European Perspective Research Articles

Between Empires: Al-Amīra Nazlı Fazıl Hanım, a Middlewoman in the “Question d’Orient” around 1900

Abstract Late nineteenth-century Tunisian history has primarily been studied from a European perspective, in the colonial context of the French Protectorate. Yet, the North-African beylik was still inscribed within the realm of the Ottoman Empire long after 1881. The strength of the Mediterranean network was epitomized by Ḫayr al-Dīn’s political figure and by his going back and forth between Tunis and Istanbul. Later on, the princess Nazlı Fazıl Hanım (d. 1913) created another layer of relationships, extending the zone of contacts to Paris and Cairo, putting Tunisia at the heart of Mediterranean intellectual exchanges. In her tow, the famous Egyptian scholar Muḥammad ʿ⁠Abduh had a notable influence over Tunisian ʿulamāʾ, and Bachir Sfar (al-Bašīr Ṣfar), forerunner of the Young Tunisians, paralleling the Young Turks, created his own path through a complex geo-political space. This article documents these personal links and the circulation of ideas within this cultural space: Maghreb in Mediterranean context, at the meeting point of provincial and imperial logics, and at the crossroads of traditionalist and reformist agendas.

Exploring the Road of Women to Medical Leadership: A European Perspective

This paper addresses and discusses several issues and perspectives for women in medical leadership from the European perspective.

Emerging Plant Intoxications in Domestic Animals: A European Perspective.

Exposure to phytotoxins that are present in imported ornamental or native plants is an important cause of animal disease. Factors such as animal behaviors (especially indoor pets), climate change, and an increase in the global market for household and ornamental plants led to the appearance of new, previously unreported plant poisonings in Europe. This has resulted in an increase in the incidence of rarely reported intoxications. This review presents some of the emerging and well-established plant species that are responsible for poisoning episodes in companion animals and livestock in Europe. The main plant species are described, and the mechanism of action of the primary active agents and their clinical effects are presented. Data reflecting the real incidence of emerging poisoning cases from plant toxins are scarce to nonexistent in most European countries due to a lack of a centralized reporting/poison control system. The diversity of plant species and phytotoxins, as well as the emerging nature of certain plant poisonings, warrant a continuous update of knowledge by veterinarians and animal owners. The taxonomy and active agents present in these plants should be communicated to ensure awareness of the risks these toxins pose for domestic animals.

Systemic Anti-Blackness and Racism in Healthcare: A European Perspective.

Despite notions of colour-blindness and denials of widespread systemic racism, anti-Black racism remains inherent in the political, economic, educational and healthcare systems in Europe. We use the Netherlands as a case study to explore some of these mechanisms. Here, we discuss how a focus on cultural deficiency and the denial of racism allows the bearers of inequality and inequity to be blamed for their own disenfranchisement. Nonetheless, scholars in the Netherlands continue to show how everyday racism is negatively impacting marginalized people's lives and their access to the social determinants of health and well-being in society.

CURRENT STATE, DYNAMICS, LEVEL OF PAY FOR LABOR AND ITS PRODUCTIVITY IN THE AGRICULTURAL SECTOR

The article examines the current state of material motivation of agrarian labor in agricultural enterprises of the natural and economic zone of the Western Polissia of Ukraine, and evaluates the dynamics and level of labor remuneration and its productivity. The main directions of labor productivity growth based on the formation and implementation of an effective motivational mechanism in each agrarian formation of the region are outlined. Among the main factors that affect the motivation of work in the agricultural sector: the importance of the availability of human capital; collective nature of work; risky nature of agricultural production; dynamism and complexity of agricultural processes; responsibility for the quality and timeliness of agro-technological operations, etc. The development of the agrarian sector of the Ukrainian economy in the conditions of the European integration perspective requires adequate changes in the system of distribution of the created aggregate product, control, registration, taxation of a significant part of the population’s monetary income and a comprehensively justified policy in the sphere of wages and taxation. Therefore, one of the factors of the strategic development of the agrarian economy is the orientation of production on the European integration path of development based on competitive relations, the activation of targeted efforts of agricultural workers, the development of their creative initiative and entrepreneurship, the search for and involvement of internal reserves in production.

Developing a Conceptual Framework for Socioeconomic Impact Research in European Cancer Patients: A 'Best-Fit' Framework Synthesis.

Multiple studies have indicated a socioeconomic impact of cancer and cancer care on patients and their families. Existing instruments designed to measure this impact lack consensus in their conceptualization of the issue. Further, various terminologies have been used in the literature (e.g., financial burden, financial hardship, financial stress) without clear definitions and consistent conceptual background. Based on a targeted review of existing models addressing the socioeconomic impact of cancer, our goal was to develop a comprehensive framework from a European perspective. A 'best-fit' framework synthesis was applied. First, we systematically identified existing models to generate a priori concepts. Second, we systematically identified relevant European qualitative studies and coded their results against these a priori concepts. Inclusion and exclusion criteria were predefined and applied thoroughly in these processes. Thematic analysis and team discussions were applied to finalize the (sub)themes in our proposed conceptual framework. Third, we examined model structures and quotes from qualitative studies to explore relationships among (sub)themes. This process was repeated until no further change in (sub)themes and their relationships emerged. Eighteen studies containing conceptual models and seven qualitative studies were identified. Eight concepts and 20 sub-concepts were derived from the included models. After coding the included qualitative studies against the a priori concepts and following discussions among team members, seven themes and 15 sub-themes were included in our proposed conceptual framework. Based on the identified relationships, we categorized themes into four groups: causes, intermediate consequences, outcomes and risk factors. We propose a Socioeconomic Impact Framework based on a targeted review and synthesis of existing models in the field and adapted to the European perspective. Our work contributes as an input to a European consensus project on socioeconomic impact research by an Organization European Cancer Institute (OECI) Task Force.

Aging of the society: the European perspective

Population aging is a key risk for the future of Europe. Th e Old Continent has to face ever-stronger new demographic trends and fi nd eff ective strategies to address them. In this study, we evaluate the progress of population aging in Europe in the period of 2008–2021. Th e broad time span of our considerations concerns the years 1960–2100. We present our new typological approach to the areas of unbalanced age structure. Its classifi cation includes four groups of countries with various distribution of aging measures, i.e., the percentage of people aged 65 and over and the dynamics of its growth. We observe that the largest group is composed of countries exceeding arithmetic means for both above-mentioned aging measures, which are located mainly in Eastern and Southern Europe. According to stages of aging by median age, most of these countries reached the stage of very old population in the 1990s

Promoting responsible AI: A European perspective on the governance of artificial intelligence in media and journalism

Abstract Artificial intelligence and automation have become pervasive in news media, influencing journalism from news gathering to news distribution. As algorithms are increasingly determining editorial decisions, specific concerns have been raised with regard to the responsible and accountable use of AI-driven tools by news media, encompassing new regulatory and ethical questions. This contribution aims to analyze whether and to what extent the use of AI technology in news media and journalism is currently regulated and debated within the European Union and the Council of Europe. Through a document analysis of official policy documents, combined with a data mining approach and an inductive thematic analysis, the study looks at how news media are dealt with, in particular regarding their responsibilities towards their users and society. The findings show that regulatory frameworks about AI rarely include media, but if they do, they associate them with issues such as disinformation, data, and AI literacy, as well as diversity, plurality, and social responsibility.

Where multilingualism and transnational education meet

This final paper contextualizes the presented empirical, theoretical, and methodological reflections in a broader European and international perspective. It formulates implications for further research on language and education as well as language policies in transnational contexts.

When a Series’ Main Protagonist Gets Stolen and Sold – A Study of NFTs and Their Approaches to Copyright Licensing

Abstract Over the past two years non-fungible tokens (NFTs) have become a highly popular, though extremely volatile trade asset. As mere data sets on the blockchain, NFTs are challenging the law to define the legal positions they entail. This article examines NFTs from the angle of copyright licensing, looking at it from a European perspective with the main focus on German law. Based on the technical specifics of NFTs, the paper evaluates the relevant legal position required for a permitted use of tokenized copyrighted content and how such a position may be obtained in the context of NFT trading. A review of the copyright schemes of 21 of the most sought-after NFT collections sets out the current state of licensing and identifies the prevailing legal uncertainties. The fact that these are not merely theoretical is then shown by the turbulent case of a ‘stolen’ ape avatar, tokenized by an NFT, that was set to star in a live-action animated series.

Review article: A European perspective on wind and storm damage – from the meteorological background to index-based approaches to assess impacts

Abstract. Wind and windstorms cause severe damage to natural and human-made environments. Thus, wind-related risk assessment is vital for the preparation and mitigation of calamities. However, the cascade of events leading to damage depends on many factors that are environment-specific and the available methods to address wind-related damage often require sophisticated analysis and specialization. Fortunately, simple indices and thresholds are as effective as complex mechanistic models for many applications. Nonetheless, the multitude of indices and thresholds available requires a careful selection process according to the target sector. Here, we first provide a basic background on wind and storm formation and characteristics, followed by a comprehensive collection of both indices and thresholds that can be used to predict the occurrence and magnitude of wind and storm damage. We focused on five key sectors: forests, urban areas, transport, agriculture and wind-based energy production. For each sector we described indices and thresholds relating to physical properties such as topography and land cover but also to economic aspects (e.g. disruptions in transportation or energy production). In the face of increased climatic variability, the promotion of more effective analysis of wind and storm damage could reduce the impact on society and the environment.

#4026 ECONOMIC EVALUATION OF ANAEMIA OF CHRONIC KIDNEY DISEASE (CKD): A SYSTEMATIC LITERATURE REVIEW AND MODEL CONCEPTUALISATION

Abstract Background and Aims Anaemia is a common complication of chronic kidney disease (CKD), affecting up to 53.4% of patients with Stage 5 CKD compared to 8.4% of patients with Stage 1 CKD [1]. Anaemia of CKD is associated with increased risk of cardiovascular events and death, increased healthcare resource utilisation (HRU), and reduced health-related quality of life (HRQoL) [2]. Established treatments for anaemia of CKD include erythropoiesis-stimulating agents (ESAs) [1,2]; however, hypoxia-inducible factor prolyl hydroxylase inhibitors (HIF-PHIs), targeting both erythropoietin production and iron metabolism (the two key mechanisms of anaemia of CKD), are an emerging class of agents in this indication [3]. The cost and HRQoL burden associated with anaemia of CKD treatment is not well characterised.1 Thus, we conducted a systematic literature review (SLR) to evaluate published economic models (including the cost inputs, time horizon, subgroups, and clinical assumptions used) and HRU data in patients with anaemia of CKD. Findings of the SLR will help guide future economic model development and inform economic evaluation strategies as part of health technology assessment submissions to support daprodustat, an HIF-PHI under development for use in both dialysis-dependent and non-dialysis-dependent patients. Method Relevant publications were identified using structured searching of MEDLINE, Embase, MEDLINE In-Process, Cochrane Controlled Trials Register, and the Cochrane Database of Systematic Reviews from database inception to 10 April 2022 using disease- (e.g. CKD, chronic kidney failure, anaemia) and economic-associated (e.g. economics, economic evaluation, quality-adjusted life-years, model structure) search terms. Additional supplemental searches (conference proceedings [2016–2021], grey literature, and bibliographies) were conducted. Studies were assessed for inclusion or exclusion by two independent reviewers, with any discrepancies resolved by a third reviewer. Objectives were to determine the structure of any published economic models and the availability of health utility data in patients with anaemia and additional complications of CKD, and to examine what cost inputs, time horizons, subgroups, and clinical assumptions are used to inform economic modelling. Results From 1397 citations identified in the searches, 40 primary studies were included in the final analysis. Review of the data revealed an established approach for modelling the ESA cost-effectiveness (i.e. a Markov model with health states defined according to CKD treatment received or anaemia status): most studies were conducted from a North American or European perspective, time horizons varied, and reporting of cycle length was poor. Only one economic evaluation included an HIF-PHI model: given the different mechanisms of action of ESAs and newer treatments, a modelling strategy focused mainly on a Markov approach may not be the most optimal way of assessing cost-effectiveness in anaemia of CKD where HIF-PHIs are used. Considerations of modelling factors that could influence cost-effectiveness of HIF-PHIs are shown in Fig. 1. While existing models typically only stratified patient populations according to age (<65 vs >65 years), for appropriate modelling of treatment effectiveness, the impact of prior treatments (including response to prior ESAs) was also considered. As in every model, comorbidities may also have a role in effect modification and this impact will need to be considered in economic models of anaemia of CKD treatment. Due to the natural history of anaemia in CKD, innovative modelling techniques that retain the Markov approach and which account for respective haemoglobin levels, CKD stage, and potential kidney transplantation should be incorporated into the economic evaluation (Fig. 2). Conclusion Adjustment of existing models using the approaches described may provide more reliable estimates of treatment efficacy in a highly heterogenous population of patients with anaemia of CKD.

Pola-R-CHP for frontline therapy in DLBCL: Are we saving money by spending more?

The study by Kambhampati et al. offers the first European perspective on cost-effectiveness of pola-R-CHP in the frontline line treatment of DLBCL patients. Nevertheless, the applicability of these results in other European settings remain questionable: Germany is indeed a wealthy country with wide access to cellular therapies in earlier lines, while this might not be the case for other European countries. The presented data must be re-assessed when long term data on PFS and OS from the POLARIX trial are available, ideally considering also real-life data. Similar CEAs in other European health care systems as well as in specific subgroups of patients are welcome to offer a broader perspective on the potential role of pola-R-CHP in Europe. Commentary on: Kambhampati et al. Cost effectiveness of polatuzumab vedotin in combination with chemoimmunotherapy (pola-R-CHP) in previously untreated diffuse large B-cell lymphoma in Germany. Br J Haematol 2023;202:771-775.

How Blockchain Technology Can Address Circularity and Trace Emission in the Energy Sector

This paper outlines the European perspective on circularity in the energy sector and details how blockchain could support it. Moreover, while the need for raw materials and e-fuels is increasing (due to the economic, industrial, and societal ecological transformation to slow down the pace of climate change), their supply becomes more and more risky. Therefore technologies to support tracing and certification are on the spot. To achieve resilience to new threats, Europe is pointing at circularity in all fields. Circularity requires the need for tracing substances and devices, food, and products, to retrieve and recycle as much as possible. Else than the need to limit the exploitation of the planet’s resources and thus stay within the planetary boundaries, circularity is tightly connected to strategic dependencies from highly unstable or politically distant countries. This issue is further aggravated by the Russia-Ukraine crisis. Digital technologies, like Distributed Ledger Technologies, can well support the implementation of circularity in many fields. The paper identifies challenges and proposes potential solutions related to the implementation of circularity. It also explores the application of circularity principles in the energy sector, with a focus on energy communities. Energy communities involve local stakeholders coming together to generate, consume, and manage renewable energy collectively. Overall, the paper provides insights into the European perspective on ecological transition, highlighting the importance of systemic transformation, resilience, and circularity in addressing climate change and achieving sustainability goals. It explores the role of digital technologies, such as Distributed Ledger Technologies (DLTs), in supporting circular practices and discusses specific applications in the energy sector.

The Glasgow declaration on sustainability in Anaesthesiology and Intensive Care.

The Glasgow declaration on sustainability in Anaesthesiology and Intensive Care.

Professional development of adult educators: A European perspective

This article provides an overview of major dimensions of the professional development of adult educators identified in European policy documents, relevant reports and research. The author reviews the relevant policy visions of the past two decades, aiming to determine the extent to which professional development of adult educators is visible in European policy documents, how it is conceptualised and under which terms it is discussed. The author argues that adult educators play an essential role in adult education and society in general, are an important factor for securing quality in the sector, and are considered to be a critical pillar of adult education. To perform this role well, they require specialised, targeted and systematic professional development programmes in a changing environment which affects both their learners’ and their own position as educators. However, the analysis of the policy documents shows that despite a consensus about the importance of quality adult education, over the past two decades little attention has been given to the initial training and continuous professional development of adult educators in practical terms. Due to a lack of opportunities, their professional development seems weak and still faces many challenges.

A European Perspective on the Protection Technology Used on MV Distribution Networks including DER

This document provides information on typical European practices for protection of MV distribution networks, including reference to distributed energy sources It primarily focuses on MV network protection but includes HV.MV substation aspects. It addresses then implications of various MV neutral treatment options on earth fault protection. Further it deals with the impact of embedded energy resources upon protection and presents modern techniques, known as Advanced Networks Protection Solutions, to handle these challenges.

Adoption of the Urban Air Mobility System: Analysis of technical, legal and social aspects from a European perspective

As the demand for mobility and traffic in European urban areas continues to grow, innovative transportation solutions, particularly Urban Air Mobility (UAM), are gaining increasing prominence. UAM takes advantage of the third dimension to reduce ground traffic by integrating low-noise electric vertical take-off and landing vehicles (eVTOLs). Nonetheless, the successful implementation of UAM necessitates not only technological advancements but also the legal framework and social considerations to guarantee effective and safe operations. Holistic investigations of UAM are scarce, especially in the European context. Therefore, this study discusses the developments and challenges of UAM from technical, legal, and social perspectives and derives a set of UAM-tailored design drivers for the effective deployment of UAM in Europe. A comprehensive literature review is conducted on the state of the art of UAM technologies, regulations, and public attitudes. Various eVTOL configurations are compared, taking into account pertinent system factors such as energy efficiency and suitability for short- or long-duration missions. Besides, the cost-effectiveness of eVTOL configurations for a specific mission is evaluated through a cost-optimization analysis: the total cost is calculated to be around 2 € per payload-kilometer, which is approximately tenfold the current price for road transport. The regulatory activities of the European Union Aviation Safety Agency are discussed for the period 2017-2022, during which several systematic improvements to the regulations have been introduced. Typical factors for assessing the public acceptance of UAM are identified, and a survey is conducted across European medium-sized cities to gain insights into public opinion. The survey results indicate that 59\% of the respondents are moderately positive toward UAM deployment, representing a more cautious attitude compared to findings from studies conducted in metropolitan cities or countries. Furthermore, 56\% of respondents are willing to try out delivery services with aerial vehicles, while, 32\% would use air taxis. This is in contrast with studies conducted in metropolitan areas or at the country level. Based on the proposed holistic investigation of UAM, the set of design drivers can be identified to reduce uncertainty in UAM adoption and ensure a flawless deployment.

Automation in Investment Advice. A European Perspective

El presente artículo investiga cómo se encuadra el asesoramiento de inversión automatizado (también llamado asesoramiento robótico) en el actual marco regulatorio europeo. Desde el punto de vista de un jurista europeo se describe y define el fenómeno, destacando sus beneficios y riesgos potenciales, y delineando los principales modelos de negocio en el mercado. Analiza los retos que implica la aplicación del régimen Mifid II, especialmente en el ámbito de la protección de los inversores.

Integration Standards and Public Administration Dimensions in Light of the Integration Perspective of Albania in the EU

After the fall of the communist regime, one of the challenges and the highest priority for the external politics, is the European integration, that is also the aspiration of all Albanians. The European integration is not merely the implementation of various political, legislation, technical and institutional criteria, but rather a union of democratic, communal and integration values and ideals of the Albanian society into the European community, into the community of freedom and democratic values and norms, where these aspirations take credit. During this transitioning period, the Albania European integration has been constantly replete with political and institutional challenges and political processes that must be developed and progressed by the political parties and the Albanian society in general. Moreover, it is worth mentioning that during this transitioning period, Albania has carried over important problematics related to the development of sustainable political institutions, a functional public administration, a free election process with democratic standards, a sustainable financial system, as well as a sustainable social, cultural and intercommunity processes. Therefore, in this context, the present paper will analyse the Albanian perspective and challenges with the focus on the standards and nature of integration in the European Union. In order to comprehend the changes and development in light of this perspective, this paper will also consider the role and the importance of Public Administration integrating dimensions, aiming at understanding the evolution of Albania and its legislation in the European perspective. The analyses of its integration dynamics are to understand the improvement of Albania's image in the world in terms of these aspects, the change of the policy-making concept, the development of political institutions, as well as the evolution of Albanian legislation to align with that of the EU. Moreover, this analysis shall not simply render this paper actual and coherent with the most essential integration politics, legislation and institutional that relate directly with the Albanian European integration process, but it will rather demonstrate that Albania has yet a very long road ahead to become part of the European Union and the achievement reached so far have been positive and promissory.
 
 Received: 05 May 2022 / Accepted: 14 May 2023 / Published: 20 May 2023