted two identical multicentre cross-sectional online surveys in 2019 and 2021 concerning the availability and use of antiretroviral drugs (boosted protease inhibitors [bPIs], integrase inhibitors [INSTIs] and nucleoside reverse transcriptase inhibitors [NRTIs]), the introduction of a rapid ART start strategy and the use of two-drug regimens (2DRs) for starting or switching ART. We also investigated barriers to the implementation of these strategies in each region. In total, 18 centres participated in the study: four from CE, six from EE and eight from Southeastern Europe (SEE). Between those 2 years, older PIs were less frequently used and darunavir-based regimens were the main PIs (83%); bictegravir-based and tenofovir alafenamide-based regimens were introduced in CE and SEE but not in EE. The COVID-19 pandemic did not significantly interrupt delivery of ART in most centres. Two-thirds of centres adopted a rapid ART start strategy, mainly in pregnant women and to improve linkage of care in vulnerable populations. The main obstacle to rapid ART start was that national guidelines in several countries from all three regions did not support such as strategy or required laboratory tests first; an INSTI/NRTI combination was the most commonly prescribed regimen (75%) and was exclusively prescribed in SEE. 2DRs are increasingly used for starting or switching ART (58%), and an INSTI/NRTI was the preferred regimen (75%) in all regions and exclusively prescribed in SEE, whereas the use of bPIs declined. Metabolic disorders and adverse drug reactions were the main reasons for starting a 2DR; in the second survey, HIV RNA <500 000 c/ml and high cluster of differentiation (CD)-4 count emerged as additional important reasons. In just 2 years and in spite of the emergence of the COVID-19 pandemic, significant achievements concerning ART availability and strategies have occurred in CE, EE and SEE that facilitate the harmonization of those strategies with the European AIDS Clinical Society guidelines. Few exceptions exist, especially in EE. Continuous effort is needed to overcome various obstacles (administrative, financial, national guideline restrictions) in some countries.

Ivan T. Berend. History Derailed: Central and Eastern Europe in the Long Nineteenth Century. Berkeley: University of California Press, 2003. xix, 330 pp. Illustrations. Maps. Tables. Bibliography. Index. $39.95, hardcover.This synthesis of nineteenth-century Central and Eastern European history by Ivan T. Berend complements his two other works on the history of this region in the twentieth century and thus provides us with the complete authorial vision of the region's modern history. The value of this book is increased by the fact that, in comparison with a few general works dealing with the region in the twentieth century, there had been a definite lack of generalizing narratives about the area's nineteenth century. This wonderfully written book is the first synthetic work on East Central Europe's nineteenth century that has managed equally successfully to integrate social, cultural and political aspects of the region's history.Since the task of this book was to give the region its proper nineteenth-century history, the author avoids wading into hot discussions on the region's discursive construction and its political implications. Berend does believe that there are some objective features shared by all parts of the region and allowing one to speak about Central Eastern Europe. In his opinion, the countries of this region faced similar economic, social and political problems-all deriving from the developmental lag between them and Western Europe, they designed similar responses to these problems, and they faced similar consequences. Berend's Central and Eastern Europe consists of Austria-Hungary (usually excluding Austria proper), the Balkans (usually excluding Greece), and Poland.The book starts with an explanation of how the basis for the distinctiveness of the region was laid down in the early modern period. By the beginning of the nineteenth century the region's leading intellectuals were well aware of their own countries' backwardness. Just as for these intellectuals, for Berend the most important distinctive features of the region can be revealed through comparing it with the Western European core. Every chapter begins with a brief outline of the developments in Western Europe against which trends in Eastern and Central Europe are discerned and measured.First the author looks at culture. Here the differences between Eastern and Western Europe seem less unbridgeable than in social or political structures. Local thinkers were part of European intellectual life. At the centre of Berend's story is the epoch of Romanticism, which, he believes, in the ease of Central Eastern Europe was conflated with Enlightenment. This particular intellectual blend gave birth to the phenomenon crucial for understanding most of the region's developments throughout the modern period, namely-to nationalism. The author believes that romanticism left its imprint not only on this nationalism but on the totality of the region's mental pattern throughout the whole long nineteenth century.Nationalism was the intellectual movement guiding political responses in theregion to the challenges of the West. Despite the fact that the author is well aware of difficulties in distinguishing between good civic and bad ethnic nationalisms, he believes that because of their belatedness and the specific social structure of the region, the local nationalisms differed significantly from the civic and democratic nationalisms of the West. …

This paper examines the democratic transformation in Central and Eastern Europe, emphasizing the contrasting trajectories, challenges, and impacts of democracies in the region post-communism. Whilst countries in Central Europe, such as Poland and the Czech Republic, have established stable parliamentary democracies characterized by cohesive political parties and organized electoral competition, Eastern European nations, especially those influenced by the former Soviet Union, experience volatility, fragmented party systems, and inconsistent governance structures. These differences are rooted in their distinct historical legacies and socio-political contexts and also the research further underscores the significance of political parties in consolidating democratic governance, with more stable and cohesive parties fostering predictable political environments in Central Europe. Conversely, Eastern Europe's parties often face fragmentation, leading to heightened political instability. External influences, notably from Western Europe and Russia, have played critical roles in shaping and impeding democratic consolidations. Western Europe's influence contributed to the development of more cohesive party systems and democratic institutions in Central Europe through integration, international cooperation, and adherence to European Union norms and standards. The study also explores the multifaceted challenges confronting democracy in the region, including weak civil societies, restrictions on media freedom, corruption, and external interference, which undermine democratic legitimacy and public trust. The rise of populist movements and authoritarian tendencies, particularly in Hungary and Poland, poses additional threats to democratic stability, prompting concerns over democratic backsliding and the resilience of institutions. Methodologically, the paper draws from secondary sources, official documents, empirical data, and contemporary media analyses to provide a comprehensive perspective on democratic transitions, governance, and civic engagement. It emphasizes the importance of civic participation, institutional reforms, and the role of civil society to address ongoing challenges effectively. In conclusion, the future of democracy in Eastern and Central Europe hinges on strengthening institutions, fostering civic participation, and mitigating external influences. While notable progress has been achieved, persistent challenges demand continuous efforts to consolidate democratic norms, enhance governance, and build resilient societies capable of withstanding internal and external pressures.

Burden, Trends and Projection of Lip and Oral Cavity Cancer in Central, Eastern and Western Europe: From the Global Burden of Disease 2023 Study.

Hepatitis C virus (HCV) infection is a major public health burden in Europe, causing an increasing level of liver-related morbidity and mortality, characterized by several regional variations in the genotypes distribution.A comprehensive review of the literature from 2000 to 2015 was used to gather country-specific data on prevalence and genotype distribution of HCV infection in 33 European countries (about 80 % of the European population), grouped in three geographical areas (Western, Eastern and Central Europe), as defined by the Global Burden of Diseases project (GBD).The estimated prevalence of HCV in Europe is 1.7 % showing a decrease than previously reported (− 0.6 %) and accounting over 13 million of estimated cases. The lowest prevalence (0.9 %) is reported from Western Europe (except for some rural areas of Southern Italy and Greece) and the highest (3.1 %) from Central Europe, especially Romania and Russia. The average HCV viraemic rate is 72.4 %, with a population of almost 10 million of HCV RNA positive patients.Genotype distribution does not show high variability among the three macro-areas studied, ranging between 70.0 % (Central Europe), 68.1 % (Eastern Europe) and 55.1 % (Western Europe) for genotype 1, 29.0 % (Western Europe), 26.6 % (Eastern Europe) and 21.0 % (Central Europe) for genotype 3. Genotype 2 seems, instead, to have a major prevalence in the Western Europe (8.9 %), if compared to Eastern (4.3 %) or Central (3.2 %), whereas genotype 4 is present especially in Central and Western area (4.9 % and 5.8 %, respectively).Despite the eradication of transmission by blood products, HCV infection continues to be one of the leading blood-borne infections in Europe. The aim of this review is, therefore, to provide an update on the epidemiology of HCV infection across Europe, and to foster the discussion about eventual potential strategies to eradicate it.

Introduction Health disparities between Eastern and Western part of Europe have been the subject of many studies. Eastern Europe experienced delay in health improvement compared to Western Europe. Life expectancy differences between East and West average 7 years in men and 5 years in women, in favor of the West. Cancer contributes to 12% and 9% of this difference in men and women, respectively. For those 20-64 years, contribution of cancer to this difference is higher at 16% and 24%, respectively. Methods Cancer mortality data and population data (1959-2010) for each country separately were derived from the WHO Mortality Database. Standardized mortality rates were calculated using the world standard population. Results In young men (20-44 years) cancer mortality was equal in Eastern and Western Europe in late 1960s. Since then, a decline in cancer mortality occurred in Western countries while Eastern countries experienced a cancer mortality increase trend. This increase began to decline in Eastern Europe in the early 1990s, decreasing the cancer mortality gap between the two European regions for this sex and age group. Similar trend disparities were observed in middle-aged men (45-64 years). However, the decline since 1990 was much slower in Eastern Europe than Western Europe, resulting in a residual gap between the two regions. The oldest men (65+ years) in Western Europe had a higher cancer mortality rate than Eastern Europe for many decades. In early 1990s cancer mortality in Western Europe declined whilst rising in the East. The trends intersected a decade later and despite the plateau observed in recent years in Eastern Europe, the gap remains persistent. In young women (20-44 years), cancer mortality diverted in the early 1970s as cancer mortality declined steadily in Western Europe while rising in the east, similarly in trend to cancer mortality among young men. By the 1990s, rates declined and the gap between the two regions trended towards closure. In middle-aged women (45-64 years) cancer mortality rates in Eastern Europe plateaued for the whole observation period, while western rates fell steadily since the 1970s, resulting in a residual gap between the two regions. For several decades, cancer mortality rates in the oldest women (65+ years) in Western Europe were higher than in the east and both regions experienced plateaus. By the 1990s western cancer mortality rates declined with little change in eastern trends. A small gap persists between the two regions. Conclusions Despite health improvement, a cancer mortality rate gap between Eastern and Western Europe persists across all sex and age strata. In particular, men at age of 45 years and more, and women at age of 45-64 years, experience the greatest disparities between the two regions. Deficiency of primary prevention and poor health awareness remain biggest challenge in Eastern part of Europe. Citation Format: Marta Manczuk, Urszula Sulkowska, Dana Hashim, Paolo Boffetta. The gap in cancer mortality between Western and Eastern Europe. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 3710. doi:10.1158/1538-7445.AM2015-3710

I: MENTAL MAPS OF EUROPE: HISTORY AND TERMS OF TRADEPortrayals of Eastern European countries as “bridges” between East and West are commonplace both in the media and in the political discourse. In particular, the popular label “gateway to the East” is used in history textbooks, tourist guides, and economic reports to equally describe Warsaw, Budapest, Bucharest, Sofia, and Istanbul (Hann 1995: 2). Thus, in the European imaginary, Easternness, in its European variant, is being continually passed on-and, as such, consistently refuted-all the way to Europe’s geographical borders as they are defined today. As definitions of the border between Western and Eastern Europe have historically shifted to highlight ethnic, economic, imperial, or religious divides within the continent, so have attitudes toward the proximity of the Orient and the threat it was perceived to represent at different moments in time. Rather than a twenty-first century phenomenon, efforts to reject an Eastern identity constitute an historically recurring pattern in the construction of Eastern European national self-definitions that has been inextricably tied to (1) the military, economic and cultural impact of the Ottoman Empire in the region on the one hand and (2) to the representations of Islam and the Orient in the geopolitical imaginary of the Euro-American core on the other. In the twentieth and twenty-first centuries, the ongoing process of negotiating geographical borders while reasserting historical claims to territory and power resulted in further subdivisions such as Central, Northern, Southern,and Southeastern Europe. Whereas Central Europe was conceived as a third zone between Eastern and Western Europe, but was coterminous with the nineteenth century geopolitical project of Mitteleuropa, Southeastern Europe was coined as a politically correct term for designating the Balkans, the easternmost region within the East itself. Due to its proximity to Asia and its legacy of Ottoman dominance, it was this last subcategory in particular which has conjured up the image of a bridge between Orient and Occident, and which as a result had periodically acquired the scent of temporal in-betweenness as well-of the semideveloped, semicolonial, semicivilized, semi-Oriental (Todorova 2002) always in the process of “catching up with the West.” The resurgence of the stigma thus attached to the concept becomes increasingly clear today, when the same stereotypes attached to the alleged “Balkan identity” are being used in the political, social scientific, and media discourse of the very Europe the ex-Communist countries are trying to (re)join. The question of the historical origin of Europe’s East-West divide is still under heavy dispute among social scientists, and-in view of its economic, political, and religious dimensions-probably evinces more than one answer. For the purposes of the present analysis, however, it can reasonably be argued that it was the Orientalist discourse of the nineteenth century-in the understanding Edward Said (1979) attributed to the term-that decisively shaped the content of the present categories of Western and Eastern Europe and made policies of demarcation from “the Orient” an important strategy of geopolitical and cultural identification with Europe for the latter region. In order to assess this claim, it is necessary to address two interrelated questions: first, what kinds of mental maps1 of the Occident, the Orient, and the boundaries separating them were being negotiated during the nineteenth century and, second, how do they relate to the remapping of European order in the process of Eastern enlargement? To this end, the impact of the so-called “Eastern question”—the growing decline of the Ottoman Empire-on the cultural self-definitions and the geopolitical agenda of its European possessions in the nineteenth century is discussed using the example of Romania; subsequently, the present-day resurgence of systems of representation based on an Orientalist type of discourse-of which Islamophobia is an instance-are examined in the context of the European Union’s “Eastern enlargement.”

Wastewater management strategies are needed for Central and Eastern Europe. Economic limitations prohibit an immediate upgrading of all wastewater treatment to the standards of Western Europe and North America. Consequently, the choice of optimal wastewater management strategy then becomes very important. One can ask a question whether the historical development of wastewater treatment in Western Europe during the last 60 years is optimal for Eastern and Central Europe or whether other alternatives are feasible. Today a broad spectrum of wastewater treatment methods is available, which allows to remove pollutants to varying efficiencies. Treatment plants now being built in Western Europe are based on high removal efficiencies and have very high marginal costs per unit pollutant removed, as well as high overall costs per unit pollutant removed.

The main goal of the chapter is to identify the differences in the scope of internal relationships among the elements composing managerial staff development (MSD) in local subsidiaries of multinational companies (MNCs) headquartered in Central Europe and operating in Eastern and Western Europe. The research sample was composed of 200 headquarters (HQs) of nonfinancial MNCs and their local subsidiaries. In the research process, some statistically significant differences between MNCs operating in Eastern and Western Europe have been identified. The correlation between the financial performance results of local subsidiaries and the advancement level of MSD appears to be higher in Eastern Europe, although the advancement level of MSD itself is higher in Western Europe. In Eastern Europe, the internal relationships among the elements composing MSD are numerous and with stronger ties than in Western Europe. MSD is of more complex and systems approach in Eastern Europe. Furthermore, here the higher the appraisal level of managerial staff’s competencies as a competitive factor, the more systems approach to MSD is practiced. In Western Europe, the higher the advancement level of individual components of MSD the less systems approach to MSD is preferred. Our study, therefore, contributes some original findings to the discipline of management science.

The successes of right -wing populist parties in Central and Eastern Europe, as well as a repeated distancing from the European Union, raise the question of whether there is such a thing as European citizenship at all. Citizenship is not understood as formal nationality, but as a sense of belonging. This ties in with the considerations of political cultural research. This article uses representative surveys to address the question: What about European Citizenship in Central and Eastern Europe? The results show that the feeling of belonging to the European Union in Eastern and Central Europe is better than its reputation and not lower than in Western Europe. However, there are differences in the recognition of plurality between the majority (not all) of Eastern European states compared to the majority of Western European states. In particular, the integration of Muslims is more strongly rejected. The same applies to the social acceptance of homosexuality. This partly explains the success of right -wing populists in Central and Eastern Europe and marks a certain cultural difference, which is primarily directed against a wet model of democracy that is considered too open to plurality. In short: Central and Eastern Europeans also see themselves as Europeans and EU members, but their ideas of a European democracy differ from Western ideas – especially in peripheral regions.

Contributors. Preface and Acknowledgements. Introduction: Organisation of the Book. Abbreviations. 1. Business Strategies for Economies in Transition of Central and Eastern Europe J.-P. Larcon. 2. Privatisation and Company Restructuring in Central and Eastern Europe: Issues and Progress S. Estrin. 3. Lessons from Czech Privatisation I. Nemcova. 4. Development of Financial Markets: The Czech Case P. Musilek. 5. Competitiveness and Industry Restructuring: The Case of Hungary A. Chikan, E. Czako. 6. The Ethical Fabric of a Transformation Economy: The Case of Hungary L. Zsolnai. 7. Economic Growth and Foreign Direct Investment: The Polish Case M. Romanowska. 8. Transition and Democracy in Romania: The Pain of a Gradualist Restructuring S. Alessandrini. 9. Company Co-Operation between Eastern and Western Europe M. Zagler, C. Ragacs. 10. Swedish Multinationals in Central and Eastern Europe J.-E. Valne, et al. 11. The Enlargement Challenge F. Debie. Index.

Background and aimOsteoarthritis ranks as one of the leading causes of disability, predominantly affecting adults aged 70 years and older. This study aimed to report trends in the burden of osteoarthritis from 1990 to 2021 based on the Global Burden of Diseases Study (GBD) 2021 across Central, Eastern, and Western Europe.MethodsThis study is a systematic analysis of secondary database estimates from the GBD 2021 study for osteoarthritis in Central, Eastern, and Western Europe, as well as the 44 countries. The age-standardized rates of incidence, prevalence, and years of life lost due to disability were evaluated by age, gender, and high body mass index (BMI).ResultsIn 2021, there were 101.2 million (95% uncertainty interval {UI}, 90.4-112.6 million) prevalent cases of osteoarthritis, a 48.3% increase from 1990. Subregional estimates showed that the incidence, prevalence, and years lived with disability (YLDs) cases in Western Europe were more than twice the number in Eastern Europe and more than four times the number in Central Europe, and had higher disability rates in young adults than their two other counterparts. Osteoarthritis accounted for approximately 6.7 million (95% UI 4.1-5.2 million) incidents, and there were 3.6 million YLDs (95% UI, 1.7-7.3) in Europe across all age groups. There was a positive association between the rising BMI in individuals under 50 years of age and the age-standardized rates of YLDs.ConclusionBetween 1990 and 2021, the prevalence of osteoarthritis across Europe has consistently increased across all age groups, exerting considerable pressure on the workforce as it increasingly affects individuals under 50 years of age. To help reduce this impact, the World Health Organization advocates recognizing high BMI as an independent disease, an approach that would directly address a key contributor to the heightened disability and health complications linked to osteoarthritis.

Health inequalities in Eastern Europe. Does the role of the welfare regime differ from Western Europe?

There is a sharp divide in mortality between eastern and western Europe, which has largely developed over the past three decades and is caused mainly by chronic diseases in adulthood. The difference in life expectancy at birth between the best and worst European countries in this respect is more than 10 years for both sexes. The reasons for these differences in mortality are not clear and data currently available permit only speculation. The contributions of medical care and pollution are likely to be modest; health behaviour, diet, and alcohol consumption seem to be more important; smoking seems to have the largest impact. There is also evidence that psychosocial factors are less favourable in eastern Europe. Available data show socioeconomic gradients in all cause mortality within eastern European countries similar to those in the West. Determinants of the mortality gap between eastern and western Europe are probably related to the contrast in their social environments and may be similar to those underlying the social gradients in mortality within countries. There is a sharp divide in mortality between western Europe and the former socialist countries of central and eastern Europe. The difference in life expectancy between countries with the lowest and highest life expectancies at birth is more than 10 years in both men and women (figs 1 and 2). The gap in mortality has largely developed in the past two or three decades.1 2 3 4 In all western European countries life expectancy increased substantially between 1970 and 1991 (by three to four years on average). By contrast, the increase in central and eastern Europe was at best negligible, and in Hungary, Poland, and Bulgaria there was a decline in male life expectancy at age 15 (figs 3 and 4). No central or eastern European country recorded an increase in …