EU Nations Research Articles

Hospital satisfaction among older adults by European Union health system clusters

Abstract Background Health systems are influenced by political, historical, cultural and socio-economic factors and differ across countries. Classification of EU health systems into 5 clusters has allowed for international comparison and policy recommendations. This study is based on the Andersen’s Behavior Model, that predicts that a sequence of predisposing, enabling and need factors influence satisfaction and utilization of healthcare services. Aim Examine the nature and relationship of predisposing, enabling and need factors associated with hospital satisfaction of older adults across EU nations by health system classification clusters. Methods Data from Wave 9, of the Survey of Health, Ageing and Retirement in Europe (SHARE) were examined using a sample of older adults from 10 EU countries. Analysis: Non-parametric one-way ANOVA (Kruskal- Wallis test) and Multinominal Logistics regression were performed to test the null hypothesis that (1) hospital satisfaction is equal across all clusters, and (2) predisposing, enabling, and need factors, are not predictors of hospital satisfaction. Findings There was a statistically significant difference in hospital satisfaction by cluster [Chi Square= 231.44, df = 21; p< .001]. Age, mental health, technology and chronic disease are predictors of healthcare facilities satisfaction. [Chi Square 50.94, df = 3, p< .001], Among those that reported to be highly unsatisfied with healthcare facilities, [chronic disease (Beta = -2.64) and mental health (Beta = -4.41) df = 1 p< .001] significantly predicted hospital satisfaction. Implications for Policy and Practice: Initiatives for the care of older adults should not only aim to increase access to care but also provide targeted services for sub populations such as older adults with mental health and chronic diseases. Further, significant investment is required in technology infrastructure within hospitals and technological assistance or training should be provided to older adults. Key messages • Older adults satisfaction with hospitals varies by health system clusters and is predicted by age, mental health, use of technology and chronic disease. • Chronic disease and mental health are strong predictors of hospital dissatisfaction among older adults.

Aretrospective cross-sectional study on district-based socioeconomic status and prostate cancer diagnosis.

Socioeconomic disparities have been linked to delayed prostate cancer diagnosis and poorer outcomes in various countries. This study aims to evaluate the socioeconomic disparities in prostate cancer diagnostics in Vienna, Austria, by examining initial prostate-specific antigen values and age at diagnosis across different districts and nationalities. This retrospective study included 1356 prostate cancer patients treated at the Medical University of Vienna between 2012 and 2022. Influence of residential districts and nationalities of the patients on the initial prostate-specific antigen (iPSA) value and on the age at diagnosis were analyzed. Patient data, including iPSA values, residential districts, and nationalities, were retrieved from the hospital's internal documentation system. The information on average income of residential districts was obtained from the City of Vienna's municipality data. Nationalities were grouped into EU and non-EU categories. Statistical analyses, including linear regression and t‑tests, were performed to examine the relationship between iPSA values, age at diagnosis, and socioeconomic variables. Linear regression was used to analyze the relationship between district income and both iPSA values and age at diagnosis. The study found no significant differences in iPSA values and age at diagnosis between patients from higher income and lower income districts. Additionally, there were no significant differences among individual districts or between EU and non-EU nationals. The findings suggest that the Austrian healthcare system provides equitable access to prostate cancer diagnostics across different socioeconomic groups.

New constellations of care: between local and transnational care practices of young Europeans living in the UK during the (im)mobility regimes of a pandemic

ABSTRACT The restrictions to international travel during the COVID-19 pandemic have posed significant barriers to transnational family life. This paper focusses on the negotiation of familial obligations of over 300 young EU nationals aged 14–25 living in Britain. We examine how care practices were reconfigured within families, as forced immobility, absence and loss became part of transnational family life. Young people’s agency was activated to engage in desirable circulations of care, while they also engaged in acts of citizenship locally that had a care dimension. Many young people contributed to local initiatives of caring for others, such as mutual aid initiatives and local groups extending care practices to non-familial relations. We examine thus the range of care receiving and care giving practices and resources involved, including material resources, time, affection and sharing information. These practices involved family members locally or at a distance, but also non-familial relations, to shape new constellations of care.

The Influence of World Heritage Sites on Tourism Dynamics in the EU 27 Nations

Culture and tourism are crucial for economic growth and sustainable development, working together symbiotically. Culture boosts tourism by supporting heritage, production, and creativity, while cultural heritage, reflecting national identity and traditions, strengthens local economies. This study uses a panel data analysis to examine the impact of cultural factors on international tourist arrivals in 27 EU nations. The Driscoll–Kraay method reveals that UNESCO World Heritage Sites, government cultural expenditures, household recreation and cultural expenditures, real GDP per job, and bed capacity positively influence international tourist numbers. Regarding cultural factors, World Heritage Sites have the most significant influence, with each additional UNESCO site leading to a 0.22% rise in tourist numbers. The most crucial determinant of tourist arrivals is bed capacity, with a one percent increase leading to a 0.66% increase in tourist arrivals. Conversely, healthcare expenditures and political civil liberties have a negative impact on tourist arrivals. This study discusses managerial implications and offers recommendations for future research.

Evaluation of methods for detection of Campylobacter in raw milk: A multi-country study

Raw milk is considered a high-risk source of Campylobacter due to faecal contamination from healthy cattle and farm environments, thus linking raw milk consumption to global outbreaks. Detection of Campylobacter in raw milk poses challenges due to low contamination levels and antibacterial properties of the milk. Culture-based protocols for Campylobacter detection in milk vary, mainly with regard to pH adjustment and the choice of enrichment broth.This European collaborative study was organised by the EU Reference Laboratory (EURL) for Campylobacter together with eight EU National Reference Laboratories (NRL) for Campylobacter with the purpose to evaluate methods for culture-based detection of Campylobacter in raw cow's milk. The study was divided into two parts, an interlaboratory part and an intralaboratory part, both organised around the same two protocols. The aim of protocol 1 was to evaluate the impact of pH adjustment and storage of the milk on the culturability of Campylobacter over time. Aliquots of the spiked milk were adjusted either to pH 7.0 or pH 7.6 or left unadjusted. The milk was stored up to 48 h at refrigerated temperature and Campylobacter was quantified according to ISO 10272-2 on day 0, 1 and 2. The aim of protocol 2 was to evaluate which enrichment broth, Bolton broth (BB) or Preston broth (PB), showed highest sensitivity in detection of Campylobacter. The spiked milk was enriched in BB and PB as described in ISO 10272-1:2017 or ISO 10272-1:2017/Amd1.2023. In the interlaboratory part, each milk batch was collected locally by each participating NRL/EURL and inoculated with the same Campylobacter strain. In the follow-up intralaboratory part, the EURL-Campylobacter repeated the tests in protocol 1 and 2 but used different Campylobacter strains and strains subjected to thermal stress prior to inoculation.The results show that pH adjustment of raw milk has a negligible impact on culture-based detection of Campylobacter, regardless of strain and level of environmental stress. The composition of milk and properties of the inoculated strain influence culture-based detection of Campylobacter over storage time, and strains subjected to additional stress prior to inoculation in milk are reduced in culturability much faster than the same strains prepared under normal conditions.Finally, the study showed that PB without Campylobacter growth supplement is less effective than BB in detecting Campylobacter in raw milk.

Is Redistribution Good for Our Health? Examining the Macrocorrelation between Welfare Generosity and Health across EU Nations over the Last 40 Years

Context: Social determinants of health are finally getting much-needed policy attention, but their political origins remain underexplored. In this article, the authors advance a theory of political determinants as accruing along three pathways of welfare state effects (redistribution, poverty reduction, and status preservation), and they test these assumptions by examining impacts of policy generosity on life expectancy (LE) over the last 40 years. Methods: The authors merge new and existing welfare policy generosity data from the Comparative Welfare Entitlement Project with data on LE spanning 1980–2018 across 21 countries in the Organization for Economic Cooperation and Development. They then examine relationships between five welfare policy generosity measures and LE using cross-sectional differencing and autoregressive lag models. Findings: The authors find consistent and positive effects for total generosity (an existing measure of social insurance generosity) on LE at birth across different model specifications in the magnitude of an increase in LE at birth of 0.10–0.15 years (p < 0.05) as well as for a measure of status preservation (0.11, p < 0.05). They find less consistent support for redistribution and poverty reduction measures. Conclusions: The authors conclude that in addition to generalized effects of policy generosity on health, status-preserving social insurance may be an important, and relatively overlooked, mechanism in increasing LE over time in advanced democracies.

Cybercrime in the Middle East: A Comparative Analysis with Global Trends

This article aims to present a modern methodological approach that will allow the selection of the optimal strategy for combating cybercrime in the Middle East. The research methodology requires using methods that would enable the assessment of the study problem and help solve it effectively; thus, the hierarchy analysis developed by T. Saaty was widely used by researchers and practitioners in solving economic problems. The method of paired comparison and the involvement of experts through the Delphi method was also used. This paper explicitly defends the choices made for countering cybercrime, stressing that these choices should be tailored to the changes in the Middle East. The study acknowledges this restriction by concentrating only on the features of cybercrime in Middle Eastern nations. To gain a more profound understanding of the problem, future studies should investigate cybercrime in other areas, such as EU nations.

Do you speak English or my language? An LMT approach to language requirements in EU nations’ visa applications

ABSTRACT This study investigates the language ideologies manifested in the linguistic hierarchies produced by relevant EU governmental/political institutions through their language requirements for visa application documents. Based on the theoretical framework of Language Management Theory (LMT), this study employs a mixed-methods approach, combining quantitative analysis of visa statistics with qualitative content analysis of 200 social media narratives. At the macro-level, it analyzes the language ideologies underpinning the language requirements for national/long-term visa application documents. At the micro-level, it explores the intersecting point where language management behaviors from different levels converge through individuals’ pre- and post-interaction management behaviors, as observed in social media posts related to document preparation and potential visa interviews. The results project a spectrum of approaches among EU countries: eight countries exhibit the tendency to civic linguistic nationalism by mandating their national/official languages as the sole language choice; while the remaining seventeen countries display varying degrees of linguistic pragmatism by accepting the required documents in English. The paper concludes by discussing the implications of these findings for language policy and ideology in the context of global mobility, suggesting that the current language requirements may not only project the language ideology but also carry broader socio-political consequences.

Carbon Leakage Concept after Carbon Pricing &amp; Green Deal Policies

As part of the European Green Deal, EU nations are required to decrease their carbon emissions by 55% by 2030 and reach carbon neutrality by 2050. The EU's emissions trading system is the cornerstone of this goal. In theory, rising carbon prices may cause carbon leakage, or the transfer of economic activity and related emissions from high-carbon economies to low-carbon economies. Losing market share to rivals in international rivalry might result in short-term international carbon leakage. In the long term, it can be accomplished by moving domestic businesses abroad. To date, a variety of tools, including offsets and free allowances granted under the ETS, have been used to support the carbon leakage risk of high-risk industries. This paper develops an international technique, the EU Emissions Trading Scheme (ETS) Phase IV consultation, to produce a sector-level risk assessment of carbon leakage in Türkiye. This methodology combines emissions intensity and trading intensity, two important indicators for assessing carbon leakage risk. Although the former is commonly employed as a measure of a company's exposure to carbon costs, the latter indicates its ability to pass on costs to customers without losing market share. According to the carbon risk study carried out in Türkiye for the aluminium, cement, paper, fertilizer, iron-steel, and ceramics sectors, cement has the highest risk, while paper carries the lowest risk

THE EVOLUTION OF NURSING AS A PROFESSION IN HEALTHCARE

Currently, nursing stands as a highly coveted profession drawing significant attention. While its roots can be traced back to ancient times, the formal recognition of nursing as a profession, labeled as such, has only emerged in recent decades. Defined as both a science and an art grounded in evidence, nursing is progressively assuming more significant roles within the healthcare and biomedical realms. The profession’s evolution is intricately linked with advancements in science, technology, and research, which have translated into tangible practices within the healthcare system. Offering both undergraduate and graduate nursing programs elevates the level of responsibility among nurses. However, this advancement lacks proper systematization and acknowledgment of educational standards within the healthcare sector. Future challenges encompass meeting the increasing healthcare demands spurred by longer life expectancies and population growth, alongside facilitating professional mobility within EU nations. Factors such as enhanced financial stability and improved working conditions contribute to the outflow of nurses from the region. Proposed solutions include establishing adaptable mobile teams, prioritizing patient education and preventative measures, integrating LED clinics/facilities, and introducing supportive robotic technologies. Nurses play a pivotal role in delivering care and advocating for health equity, emphasizing the necessity of fostering collaborative partnerships for the future sustainability of healthcare systems.

Labeling and assessment of energy and sustainability performances in the civil sector: The case study of ESA-ESRIN in Rome

The continuous improvement of the energy and sustainability performances of buildings is stimulated by mandatory rules, economic incentives and voluntary sustainability pathway of which energy efficiency is one of the most important components. The tools to evaluate the energy, sustainability, automation and energy metering performances of buildings, to check the status and lead the investments, are often complex, slow, expensive and related to the specific Countries, making difficult the job for the facility management departments of national or international organizations in EU.The present paper wants to give a contribute to existing literature by providing a new energy, sustainability, automation and energy metering label system to quickly, simply and economically evaluate the performances of office buildings in Europe. This tool has been tested on a case study, a research center of the European Space Agency (ESA-ESRIN) in Rome, Italy.The results of the test show that the tool has been successfully applied on the buildings of the research center using the data provided by the facility management department of ESA-ESRIN and the energy audit of the center. The labels can correctly represent the state of the buildings in a more cost-effective way if compared to the national energy certification and to international sustainability protocols.This study provides the facility management departments of public and private companies in EU - especially if they manage buildings in different EU nations - a reliable tool to quicky evaluate the energy, sustainability, automation and energy metering performances of their buildings.

Social Relations Among Diverse Rural Residents in the Scottish Highlands

This article focuses on the development and the limitations of convivial, instrumental, and intimate family relations among diverse rural residents in the Inner Moray Firth area of the Scottish Highlands. Drawing on 22 semi‐structured interviews with international migrants (EU nationals), internal migrants (UK nationals), and participants who were born there and never left, this article identifies and critically discusses how different types of social relations develop, or not, within and between these groups of rural residents. This article indicates that while all participants experienced convivial relations, these encounters did not always transfer into close, meaningful relations. The instrumental and meaningful relations, however, were more ambivalent in practice and related to internal divisions within rural communities defined along the lines of who is perceived to be “local” or “not local.” The instrumental ties were developed among participants with common interests, similar life stages, and experiences and varied in terms of ethnic and national composition. Similarly, while family ties were crucial for a sense of belonging, their ethnic and national composition differed. By illustrating the complex composition of convivial, instrumental, and family ties in rural Highlands, this article highlights that meaningful social relations supporting social integration should not be understood via social encounters with “local” residents only, but also intimate and instrumental social relations within and between migrant populations.

A Cross-Sectional Analysis of the Relationship between Digital Technology Use and Agricultural Productivity in EU Countries

Amidst the rapid evolution of digital technologies and their prospective implications for agricultural productivity, farmers are increasingly turning to Agriculture 4.0. As digitization permeates every facet of agriculture, the potential for boosting productivity while ensuring sustainability and resilience becomes increasingly tangible. The objective of this study is to understand how the adoption of digital technologies influences agricultural productivity within the diverse socioeconomic and agricultural landscapes of EU nations. The research of this study aims to address questions concerning the impact of digital technology use on agricultural productivity across EU countries. This study employs a robust analytical framework combining equation modeling (SEM), artificial neural networks, and cluster analysis. SEM analysis reveals significant associations and influences between digital technology use and productivity related to the total labor force across EU countries. Moreover, cluster analysis outlines distinct clusters of EU member states distinguished by varying degrees of digital technology incorporation and corresponding agricultural productivity, emphasizing the diverse socioeconomic contexts that influence these associations. These findings underscore the significance of embracing digital technology as a catalyst for enhancing agricultural productivity across EU nations. Future research could focus on devising strategies to promote the widespread adoption of digital technologies in agriculture across EU member states, and longitudinal analyses could offer insights into the dynamic relationship between digital technology use and agricultural output, informing policy interventions.

Concentration units used to report blood- and breath-alcohol concentration for legal purposes differ between countries which is important to consider when blood/breath ratios of alcohol are compared and contrasted.

This technical note reviews the plethora of concentration units used to report blood-alcohol concentration (BAC) and breath-alcohol concentrations (BrAC) for legal purposes in different countries. The choice of units sometimes causes confusion when scientific papers originating from a certain country might be introduced into evidence via expert testimony, such as when alcohol-related crimes are prosecuted. The concentration units are also important to consider when blood/breath ratios (BBRs) of alcohol are calculated and compared between countries. Statutory BAC limits for driving in most nations are reported in mass/volume (m/v) units, such as g/100 mL (g%) in the United States, mg/100 mL (mg%) in the United Kingdom and Republic of Ireland, or g/L (mg/mL) in many EU nations. By contrast, Germany and the Nordic countries report BAC as mass/mass (m/m) units, hence g/kg or mg/g, which are ~5.5% lower than m/v units, because whole blood has an average density of 1.055 g/mL. There are historical reasons for reporting BAC in mass/mass units because the aliquots of blood analyzed were measured by weight rather than volume. The difference between m/m and m/v is also important in postmortem toxicology, such as when distribution ratios of ethanol between blood and other biological specimens, such as urine, vitreous humor, and cerebrospinal fluid, are reported.

Examining the Impact of Fiscal Rules on Fiscal Stability in EU Member States

Following the rapid escalation of budget deficits and public debt across many EU nations post-2008, fiscal policy has encountered a formidable challenge in devising suitable measures to fortify fiscal discipline and enhance the quality of public finance. Institutional mechanisms, including numerical fiscal rules, play a pivotal role in upholding fiscal discipline and bolstering the fiscal credibility of states. These rules typically entail permanent constraints on fiscal policy, delineated by indicators that set thresholds for specific fiscal aggregates such as budget deficits, public debt, public expenditure, or public revenue. The theoretical aim of this article is to scrutinize the institutional dimensions of numerical fiscal rules, encompassing their type, legal foundation, transparency, complexity, flexibility, adequacy, and coherence. The empirical objective, conversely, is to conduct statistical analysis and investigate the correlation between the fiscal rules index and the levels of budget deficit and public debt across the 28 Member States of the European Union. Evaluating the efficacy of implemented fiscal rules, both at the European and national levels, constitutes a crucial aspect of this analysis.

Between Empowerment and Surveillance: Forced Migration and Information and Communication Technologies

Amidst a surge in migration from conflict zones across the Middle East and Africa, leading to the arrival of more than a million displaced individuals in Europe, a nascent research field, primarily explored by European scholars, examines how information and communication technologies (ICTs) reshape refugees’ experiences during and after migration. This emerging inquiry explores how ICTs can empower displaced migrants, enhancing their resilience and enabling survival, family connection, adaptation, inclusion, and rights advocacy. Concurrently, recent studies in the area of border and surveillance underscore technology’s pivotal role in shaping security-oriented agendas within migration and mobility regimes across the US, EU, and other nations. This study systematically and critically reviews digital migration literature from 2006 to 2021 with metadata obtained and synthesized from Scopus and Dimensions databases, investigating the interplay between forced migrants’ use of digital technologies to navigate restrictive migration systems and their interaction with surveillance technologies. It seeks to identify the ambivalent positions in digital migration studies and assess migrants’ potential empowerment through ICTs.

Electoral Participation of Non‐National EU Citizens in France: The Case of the Nord

Since the 1993 Maastricht Treaty, EU citizens have the right to vote in European and local elections in the member state they reside in. In France, only about a quarter do so. Our article considers what factors explain the registration and participation of non-national citizens for the French Department of the Nord where around 35,000 non-French European citizens of voting age are living. Among them, 11,638 are registered to vote in the French municipal elections. Following the 2020 municipal elections, we have consulted the electoral rolls in each of the 648 communes to know who actually cast a vote. Based on detailed census data on each EU nationality and on other information contained on the electoral lists and rolls (age, gender, place of birth, etc.) and also contextual variables, this article seeks to identify the main factors associated with registering in the first instance and turning out to vote in the second. Our results confirm wide variation in registration and voting rates according to nationality. They also show that beyond voters’ nationality and the “usual suspects” of electoral participation, contextual factors are important predictors.

BENEFITS OF MANAGING FOOD LOSS AND WASTE FOR SUSTAINABLE RURAL DEVELOPMENT IN INDONESIA

The reduction of food loss and waste (FLW) has become a global priority under the Sustainable Development Goals (SDG). Reports from the United Nations and FAO reveal alarming statistics, with 13.3 percent of the world’s food lost post-harvest and 17 percent wasted at the consumer level. FLW is a problem found in both industrialized nations like the EU and emerging countries like Indonesia. While EU nations have committed to reducing per capita food waste by 2030, Indonesia has only begun addressing FLW. This paper explores the awareness and management of FLW in Indonesia, focusing on food recovery and redistribution strategies and their potential impact on rural sustainability development. It addresses FLW management through literature review with the aim of raising awareness to the urgency of FLW management and to support the circular economy in Indonesia. FLW is closely associated with consumer behaviour, and lessons from the EU suggests that supporting local farmers and improving the supply chain can help reduce FLW. The role of food recovery and redistribution in reducing FLW in Indonesia highlights the successful practices, emphasizing the transformation of „ugly food“ and the redistribution of excess edibles to combat FLW. Non-profit organizations in Indonesia have emerged to combat FLW by redistributing edible leftovers to those in need. Additionally, FLW recovery practices extend to agriculture, involving the reprocessing of unharvested agricultural products onto animal feed or organic fertilizers. These initiatives not only reduce waste, but also contribute to food security and poverty alleviation, especially in rural areas. The study concludes that addressing FLW in Indonesia can lead to increased food availability and sustainability. It recommends the development of national policies, programs, and partnerships to promote FLW management and the well-being of Indonesian communities. Further research is needed to identify specific challenges and opportunities for implementing food recovery and redistribution initiatives effectively. By taking concrete steps to reduce FLW, Indonesia can enhance food security and simultaneously align itself with the global sustainability agenda. Keywords: Food loss and waste (FLW), food recovery, redistribution, sustainable rural development JEL: O31, Q53, R11

Establishing an EU-wide front-of-pack nutrition label: Review of options and model-based evaluation.

This paper reviews the effectiveness of four types of front-of-pack nutrition labels (FoPLs) in influencing calorie purchases. The four FoPL types are poised for unified implementation across European countries. Further, this study extends its analysis to evaluate the impacts of the voluntary adoption of these FoPLs within 27 EU nations. Nutri-Score displays higher potential for yielding positive health and economic outcomes, compared with other FoPLs. Across EU countries, Nutri-Score is projected to avert nearly two million cases of non-communicable diseases, in total, between 2023 and 2050. Keyhole demonstrates effects of a similar magnitude but with no statistical significance. Nutri-Repere shows smaller impacts, while Nutri-Couleurs has non-significant effects. Nutri-Score is projected to significantly lower annual healthcare spending by 0.05%, whereas the other labels have negligible impacts. By reducing cases of disease, FoPLs have the potential to improve employment and work productivity. Nutri-Score surpasses the other labels with an estimated annual gain of 10.6 full-time equivalent workers per 100,000 individuals of working age across EU countries. In all, mandatory implementation of any of the four labels would lead to greater effects than those obtained with a voluntary implementation, providing evidence to inform legislation proposal for an EU-wide nutrition labelling system.

Article: The European Triangle: On the Relationship between Primary EU Law, Secondary EU Law and National Law in the Field of Direct Taxation

National tax law provisions, EU Directives’ provisions and primary EU law interact. National rules may be based on EU law, EU law may prohibit national legal requirements, and sometimes secondary EU law can be contrary to primary EU law. The three sources of law that, in concert, form a triangle by connecting the three sources,affect each other, especially for interpretational purposes. The author analyzes the relation between the different sources of law, taking each side of the triangle as starting points, and critically addresses flaws in the current approach towards interpretation of EU law, direct effect and the compatibility of secondary EU law with primary EU law. Especially with an increasing number of forthcoming EU Directives in the field of direct taxation, the determination to what extent a directive is an acceptable political compromise or is contrary to fundamental principles is getting increasingly important. EU Law, Directives, Interpretation, Implementation, Harmonization, Direct effect, Fundamental Rights, manifest error, ATAD, DAC