Implementation Timeline Research Articles

A comparative analysis of national dementia plans: preventive strategies in five European countries

Abstract Background About 8.5% of people aged +65 live with dementia in Europe. Preventive measures can avert up to 40% of cases. The aim of the study is to analyse National Dementia Plans (NDP) in Europe, to elicit how much dementia prevention is considered a priority and whether policies are evidence-based. Methods A qualitative comparative analysis was performed between NDPs of countries with the best healthy life expectancy in the elderly in Europe. The NDPs of France, Ireland, Italy, Spain, and Sweden were included. The consensus on actions and elements of prevention policies was evaluated, according to the WHO recommendations and to Cheung’s framework designed for evaluating chronic diseases policies. Results All the NDPs prioritised early diagnosis, public awareness, and community engagement for dementia risk reduction. They fostered the development of information system for data collection and established committees for progress monitoring. However, not all NDPs defined timelines for policy implementation and most of them expired years ago. NDPs included prevention research agenda, but their preventive actions did not address alcohol consumption, traumatic brain injury, and air pollution, representing 3 well-known risk factors attributable for the 15% of preventable cases. Neither integration of dementia with other chronic disease preventive strategies was present and a clear allocation of funds for NDPs always missed. Conclusions NDPs partially address risk factors of preventable cases. All countries need to update their NDPs, integrating new scientific evidence and allocating clear financial funds. This can potentially prevent millions of new cases, decreasing the burden of disease and improving the sustainability of health systems. Key messages • NDPs do not target adequately dementia in Europe. • New evidence-based preventive policies, including most recent identified risk factors, would have a clear impact on burden of disease and health systems’ sustainability.

1.X.1. Achieving universal health coverage: international lessons from Irish policy implementation

Abstract Health systems all over the world are struggling to meet population health needs and provide timely access to universal healthcare in the context of the COVID-19 pandemic. COVID-19 occurred in Ireland in the early years of implementation of a national plan for universal healthcare, called Sláintecare. While many health systems are experiencing a retrenchment on universalism in the context of COVID-19, in Ireland despite tediously slow Sláintecare implementation, the pandemic provided a boost to reform implementation and universalism. The reason for this workshop is to draw on a publicly funded Health Research Board Applied Partnership Award, entitled ‘Foundations’, harnessing lessons from the Irish COVID-19 health system response to inform Sláintecare’s implementation https://hrbopenresearch.org/articles/3-70/v1 The objectives of the workshop are to 1) provide academic research evidence from the Irish experience of universal health system reform during and since COVID-19; 2) to give participants space to reflect on the implications of the Irish universal health system reform on international health systems and policy; 3) to actively involve workshop participants in an engaged discussion on implementing universal health coverage in the context of COVID-19. The added value of the workshop is to share learnings from an academic research programme, which is coproducing evidence in partnership with the Irish health system, in a worldwide context, providing relevant and thought-provoking discussion and analysis for an international audience. Four separate inter-related presentations will draw on aspects of the Foundations’ research project. Presentation 1, Prof Sara Burke will outline recent academic literature on universalism and the politics of reform implementation in the context of COVID-19 and present a timeline of universal healthcare reform implementation since 2018 when Sláintecare was adopted by the Irish government (14 mins). Presentation 2, Dr Sarah Parker will detail a specific study which set out to advance understanding of how and to what extent COVID-19 has highlighted opportunities for change that enabled better access to universal, integrated care in Ireland, with a view to informing universal health system reform and implementation (10 mins). Presentation 3, Dr Katharine Schulmann and Carlos Bruen will present findings on the governance of reform implementation and implications for all health systems (10 mins). Presentation 4, Dr Philip Crowley, Health Service Executive (HSE) National Director of Strategy and Research and Chair of the Foundations’ research steering group will reflect how research findings can inform implementing reform and their implications for all health systems (6 mins). There will be four presentations totalling 40 mins, followed by questions and discussion chaired by an international expert/academic on universal health systems. Key messages • COVID-10 has highlighted how universal health coverage is more important than ever, however the pandemic has resulted in some retrenchment on universalism. • While data and research drove health system decision making during the pandemic, embedding research evidence into health system and policy reform remains challenging and can be politically opposed.

Integrating automated dispensing cabinets into the medication dispensing process: feedback from the practice in European hospitals

ObjectivesAutomated dispensing cabinets (ADCs) offer improved medication safety, greater efficiency and return on investment. However, integrating ADCs into medication dispensing processes can be challenging in complex hospital environments. This study...

Factors Affecting Project Owners' Commitment to Implement Green Building Principles in the South Kalimantan Province of Indonesia

The construction of green buildings faces various challenges, including high costs, extended implementation timelines, and numerous requirements that must be satisfied. This study aims to analyze the factors influencing the implementation of green buildings. The research focuses on the PUPR Office in South Kalimantan Province, as well as planning consultants, construction management personnel, and contractors involved in the construction projects of the South Kalimantan Sports Hall and the Sheikh Muhammad Arsyad Al-Banjari Mosque in South Kalimantan Province. Key factors affecting the implementation of green buildings include financial commitment, energy savings, and the utilization of environmentally friendly materials. These factors encompass several variables: additional fund allocation for green buildings, the skills and experience of designers, the integration of natural and artificial lighting, energy-saving planning, the application of prefabrication technology and flatpack design, the use of sustainable materials, the incorporation of local wisdom, and strategies for light efficiency and outsourcing that involve gain sharing. Keywords: Building Construction, Building Energy Performance, Energy, Green Building, Green Construction

Problematic aspects of covering costs related to insolvency proceedings

The article is dedicated to examining the problematic aspects that arise in practice concerning the formation, execution, and reimbursement of costs associated with insolvency proceedings for small and medium­sized enterprises and developing proposals to address these issues. Special attention is given to the analysis of the current insolvency legislation in Ukraine, identifying its shortcomings in regulating the composition of expenses in bankruptcy cases, the mechanisms for covering these costs, and the determination oftheirfunding sources. The authors argue that the feasibility of applying bankruptcy procedures, an objective assessment of their effectiveness, and the independence of insolvency practitioners largely depend on the provision of adequate financing for the costs associated with insolvency proceedings. The article highlights the specifics of applying bankruptcy procedures in situations where the debtor lacks sufficient assets to cover the expenses associated with the proceedings. The author proposes the introduction of a new simplified liquidation procedure that provides for minimal implementation timelines and reduced costs. Such a procedure has the potential to significantly alleviate the financial burden on debtors and simplify the process for insolvency practitioners. The relevance and necessity of urgently improving the regulatory framework governing the costs associated with insolvency proceedings are substantiated, along with the comprehensive provision of debtors with effective legal instruments to resolve their obligations in a state of insolvency. Based on the conducted research, practical recommendations have been developed for amending the insolvency legislation. These proposalsinclude standardizing thelistof expenses, improving the mechanisms for advancing costs, introducing more efficient methods for covering expenses and ensuring the timely payment of costs associated with insolvency proceedings. Thus, the article aims to contribute to the further improvement of Ukraine’s insolvency legislation, enhancing its effectiveness and ensuring greater legal certainty for all participants in the bankruptcy process.

Factors Affecting the Perceived Social Support of Adolescent Girls and Women Aged 10-45 Years With Disabilities in Selected Sub-districts of Bangladesh.

Background Perceived social support is crucial for the well-being of women and adolescent girls with disabilities. In Bangladesh, social support can significantly influence their quality of life, yet it remains understudied. This study aims to identify the factors affecting perceived social support among women and adolescent girls with disabilities in selected sub-districts of Bangladesh. Methodology In this cross-sectional study, a total of 152 women and adolescent girls with disabilities participated. The study was conducted in Bogura Sadar and Chapainawabganj Sadar upazilas of Bangladesh. The implementation timeline of the study was from March to April 2023. The chi-square test and multiple linear regression analysis were conducted to explore the factors affecting perceived social support among the participants in the selected sub-districts of Bangladesh. Results In the chi-square test, associations were noted betweenmenarche age, male education, and household income categories with perceived social support categories.In Fisher's exact test, an association was observed between females with partial hearing disability and perceived social support categories. The multiple linear regression analysis showed that better levels of education in men, high household income, and a younger age of menarche and partial hearing disability were the predictors of higher perceived social support among women and adolescent girls with disabilities. Conclusions This study underscores the multifaceted nature of perceived social support among women and adolescent girls with disabilities in Bangladesh. Interventions aimed at enhancing social support should consider identified predictors to provide tailored support for women and adolescent girls with disabilities. Enhanced social support can lead to overall well-being for this vulnerable population.

Development of a multi-level/multi-modal intervention for health care transition preparation

AimsHealth care transition (HCT) to adult care and young adult disease self-management is a multi-step process involving three major stakeholders – the adolescent, the caregiver, and the provider. Preparation gaps exist within each of these stakeholder groups. This paper presents the development of the Intervention to Promote Autonomy and Competence in Transition-aged Youth (IPACT), a multi-level (adolescent, caregiver, provider), multi-modal (interactive skill building sessions, educational materials, videos) intervention to address gaps in all three stakeholder groups simultaneously and help support achieving the three core elements of HCT planning. MethodsEight processes were utilized to develop the IPACT intervention, including reliance on existing literature and materials, stakeholder feedback at multiple points during development, and regular support and guidance from service liaisons within each of four tertiary-care clinics targeted for this intervention within a large, urban children’s hospital. ConclusionsIPACT includes the conceptual schema, logic model, intervention curriculum components, and implementation timeline. IPACT could be used by programs to simultaneously address gaps in stakeholder HCT planning knowledge and skills.

Comparing automated surveillance systems for detection of pathogen-related clusters in healthcare settings

BackgroundDetection of pathogen-related clusters within a hospital is key to early intervention to prevent onward transmission. Various automated surveillance methods for outbreak detection have been implemented in hospital settings. However, direct comparison is difficult due to heterogenicity of data sources and methodologies. In the hospital setting, we assess the performance of three different methods for identifying microbiological clusters when applied to various pathogens with distinct occurrence patterns.MethodsIn this retrospective cohort study we use WHONET-SaTScan, CLAR (CLuster AleRt system) and our currently used percentile-based system (P75) for the means of cluster detection. The three methods are applied to the same data curated from 1st January 2014 to 31st December 2021 from a tertiary care hospital. We show the results for the following case studies: the introduction of a new pathogen with subsequent endemicity, an endemic species, rising levels of an endemic organism, and a sporadically occurring species.ResultsAll three cluster detection methods showed congruence only in endemic organisms. However, there was a paucity of alerts from WHONET-SaTScan (n = 9) compared to CLAR (n = 319) and the P75 system (n = 472). WHONET-SaTScan did not pick up smaller variations in baseline numbers of endemic organisms as well as sporadic organisms as compared to CLAR and the P75 system. CLAR and the P75 system revealed congruence in alerts for both endemic and sporadic organisms.ConclusionsUse of statistically based automated cluster alert systems (such as CLAR and WHONET-Satscan) are comparable to rule-based alert systems only for endemic pathogens. For sporadic pathogens WHONET-SaTScan returned fewer alerts compared to rule-based alert systems. Further work is required regarding clinical relevance, timelines of cluster alerts and implementation.

Digital dermatopathology implementation: Experience at a multisite academic institution.

Technology has revolutionized not only direct patient care but also diagnostic care processes. This study evaluates the transition from glass-slide microscopy to digital pathology (DP) at a multisite academic institution, using mixed methods to understand user perceptions of digitization and key productivity metrics of practice change. Participants included dermatopathologists, pathology reporting specialists, and clinicians. Electronic surveys and individual or group interviews included questions related to technology comfort, trust in DP, and rationale for DP adoption. Case volumes and turnaround times were abstracted from the electronic health record from Qtr 4 2020 to Qtr 1 2023 (inclusive). Data were analyzed descriptively, while interviews were analyzed using methods of content analysis. Thirty-four staff completed surveys and 22 participated in an interview. Case volumes and diagnostic turnaround time did not differ across the institutionduring or after implementation timelines (p = 0.084; p = 0.133, respectively). 82.5% (28/34) of staff agreed that DP improved the sign-out experience, with accessibility, ergonomics, and annotation features described as key factors. Clinicians reported positive perspectives of DP impact on patient safety and interdisciplinary collaboration. Our study demonstrates that DP has a high acceptance rate, does not adversely impact productivity, and may improve patient safety and care collaboration.

Cardiac arrest and cardiopulmonary resuscitation in the next decade: Predicting and shaping the impact of technological innovations

IntroductionCardiac arrest (CA) is the third leading cause of death, with persistently low survival rates despite medical advancements. This article evaluates the potential of emerging technologies to enhance CA management over the next decade, using predictions from the AI tools ChatGPT-4 and Gemini Advanced. MethodsWe conducted an exploratory literature review to envision the future of cardiopulmonary arrest (CA) management. Utilizing ChatGPT-4 and Gemini Advanced, we predicted implementation timelines for innovations in early recognition, CPR, defibrillation, and post-resuscitation care. We also consulted the AI to assess the consistency and reproducibility of the predictions. ResultsWe extrapolate that healthcare may embrace new technologies, such as comprehensive monitoring of vital signs to activate the emergency system (wireless detectors, smart speakers, and wearable devices), use new innovative early CPR and early AED devices (robot CPR, wearable AEDs, and immersive reality), and post-resuscitation care monitoring (brain-computer interface). These technologies could enhance timely life-saving interventions for cardiac arrest. However, there are many ethical and practical challenges, particularly in maintaining patient privacy and equity. The two AI tools made different predictions, with a horizon for implementation ranging between three and eight years. ConclusionIntegrating advanced monitoring technologies and AI-driven tools offers hope in improving CA management. A balanced approach involving rigorous scientific validation and ethical oversight is necessary. Collaboration among technologists, medical professionals, ethicists, and policymakers is crucial to use these innovations ethically to reduce CA incidence and enhance outcomes. Further research is needed to enhance the reliability of AI predictive capabilities.

Unification of Efforts to Improve Global Access to Cancer Therapeutics: Report From the 2022/2023 Access to Essential Cancer Medicines Stakeholder Summit.

There is an urgent need to improve access to cancer therapy globally. Several independent initiatives have been undertaken to improve access to cancer medicines, and additional new initiatives are in development. Improved sharing of experiences and increased collaboration are needed to achieve substantial improvements in global access to essential oncology medicines. The inaugural Access to Essential Cancer Medicines Stakeholder Meeting was organized by ASCO and convened at the June 2022 ASCO Annual Meeting in Chicago, IL, with two subsequent meetings, Union for International Cancer Control World Cancer Congress held in Geneva, Switzerland, in October 2022 and at the ASCO Annual Meeting in June of 2023. Invited stakeholders included representatives from cancer institutes, physicians, researchers, professional societies, the pharmaceutical industry, patient advocacy organizations, funders, cancer organizations and foundations, policy makers, and regulatory bodies. The session was moderated by ASCO. Past efforts and current and upcoming initiatives were initially discussed (2022), updates on progress were provided (2023), and broad agreement on resulting action steps was achieved with participants. Summit participants recognized that while much work was ongoing to enhance access to cancer therapeutics globally, communication and synergy across projects and organizations could be enhanced by providing a platform for collaboration and shared expertise. The summit resulted in new cross-stakeholder insights and planned collaboration addressing barriers to accessing cancer medications. Specific actions and timelines for implementation and reporting were established.

Integrating project management with advanced cooling solutions for data centers: A path to enhanced energy efficiency

Data centers play a crucial role in modern digital infrastructure, but their energy consumption and associated carbon footprint are significant concerns. Among the various energy-consuming components of data centers, cooling systems stand out as major contributors. This paper explores the integration of project management principles with advanced cooling solutions to enhance energy efficiency in data centers. By effectively managing projects and implementing innovative cooling technologies, data center operators can achieve significant reductions in energy consumption and operational costs. The integration of project management practices with advanced cooling solutions involves several key steps. First, project management methodologies such as Agile or Waterfall are applied to plan and execute the implementation of advanced cooling technologies. This includes assessing current cooling systems, identifying suitable advanced solutions, and developing a timeline for implementation. Next, advanced cooling solutions such as liquid cooling, containment systems, or free cooling are deployed to reduce the energy required for cooling data center equipment. One of the primary benefits of integrating project management with advanced cooling solutions is enhanced energy efficiency. Advanced cooling technologies can significantly reduce the energy consumed by data center cooling systems, leading to lower operational costs and a smaller carbon footprint. Additionally, the use of project management methodologies ensures that the implementation of these technologies is carried out efficiently and effectively. Furthermore, this integration can lead to improved data center performance and reliability. By optimizing cooling systems, data center operators can ensure that IT equipment operates within optimal temperature ranges, reducing the risk of overheating and downtime. Additionally, the implementation of advanced cooling solutions can future-proof data centers against increasing heat loads from high-density computing equipment. In conclusion, integrating project management with advanced cooling solutions offers a promising path to enhance energy efficiency in data centers. By adopting this approach, data center operators can achieve significant energy savings, reduce their environmental impact, and improve overall operational efficiency.

Which Lipid Nanoparticle (LNP) Designs Work? A Simple Kinetic Model Linking LNP Chemical Structure to In Vivo Delivery Performance.

Although lipid nanoparticles (LNPs) are the predominant nanocarriers for short-interfering RNA (siRNA) delivery, most therapies use nearly identical formulations that have taken 30 years to design but lack the diverse property ranges necessary for versatile application. This dearth in variety and the extended timeline for implementation are attributed to a limited understanding of how LNP properties facilitate overcoming biological barriers. Herein, a simple kinetic model was developed by using major rate-limiting steps for siRNA delivery, and this model enabled the identification of a critical parameter to predict LNP efficacy without extensive experimental testing. A volume-averaged log D, the "solubility" of charged molecules as a function of pH weighted by component volume fractions, resulted in a good correlation between LNP composition and siRNA delivery. Both the effects of modifying the structures of ionizable lipids and LNP composition on gene silencing were easily captured in the model predictions. Thus, this approach provides a robust LNP structure-activity relationship to dramatically accelerate the realization of effective LNP formulations.

Using community-based participatory research to support the development of a co-located intergenerational program

This paper presents the findings of a ten-week research project exploring the intricacies of a co-located intergenerational program in Southeast Queensland. The research involved an early learning centre, North Early Learning, operated by a large not-for-profit organisation, Queensland Child Learning, and an aged care residence, Aged Care Living (pseudonyms). The research question underpinning this paper focused on identifying the views of educators, children, and families currently attending the early childhood education and care centre who will participate in the co-located intergenerational program. Employing a community-based participatory research approach, the study explores the perspectives of educators, children, and families participating in the program through visual children’s surveys, facilitated interviews, and online surveys. The findings highlight positive attitudes from educators and families toward intergenerational programs, leading to the development of an implementation timeline aligned with the needs of educators, children, and families that are reflective of the unique context of the centre.

Strategic Integration of Artificial Intelligence in Health-care Systems: Assessing Costs, Technological Upgrades, and Training Timelines

BACKGROUND: In recent years, the evaluation of artificial intelligence (AI) in health-care sector has undergone significant growth and is substantially helpful in supporting clinical decision-making based on evidence. The primary aim of the study is to investigate the strategic integration of AI in health-care systems, specifically focusing on assessing costs, technological upgrades, and training timelines. MATERIALS AND METHODS: This study followed quantitative techniques to explore the AI integration’s importance in the systems of health care highlighting training timelines, upgradation of technology, and associated costs. Using descriptive statistics, data were evaluated and a survey was performed on the professionals of emergency medical care. The study employed a combination of descriptive statistics analysis, such as mean and median calculations, to analyze the data. To select participants, this study applied purposive sampling. The selected sample size of the study was 242 from the Indian health-care context. RESULT: The results of this study indicated that clear training timelines establishment, technological upgradation, and cost assessments are important for successfully integrating AI technologies. In addition, the discussion explored the acceptance of the significance of stakeholders’ collaboration, cost-effective strategies for training, and information technology infrastructure enhancements. The training costs for AI implementation in health care, with 66.12%–69.83% of respondents selecting “strongly agree” and 25.21%–29.75% selecting “agree.” Strong consensus on the necessity of providing specific timelines for AI implementation in emergency departments, with “strongly agree” responses ranging from 66.12% to 68.60%, and “agree” responses from 26.45% to 29.75%. Issues including timeline adherence and funding constraints were discovered, focusing on the necessity for proactive management. CONCLUSION: This research highlighted comprehensive planning’s major role in the integration of AI. Health-care organizations by addressing training timelines, technological upgradation, and cost optimize the incorporation of AI. However, engagement with different financial experts and collaboration with stakeholders are necessary for successfully achieving organizational goals.

The influence of context on the implementation of integrated palliative care in an academic teaching hospital in South Africa.

Palliative care (PC) has been integrated to a limited extent in the South African healthcare system. Contextual factors may be a pivotal influence in this integration. This study aims to explore contextual factors that are possibly influencing the integration or lack thereof in an academic teaching hospital (ATH). A mixed-method study was conducted in a large ATH in South Africa. The mixed methods were conducted in parallel and then merged. Findings were integrated to describe the contextual factors influencing PC integration, to develop a timeline of implementation and assess the probable influence of context on the integration process. The mixed-methods phases included a narrative review of published literature related to health systems, integration of health interventions and PC in teaching hospital settings; followed by interviews, documentary and routine data analyses. Semi-structured interviews with purposively sampled participants provided the qualitative data. Primary national, provincial and organizational documents expanded the contextual phenomena and corroborated findings. Routine hospital admission and mortality data was statistically analysed to expand further and corroborate findings. All qualitative data was thematically analysed using deductive coding, drawing from the aspects of the contextual dimensions of integration. Enabling contextual factors for local PC integration were global and local advocacy, demonstrated need, PC being a human right, as well as the personal experiences of hospital staff. Impeding factors were numerous misconceptions, PC not valued as a healthcare priority, as well as limitations in functional elements necessary for PC integration: national and regional political support, leadership at all levels and sustainable financing. The normative and functional contextual aspects interplay at macro, meso and micro levels positively and negatively. How stakeholders understand and value PC directly and indirectly impacts on PC integration. Strategic interventions such as mandatory education are required to ensure PC integration. The health system is dynamic, and understanding the context in which the health system functions is core to the integration of PC. This may assist in developing integration strategies to address PC integration and the transferability of these strategies.

Assessing and Improving Water Supply Resiliency in New Braunfels, Texas

Key TakeawaysA holistic resiliency study provides a long‐term perspective on the strengths and vulnerabilities of water supplies and encourages proactive planning.A workshop‐driven approach can tap into the institutional knowledge of staff at all levels.With this approach, utilities can assess their resiliency, understand present and future water supplies, estimate likelihood and consequences of failure, and anticipate demand changes.Decision makers can use a cost–benefit analysis to prioritize solutions and develop implementation timelines based on supply and demand projections.

SAN ANTONIO TRANSPORTATION PLANNING SYSTEM: MAPPING INFRASTRUCTURE CAPACITY AND COORDINATION

Abstract Ride Connect Texas and its partnering agencies seek to develop an expanded senior mobility management system supported by a One Call One Click transportation planning system. Its purpose is to enhance on-demand transportation system coordination and the application of technology, providing consumers, service providers, and mobility managers with direct access to comprehensive transportation information. GIS mapping is used to help develop a spatial awareness of the transportation challenges among older people and individuals with a disability and the current system capacity. Interviews with transit, non-transit, and health and human service agencies will reveal factors that influence coordination among providers and opportunities for capacity expansion. Surveys and focus groups of older adults and individuals with disability will show differentiating characteristics of riders and transportation needs and challenges. GIS mapping will allow us to geocode these findings relative to the user’s street address and zip code, illustrating variations in specialized client needs, service availability, travel behavior, and available amenities for basic daily living. Mapping will identify gaps in transportation services, hot zones revealing high user demand and low system capacity, and the ability to reduce fragmentation of service through seamless technology-based coordination. The mapping element informs the measurement of a community’s transportation system capacity for this user group. The value proposition of this tool is its ability to help any community measure its readiness toward developing a comprehensive implementation strategy for coordinated demand response transportation, including resource mobilization strategies, capacity augmentation, phasing of the system, and implementation timeline.

The Role of Environmental Management Systems and Energy Management Systems in the Adoption of Energy Recuperation Technologies in Central European Manufacturing Companies

The diffusion of technologies within an economic system is an intricate process, influenced by a variety of factors, including governmental policies, the characteristics of adopting companies, and the technologies that can be adopted. This study aimed to investigate the relationship between the implementation of environmental management systems (EMSs), such as ISO 14001, or energy management systems (EnMSs), such as ISO 50001, and the adoption of energy recuperation technologies (ERTs), which are a subset of energy efficient technologies (EETs). To achieve this, our research leveraged data from the 2018 European Manufacturing Survey, specifically a subsample of 798 companies across five European countries: Croatia, Slovenia, Austria, Slovakia, and Lithuania. Due to the investigation of relationships and the type of variables used, we employed a two-step ordinary least squares (OLS) regression analysis. Our analysis uncovered that the current utilization of EMSs and EnMSs within companies is significantly linked to the current use of ERTs. However, upon further examination of the implementation timeline, it became improbable that EMSs or EnMSs have a substantial impact on enhancing the adoption of these technologies in the short term. Moreover, our results show that technological intensity and product complexity does not play a determining role in the adoption of ERTs, but they did show that larger companies tend to invest more in ERTs, which is in line with the findings of previous studies.

Modernization and Digitalization of the EU Withholding Tax Procedure: Opportunities Offered by the FASTER Initiative

The EU’s Faster and Safer Relief of Excess Withholding Taxes (FASTER) initiative aims to modernize and digitalize the withholding tax procedure. It addresses two key issues: preventing tax abuse and double taxation for cross-border investors. Cum/Ex and Cum/ Cum scandals exposed vulnerabilities in the current system, leading to substantial tax losses. To streamline the process, FASTER introduces a uniform EU Digital Tax Residence Certificate (eTRC), enabling digital reimbursement applications. It also offers two fast-track procedures, ‘relief at source’ and ‘quick refund’, alongside standard reporting obligations for certified financial intermediaries to enhance transparency. While the initiative promises annual savings of EUR 5.17 billion for investors, it places a significant burden on financial intermediaries. Implementing eTRCs and meeting reporting requirements involve substantial costs. Concerns regarding data protection and implementation timelines exist. The proposal is currently under public consultation until 21 August 2023, and the implementation is targeted for 1 January 2027, subject to further developments and consultations. In summary, FASTER seeks to modernize the withholding tax process to combat abuse and facilitate cross-border investments, but its impact on financial intermediaries and data protection considerations remain noteworthy. FASTER, Withholding tax, Digitalization, Tax fraud, Double taxation, eTRC, data protection, reporting obligation, national register, cum/ex