Background and Objectives: Vitamin D deficiency is a pervasive public health issue in high-latitude regions, yet large-scale population data for the Baltic states remain sparse. This study aimed to determine the prevalence of vitamin D status and identify its primary determinants within a primary care setting in Lithuania. Materials and Methods: We conducted a retrospective cross-sectional analysis of serum 25-hydroxyvitamin D [25(OH)D] concentrations from 14,330 unique patients (aged 1–101 years) collected during 2025 at a major clinic in Vilnius. Vitamin D status was categorized according to the Central and Eastern European Expert Consensus thresholds. Results: The overall median 25(OH)D concentration was 68.3 nmol/L, placing it in the “insufficiency” range (50–75 nmol/L). Seasonality emerged as the most significant predictor of deficiency; multivariable logistic regression showed a maximal risk reduction in September (OR 0.33; 95% CI: 0.27–0.41) and August (OR 0.34) compared to January, while June and November provided no significant protection. Age-specific analysis revealed a non-linear “U-shaped” distribution: children aged 0–6 years had the highest levels (median ~87–91 nmol/L), likely due to rickets prophylaxis, whereas adolescents (12–18 years) exhibited the highest vulnerability, with approximately 80% suffering from deficiency or insufficiency. Males faced a 13.9% higher likelihood of deficiency than females (OR 1.14; p = 0.0036), potentially due to lower rates of elective supplementation. Conclusions: These findings suggest that current supplementation strategies successfully protect infants but fail to sustain adequacy through adolescence and adulthood, particularly during the “vitamin D winter.” Targeted public health interventions for adolescents and year-round monitoring are recommended to mitigate the high prevalence of suboptimal vitamin D status in Lithuania.

In recent years, sociological interest in the study of social class-particularly its subjective dimensions-has intensified. This article contributes to this growing body of literature by focusing on Poland as a case within the Central and Eastern European region. It emphasizes the role of historical context and family histories in shaping processes of class mobility and class reproduction, and examines these processes from a biographical perspective. Drawing on a comparative analysis of biographical pathways of upward mobility and reproduction, we introduce two analytical concepts naming the historical moments/processes potentially reshaping individuals' class histories: openings, referring to moments that facilitate upward mobility, and ruptures, referring to interruptions in reproduction or obstacles to upward mobility. We also identify three pivotal historical moments that emerge in the collected narratives as shaping class histories and class identities in Poland: the Second World War, the 1989 political and educational transformation, and the integration into EU institutionsfrom 2004 onwards. The analysis is based on 42 biographical interviews with academics. It demonstrates the value of qualitative, biographical methods for examining class identities, which often diverge from patterns captured by purely objective criteria. This approach further allows us to reveal the role of social history and multigenerational family history in making the individuals' class histories and identities complex and ambiguous.

1514 Background: Care for patients with glioblastoma is largely organized around scheduled clinic encounters, yet symptom management, decision-making, and caregiver responsibility extend beyond office visits. While patient portals, phone triage, and after-hours call coverage exist, these pathways are often resource-intensive, variably available, and insufficient to meet ongoing informational and emotional needs. Scalable, low-cost tools that extend access to vetted support outside clinic hours without increasing clinician workload may help address gaps in care delivery. We evaluated real-world use of a freely accessible, patient- and caregiver-facing digital support tool in glioblastoma. Methods: A freely accessible AI chatbot supporting informational, emotional, and care-navigation needs was deployed online without registration or recruitment. The tool excluded medical decision-making and clinical recommendations. De-identified conversation logs generated during routine use were retrospectively analyzed over a 4-month period (Sep 15, 2025 – Jan 14, 2026). Analyses included descriptive characterization of conversation volume, geographic distribution, timing of use, engagement depth, user-reported feedback, and primary topics addressed. All analyses used aggregate, de-identified data with no interaction or intervention involving human subjects. The protocol is IRB exempt per 45 CFR 46.104(d)(4) (WCG IRB 20260304). Results: During the study period, the chatbot supported 1,661 conversation threads comprising 15,197 messages across 54 countries. Most conversations originated from the United States (59.9%), followed by the United Kingdom (7.3%), Australia (5.2%), Canada (4.1%), and Greece (3.8%). Conversations were predominantly multi-turn and included use outside clinic hours. The tool was used primarily in English; however, ~12% of messages occurred in other languages, most commonly Spanish and French with additional use of Arabic, German, Italian, Portuguese, Hebrew, Hindi, and several Central and Eastern European languages. Conversations most frequently addressed imaging interpretation and scan-related uncertainty, treatment decision-making, symptom management and treatment-related side effects, and caregiver concerns. Additional topics included clinical trial exploration and prognosis clarification. When clinical trial–related questions arose, users were directed to a brain tumor trial finder. Across the study period, 374 users engaged in trial searches across 22 countries; among respondents to a trial-interest query (n = 251), 92% expressed interest. Voluntary user feedback (n = 97) demonstrated high perceived usefulness and trust (net promoter score, 80). Conclusions: A freely accessible AI chatbot demonstrated feasibility as a scalable approach to extending access to care for patients with glioblastoma and their caregivers outside office hours.

The emergence of new political and social structures in Western and Central Europe during the transition from Antiquity to the Middle Ages has long been attributed to large-scale migrations. Yet emerging evidence increasingly emphasizes the role of small-group mobility in reshaping the Roman world1-3. Here we present 258 ancient genomes from the former Roman frontier of southern Germany, which we analyse alongside 2,500 ancient and 379 modern genomes. Population genetic analyses reveal a major demographic shift coinciding with the late fifth century collapse of Roman state structures, when a founding population of northern European ancestry mixed with genetically diverse Roman provincial groups. Pedigree reconstruction and filia, a method for inferring the ancestry of unsampled relatives, indicate widespread intermarriage and minimal cultural differentiation. Genetic structure persisted through the sixth century, with admixture forming a population resembling modern Central Europeans by the early seventh century. Using Chronograph to refine the chronology of genealogically linked individuals, we estimate a generation time of 28 years, life expectancies of 39.8 years for womenand 43.3 years for men, high infant mortality, and a society in which nearly onequarter of children lost at least one parent by age 10, yet most still grew up with grandparents. Pedigrees further reveal a society centred on nuclear families thatpracticed lifelong monogamy, strict incest avoidance, flexible lineage continuation and no levirate unions, indicating continuity with Late Roman social practices that later shaped the European family.

Family caregivers of adults with cognitive impairment, including dementia, often face complex challenges. However, social exclusion among caregivers aged 50years and older particularly within the distinctive Central and Eastern European context, remains critically underexplored. This study uses Poland, a country where strong family care norms coexist with limited formal support, as a crucial case study to examine how social exclusion manifests in the caregiving experiences of older family caregivers. Using photovoice, a novel participatory action research method for this context, the study engaged six family caregivers aged 50 and above from a single city in Poland. Participants photographed aspects of their caregiving experiences and took part in reflective group discussions. Data from these discussions were analyzed thematically to identify key domains of social exclusion. No statistical tests were applied due to the qualitative and exploratory nature of the study. Thematic analysis revealed four interconnected domains of social exclusion: (1) Relational exclusion-including the erosion of social networks and experiences of stigma; (2) Institutional exclusion-such as difficulties accessing care services, transportation, and public infrastructure; (3) Material exclusion-highlighting financial strain and unmet resource needs; and (4) Paradoxical caregiving roles-reflecting the simultaneous marginalization and moral elevation of caregivers. These findings illustrate the layered and dynamic nature of exclusion in the caregiving trajectory. A key contribution of this work is the methodological approach. Despite the study's small and localized sample, it demonstrates the pioneering value of photovoice in capturing the context-specific dimensions of social inequality in caregiving acting as a critical tool to amplify caregiver voices. By centering older caregivers in Poland, the study offers novel insights into how familial care responsibilities intersect with systemic gaps in formal support. Despite limitations in generalizability, these context-specific findings demonstrate the impact of Polish systemic gaps and can enrich cross-national discussions on caregiver vulnerability and resilience, emphasizing the need for targeted social protection policies and inclusive service design.

Purpose The innovation activities of firms are shaped by a variety of barriers that can, paradoxically, either stimulate or hinder their innovation performance. Collaboration among ecosystem partners is often essential for navigating these challenges, particularly in Central and Eastern European (CEE) countries, where persistent shortages of resources and skills make external support crucial. Despite its importance, collaboration does not uniformly yield positive outcomes and can exert a double-edged influence on innovation processes. This study examines whether innovation barriers are transformed into product and process innovations through different types of collaboration and how these mediation patterns unfold in catching-up CEE economies. Design/methodology/approach This study uses Partial Least Squares Structural Equation Modeling (PLS-SEM) to analyze how innovation barriers influence the innovativeness of firms, using a sample of 4,230 firms across eight CEE states. Firm-level data are drawn from the Community Innovation Survey (CIS) and capture innovation barriers, product and process innovations, and three collaboration types: private market, value chain and public research. The model focuses on the mediating role of these collaboration types and includes a multi-group comparison between firms collaborating only domestically and those engaged with foreign partners. Findings Our findings show that value-chain ties consistently channel innovation barriers into process innovation, while product innovations require public research linkages to be present. Interestingly, we show that private market ties can boost process innovation but also play an unsuccessful role in mediating innovation barriers to new products. When considering firms' international engagement, those linked with foreign cooperation partners benefit more from the public research route to product novelty, while domestically oriented firms rely more strongly on value-chain collaboration for process upgrading. Originality/value This paper contributes by treating collaboration as a partner-specific mediating mechanism rather than a generic enabler and by introducing a threefold distinction between private market, value-chain and public research collaboration. It provides context-sensitive evidence from underexplored CEE innovation systems on how distinct collaboration modes convert innovation barriers into product and process innovations and how these effects differ between nationally and internationally oriented firms.

ABSTRACT Universities increasingly rely on effective knowledge creation to remain competitive and relevant in a changing educational landscape. This study explores how autonomy and participation in decision‐making influence knowledge creation in Romanian universities, with affective commitment considered as a potential mechanism linking these factors. Data were collected through a survey of 125 academic and administrative staff across 10 tertiary institutions. The measurement model was validated using exploratory and confirmatory factor analyses, and structural equation modeling was applied to examine the hypothesized relationships. The findings indicate that autonomy and participation in decision‐making significantly enhance affective commitment, which in turn positively predicts knowledge creation. Moreover, affective commitment mediates the effects of both autonomy and participation in decision‐making on knowledge creation. These results contribute to the literature by providing evidence from a Central and Eastern European context, highlighting the importance of organizational practices that empower staff and build commitment as drivers of knowledge management in higher education.

• existence of barren plateaux is one of the challenges in the practical use of variational quantum classifiers; • a noise-based mechanism that shifts training data during optimization, helping escape barren plateaux, is proposed; • the approach is tested with a variational quantum classifier modeling BET index changes using other indices from Europe and the United States; • simulations use the Pennylane framework. The barren plateaux phenomenon has been identified as a significant challenge for variational quantum algorithms, particularly for classification tasks. In this article, we propose a novel approach to mitigating this problem for variational quantum classifiers during the optimization phase. The noisy optimization mechanism shifts the training data by adding a small amount of uniform noise, thereby inducing changes in the parameters being searched. The effectiveness of the method is evaluated using real financial data, modeling the evolution of the BET index in relation to well-known indices from neighboring Central and Eastern European countries, as well as from Western Europe and the United States. The results demonstrate that this approach significantly improves upon the corresponding baseline quantum classifier and provides results comparable to those of established classical methods.

ABSTRACT This paper examines asymmetries in the wage-price spiral risk in Central and Eastern European economies. Using a Macro-at-Risk (MaR) framework, the distributional behavior of a Wage-Price Index and its upper-tail outcomes across regimes is analyzed. The results identify episodes of elevated wage-price pressures. Significant state dependence emerges primarily in Romania, where the sensitivity of upper-tail outcomes to the interest-rate gap appears weaker once Wage-Price Index is elevated. These findings suggest policy responses may need to be more preemptive. To support this, a MaR-based classification framework is proposed to estimate the probability that wage and price developments will exceed normal levels.

The objective of this paper is to examine the impact of remittances on self-employment rates in post-transition countries, with a particular focus on the difference in remittance effects between male and female self-employment rates. This paper uses panel data analysis to examine a sample of 25 countries over the period from 2008 to 2022. The remittance effects are estimated through the application of the System GMM approach. The findings indicate that remittance inflows have a positive and statistically significant impact on the self-employment rate. Specifically, a 10 percent increase in remittances per capita has been shown to increase the total self-employment rate by 0.08 and the female self-employment rate by 0.12 percent. By contrast, though remittance inflows contribute to an increase in the male self-employment rate, this effect is statistically insignificant. Analysis by region reveals that remittances support self-employment activities in SEE and CIS countries; however, remittance effects are negative in the Central and Eastern European - EU member states. Thus, the findings of this study suggest that remittance-receiving countries should devise effective measures for unconstrained remittance flows and remittance channeling into entrepreneurial activities.

Background/Objectives: The COVID-19 pandemic intensified concerns regarding the resilience and financing architecture of mental health services, yet it remains unclear whether crisis-induced adjustments fundamentally altered hospital case-mix complexity or merely exposed pre-existing structural configurations. This study examines the relationship between financing regimes and case-mix complexity in psychiatric hospitals in Romania, a Central and Eastern European health system characterized by mixed financing arrangements and pronounced interregional heterogeneity. Methods: Using administrative data comprising 752 hospital section–year observations (2019–2024), we identify structural financing–organization regimes through a two-step clustering procedure (hierarchical Ward method followed by K-means refinement) based on revenue composition, expenditure allocation, workforce structure, and operational pressure indicators. Results: Three distinct regimes emerge, reflecting persistent institutional configurations rather than temporary crisis-induced groupings. Chi-square tests confirm that regime membership is statistically independent of pandemic timing. A multivariate regression model controlling for financing composition and expenditure structure shows that structural variables (particularly the share of contract-based revenues and the allocation of expenditures) exert systematic and economically meaningful effects on the case-mix index (CMI). Pandemic and post-pandemic indicators do not retain robust explanatory power once structural determinants are accounted for. Regional robustness analyses further demonstrate that financing architecture consistently outweighs temporal shock effects in explaining territorial variation in clinical complexity. Conclusions: The findings suggest that psychiatric hospital case-mix dynamics are structurally embedded within differentiated financing regimes whose influence persists beyond crisis periods. By integrating regime identification with outcome modeling in a Central and Eastern European context, this study contributes to the international literature on health system resilience and highlights the primacy of institutional financing architecture over episodic shock effects in shaping hospital complexity.

ABSTRACT This study investigates the phenomenon of ESG (environmental, social, governance) decoupling in small and medium‐sized enterprises (SMEs) across the Visegrad Group (V4) countries: Poland, Czechia, Slovakia, and Hungary. While ESG frameworks are increasingly adopted as a strategic response to sustainability challenges, their implementation in the SME sector remains fragmented and often symbolic. Drawing on institutional theory and using survey data from 1392 SMEs, the study operationalises decoupling as a firm‐level signed Talk–Walk gap (ESGd i = Talk i − Walk i ) capturing misalignment between communicated ESG readiness (Talk) and implemented ESG practices (Walk). The results indicate measurable ESG decoupling across all four countries. Although descriptive country‐level averages show small shifts (with Poland exhibiting slightly higher alignment and Hungary a larger descriptive gap), the overall distribution of ESGd does not differ significantly across countries. Bivariate and multivariate analyses show that external institutional pressures, including regulatory demands, partner and supply‐chain requirements, customer expectations, and finance‐related requirements, are positively associated with ESG decoupling, although the relative importance of specific pressures varies across countries. This suggests that SMEs may increase ESG signalling faster than implementation when internal capabilities are constrained. The study extends ESG decoupling research to SMEs in a Central and Eastern European context and highlights the need for policy and market instruments that support capability building and enable substantive ESG integration beyond compliance.

Mental health disorders affect approximately 84 million people in the European Union (18.4% of the total EU population), with significant variations in preventive care approaches across member states. Despite growing policy attention, significant implementation gaps persist, particularly in Central and Eastern European countries. This study examines mental health prevention strategies in Poland in comparison with selected EU member states. A comprehensive document analysis was conducted examining strategic documents, legal acts, and reports from 2013-2025. We analyzed national health programs, legal regulations, and reports from international organizations (WHO, EU) across Poland and ten purposively selected EU member states. Search strategy covered policy databases (WHO, European Commission, national government websites, OECD, Eurostat), academic literature (PubMed, Web of Science, and Scopus), and grey literature. Total documents reviewed: 127 policy documents, 89 peer-reviewed articles, 34 statistical reports. Final inclusion: 42 policy documents, 28 peer-reviewed articles, 12 statistical reports. Significant differences were identified in mental health prevention approaches between Poland and other EU countries. In Poland, 25% of individuals with mental health conditions receive adequate care, with 8.9 psychiatrists and 28.2 nurses per 100,000 population compared to 11.5 psychiatrists and 31.6 nurses per 100,000 in Czech Republic. Nordic countries demonstrate the highest level of comprehensive preventive programs. Universal prevention programs exist in Denmark, Finland, Netherlands, Lithuania, Latvia, Portugal, Luxembourg, and Sweden, while Poland lacks systematic solutions despite policy support. Systematic implementation of evidence-based mental health interventions is necessary in Poland, including early intervention, intersectoral cooperation, and targeted mental health programs for children and adolescents aged 7-18 years. The study highlights the need for comprehensive policy integration and increased resource allocation to achieve parity with leading EU member states.

The global digital transformation and increasing geopolitical instability have fundamentally changed the role of IT consulting, shifting it from a supportive function to a core driver of economic resilience. This is particularly evident in the Central and Eastern European (CEE) region, which has emerged as a key technological hub over the last fifteen years. The study employs a comparative analysis of the IT consulting markets in Ukraine, Poland, Romania, and the Czech Republic during 2010–2025. The research methodology is based on a systematic review of market dynamics, including the number of registered companies, revenue per specialist, and the evolution of service delivery models. The author uses data from international analytical platforms (Statista, PwC) and industry reports (IT Ukraine Association, N-iX) to identify regional patterns. The analysis identifies three distinct waves of IT consulting transformation: the post-crisis recovery (2010–2014), the digital transformation boom (2015–2021), and the current shift toward adaptive and resilient strategies (2022–2025). The study categorizes three dominant regional models. The Western European model (Germany, France) focuses on Industry 4.0 and strategic IIoT consulting. The Central European model (Poland, Romania) leverages EU institutional support to function as a technological integrator. The Ukrainian model, defined as “Resilient Consulting,” has unique characteristics shaped by extreme security challenges, leading to the emergence of world-class expertise in MilTech and cybersecurity. Financial metrics reveal a performance gap: the Czech Republic leads in revenue per specialist ($77.5k) due to high-value industrial consulting, while Ukraine is rapidly increasing its consulting share from 12% to 18.4% despite wartime risks. The findings suggest that the Ukrainian IT sector is undergoing a qualitative transition from staff augmentation to solution architecture. By the end of 2025, the share of consulting in Ukraine's IT export structure is projected to reach 22%. The study concludes that Ukraine's strategic priority until 2030 should be adopting Western intellectual property standards and further integrating MilTech solutions into global security chains.

Green tax and green technology as drivers of environmental sustainability in ten Central and Eastern European countries: new insights from MMQR

As the foreign direct investment (FDI)-driven catch-up model of eight Central and Eastern European (CEE-8) economies approaches its limits, strengthening the export capacity of small and medium-sized enterprises (SME) may play an important role in sustaining economic convergence within the European Union (EU). Despite deep integration into EU production networks, domestic SME participation in international trade remains limited. In this context, digitalization is increasingly seen as a factor that may reduce information, coordination, and administrative barriers associated with SME cross-border trade. This study examines how different dimensions of digitalization relate to intra-EU export performance of SMEs in the CEE-8, conceptualizing digitalization across three distinct but interacting layers: firm-level digital adoption, societal digital usage, and the institutional digital environment. Using a balanced panel dataset covering 2018–2023, the analysis employs a one-way fixed-effects estimator with wild cluster bootstrap inference to address the small-cluster setting. Results indicate that societal digital usage and digital public services for businesses are strongly and positively associated with SME intra-EU export performance. Firm-level digitalization shows a more complex pattern: internal digital tools display delayed positive associations after a maturation period, while e-commerce participation is consistently negatively associated with aggregate export volumes. Robustness checks using Driscoll-Kraay standard errors and alternative functional forms confirm the stability of the core findings. The results suggest that strengthening digital foundations and reducing cross-border digital frictions can support more effective CEE-8 SME participation in the EU Single Market.

This paper examines the impact of institutional quality and selected macroeconomic factors on foreign direct investment (FDI) inflows in 22 Central and South-Eastern European countries over the period 2007-2023. To account for endogeneity, unobserved heterogeneity, and the dynamic nature of FDI, the analysis employs dynamic panel data estimators, namely the Arellano–Bond difference GMM and the Blundell-Bond system GMM. Institutional quality is proxied by six Worldwide Governance Indicators: Control of Corruption, Government Effectiveness, Political Stability, Regulatory Quality, Rule of Law, and Voice and Accountability. In addition, the model controls for key macroeconomic determinants, including GDP per capita, trade openness, inflation, population size, and mobile subscriptions as a proxy for infrastructure development. The empirical results indicate that institutional quality indicators are generally not statistically significant across model specifications, with the exception of political stability, which consistently exhibits a positive association with FDI inflows. In contrast, macroeconomic variables – particularly population size and trade openness – emerge as robust determinants of FDI, while the lagged dependent variable confirms strong persistence in FDI inflows over time. Inflation is found to be positively associated with FDI in some specifications, suggesting that its effect may reflect short-term macroeconomic conditions rather than long-run stability. Overall, the findings suggest that, in Central and South-Eastern Europe, market size and economic openness play a more prominent role in attracting FDI than improvements in institutional quality. The study also highlights potential measurement limitations and structural rigidities that may obscure the observable impact of institutions on FDI, contributing to the ongoing debate on the relative importance of institutional reforms versus macroeconomic fundamentals in transition economies.

Abstract This Symposium analyses how European Union (EU) member states have adjusted domestic policies in response to the evolving governance of the single market since the 2008 financial crisis and subsequent EU shocks. Confronted with new opportunities and constraints, countries have adopted diverse forms of domestic agency that have, in turn, reshaped the de facto governance of the single market. We focus on Central and Eastern Europe (CEE), where such forms of agency have been novel and unexpected, given the region's high transnational dependency and their traditional position as passive EU rule‐takers. We show that CEE states have engaged creatively with EU‐level changes, often mobilising actors beyond central governments to tackle domestic economic challenges. This editorial introduction traces the evolving interdependence between CEE agency and the EU's institutional regime, whilst the four empirical contributions examine how CEE countries have leveraged new EU incentives and limitations in practice, with a focus on the manufacturing and finance sectors. Our findings reveal a critical tension: the EU's governance shifts since 2008 have produced a hybrid regulatory framework that combines tighter supranational constraints in some domains with expanded scope for adaptive and experimental domestic agency in others. CEE states have leveraged this uneven regulatory space in creative ways, but outcomes in terms of economic upgrading and convergence remain mixed and uncertain. We conclude that this hybrid governance framework risks entrenching fragmentation within the single market and reinforcing the socio‐economic challenges of the EU's Eastern periphery. By questioning assumptions of minimal CEE agency in managing transnational dependencies and by identifying the specific forms of domestic agency that have emerged in the region since 2008, the Symposium underscores the need to balance national experimentation with strategic economic cohesion and co‐ordination at the EU level.

Health and spa tourism is a rapidly growing sector that merges traditional healing with modern innovations to meet increasingly diverse client needs. Understanding professionals’ perspectives is crucial for developing sustainable strategies that enhance service quality, organizational performance, and long-term business viability. Drawing on qualitative narrative analysis and thematic network analysis, this study explores the key factors that spa tourism professionals in Băile Felix—the largest spa resort in Romania—associate with business success, competitive differentiation, and sustainable development. Data were collected through semi-structured interviews with 41 entrepreneurs and managers who provided detailed narratives on their strategic goals and market positioning. Rather than measuring customer psychological constructs directly, this study captures professionals’ expert attributions regarding service quality, staff professionalism, infrastructure investment, and economic objectives, and interprets these as managerial perceptions grounded in operational experience. Five research propositions guided the interpretive analysis: (P1) professionals narratively associate service quality and treatment diversity with perceived business performance and guest retention signals; (P2) staff professionalism and attitude are attributed as the primary drivers of competitive differentiation; (P3) infrastructure investment and innovation are framed as prerequisites for sustaining market positioning; (P4) the identified themes form a structurally interconnected network with key bridging nodes; and (P5) professional narratives reveal tensions between short-term economic objectives and longer-term commitments to service quality and sustainability. Thematic network analysis identified four central constructs—service quality and treatment diversity, staff professionalism and attitude, innovation and infrastructure investment, and economic and development objectives—and mapped 16 interconnected sub-themes, with modularity analysis (Q = 0.42) confirming a moderately cohesive structure. Sustainable innovation was operationalized across environmental efficiency, social value, and economic resilience dimensions, and found to be embedded systemically across multiple thematic clusters rather than treated as an isolated practice. The originality of this study lies in integrating narrative and thematic network analysis to reveal how these constructs co-evolve within a sustainability-oriented system, offering a novel methodological lens for spa tourism research in post-transitional Central and Eastern European contexts. Findings provide actionable insights for spa managers, policymakers, and investors seeking to balance modernization with tradition in resource-constrained destinations.

ABSTRACT Democratic backsliding is on the rise globally, prompting renewed attention to the strategies through which democracies resist authoritarian encroachments. One form of resistance involves the transition of protest movements into the electoral arena, in the form of so-called “movement parties.” While widely studied in Western Europe, this new party form has received little attention in Eastern European countries where governing elites are fundamentally undermining democracy. This article investigates two movement parties that have emerged in Central and Eastern European countries experiencing democratic backsliding – Momentum in Hungary and USR in Romania – and their impact on the quality of democracy. Focusing on their interaction with media institutions – key arenas both for contesting and enabling democratic erosion – the study draws on semi-structured interviews with party representatives and journalists, party materials and press coverage. The findings show that both parties challenged entrenched elites and introduced new ethical standards, yet their ability to institutionalize democratic gains and counter democratic erosion has been severely limited by media capture and persistent power asymmetries. By analysing the interplay between movement parties and traditional media institutions, the article offers new insights into the constraints and possibilities for democratic innovation under hybrid and democratically declining regimes.