European Social Fund Research Articles

Long-term effect of obstructive sleep apnea and CPAP treatment on blood pressure control in patients after acute coronary syndrome

Abstract Funding Acknowledgements Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Instituto de Salud Carlos III (ISCIII) (PI10/02763, PI10/02745, PI18/00449, PI19/00907), co-funded by FEDER “Una manera de hacer Europa”, SEPAR, Catalonian Cardiology Society, ResMed Ltd. (Australia), EsteveTeijin (Spain), Oxigen Salud (Spain), Associació Lleidatana de Respiratori (ALLER), CIBERES. MS received financial support from a "Ramón y Cajal" grant (RYC2019-027831-I) from the“Ministerio de Ciencia e Innovación - Agencia Estatal de Investigación” co-funded by the European Social Fund (ESF)/“Investing in your future”. AZ held the predoctoral fellowship “Ajuts 2021 de Promoció de la Recerca en Salut-9ª edició” from IRBLleida/Diputació de Lleida. JdB acknowledges receiving financial support from ISCIII (Miguel Servet 2019: CP19/00108), co-funded by the European Social Fund (ESF), “Investing in your future”. Rationale Obstructive sleep apnea (OSA) is prevalent in acute coronary syndrome (ACS) patients and is a cause of secondary hypertension. Objectives To evaluate the long-term effects of OSA and CPAP treatment on blood pressure (BP) control in patients discharged after an ACS. Methods Post hoc analysis of the ISAACC study included 1803 patients admitted for ACS (NCT01335087). Patients with OSA (apnea-hypopnea index ≥15 events/h) were randomly assigned to receive either CPAP or/and usual care and followed up for one to 5 years. Office BP was determined at each visit. Measurements and Main Results We included 596 patients without OSA, 605 patients in the CPAP group, and 602 patients in the usual care group. 52% of the patients had a diagnosis of hypertension at baseline. Median age and body mass index were 59 [52.0;67.0] years and 28.2 [25.6;31.2] kg/m2, respectively. After a median [25th;75th percentile] follow-up of 41.2 [18.3;59.6] months, BP changes were similar between OSA and non-OSA groups. However, we observed an increase in BP in the third tertile of the AHI (AHI>40 events/h) with a maximum difference in mean BP of +3.3 mmHg at 30 months. OSA patients with good CPAP adherence (≥4 hours/night) reduced mean BP after 18 months compared to non-OSA and poor CPAP adherence patients, maximum mean difference (95% CI) of -4.7 (-6.7,-2.7) mmHg. In patients with severe OSA we observed a maximum mean difference of -7.1 (-10.3,-3.8) mmHg. Conclusions In patients discharged after an ACS, severe OSA is associated with a long-term increase in BP, which is reduced by good CPAP adherence.

Prognostic factors in real-world elective supported high risk percutaneous coronary intervention with pLVAD or ECMO

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – EU funding. Main funding source(s): University Hospital of Salamanca - contract (CM19/00055) supported by the Instituto de Salud Carlos III in Spain (Co-funded by European Social Fund "Investing in your future"). Background/Introduction Percutaneous coronary intervention (PCI) is the last remaining revascularization option in high risk (HR) patients affected by complex coronary artery disease not suitable for surgery. Elective mechanical circulatory support (MCS) could be necessary to keep hemodynamics during these procedures. In this context, selection of the patients balancing the risk-benefit is a challenge. Purpose Analyse the factors related to mortality in patients who underwent elective HR-PCI with MCS: veno-arterial extracorporeal membrane oxygenation (VA-ECMO), Impella CP® or percutaneous heart pump (PHP). Methods The study is a retrospective single centre registry, including all elective MCS implants for HR-PCI in a referral hospital. All of them were previously discussed in clinical session, deciding this modality of intervention by the Heart Team. Univariate analysis of variables related to discharge survival was performed using SPSS Statistics. Results Twenty-seven patients underwent supported elective HR-PCI from 2013 to Sep-2021 (Figure 1). They were patients with low LVEF, high percentage of admission for ACS or HF, high coronary anatomy complexity (mean syntax score 31.4±9.5), and high surgical risk (mean STS morbidity-mortality score 24.17±16.0). In 88.9% of the patients, the circulatory support device was removed after completing the procedure, remaining in the rest due to persistent instability. The main access site was femoral, using axillary arterial access when the iliofemoral arteries were not suitable. Endotracheal intubation was needed in 29.6% of patients. Deaths during the admission (14.8%) were not directly related with the procedure but with posterior complications (alveolar haemorrhage, multiorgan failure, refractory heart failure and sepsis). Variables related to mortality were concomitant more than mild valvular heart disease; higher creatinine serum levels and lower pH before the procedure; axillary access and need for endotracheal intubation during or after the intervention; periprocedural mayor and minor bleeding and postprocedural critical care infections (Figure 1). We did not find other differences in terms of baseline characteristics, complexity of revascularization, type of support or development of complications. In the follow-up (median 4.8 [29.7] months) 70.4% of patients remain alive after the intervention (Figure 2). Conclusion Temporary MCS used prophylactically in elective high-risk PCI appeared feasible and safe in the real-world setting and could be an alternative for patients dismissed for surgery because of high-risk. Moreover, we found some prognostic variables related to discharge survival to help clinicians with the selection of the most appropriate patients. Randomized studies are required to determine a better selection of cases according to risk-benefit

Analysis of adverse events in the elderly after acute myocardial infarction with reduced left ventricular ejection fraction

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – EU funding. Main funding source(s): Contract (CM19/00055) supported by the Instituto de Salud Carlos III in Spain (Co-funded by European Social Fund "Investing in your future"). Background Elderly patients present higher risk for developing complications after an acute myocardial infarction (AMI) and reduced left ventricular ejection fraction (rLVEF) constitutes an adverse prognostic factor. Purpose The main objective was to characterize elderly population with AMI and rLVEF and analyze prognostic factors. Methods Retrospective analysis of hospitalized elderly patients (> 75 years old) with AMI and rLVEF <40% between January 2018 and December 2019. We analyze the occurrence of adverse outcomes in the follow-up: combined event (death from any cause and/or hospitalization from heart failure (HF) and/or AMI and/or ventricular arrhythmias) and its relationship with different variables (Figure 1). Results Out of 179 patients, 100 >75 years old patients (55.9%) were included (Figure 1). After a mean follow-up of 3.8 [18.4] months, the combined event happened in 52% of them (figure 1, figure 2). Older age was associated with the combined event (86.8+8 years occurrence of event vs. 82.6+5.1 event-free, p=0.003). Variables significantly related with the occurrence of the combined event were chronic kidney disease (CKD) (72.7% occurrence of event vs. 46.2% event-free, p=0.032), higher values of creatinine (1.6+1 vs. 1.1+0.3, p=0.002), the presentation with acute pulmonary oedema (APO) (91.7% vs. 39.5%, p<0.001) and cardiogenic shock (93.2% vs. 41%, p<0.001), the need for noradrenaline (92.9% vs. 45.3%, p=0.001) and dobutamine (100% vs. 46.7%, p=0.001), the revascularization (completely percutaneous 43.5% of combined event, partial percutaneous 41.4%, partial surgical 100%, absence of revascularization 78.6%, p=0.034) and the presence of associated severe valvular disease (84.6% vs. 42%, p<0.001). We observed a trend although not statistically significant, to present higher values of NT-proBNP at the admission (16850 vs. 9044, p=0.71) and the initial presentation of non-ST elevation-acute coronary syndrome (NSTE-ACS) (28.6% of event in ST segment elevation myocardial infarction (STEMI) vs. 58.6% in NSTE-ACS, p=0.088) in patients who suffered the combined event in the follow-up. Conclusions More than half the patients with 75 years old or higher presented adverse outcomes in the short term after a hospitalization for AMI with rLVEF. The most advanced age, the presentation as APO or cardiogenic shock, CKD, absence of revascularization, need for drugs and the presence of concomitant severe valvular disease were related with the appearance of the combined event (death, HF, AMI, ventricular arrhythmias).

Incidence and prevalence of lymphatic neoplasms in Poland 2009–2015 determined on analysis of National Health Fund data used in the ‘Maps of healthcare needs — database of systemic and implementation analyses’ project

Introduction: The need for epidemiological data on blood neoplasms is driven by both systemic and scientific requirements. Due to the fact that all services provided to patients with these cancers in Poland are reported to the National Health Fund (NHF), the aim of this study was to try to use this data to estimate the incidence and prevalence of lymphatic neoplasms in Poland, as well as to determine overall survival (OS) in this group of patients. Materials and methods: The analysis was carried out as part of the ‘Maps of health needs — database of system and implementation analyses’ project, co-financed by the European Union through the European Social Fund under the Operational Program Knowledge Education Development. Results : The registered incidence of follicular lymphoma (FL) in 2014 was 1.74/100,000, whilst the registered prevalence was 15.56/100,000. The median OS of patients registered in the NHF system in 2009–2015 with an FL diagnosis was over 60 months, and the estimated 3- and 5-year OS rates were 76.6% and 68.8% respectively. In 2014, the incidence and prevalence of diffuse large B-cell lymphomas (DLBCL) was 3.76/100,000 and 27.48/100,000, respectively. The median OS was over 60 months, and the estimated 3- and 5-year OS rates were 68.7% and 61.1%, respectively. On the other hand, the incidence and prevalence of chronic lymphocytic leukemia (CLL) were 8.65/100,000/year and 38.28/100,000/year, respectively. The median OS was over 60 months, and the estimated 3- and 5-year OS rates were 77.8% and 64.8%, respectively. In the case of plasma cell myeloma (PCM), the registered incidence and prevalence were 4.92/100,000/year and 23.28/100,000/year, respectively. The median OS was 60 months, and the 3- and 5-year OS rates were 62.8% and 49.7%, respectively. Conclusions: The data reported to the National Health Fund in order to obtain reimbursement of medical services seems to be the most reliable data covering such a large population of patients. The results are similar to data from European and American registries for DLBCL and PCM. However, the FL and CLL data requires further verification.

Long-term mortality following SARS-CoV-2 infection: A national cohort study from Estonia.

SummaryBackgroundThe objective of this study was to describe 12-month mortality following SARS-CoV-2 infection compared with a reference population with no history of SARS-CoV-2.MethodsNationwide cohort study using electronic health care data on SARS-CoV-2 RNA positive cases (n= 66,287) and reference group subjects (n=254,969) with linkage to SARS-CoV-2 testing and death records.FindingsPeople infected with SARS-COV-2 had more than three times the risk of dying over the following year compared with those who remained uninfected (aHR 3·1, 95%CI 2·9-3·3). Short-term mortality (up to 5 weeks post-infection) was significantly higher among COVID-19 group (1623·0/10 000) than in the reference group (118/10 000). For COVID-19 cases aged 60 years or older, increased mortality persisted until the end of the first year after infection, and was related to increased risk for cardiovascular (aHR 2·1, 95%CI 1·8-2·3), cancer (aHR 1·5, 95%CI 1·2-1·9), respiratory system diseases (aHR 1·9, 95%CI 1·2-3·0), and other causes of death (aHR 1·8, 95%CI 1·4-2·2).InterpretationIncreased risk of death from SARS-CoV-2 is not limited to the acute illness: SARS-CoV-2 infection carries a substantially increased mortality in the following 12 months. This excess death mainly occurs in older people and is driven by broad array of causes of death.FundingResearch was carried out with the support of Estonian Research Council (grants PRG1197, PRG198), European Regional Development Fund (RITA 1/02-120) and European Social Fund via IT Academy program.

EHealth challenges in rehabilitation processes - rehabilitation professionals’ experiences in the North Savo region

Aging people are forced to steadily extend their working-lives since the old-age dependency ratio will rise considerably in the near future. Meanwhile, social and healthcare resources will become increasingly scarce, although the need for healthcare and rehabilitation services is bound to increase. The aim of this study was to examine rehabilitation professionals’ experiences related to eHealth and technology in the rehabilitation process in the North Savo region. The research was carried out as a part of the European Social Fund (ESF) funded project ”Expertise and Business Network for Rehabilitation Services in Northern Savo”. 30 rehabilitation workers were interviewed (67% women) in 2020. The participants were aged 24-60 years and their job titles were e.g. doctors, physiotherapists, practical nurses and community sector representatives. The interviews were carried out using a semi-structured format. The interviews were recorded, transcribed, and analysed using the inductive content analysis method. The technology and digitalisation experiences of the rehabilitation workers in North Savo region can be divided into five categories. Technical problems causing challenges in rehabilitation included inadequate information and patient data management, and poor or lacking data-applications, ICT-tools and systems. The cost of technology was perceived as a factor influencing rehabilitation from both an individual and organisational perspective. The emergence of COVID-19 has had a positive impact on the use of technology and digital services. Suitable technology and digital services for rehabilitation need to be developed towards a more individual, client-centric direction. To promote the adoption of technology in the field of rehabilitation and to support positive change in attitudes towards technology, more education is needed. The ever-evolving field of rehabilitation demands effective eHealth applications and processes alongside highly competent rehabilitation professionals to meet the needs of the aging population base in North Savo region. There is a need for more client-centric eHealth and rehabilitation processes, wherein the rehabilitation workers’ needs are met – physically and psychosocially. By bringing together rehabilitation and ICT expertise in North Savo region, it is possible to provide training and education to raise the level of both the rehabilitation processes and level of expertise of rehabilitation workers in the region.

IDF21-0007 Is adherence to an exercise program an important key to reduce foot ulcer risk?

Background: Diabetic foot is one of the most prevalent complications of diabetes. It has the potential risk of pathologic consequences including infection, ulceration and amputation, and is associated with disability, death and substantial costs. Diabetic foot result from neuropathy and/or ischemia and the premature identification of risk factors may avoid ulcerations and amputations. Several benefits in this area can be induced by different exercise programs, although effects of physical activity have a dose–response pattern. Aim: This study aimed to investigate the association between foot ulceration risk and adherence to a multi-component exercise program in middle-aged and older patients with type 2 diabetes (T2D). Method: The study involved 79 individuals with T2D recruited from primary health care units to participate in Diabetes em Movimento® Vila Real (Portugal). This community-based exercise program is composed by three exercise sessions per week, 75 min per session (aerobic, resistance, agility/balance, and stretching exercise), during nine months. Risk of ulceration was assessed before and after the exercise program, with a protocol that included patients’ relevant clinical history, clinical foot examination (observation of structural and dermatological characteristics, 10-g Semmes-Weinstein monofilament test, 128-Hz tuning fork test, and palpation of peripheral arterial pulses), and the evaluation of the difficulties in taking care of the feet (ability to see both the plantar surfaces). One-way ANOVA was used to analyze the association between exercise program adherence and changes in the risk of ulceration (improved, unchanged, worsened). Results: 75 individuals concluded the study and were included in final analysis (35 men, 40 women 64.43 ± 7.05 years old, body mass index 29.98 ± 4.41 kg/m2, non-smokers). After nine months of exercise (overall exercise intensity of 12.73 ± 0.95 points in Borg rating of perceived exertion scale of 6–20 points), 26 subjects (34.7%) decreased risk of ulceration, 35 (46.7%) maintained the risk, and 14 (18.6%) increased the risk. Those who decreased the risk had higher adherence to exercise program than those who increased the risk (65.60% versus 45.43%, p < 0.05, partial η2 = 0.14). Overall, participants’ adherence to exercise was 58.85 ± 25.18 % (ranging from 3.70 to 98.15%). Discussion: The results of this study suggest that higher compliance to an exercise program seems associated with a decrease in the risk of foot ulceration in middle-aged and older patients with T2D. Besides the need for implementation exercise programs for T2D control and related comorbidities, there is an urgent demand to develop motivation strategies to increase exercise adherence in order to maximize physical activity benefits. Funding: This work was supported by the Foundation for Science and Technology (FCT, Portugal) and European Social Fund (ESF), through a Doctoral grant endorsed to the first author (SFRH/BD/143195/2019) under the Norte 2020 – Norte’s Regional Operation Programme.

FEATURES OF FINANCING THE SOCIAL POLICY OF HUNGARY

The issues of correlation of national and supranational sources of financing of the social sphere in Hungary are investigated. Due to the potential impact of all EU structural funds on the development of the social sphere and the difficulty of strictly scientific measurement of the contribution of each of them to social development, special attention is paid to the projects of the European Social Fund in Hungary. An analysis of the available information on completed and ongoing projects showed a noticeable focus on local issues and very little impact on national priorities. In connection with the accusations of the Hungarian opposition in the misuse of funds from EU funds, the country's authorities examined the relationship between Hungary and the European Anti-Fraud Office (OLAF). It is noted that Hungary has a fairly effective and fully compliant system for monitoring and using EU funds. To date, OLAF has not identified any abuse of funds from the ESF. Preliminary assessments of the possibilities of Hungary for the long-term provision of humanitarian assistance to Ukrainian refugees on the territory of Hungary have been made. It is pointed out that the continued influx of refugees and the growing number of people who want to choose Hungary as a destination country complicates the implementation of the current social policy, especially in the context of the implementation of election promises.

Support for social entrepreneurship in Poland under the European Social Fund – changes and challenges

he European Commission directs its financial instruments to the broadly understood social economy sector, including the development of social entrepreneurship. In 2011, the European Commission presented the Social Business Initiative (SBI), defining the activities of the European Union to support the development of social enterprises (key stakeholders of the social economy). According to the assumptions of the European Commission, social enterprises are specific organisations that combine social objectives with initiatives promoting entrepreneurial attitudes, focusing on achieving wider social goals or exerting social impact. Financial support is also intended to generate changes in a broader time perspective in the coming years of the EP’s activity. Since Poland’s accession to the European community in 2004, the social economy (including social enterprises) has received financial support in many areas of its activity. The beneficiaries of the funds covered not only social economy entities (PES), but also institutions supporting the development of the social economy, mainly social entrepreneurship, such as Social Economy Support Centers (OWES). It is mainly these key entities of the social economy – social enterprises have become places of new jobs and motivators of civic activity. The aim of the article is to quantify the financial support received from the European Social Fund in the years 2004–2016 for activities aimed at the development of social entrepreneurship (SE).

Advising, an Indispensable Element in Training Students. Usefulness of POSDRU Grants

The present work aims at improving the ability of innovation of institutions for education and training through advisory activities for students in order to prepare them for society and for the environment. In this paper are presented efficiency analysis of career counseling activities in the framework of a European project. Demonstration of the appropriateness of professional counselors will be made on the basis of a pilot group of students advising in career as part of a European project, co-financed by the EUROPEAN SOCIAL FUND, Sectoral operational program Human Resources Development 2007-2013, Priority axis no.2 ""Linking learning with lifelong labor market"", Major field of intervention no. 1.3 “Transition from school to life”, Project title: ""Partnership developed for advice and practice of students in order to increase their employability- CONPRACTIS"", Contract no.: POSDRU/189/2.1/G/156607. Counselling and career guidance are important for students in order to gain the relevant skills and competencies for a job and the right attitude towards work, sense of responsibility, gaining practical experience in the workplace, the ability to solve new problems and to understand the context in which action must be taken; the ability to adapt to any working conditions, the provision of ""affective competence"" relevant, appropriate social skills. Many studies and European statistics highlight the relationship of dependency between the welfare economy and education level but, at the same time, draw attention to the danger of ""scatter"" one of the most valuable resources-human resources. Correspondence between the quality of vocational training, on the one hand, and the requirements of the labor market on the other hand, is essential in a knowledge-based economy. Research shows that the unemployment rate among young people may cause permanent sequelae, such as an increase in the risk of being unemployed in the future, low levels of future earnings, loss of human capital, the transmission of poverty from one generation to another or a lesser motivation. One of the reasons identified is the lack of experience to submit to the interview, on condition that the student does not have the experience of another job, but neither-and leverages and presents it in a way convincing powers and abilities held when â when attending the interview.

The role of the EU during the pandemic concerning social issues

Examining the EU’s performance in the pandemic crisis requires a comparison with two milestones in the trajectory of European integration: the 1973 oil crisis and the 2008 financial crisis. The EU has been more effective in this moment than in the one immediately preceding it. This was not difficult. But if one examines the dynamism of post-1973 and measures it against the burden of the current European Council, optimism fades. However, the financial muscle, then as the European Social Fund, now updated, is still in excellent shape.

Pop-up architecture as a tool for popularizing theatre: Prototype No. 1

Abstract This article builds on previous research dealing with temporary theatres in the context of Europe and Slovakia, discusses the topic of pop-up pavilions in terms of architecture, their use in marketing and as a potential tool for reviving the theatre scene. Just as temporary architecture can activate neglected areas in the city and bring stimuli for a permanent change, we believe that it can be equally stimulating in the area of theatre. The Shed by Haworth Tompkins is one of the examples to demonstrate a possible positive contribution of such designs to a permanent theatre and its surroundings. Based on the analysis of similar examples and statistical data on the attendance of theatre performances, we decided to design and implement a prototype of a minimal theatre scene, which also provides wide variability and can be used beyond the time dedicated to theatre activities. In the design phase, we examine the limits of variability and explore the basics of kinetic architecture. In the second phase after the object is assembled and implemented, the subject of research will be its impact on the environment, the extent of user interaction with the object and the overall functionality of the object. The ambitions of our project do not reach as high as presented in The Shed. The aim was to test the possibilities and viability of a much smaller object, to document the cultural, educational, and even economic benefits, in domestic conditions of Slovakia. Thanks to The Program for the Support of Young Researchers of the Slovak University of Technology and The PUN (Universal Design Support) Project No. 321041APA3 financed by the European Social Fund, the object is currently in production, and later will be moved to the faculty premises, surface-threated and then assembled for the very first time. The prototype should be fully available by the end of the year 2022.

From EU Structural Funds to Levelling Up: Empty signifiers, ungrounded statism and English regional policy

This paper argues that EU structural policy administered through the European Regional Development Fund (ERDF) and the European Social Fund (ESF) had a relatively limited impact in addressing competitiveness and productivity weaknesses in the English regions due to the emphasis on supply-side policies and deficiencies within the institutional framework for governing economic development. By analysing projects supported by the ERDF and the ESF in England from 2007 to 2013, we demonstrate that funding was used to shape self-organising networks of private and public sector actors, notably local councils, to encourage the development of entrepreneurship, research and development, the creative industries, transport services, and universities and educational providers. In the absence of an overarching strategic vision, and given long-standing socio-economic and political weaknesses, the effect of EU structural funding on the English regions was nonetheless marginal at best. Our case-study highlights that England’s path-dependent and ungrounded statism combined with a neoliberal supply-side logic Structural Funds to create an empty signifier of regional development that failed to adequately respond to the structural needs of less affluent regions. Meanwhile, the post-Brexit approach to regional development, namely the levelling up agenda, represents a continuation of this empty signifier rather than a significant break with the past.

Developing Environmental Competence

Achieving a higher level of sustainable development is an increasingly important issue. Developing environmental consciousness on individuals and organizations can be successful only on a stable methodological base. This task is feasible with the support of competence management. The paper summarizes a comprehensive model for evaluating environmental consciousness that provides the necessary frames and empiric results of analysing the environmental management tools and the organizational size. This research was carried out as part of the TAMOP-4.2.1.B-10/2/KONV-2010-0001 project with support by the European Union, co-financed by the European Social Fund.

Remote and Technology-Based Dialogic Development during the COVID-19 Pandemic: Positive and Negative Experiences, Challenges, and Learnings

This study aimed to analyze the challenges, learning experiences, and effects of the COVID-19 pandemic in a social, healthcare, and special education development project financed by the European Social Fund. The theoretical framework of the project relied on the theories of dialogic development and leadership. The method was participatory action research using data collected from various assessments and a questionnaire. Reports of neutral, negative, and positive experiences among two participant groups of the project—the implementers and pilot organizations—in remote work, devices and applications, and remote and technology-based development processes, were recorded. Both participant groups reported increased pressure at work, social isolation, professional loneliness, and improved work control and efficiency. The pilots have learned the development method, and development has been able to continue by utilizing technology despite the pandemic. Development through technology was more difficult, and new dialogic interaction tools have been created. The project was most effective with regard to leadership, teams, renewal, and information flow. There is a need for wide-ranging dialogues with various working life actors when outlining the ways in which future work will be carried out and to reflect on how remote work, technology, and digitalization affect well-being at work, social relations, and leadership.

The Puzzle of ‘Unspent’ Funds in Italy’s European Social Fund

This chapter focuses on the spending dynamics around one of the largest social funds globally: the European Social Fund (ESF). More specifically, it explores the institutional conditions and the tensions around its use/lack thereof in Italy, one of the largest recipients of the Fund. While financial execution does not subsume the effective implementation or the effectiveness of the activities that are funded, the chapter suggests that it is a key marker in the policy debate in Italy, and seeks to analyse the terms of this debate by placing it in its institutional and financial context, in particular against the backdrop of reforms enacted at both the European Union (EU) and the domestic level. It argues that late spending is not only a marker of a series of institutional blockages, it also reveals a specific mode of governance that is shaped at the same time by national, regional and supranational institutions, norms, and interests as well as by flows of funds and ideas that converge and materialise in a variety of administrative, political and financial practices.

The Pivotal Role of Mid-level Implementation Bodies in Italy’s Cohesion Policy

This chapter examines the changing dynamics of expenditure management in Italy by connecting them to recent institutional reforms and to their implications for implementation practices. To this end, it maps the actors involved in the programme implementation of the European Social Fund (ESF) and the features related to the reprogramming of the Operational Programme, while analysing their role during the period 2014‒20. Adopting a multilevel perspective, it focuses on the role of mid-level implementation bodies. It highlights the implications of the COVID-19 emergency on implementation and reprogramming activities as well as the and on the interplay between actors. By analysing documents, and by building on empirical observations collected through interviews, the author shows how social practices and modalities of communication are relevant aspects of the policy implementation process, thereby providing a wider picture with regard to fund deployment.

Tools for social policy management: the SiSo Scale for measuring situations of social difficulty

AbstractThe design and evaluation of social policies requires information systems that enable social intervention with the people targeted by the programmes and services and that also offer indicators for the follow-up and monitoring of the policies adopted. The article presents the process of validation of a tool for diagnosing situations of social difficulty arising from social exclusion. The scale has been implemented in one of Spain’s seventeen Autonomous Communities and has been selected on the basis of Good Practice under the European Social Fund. Expert judges were consulted for content validity; the metric properties of the scores obtained by the scale were examined and an exploratory factorial analysis (EFA) was performed to study the internal structure. The results show that the scale has adequate levels of content validity, construct validity and internal consistency. The SiSo Scale supplies a synthetic index of Social Position, providing professionals with the technical tools needed to carry out social diagnoses and simultaneously giving valid and reliable information on the social condition of people in a situation of social exclusion, which can guide social policy decision-making.

Intrarater reliability of the Abilitator—a self-report questionnaire on work ability and functioning aimed at the population in a weak labour market position: a test–retest study

ObjectivesThe Abilitator is a patient-reported outcome measure (PROM) of work ability and functioning of those in a weak labour market position. It covers items for work ability and self-rated health,...

Katharina Zimmermann (2019), Local Policies and the European Social Fund: Employment Policies Across Europe, £75.00, pp. 224, hbk.

Katharina Zimmermann (2019), Local Policies and the European Social Fund: Employment Policies Across Europe, £75.00, pp. 224, hbk.