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In Europe, there has been a significant shift in the movement of people and things. Nonetheless, despite the fact that transportation is an important component of the supply chain, its environmental consequences pose a severe threat to the ecosystem as a whole. As a result, we intend to explore the relationship between transportation, economy, and CO2 emissions. We used the Static method with Pooled OLS, then tested the Granger causality to validate the use of dynamic approach via the GMM system. The major findings revealed that GDP and trade openness had a considerable impact on CO2 emissions. Although the three modes of transportation have different effects on CO2 emissions, road density has a positive and considerable impact on CO2 emissions. The railway network is inversely connected to CO2 emissions. While the quantity of flight passengers has no substantial effect on emissions. In terms of the impulse response function, there is an initial shock in period 2 for the response of air passengers carried to CO2 emissions, followed by convergence back to zero in period 6, whereas road density has a slight decrease in period 2 with a post shock peak in period 4, followed by convergence back to zero in period 5. The variance decomposition results reveal a little increase until the fifth period for road density, air passengers, and trade openness with coefficients equal to 0.0893, 0.636, and 1.573, respectively, after which these three variables offer decreasing coefficients., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background Value-based healthcare (VBHC) is a conceptual framework to improve the value of healthcare by health, care-process and economic outcomes. Benchmarking should provide useful information to identify best practices and therefore a good instrument to improve quality across healthcare organizations. This paper aims to provide a proof-of-concept of the feasibility of an international VBHC benchmarking in breast cancer, with the ultimate aim of being used to share best practices with a data-driven approach among healthcare organizations from different health systems. Methods In the VOICE community—a European healthcare centre cluster intending to address VBHC from theory to practice—information on patient-reported, clinical-related, care-process-related and economic-related outcomes were collected. Patient archetypes were identified using clustering techniques and an indicator set following a modified Delphi was defined. Benchmarking was performed using regression models controlling for patient archetypes and socio-demographic characteristics. Results Six hundred and ninety patients from six healthcare centres were included. A set of 50 health, care-process and economic indicators was distilled for benchmarking. Statistically significant differences across sites have been found in most health outcomes, half of the care-process indicators, and all economic indicators, allowing for identifying the best and worst performers. Conclusions To the best of our knowledge, this is the first international experience providing evidence to be used with VBHC benchmarking intention. Differences in indicators across healthcare centres should be used to identify best practices and improve healthcare quality following further research. Applied methods might help to move forward with VBHC benchmarking in other medical conditions. [ABSTRACT FROM AUTHOR]

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Alzheimer's disease (AD), breast cancer (BC) and prostate cancer (PC) continue to be high in the research and innovation agenda of the European Commission (EC). This is due to their exceptionally large burden to the national health systems, the profound economic effects of opportunity costs attributable to decreased working ability, premature mortality and the ever-increasing demand for both hospital and home-based medical care. Over the last two decades, the EC has been steadily increasing both the number of proposals being funded and the amounts of financial resources being allocated to these fields of research. This trend has continued throughout four consecutive science funding cycles, namely framework programme (FP)5, FP6, FP7 and Horizon 2020 (H2020). We performed a retrospective assessment of the outputs and outcomes of EC funding in AD, BC and PC research over the 1999–2019 period by means of selected indicators. These indicators were assessed for their ability to screen the past, present and future for an array of causal relationships and long-term trends in clinical, epidemiological and public health sphere, while considering also the broader socioeconomic impact of funded research on the society at large. This analysis shows that public–private partnerships with large industry and university-based consortia have led to some of the most impactful proposals being funded over the analysed time period. New pharmaceuticals, small molecules and monoclonal antibodies alike, along with screening and prevention, have been the most prominent sources of innovation in BC and PC, extending patients' survival and enhancing their quality of life. Unlike oncology, dementia drug development has been way less successful, with only minor improvements related to the quality of supportive medical care for symptoms and more sensitive diagnostics, without any ground-breaking disease-modifying treatment(s). Significant progresses in imaging diagnostics and nanotechnology have been largely driven by the participation of medical device industry multinational companies. Clinical trials funded by the EC were conducted, leading to the development of brand-new drug molecules featuring novel mechanisms of action. Some prominent cases of breakthrough discoveries serve as evidence for the European capability to generate cutting-edge technological innovation in biomedicine. Less productive areas of research may be reconsidered as priorities when shaping the new agenda for forthcoming science funding programmes. [ABSTRACT FROM AUTHOR]

Central and Eastern European (CEE) countries have ratified the United Nations Convention on the Rights of Persons with Disability, necessitating adjustments in tax and benefit policies. However, the eventual outcome of these modifications remains uncertain. To evaluate possible changes, we conducted a comparative analysis of current instruments in CEE countries vis-a-vis Sweden, Denmark, and Finland. Our research discovered that tax and benefit systems in both CEE and Scandinavian countries are built on the same foundational principles, yet differ significantly in their specific solutions and approaches. Notably, benefits systems in CEE countries are considerably more intricate and inclined toward means-tested benefits and specialized instruments dedicated solely to individuals with disabilities. We posit that changes arising from the convention's implementation will streamline the benefits system, incorporating more generalized instruments with disability added as supplementary eligibility conditions or income parameters. The velocity of this transformation will be influenced by the pace of economic growth, as evidenced by the strong positive correlation between disability expenditure's proportion in gross domestic product and the European Union countries' level of economic development. JEL classification D61, H51, O52 [ABSTRACT FROM AUTHOR]

Cooperation in the delivery of public services is generally framed as desirable, but it is often hindered by serious collective action problems. The article compares inter-municipal cooperation in seven countries with different institutional settings. It investigates the rules of governance characterising these diverse institutional settings and assesses how they deal with the multiple principal problem. The authors find that in almost all cases, all participating municipalities are represented on the supervisory board of the cooperative entity. In contrast, in other less frequent case cooperation is frequently managed through a different tier of local government, thus circumventing the multiple principal problem affecting inter-municipal arrangements in the other countries. [ABSTRACT FROM AUTHOR]

Legume-supported cropping systems affect environmental, production, and economic impacts. In Europe, legume production is still marginal with grain legumes covering less than 3% of arable land. A transition towards legume-supported systems could contribute to a higher level of protein self-sufficiency and lower environmental impacts of agriculture. Suitable approaches for designing legume-supported cropping systems are required that go beyond the production of prescriptive solutions. We applied the DEED framework with scientists and advisors in 17 study areas in nine European countries, enabling us to describe, explain, explore, and redesign cropping systems. The results of 31 rotation comparisons showed that legume integration decreased N fertilizer use and nitrous oxide emissions (N2O) in more than 90% of the comparisons with reductions ranging from 6 to 142 kg N ha−1 and from 1 to 6 kg N2O ha−1, respectively. In over 75% of the 24 arable cropping system comparisons, rotations with legumes had lower nitrate leaching and higher protein yield per hectare. The assessment of above-ground biodiversity showed no considerable difference between crop rotations with and without legumes in most comparisons. Energy yields were lower in legume-supported systems in more than 90% of all comparisons. Feasibility and adaptation needs of legume systems were discussed in joint workshops and economic criteria were highlighted as particularly important, reflecting findings from the rotation comparisons in which 63% of the arable systems with legumes had lower standard gross margins. The DEED framework enabled us to keep close contact with the engaged research-farmer networks. Here, we demonstrate that redesigning legume-supported cropping systems through a process of close stakeholder interactions provides benefits compared to traditional methods and that a large-scale application in diverse study areas is feasible and needed to support the transition to legume-supported farming in Europe. [ABSTRACT FROM AUTHOR]