European Comparison Research Articles

Is single parenthood increasingly an experience of less-educated mothers? A European comparison over five decades

Is single parenthood increasingly an experience of less-educated mothers? A European comparison over five decades

Population age structure dependency of the excess mortality P-score

BackgroundSince the outbreak of the COVID-19 pandemic, the excess mortality P-score has gained prominence as a measure of pandemic burden. The P-score indicates the percentage by which observed deaths deviate from expected deaths. As the P-score is regularly used to compare excess mortality between countries, questions arise regarding the age dependency of the measure. In this paper we present formal and empirical results on the population structure bias of the P-score with a special focus on cross-country comparisons during the COVID-19 pandemic in Europe.MethodsP-scores were calculated for European countries for 2021, 2022, and 2023 using data from the 2024 revision of the United Nations’ World Population Prospects and the HMDs Short Term Mortality Fluctuations data series. The expected deaths for 2021, 2022, and 2023 were estimated using a Lee–Carter forecast model assuming pre-pandemic conditions. P-score differences between countries were decomposed using a Kitagawa-type decomposition into excess-mortality and structural components. To investigate the sensitivity of P-score cross-country rankings to differences in population structure we calculated the rank-correlation between age-standardized and classical P-scores.ResultsThe P-score is an average of age-specific percent excess deaths weighted by the age-distribution of expected deaths. It can be shown that the effect of differences in the distribution of deaths only plays a marginal role in a European comparison. In most cases, the excess mortality effect is the dominant effect. P-score rankings among European countries during the COVID-19 pandemic are similar under both age-standardized and classical P-scores.ConclusionsAlthough the P-score formally depends on the age-distribution of expected deaths, this structural component only plays a minor role in a European comparison, as the distribution of deaths across the continent is similar. Thus, the P-score is suitable as a measure of excess mortality in a European comparison, as it mainly reflects the differences in excess mortality. However, this finding should not be extrapolated to global comparisons, where countries could have very different death distributions. In situations were P-score comparisons are biased age-standardization can be applied as a solution.

The hidden lessons in textbooks: Gender representation and stereotypes in European mathematics and language books

AbstractThis cross‐national European comparison examined gender representation and stereotypes in mathematics and language textbooks from Germany, Italy, Lithuania, the Netherlands and Romania. The results showed that female characters were numerically underrepresented. Female characters were also less often a main character or individually portrayed compared to male characters, but not proportionally to the overall lower number of female characters. Characters in occupational roles were less often female than male, whereas among characters with gender non‐conform characteristics, these were more often female than male in some textbooks. There was no sexual diversity among characters. The differences in gender representation are found within each country, but gender differences were smaller in more gender‐egalitarian countries. If textbooks are to offer the same learning benefits to both boys and girls, students should be equally represented in a diversity of roles and occupations.

Approved and Commercialized Antidiabetic Medicines (Excluding Insulin) in Seven European Countries-A Cross-Sectional Comparison.

Diabetes mellitus is a complex, multifactorial, progressive condition with a variety of approved therapeutic options. The purpose of this study was to offer an overview of the authorized antidiabetic medicines (excluding insulin) compared with marketed products in seven European countries. Data were obtained from primary sources, including the websites of national authorities and directly from specialists in the countries of interest. The range of marketed medicines compared with the authorized group was assessed in terms of active pharmaceutical ingredients (>60% in Bulgaria, France, Serbia), brand names (>70% in Bulgaria, the Czech Republic, Romania, Serbia, Spain), pharmaceutical forms (>60% in all countries), strengths (>60% in Bulgaria, the Czech Republic, Romania, Serbia, Spain), marketing authorization holder (≥50% in all countries) and the status of medicine. Spain was found to have the highest number of products based on most of these attributes. Over 90% of authorized medicines had a pharmacy price in Serbia. Regarding the newer class of GLP-1 receptor agonists, a retail price for all approved substances was available in Bulgaria, Romania, Serbia, and Spain. Only one brand name with one concentration was found available for some agents, being susceptible to drug shortages: glibenclamide (Romania, Serbia, Spain), glipizide (the Czech Republic, Poland, Romania, Spain), glisentide (Spain), acarbose (the Czech Republic), sitagliptin (Bulgaria, Poland), vildagliptin (the Czech Republic, Poland) and saxagliptin (the Czech Republic, France, Romania, Serbia). An overview of the national and international therapeutic options may allow competent authorities and health professionals to take rapid measures in case of supply problems or health crises.

Eco-innovation policies for food waste management: A European Union-ASEAN comparison

This study investigates the impact of eco-innovation policies on the reduction of food waste in the European Union (EU) and the Association of Southeast Asian Nations (ASEAN). Eco-innovations are a range of new technologies and practices that aim to tackle the global food waste crisis. These innovations not only promote economic growth but also contribute to sustainability and social well-being. Guided by circular economy principles, governments play a critical role in fostering eco-innovation. This study compares policy approaches in five developed nations from EU (Germany, France, Belgium, Denmark, Ireland) and five developing nations from ASEAN (Indonesia, Malaysia, Philippines, Thailand, Vietnam). These countries were chosen due to their diverse economic profiles and varied food waste management strategies. Documentary analysis and PESTEL analysis of policies reveals that both regions leverage regulations, incentives, and awareness campaigns to encourage eco-innovation within the food sector. However, challenges remain in areas such as infrastructure and consumer behavior. This research emphasizes the potential of eco-innovation policies to achieve Sustainable Development Goals related to food systems, highlighting the value of knowledge sharing and collaboration between the EU and ASEAN to address this urgent global issue.

Accuracy Assessment and Comparison of National, European and Global Land Use Land Cover Maps at the National Scale—Case Study: Portugal

The free availability of Sentinel-1 and 2 imageries enables the production of high resolution (10 m) global Land Use Land Cover (LULC) maps by a wide range of institutions, which often make them publicly available. This raises several issues: Which map should be used for each type of application? How accurate are these maps? What is the level of agreement between them? This motivated us to assess the thematic accuracy of six LULC maps for continental Portugal with 10 m spatial resolution with reference dates between 2017 and 2020, using the same method and the same reference database, in a bid to make the results comparable. The overall accuracy and the per class user’s and producer’s accuracy are compared with the ones reported by the map producers, at the national, European, or global level, according to their availability. The nomenclatures of the several maps were then analyzed and compared to generate a harmonized nomenclature to which all maps were converted into. The harmonized products were compared directly with a visual analysis and the proportion of regions equally classified was computed, as well as the area assigned per product to each class. The accuracy of these harmonized maps was also assessed considering the previously used reference database. The results show that there are significant differences in the overall accuracy of the original products, varying between 42% and 72%. The differences between the user’s and producer’s accuracy per class are very large for all maps. When comparing the obtained results with the ones reported by the map producers for Portugal, Europe or globally (depending on what is available) the results obtained in this study have lower accuracy metrics values for all maps. The comparison of the harmonized maps shows that they agree in 83% of the study area, but there are differences in terms of detail and area of the classes, mainly for the class “Built up” and “Bare land”.

Financial Performance (Dis)parity in Post-transition Europe

Decades after the transition processes have spread across Central, Eastern, and South-Eastern Europe (CESEE), the former Soviet Union, and the Baltic, it was interesting to perform the post-transition and non-transition advanced European economies comparison to capture the outcomes of the 'catching-up process' . In this analysis, I tried to reach the results of this ‘catching process’ using the firm-level accounting data, namely, enterprises' annual accounts rather than countries' national accounts. The goal was to evaluate if post-tran- sition countries' enterprises have reached the financial performance of non-transition countries' enterprises across Europe, three decades after the transition processes began. The research captured firm-level financial performance aspects revealing some differentiators, namely, financial report indicators that differed for the enterprises belonging to post-transition countries in comparison with the ones belonging to non-transition countries in Europe. The findings related to the liquidity, solvency, indebtedness, profitability indicators, and labor intensity ratio were derived by logit regression models. The observations for 569 European companies were provided by Orbis Europe for the year 2021 annual accounts. According to the results, enterprises in post-transition countries, characterized by lower total assets and working capital scale, were likely to have lower profit margins, share of employees’ costs in operating turnover, current ratio, and gearing, while higher solvency and liquidity ratio. Mild marginal effects indicated the gap narrowed but with still existing significant disparities, particularly in the field of liquidity.

Head-to-head comparison of American, European, and Asian TIRADSs in thyroid nodule assessment: systematic review and meta-analysis.

Ultrasound-based risk stratification systems (Thyroid Imaging Reporting and Data Systems (TIRADSs)) of thyroid nodules (TNs) have been implemented in clinical practice worldwide based on their high performance. However, it remains unexplored whether different TIRADSs perform uniformly across a range of TNs in routine practice. This issue is highly relevant today, given the ongoing international effort to establish a unified TIRADS (i.e. I-TIRADS), supported by the leading societies specializing in TNs. The study aimed to conduct a direct comparison among ACR-, EU-, and K-TIRADS in the distribution of TNs: (1) across the TIRADS categories, and (2) based on their estimated cancer risk. A search was conducted on PubMed and Embase until June 2023. Original studies that sequentially assessed TNs using TIRADSs, regardless of FNAC indication, were selected. General study characteristics and data on the distribution of TNs across TIRADSs were extracted. Seven studies, reporting a total of 41,332 TNs, were included in the analysis. The prevalence of ACR-TIRADS 1-2 was significantly higher than that of EU-TIRADS 2 and K-TIRADS 2, with no significant difference observed among intermediate- and high-risk categories of TIRADSs. According to malignancy risk estimation, K-TIRADS often classified TNs as having more severe risk, ACR-TIRADS as having moderate risk, and EU-TIRADS classified TNs as having lower risk. ACR-, EU-, and K-TIRADS assess TNs similarly across their categories, with slight differences in low-risk classifications. Despite this, focusing on cancer risk estimation, the three TIRADSs assess TNs differently. These findings should be considered as a prerequisite for developing the I-TIRADS.

Legal Regulation of Care for Mixed Marriages in Selected Central European Countries Comparison and Proposals

W artykule przedstawiono sposoby regulacji prawnej dotyczącej małżeństw mieszanych w Kościele katolickim w wybranych krajach Europy Środkowej: w Czechach, Polsce, Republice Słowackiej, Niemczech i Austrii. W części porównawczej przedstawia porównanie rozwiązań w zakresie: zapowiedzi przed zawarciem małżeństwa, oświadczenia przed prośbą o zgodę na zawarcie małżeństwa mieszanego, upoważnienia do zezwolenia na zawarcie małżeństwa, dyspensy od formy kanonicznej oraz możliwości dostępu do sakramentu Eucharystii w małżeństwach mieszanych. W części syntetycznej przedstawia nie tylko ocenę opisanych rozwiązań i propozycje ich udoskonalenia, ale także sposób wydawania i publikowania odpowiednich przepisów i formularzy z punktu widzenia duszpasterstwa i otwartości Kościoła. W aneksie omawia rozwiązanie prawne podobnych sytuacji (małżeństwo strony katolickiej z osobą nieochrzczoną oraz ze stroną katolicką oddaloną od wiary i praktyki chrześcijańskiej) oraz przedstawia ramowo projekt dyrektywy Konferencji Episkopatu w sprawie małżeństw mieszanych i podobnych w Republice Czeskiej.

Politikai átrendeződés a pandémia és a háború árnyékában

Latvia’s party system has been one of the most unstable in European comparison since the 1990s, essentially since independence and democratization. Although there was a period in the middle of the 2010s, which showed the stabilization of the range of relevant parties and a decrease in the number of parties, by the end of the decade the fluctuation between the parties of the Baltic republics was again high. The Kariņš cabinet, formed after a record long time after the 2018 election, nevertheless set a unique record in the country: it was the first government to complete a full four-year parliamentary term. The government faced two challenges during its tenure, the pandemic that began in the spring of 2020, and the Russian aggression against Ukraine that began on February 24, 2022. Both had a significant impact on the development of the party structure. The aim of this paper is to present the changes in the political palette of Latvian parties in the last two legislative cycles, to analyze the results of the October 2022 election, giving priority to the effects of the Russian-Ukrainian war on the transformation of the party structure and the results of the elections.

The German Environmental Tax Reform: a difference-in-differences analysis of its impacts in European comparison

AbstractIn 1998, the red-green Schröder government implemented the Environmental Tax Reform (ETR), raising taxes on petrol, diesel, natural gas and heating oil and introducing a new duty on electricity in Germany. At the same time, it cut non-wage labour costs by reducing public pension contributions. The goal was to achieve Germany’s Kyoto Protocol emissions targets and to reduce a level of unemployment unprecedented since World War II while avoiding the burden on the public budget through revenue recycling. Employing microdata from household budget surveys of 1998 and 2003, this article analyses whether increased duties on motor fuels and electricity lead to a substantial reduction in households’ consumption of these goods. Considering the ETR as a natural experiment, it uses the difference-in-differences approach in a European context with Germany as the treatment group and Italy, Spain and the UK as the control group. Ordinary least square regressions reveal that motor fuel demand is price inelastic, while electricity consumption increased despite the substantial rise in prices. Quartile regressions show that the effect of the motor fuel tax is slightly higher at the bottom than at the upper tail of the distribution supporting the notion that low-level consumers are more likely to find alternative substitutes.

Reproducibility of the wet part of the soil water retention curve: a European interlaboratory comparison

Abstract. The soil water retention curve (SWRC) is a key soil property required for predicting basic hydrological processes. The SWRC is often obtained in the laboratory with non-harmonized methods. Moreover, procedures associated with each method are not standardized. This can induce a lack of reproducibility between laboratories using different methods and procedures or using the same methods with different procedures. The goal of this study was to estimate the inter- and intralaboratory variability of the measurement of the wet part (from 10 to 300 hPa) of the SWRC. An interlaboratory comparison was carried out between 14 laboratories, using artificially constructed, porous reference samples that were transferred between laboratories according to a statistical design. The retention measurements were modelled by a series of linear mixed models using a Bayesian approach. This allowed the detection of sample-to-sample variability, interlaboratory variability, intralaboratory variability and the effects of sample changes between measurements. The greatest portion of the differences in the measurement of SWRCs was due to interlaboratory variability. The intralaboratory variability was highly variable depending on the laboratory. Some laboratories successfully reproduced the same SWRC on the same sample, while others did not. The mean intralaboratory variability over all laboratories was smaller than the mean interlaboratory variability. A possible explanation for these results is that all laboratories used slightly different methods and procedures. We believe that this result may be of great importance regarding the quality of SWRC databases built by pooling SWRCs obtained in different laboratories. The quality of pedotransfer functions or maps that might be derived is probably hampered by this inter- and intralaboratory variability. The way forward is that measurement procedures of the SWRC need to be harmonized and standardized.

Role of German cardiac arrest centers in mediating basic life support

Despite ameasurable increase in recent years, the bystander resuscitation rate in Germany lags behind the European comparison. Special centers for the care of patients after cardiac arrest, so-called cardiac arrest centers (CAC), have been established. The aim of this work is to evaluate the role of CACs, in addition to in-hospital patient care, in improving the bystander resuscitation rate in Germany and what obstacles exist in the implementation of resuscitation training. Online survey by the working group cardiopulmonary resuscitation (AG42) of the German Society of Cardiology (DGK) and the German Resuscitation Council (GRC) RESULTS: Of the 74 participating clinics (78.4% certified as CAC), 23 (31.1%) conduct lay resuscitation training. These mainly take place within the framework of action days for resuscitation (82.6%) or in schools (39.1%). Permanent cooperation with at least one school existed in 52.2%. Basic life support (BLS) resuscitation dummies are available in 63.5% of these clinics and an automated external defibrillator (AED) demonstration device in 43.2%. According to the interviewees, the biggest obstacles to the consistent implementation of resuscitation courses in schools include lack of qualified instructors, lack of refinancing and difficulties with regard to coordinating activities between schools and providers. Direct training of lay rescuers by hospitals faces several obstacles. To increase the bystander resuscitation rate, focusing on targeted training of teachers as multipliers (train-the-trainer) can be agood approach for cardiac arrest centers.

TransFAIR study: a European multicentre experimental comparison of EHR2EDC technology to the usual manual method for eCRF data collection

PurposeRegulatory authorities including the Food and Drug Administration and the European Medicines Agency are encouraging to conduct clinical trials using routinely collected data. The aim of the TransFAIR experimental comparison...

Inclusive child welfare services, disabled children, and their families: insights from a European comparison of social policy and social (work) practice in Austria, Iceland, and Ireland

ABSTRACT All children and their families have a right to CW services that ensure their equal opportunities. However, due to structural, social, and cultural barriers, CW services are not equally accessible for all families. This is particularly true for disabled children and their families. The aim of this paper is to highlight the potentials of a European comparison of inclusive CW services to disabled children and their families. For this purpose, CW is approached from a human rights perspective, theories on childhood dis/ability and intersectionality theory. Perspectives from Austria, Iceland and Ireland are introduced, analysed through an intersectional human rights lens, and then compared. An argument is made for a European analysis of social policy (and subsequently social work practice) regarding inclusive CW services. Three insights that can be gained from such research are discussed: (1) the inclusivity of CW services for disabled children and their families, (2) the relevance of intersecting social positions of disabled children and their families for the provision and receipt of CW services, and (3) the role of CW policy and practice in constructing abledness in terms of normatised childhoods as the basis for service provision.

Fecal Microbiota Transfer (FMT) in Germany - Status and Perspective

Fecal microbiota transfer (FMT) is a treatment to modulate the gastrointestinal microbiota. Its use in recurrent Clostridioides difficile infection (rCDI) is established throughout Europe and recommended in national and international guidelines. In Germany, the FMT is codeable in the hospital reimbursement system. A comprehensive survey on the frequency of use based on this coding is missing so far. Reports of the Institute for Hospital Remuneration (InEK), the Federal Statistical Office (DESTATIS), and hospital quality reports 2015-2021 were examined for FMT coding and evaluated in a structured expert consultation. Between 2015 and 2021, 1,645 FMT procedures were coded by 175 hospitals. From 2016 to 2018, this was a median of 293 (274-313) FMT annually, followed by a steady decline in subsequent years to 119 FMT in 2021. Patients with FMT were 57.7% female, median age 74 years, and FMT was applied colonoscopically in 72.2%. CDI was the primary diagnosis in 86.8% of cases, followed by ulcerative colitis in 7.6%. In Germany, FMT is used less frequently than in the European comparison. One application hurdle is the regulatory classification of FMT as a non-approved drug, which leads to significantly higher costs in manufacturing and administration and makes reimbursement difficult. The European Commission recently proposed a regulation to classify FMT as a transplant. This could prospectively change the regulatory situation of FMT in Germany and thus contribute to a nationwide offer of a therapeutic procedure recommended in guidelines.

Employers’ Retirement Age Norms in European Comparison

Abstract Policies incentivizing longer working lives can remain ineffective if employers are not able and willing to employ an aging workforce. Depending on what employers consider appropriate age norms for work and retirement, they may be more willing to recruit and retain older workers. This study investigates how these retirement age norms differ across Europe and how they are related to country- and gender-specific pension policies and employment practices. The study uses data from the European Social Survey round 9 (collected in 2018) for 27 countries. Employers are identified as self-employed with personnel and managers who supervise others. The data include questions about the ages of when someone is too young to retire and when someone is too old to work. These items are combined and used in a set of multilevel interval regression models to analyze: (a) How employers’ retirement age norms differ from those of employees and (b) How employers’ retirement age norms vary across countries. The results indicate that, overall, employers have higher retirement age norms than employees, but that the difference narrows substantially once controlled for other factors. Employers’ retirement age norms are positively related to countries’ gender-specific statutory retirement ages and older-worker employment rates. In the case of statutory retirement ages, this association is stronger among employers than among various socioeconomic groups of employees.

Merging and diverging operations: benchmark of three European microscopic simulation tools and comparison with analytical formulations

PurposeWe benchmark three European microscopic simulation software’s ability to reproduce congested patterns at merges and diverges by comparing their macroscopic outputs to validated analytical formulations. The capacity drop and, in the specific case of merges, the priority ratio are assessed. At the microscopic scale, the spatial distribution of lane changes at merges is examined.MethodA single reference state is built for all three simulation tools. A point-based diverge and an extended merge are reproduced in the simulation tools. Under traffic conditions ranging from free-flow to congestion, vehicles counts and vehicles trajectories are collected to compute the selected indicators, which help to conclude for the considered reference state.ResultsThe considered simulation tools correctly reproduce the merges and diverges elementary behaviors. However, their default configuration does not, entirely or partially, reproduce the traffic conditions induced by insertions and desertions as predicted by the analytical models.DiscussionThe study could be enriched by including the benchmark of other simulation tools. In addition, the networks studied are elementary and may not reflect completely the traffic situations encountered on the highways.

Mapping redistribution in terms of family: A European comparison

Redistribution is one of the fundamental characteristics of developed societies. While societal redistribution between working and non-working citizens has been studied intensively, redistribution in terms of family has been analysed mainly as private redistribution. In this contribution, we study societal redistribution in terms of family by systematically analysing its regulation and simulating its results. We map family-related redistribution in Europe by analysing to whom financial resources are granted (benefits) and from whom resources are demanded (obligations) to identify the degree and logic of family-related redistribution. We compare 68 family forms in 27 European countries based on the micro-simulation model EUROMOD. The findings show that there are clear country-clusters of redistribution in terms of family. They differ, though, as to benefits and obligations. The degree of redistribution reveals that in most countries, societal redistribution is highest towards low-income, single-parent families and lowest towards low-income family forms without children.

DARWIN EU® is an electronic platform for the collection and analysis of health data in the European Union

The growing volume and complexity of data that is currently being collected in a variety of settings and devices is of varying degrees and quality, posing a challenge for the public health sector to develop a robust electronic system that can be collected, analyzed and made available to clinicians. The creation of a system, the development of the capabilities and potential of information technologies for obtaining, managing and analyzing a large amount of data, will allow to identify facts regarding the safety and effectiveness of the use of drugs, to investigate the validity of statements made by pharmaceutical companies, to obtain a more accurate characterization of treatment methods in individual healthcare sectors and to provide doctors with quick and constant access to this information, which will facilitate its use in the treatment of patients. The development of such a tool is a priority for the health care system in a changing world. An example of such a tool is the Data Analysis and Real Word Interrogation Network (DARWIN EU®), which was launched on February 9, 2022 by the European Medicines Agency. The purpose of this article is to review the history of creation, organizational structure, operating principles, current experience of the European Union regulatory network and comparison with the experience of international regulatory bodies. The article, along with the experience of the European Medicines Agency, also considers similar initiatives in the US and Canada.