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Since the awareness of adverse effects associated with pharmaceutical excipients in drug formulations, these excipients are no longer considered inert substances. Numerous countries have recognized the potential risks that they pose to patients and have implemented diverse regulations to evaluate their safety, compatibility, toxicity, and quality. Regulatory authorities have proactively implemented measures to evaluate excipients and have formulated comprehensive guidelines that manufacturers are obligated to follow. This review primarily highlights the different provisions governing the utilization of excipients in drug formulation by regulatory authorities worldwide. Nonetheless, it is worth noting that there are still many countries that do not perceive excipients as posing a potential threat. [ABSTRACT FROM AUTHOR]

This article explores the role that green gentrification plays in exacerbating racial tensions within historically marginalized urban communities benefiting from new environmental amenities such as parks, gardens, waterfront restoration and greenways. Building on extensive qualitative data from three cities in Europe (Amsterdam, Vienna, Lyon) and four cities in the United States (Washington, Austin, Atlanta, Cleveland), we use thematic analysis and grounded theory to examine the complex relationship between historical environmental and racial injustices and current racial green inequities produced by the green city agenda. Our analysis also offers insights into the main differences in how community members articulate concerns and demands over racial issues related to green gentrification in Europe versus North America. Results show that urban greening—and green gentrification specifically—can create 'compounded environmental racisms' by worsening racial environmental injustices and further perpetrating green racialized displacement, re‐segregation and exclusion. The latter is produced by the racial inequities embedded in green infrastructure projects and the related unequal access to environmental benefits, affordable housing, political rights and place‐making. Moreover, we find that settler colonial practices combined with persisting exposure to toxins and re‐segregation in the United States together with neocolonial spatial and social practices in Europe shape how racialized community members perceive and interact with new green amenities. [ABSTRACT FROM AUTHOR]

Economic change over the past 20 years has rendered many individuals and territories vulnerable, leading to greater interpersonal and interterritorial inequality. This rising inequality is seen as a root cause of populism. Yet, there is no comparative evidence as to whether this discontent is the consequence of localised interpersonal inequality or stagnant growth in 'left-behind' places. This article assesses the association between levels and changes in local GDP per capita and interpersonal inequality, and the rise of far-right populism in Europe and in the USA. The analysis—conducted at small region level for Europe and county level for the USA—shows that there are both similarities and differences in the factors connected to populist voting on both sides of the Atlantic. In the USA, neither interpersonal inequality nor economic decline can explain populist support on their own. However, these factors gain significance when considered together with the racial composition of the area. Counties with a large share of white population where economic growth has been stagnant and where inequalities have increased supported Donald Trump. Meanwhile, counties with a similar economic trajectory but with a higher share of minorities shunned populism. In Europe, the most significant factor behind the rise of far-right populism is economic decline. This effect is particularly large in areas with a high share of immigration. [ABSTRACT FROM AUTHOR]

(1) Background: Patients' experiences and satisfaction with their treatment are becoming increasingly important in the context of quality assurance, but the measurement of these parameters is accompanied by several disadvantages such as poor cross-country comparability and methodological problems. The aim of this review is to describe and summarize the process of measuring, publishing, and utilizing patient experience and satisfaction data in countries with highly developed healthcare systems in Europe (Germany, Sweden, Finland, Norway, the United Kingdom) and the USA to identify possible approaches for improvement. (2) Methods: Articles published between 2000 and 2021 that address the topics described were identified. Furthermore, patient feedback in social media and the influence of sociodemographic and hospital characteristics on patient satisfaction and experience were evaluated. (3) Results: The literature reveals that all countries perform well in collecting patient satisfaction and experience data and making them publicly available. However, due to the use of various different questionnaires, comparability of the results is difficult, and consequences drawn from these data remain largely unclear. (4) Conclusions: Surveying patient experience and satisfaction with more unified as well as regularly updated questionnaires would be helpful to eliminate some of the described problems. Additionally, social media platforms must be considered as an increasingly important source to expand the range of patient feedback. [ABSTRACT FROM AUTHOR]

In this article, we contribute to the scant literature covering quantitative studies on the determinants of the non-academic staff incidence in higher education institutions by analysing how the proportion of non-academic staff is related to key features such as size, prestige, year of foundation and financial structure of universities. We apply nonlinear regression analysis to compare HEIs across Europe and the USA, taking into account time and cross-country heterogeneity of the two balanced panel datasets concerning European and American universities over a period of 6 years (2011–2016 for Europe and 2012–2017 for the USA). Evidence suggests that in both Europe and the USA, public and larger (if sufficiently large) as well as more research-oriented units are characterised by a higher proportion of non-academic staff. In Europe, we observe an inverted U-shaped effect of the share of non-personnel expenditure and the foundation year on the proportion of non-academic staff, while the proportion of non-academic staff decreases with the share of core and third-party funding. For the USA, we obtain similar findings except that the share of core funding and third-party funding is characterised by a U-shaped effect, and the impact of the share of non-personnel expenditure has no empirical effect on the proportion of non-academic staff. Additionally, we discover that some factors that contribute to the proportion of non-academic staff may constitute indicators of performance, suggesting the need for further research to extend our knowledge on the complex issue of the role played by non-academic staff in university performance. [ABSTRACT FROM AUTHOR]

Despite widely recognised effectiveness against the spread of COVID-19, vaccine hesitancy persists. This systematic literature review aimed to clarify the definition and the operationalisation of the term 'vaccine hesitancy' and disclose the various psychosocial factors underlying this phenomenon. The results of studies conducted in European countries and in the United States after the vaccines became available were taken into account. The review was conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analyses statement. Twelve studies met the inclusion criteria and were reviewed. efinitions and measures of vaccine hesitancy differed across the studies, limiting their comparison. Nonetheless, by drawing on theoretical frameworks, we were able to identify several psychosocial variables in determining vaccine hesitancy. Our findings point to the need for a transdisciplinary approach to understanding the antecedents of vaccine hesitancy. A better understanding of the phenomenon may help to develop interventions and social policies to address a complex challenge such as vaccination hesitancy., (© 2024 Wiley Periodicals LLC.)

Europe and North America are the 2 largest recipients of international migrants from low-resource regions in the world. Here, large differences in cardiovascular disease (CVD) morbidity and death exist between migrants and the host populations. This review discusses the CVD burden and its most important contributors among the largest migrant groups in Europe and North America as well as the consequences of migration to high-income countries on CVD diagnosis and therapy. The available evidence indicates that migrants in Europe and North America generally have a higher CVD risk compared with the host populations. Cardiometabolic, behavioral, and psychosocial factors are important contributors to their increased CVD risk. However, despite these common denominators, there are important ethnic differences in the propensity to develop CVD that relate to pre- and postmigration factors, such as socioeconomic status, cultural factors, lifestyle, psychosocial stress, access to health care and health care usage. Some of these pre- and postmigration environmental factors may interact with genetic (epigenetics) and microbial factors, which further influence their CVD risk. The limited number of prospective cohorts and clinical trials in migrant populations remains an important culprit for better understanding pathophysiological mechanism driving health differences and for developing ethnic-specific CVD risk prediction and care. Only by improved understanding of the complex interaction among human biology, migration-related factors, and sociocultural determinants of health influencing CVD risk will we be able to mitigate these differences and truly make inclusive personalized treatment possible.

Ethical issues around triage have been at the forefront of debates during the Covid‐19 pandemic. This essay compares both discussion and guidelines around triage and the reality of what happened in the United States and in Europe, both in anticipation of and during the first wave of the pandemic. Why did the issue generate so many vivid debates in the United States and so few in most European countries, although the latter were also affected by the rationing of health care resources? Are countries with socialized health care systems better equipped to face the hard choices of triaging? Important lessons in transparency, trust, and accountability for policy‐makers can be drawn from this comparison, demonstrating that fostering public involvement and ethical debate remains a critical element for the sustained acceptance of any triage plan. [ABSTRACT FROM AUTHOR]

Background: Rising midlife mortality in the USA has raised concerns, particularly the increase in 'deaths of despair' (due to drugs, alcohol and suicide). Life expectancy is also stalling in other countries such as the UK, but how trends in midlife mortality are evolving outside the USA is less understood. We provide a synthesis of cause-specific mortality trends in midlife (25-64 years of age) for the USA and the UK as well as other high-income and Central and Eastern European (CEE) countries., Methods: We document trends in midlife mortality in the USA, UK and a group of 13 high-income countries in Western Europe, Australia, Canada and Japan, as well as seven CEE countries from 1990 to 2019. We use annual mortality data from the World Health Organization Mortality Database to analyse sex- and age-specific (25-44, 45-54 and 55-64 years) age-standardized death rates across 15 major cause-of-death categories., Results: US midlife mortality rates have worsened since 1990 for several causes of death including drug-related, alcohol-related, suicide, metabolic diseases, nervous system diseases, respiratory diseases and infectious/parasitic diseases. Deaths due to homicide, transport accidents and cardiovascular diseases have declined since 1990 but saw recent increases or stalling of improvements. Midlife mortality also increased in the UK for people aged 45-54 year and in Canada, Poland and Sweden among for those aged 25-44 years., Conclusions: The USA is increasingly falling behind not only high-income, but also CEE countries, some of which were heavily impacted by the post-socialist mortality crisis of the 1990s. Although levels of midlife mortality in the UK are substantially lower than those in the USA overall, there are signs that UK midlife mortality is worsening relative to that in Western Europe., (© The Author(s) 2024. Published by Oxford University Press on behalf of the International Epidemiological Association.)

Geographical variability of cancer burden was almost exclusively estimated for common cancers. Since rare cancers (RC) have become an area of priority for basic and clinical research and public health organizations, this paper provides, using a common methodology, a detailed comparison of incidence and survival for RC in the US and Europe. We estimated incidence and net survival of 199 malignant RC from data of 2 580 000 patients collected by 18 US‐SEER and 94 European registries, diagnosed within the most recent common period 2000‐2007. RC were defined according to the criterion of crude annual incidence rates <6/100 000. In total, 196 RC were classified as rare in both populations. Of these, 43 had incidence rates significantly different by at least 0.2 per 100 000:34 higher in the US and 9 higher in Europe. Five‐year net survival for all RC combined significantly differed: 54% in the US and 48% in Europe. Survival for 62 RC was significantly higher in the US vs 6 higher in Europe. Differences were not concentrated in a particular cancer family, and were mostly relevant for cases diagnosed >65+ years of age. Use of standardized methods evidenced that incidence and survival rate of majority of RC were higher in the United States compared to Europe. Possible reasons for such differences, requiring further studies, include distribution of risk factors, ability to diagnose RC, different registration practices, and use of updated International Classification of Diseases for Oncology. [ABSTRACT FROM AUTHOR]

Regulatory involvement in the generic drug development hastens the drug approval process which directly/indirectly accelerated the launching of drug into the market. The regulatory documents whether in-house of documents to be submitted to regulatory authorities should be carefully reviewed by the skilled personnel to minimize the queries raised by the regulatory agencies and speed up the approval process. These are few differences in the dossier submission requirements among the three regions, i.e., the USA, Europe, and India which has been clearly represented through succinct comparisons third part of this work. Generic manufacturers may file an abbreviated new drug application that incorporates the safety/effectiveness data submitted by original innovator drug manufacturer and adds only bioequivalence studies. Therefore, it is very difficult and challenging task to approve a drug by the manufacturing companies, simultaneously submitted in all the regulatory authorities. The literature work, the comparison parameters, and difference in generic drug approval requirements have been delineated in this work, which gives clear depict where India lies in its generic drug approval process and the challenges that Indian regulatory authority has to overcome in the near future. [ABSTRACT FROM AUTHOR]

In this paper, we argue that the relationship between shareholder conflicts and corporate assets can generate multiple equilibrium configurations that can be helpful to understand how corporate governance systems may change under different historical models of capitalism. These relationships can be modeled as 'meta-complementarities' existing among two different sets of institutional complementarity. The first institutional complementarity arises in realm of the conflicts among different stakeholders and generates multiple equilibria that define different systems of rights on corporate assets. The second institutional complementarity arises between corporate rights and assets. Dispersed shareholders and non-unionized workers are complementary organizational forms and generate a form of corporate governance interacting with complementary corporate assets. A similar set of institutional meta-complementarities characterizes the relation between concentrated ownership, unionized workers and corporate assets. [ABSTRACT FROM AUTHOR]

I draw on the findings of a recently completed comparative research project to address the question: how did intergenerational social mobility change over cohorts of men and women born in the first two-thirds of the twentieth century, and what role, if any, did education play in this? The countries studied are the US, France, Germany, the Netherlands, and Sweden. Notwithstanding the differences between them, by and large they present the same picture. Rates of upward mobility increased among cohorts born in the second quarter of the century and then declined among those born later. Among earlier born cohorts, social fluidity increased (that is, the association between the class a person was born into and the class he or she came to occupy as an adult declined) and then remained unchanged for those born after mid-century. The association between class origins and educational attainment followed much the same trend as social fluidity. This suggests that growing equalization in education may have contributed to the increase in social fluidity. In our analyses we find that this is so, but educational expansion also led to greater fluidity in some countries. There is also a strong link between upward mobility and social fluidity. Upward mobility was mostly driven by the expansion of higher-level white-collar jobs, especially in the 30 years after the end of the Second World War. This facilitated social fluidity because people from working class and farming origins could move into the service or salariat classes without reducing the rate at which children born into those classes could remain there. Educational expansion, educational equalization, and rapid structural change in the economies of the US and Europe all contributed to greater social fluidity among people born in the second quarter of the twentieth century. For people born after mid-century, rates of downward mobility have increased: however, despite the lack of further educational equalization and less pronounced structural change, social fluidity has remained unchanged. [ABSTRACT FROM AUTHOR]

Abstract Objective The European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 health-related quality of life questionnaire is one of the most widely used cancer-specific health-related quality of life questionnaires worldwide. General population norm data can facilitate the interpretation of QLQ-C30 data obtained from cancer patients. This study aimed at systematically collecting norm data from the general population to develop European QLQ-C30 norm scores and to generate comparable norm data for individual countries in Europe and North America. Methods We collected QLQ-C30 data from the general population across 11 European Union (EU) countries, Russia, Turkey, Canada and United States (n ≥ 1000/country). Representative samples were stratified by sex and age groups (18–39, 40–49, 50–59, 60–69 and ≥ 70 years). After applying weights based on the United Nations population distribution statistics, we calculated QLQ-C30 domain scores to generate a 'European QLQ-C30 Norm' based on the EU countries. Further, we calculated QLQ-C30 norm scores for all 15 individual countries. Results A total of 15,386 respondents completed the online survey. For the EU sample, most QLQ-C30 domains showed differences by sex/age, with men scoring somewhat better health than women, while age effects varied across domains. Substantially larger differences were seen in inter-country comparisons, with Austrian and Dutch respondents reporting consistently better health compared with British and Polish respondents. Conclusions This study is the first to systematically collect EORTC QLQ-C30 general population norm data across Europe and North America applying a consistent data collection method across 15 countries. These new norm data facilitate valid intra-country as well as inter-country comparisons and QLQ-C30 score interpretation. Highlights • Updated general population norm data for EORTC QLQ-C 30 based on 15,386 persons across 13 European countries, Canada, and USA. • Study strength: all individual country QLQ-C30 norm data collected based on a common sampling strategy and survey design. • New normative data facilitate valid intracountry and especially intercountry comparisons and QLQ-C30 score interpretation. [ABSTRACT FROM AUTHOR]

Understanding the challenges of professionals in addressing child adversity is key to improving the detection, protection, and care of exposed children. We aimed to synthesize findings from qualitative studies of professionals’ lived experience of addressing child adversity. Through a systematic search, we identified eight qualitative studies and synthesized them using metaethnography. We generated three themes, “feeling inadequate,” “fear of making it worse,” and “facing evil,” and one overarching metaphor, “walking children through a minefield.” The professionals felt that they lacked the means necessary to explore child adversity, that they were apprehensive of worsening the child’s situation, and that their work with child adversity induced emotional discomfort. This metasynthesis indicated that the professionals’ efficiency in exploring abuse relied upon their ability to manage emotional and moral distress and complexity. To support children at risk, we propose developing professionals’ ability to build relationships, skills in emotion regulation, and proficiency in reflective practice. [ABSTRACT FROM AUTHOR]

Low-cost carriers (LCCs) are assumed to adopt a certain business model in which an important element is the concentration of services at secondary and regional airports. Yet, evidence suggests that increasingly LCCs also establish themselves in what can be considered the major airports. This raises the question of whether LCCs are changing their business model and adopting practices associated with the traditional, incumbent airlines, and if so what might cause such change. Based on categorization of airports and using OAG flight data the US and European markets are investigated. Focusing on several LCCs, with more attention given to Southwest and Ryanair, their profile of operation with respect to the type of airports used is analysed for a period of between 15 and 25 years and up to 2015. The results clearly indicate that LCCs are increasing their operations from major airports, while generally continuing their growth and expansion strategy. The main implication of which is the increase in direct competition between LCCs and traditional airlines while the impacts of this change on the smaller airports are not clear yet and need to be investigated further. [ABSTRACT FROM AUTHOR]

Urban growth management has become a common term to circumscribe strategies and tools to regulate urban land use in metropolitan areas. It is particularly used to counteract negative impacts of urban sprawl but also to frame future urban development. We discuss recent challenges of urban growth in 6 European and 2 US American city-regions. The paper compares the urban development focusing on a quantification of drivers and effects of urban growth and a qualitative analysis of the applied urban growth management tools. We build our analysis on findings from the EU-FP6 project PLUREL. The cities have different success in dealing with urban growth pressure - some can accommodate most growth in existing urban areas and densify, others expand or sprawl. Urban growth management is no guarantee to contain urban growth, but the case studies offer some innovative ways how to deal with particular challenges. [ABSTRACT FROM AUTHOR]

This article examines how the urban context, rather than national or regional context, shapes local immigrant integration policies. We draw on the integration experiences of four large European and American cities—Berlin, Amsterdam, New York City, and San Francisco—to develop a basic inductive framework for explaining when and why city officials enact and implement policies that promote immigrant integration. Our framework highlights the importance for cities to have (1) left-leaning governments, (2) immigrants who constitute a large part of the city electorate and are part of local decision-making structures, and (3) an infrastructure of community-based organisations that actively represent immigrants’ collective interests in local politics and policy-making. We show that when these three factors exist synergistically, cities are more likely to commit themselves to policies that promote immigrant integration even when the national context is not very hospitable to immigrant rights. [ABSTRACT FROM PUBLISHER]

INTRODUCTION Asylum seekers face a wide array of challenges, including the need for a fair and just adjudication process. In the state of Georgia, the Atlanta Asylum Network addresses the needs of such individuals by providing them physical, psychological and gynecological assessments, the results of which are presented to the courts in the asylum appeal process. OBJECTIVE As a component of the Network’s program evaluation, assess outcomes among asylum seekers using its services, as well as relation of outcomes to type of service provided, the individual’s geographic origin and English language proficiency. METHODS A retrospective examination was conducted of program data gathered by the Network between 2003 and 2012. Subjects included asylum seekers who received assessments by the Network during this period. The primary variable of interest was the final case outcome, defined as determination of asylum status: granted, withholding of removal, administrative closure and prosecutorial discretion, denied or voluntary departure. Outcomes were subsequently collapsed into a single positive or negative outcome variable. Positive outcomes included asylum granted, removal withheld, administrative closure and prosecutorial discretion. Negative outcomes included asylum denied and voluntary departure. We conducted bivariate and multivariate analyses, relating final case outcomes to Network services, geographic origin and English language proficiency, among the key variables. RESULTS A total of 69 of 120 asylum seekers in the study had a known final case outcome, and of those, 63.8% (44) had a positive outcome; or 37% of the total number of asylum seekers (n = 120). Among the 20 who received 2 of the 3 types of assessment (physical, psychological, gynecological), 16 (80%) received a positive case outcome. Most persons with a known final outcome came from Africa (41), where 78% (32) of cases resulted positive. Asylum seekers not proficient in English were 2.4 times more likely to have a negative case outcome. CONCLUSION Network assessment appears to result in higher rates of positive case outcomes compared to the average for asylum seekers seen in the Atlanta circuit court. Areas for programmatic improvement include systematic followup and increased community awareness of Network services, since the Network may directly impact future case outcomes by offering assessment to more asylum seekers. Access to English language instruction and legal representation for asylum claimants may also contribute to more cases with positive outcomes. [ABSTRACT FROM AUTHOR]

Financial regional arrangements vary across countries and change over time. Until recently, most economists and political scientists took the European model of monetary integration as the yardstick to which all other regional financial arrangements had to measure up in this article. It is argued that the Euro crisis provides an opportunity for scholars to adopt a different perspective that does not interpret the variety of financial arrangements merely as economic deficiencies caused by the incapacity or unwillingness of regions to follow the European model. Instead, the comparative study of monetary and financial regionalism has to account for the different factors that shape variations. These go from different levels of economic development, over regional political and economic preferences to historical processes which shape the institutional context and the constellation of interests and social forces. Such an approach, which integrates economic and political science approaches, de-centres the Euro model and opens up a new understanding of the global diversity of regional monetary and financial cooperation, and their potential to cope with financial crises. [ABSTRACT FROM PUBLISHER]

OBJECTIVES: To investigate the until now undefined extent of differences in baseline characteristics, practice patterns and clinical outcomes of patients undergoing coronary artery bypass grafting (CABG) for complex coronary artery disease in the USA versus Europe. METHODS: The impact of geographic enrolment on clinical outcomes was explored using the as-treated population of 1510 patients with de novo left main and/or three-vessel disease who underwent CABG in either the SYNTAX randomized trial or registries, and who were followed up for 5 years. RESULTS: There were 259 (17%) patients enrolled in the USA. Patients in the USA had more comorbidities. Off-pump procedures were more frequent in the USA (32 vs 13% in Europe; P < 0.001), and crystalloid cardioplegia was used less often (17 vs 38% in Europe; P < 0.001). In the USA, more grafts per patient were used (3.1 ± 0.8 vs 2.7 ± 0.7 in Europe; P < 0.001), with less complete arterial grafting (5 vs 18% in Europe; P < 0.001) but more complete revascularization (80 vs 66% in Europe; P < 0.001). At 5-year follow-up, patients treated in the USA versus Europe had comparable rates of major adverse cardiac and cerebrovascular events (MACCEs: 28.7 vs 24.3%, respectively; P = 0.11) and the composite safety endpoint of death, stroke and myocardial infarction (MI; 15.3 vs 17.5%, respectively; P = 0.43), but a significantly higher rate of repeat revascularization (15.0 vs 9.8%, respectively; P = 0.011) driven by repeat percutaneous coronary intervention (14.6 vs 9.2%; P = 0.005) and not repeat CABG (0.4 vs 0.8%; P = 0.48). Rates of graft occlusion were significantly higher in the USA versus Europe (8.7 vs 3.2%; P < 0.001). In multivariate analysis, enrolment in the USA was a non-significant predictor of MACCE [hazard ratio (HR) = 1.31, 95% confidence interval (95% CI) 1.00-1.73; P = 0.053], but independently predicted repeat revascularization (HR = 1.66, 95% CI 1.12-2.46; P = 0.011) and graft occlusion (HR = 2.65, 95% CI 1.52-4.62; P = 0.001). It was also a non-significant predictor of reduced rates of MI (HR = 0.38, 95% CI 0.14-1.06; P = 0.064). Differences between the USA and Europe were most pronounced among patients who underwent off-pump CABG. CONCLUSIONS: Repeat revascularization rates following CABG in the USA versus Europe were increased at 5 years, particularly in off-pump patients. There was no significant difference in the rate of death, stroke and MI. [ABSTRACT FROM AUTHOR]

The analysis of the location patterns of economic activities in both Europe and the US has been addressed in an extensive literature dependent on increasingly more sophisticated techniques that arguably reframe debate away from the policy questions in focus and towards debate on the complex empirical techniques that seem to be in vogue at any given time. In part this has been a response to some clear shortcomings in the use of simple locational Gini coefficients. It is argued herein that simple index approaches can still retain value if augmented with intuitive reading of some relevant maps. An example of the utility of this approach is provided in relation to the location patterns of four exemplar manufacturing industries in the EU and USA. [ABSTRACT FROM AUTHOR]

The European Union chemical regulation REACH entered into force in 2007. The most ambitious regulations on chemicals in the World will soon become a source of inspiration for other countries to review their own national regulations on chemicals. This is also the case of the USA where the failure of the Toxic Substances Control Act (TSCA) of 1976 to provide a high level of protection for human health and environment contributed to a general consensus for reform. Several reform proposals were considered and discussed in both chambers of Congress, reflecting to various degrees some principles of the European REACH. This article deals with the US chemical policy reform in the context of the European experience with REACH, assessing whether the US chemical policy review is subject to Europeanisation or whether the influence of REACH on the US reform is merely superficial. [ABSTRACT FROM AUTHOR]

This article is concerned mostly about the institutional competitiveness of EU compared to the USA from the point of view of the quality of the business environment. On short term, EU economic environment can become as free as EU decisional bodies and politicians would want or allow it. EU official position appears to be ambiguous concerning the future of the business environment, despite acknowledging the necessity of improving it in order to stimulate entrepreneurship. Despite economic, political and regulatory integration, European business environment varies across among member states. This heterogeneity has advantages that would be jeopardized by a top-down and forced harmonization. The main advantage is institutional competition that could lead to voluntary generalization and further improvements of best practices, while a coerced uniformity would prevent future institutional experiments and benchmarking. Adoption of first, second or even third best practices at EU level would make European business environment more favorable than USA's. At national level, adopted policies depend ultimately upon median voter's understanding of their respective costs and benefits. Polls and electoral results suggest that the median voter is sometimes confused in making this evaluation. One concluding remark is that the only durable remedy to that persistent confusion is economic education. [ABSTRACT FROM AUTHOR]

Based upon an empirical research (a questionnaire survey) carried out among social geographers of different countries at the turn of 2013 and 2014, the main purpose of this article is to demonstrate the major characteristics and conditions of scientific qualification and the evaluation of scientific performance in different countries from social geographical aspect. The importance of publications and citations is also discussed in the judgement of academic performance. Not only are the differences revealed among European countries and USA in the scientific qualification and scientific performance but also the similarities. The most important consequences of the survey are the followings: the differences between developed Western countries and Eastern European countries in the requirements of scientific qualification have decreased meanwhile the role of qualitative viewpoints has increased in the different evaluation processes. [ABSTRACT FROM AUTHOR]

This paper empirically investigates the contagion effects of the Global Financial Crisis (2007-2009) from the financial sector to the real economy by examining nine sectors of US and developed European region. We provide a regional analysis by testing stock market contagion on the aggregate level and the sector level, on the global level and the domestic/regional level. Results show evidence of global contagion in US and developed European aggregate stock market indices and all US sector indices, implying the limited benefits of portfolio diversification. On the other hand, most of the European regional sectors seem to be immune to the adverse effects of the crisis. Finally, all non-financial sectors of both geographical areas seem to be unaffected by their domestic financial systems. These findings have important implications for policy makers, investors and international organizations. [ABSTRACT FROM AUTHOR]

Management of postoperative pain remains an important clinical problem throughout the world. Using the PAIN-OUT acute pain registry database to examine perioperative pain management in orthopedic surgery patients, we compared patient-reported outcomes (PROs) in a pooled sample obtained from four American hospitals ( N = 473) with PROs in a pooled sample of 20 European institutions ( N = 8799). Most American hospitals consistently assess acute pain in surgical patients due to Joint Commission accreditation guidelines. Therefore, we hypothesized that this practice would create a climate of clinical staff sensitivity to patients' pain and a greater readiness to intervene when pain is higher than one would find in Europe as a whole. American institutions might then provide better control of postoperative pain after orthopedic surgery than European institutions. Because of the large sample sizes, our analyses focused on effect size rather than statistical significance. Evaluation of the pain PROs revealed that European patients reported much lower Worst Pain on the first day after orthopedic surgery than American patients. The mean Worst Pain (± SD) for Europeans was 5.4 (2.5) but for Americans the mean was 7.4 (2.7), p < .0001, a large effect size. Europeans also reported significantly less emotional discomfort, less interference of pain with activity and lower Least Pain. Nonetheless, 98.3% of American patients received opioids on the ward on the first postoperative day compared to 70.2% of European patients, and 41.1% received regional analgesia on the ward while 15.9% of European patients received regional analgesia (both small effect sizes). Overall, the results are clear in demonstrating much better pain control in the ensemble of European countries as compared to the United States. [ABSTRACT FROM AUTHOR]

Regulating children’s and adolescents’ access to video games appeared on the agenda of media lawmakers from the 1990s on. Approaches in western democracies have largely followed the approach of industry self-regulation, resulting in a diverse set of different types of self-regulation systems. This study applies a comparative perspective on the actual rating practices, asking how far regulation systems differ systematically and how far these differences might lead to different rating decisions. The study analyzes both the set-up of three major western regulation systems (the German USK, the pan-European PEGI and the US ESRB) and the actual rating decisions in each of the three systems relying on secondary data at the aggregate level, individual rating decisions for 182 top-selling titles and a list of favorite video games of 744 adolescents in the US and Germany. Findings illustrate that each system has a distinct focus, according to which it regulates different video game use more strongly than the other systems. [ABSTRACT FROM PUBLISHER]

Background: Lyme disease incidence is increasing in Europe, the USA, and Canada. In 2010, a comparison of surveillance systems for Lyme disease (LD) in humans in 28 European countries showed that systems highly varied, making epidemiological comparisons difficult. Details by country were not published. In 2018, one of LD clinical manifestations, neuroborreliosis, was added under European Union (EU) surveillance to standardise definitions. In this study, we identified and compared, 10 years after the European inventory, the characteristics of national surveillance systems and policies for LD in humans, with additional countries., Methods: Thirty-four European and North American countries were included. Information on national "traditional" systems (which compile data reported by clinicians and laboratories) and "public participatory" websites and mobile applications (which collect information directly from the public) were searched in MEDLINE, a systematic evidence map, and Google. An existing framework on LD surveillance was adapted to capture information on the administration level, indicators, reporting entities, coverage, and obligation to report., Results: A surveillance system was found for 29 (85%) countries. Twenty-four had a traditional system alone, one had a public participatory system alone, and the remaining had both. Among countries with traditional systems, 23 (82%) administered them at the national level. Nineteen (68%) required mandatory reporting. Sixteen (57%) used both clinicians and laboratories as reporting entities. Eighteen (64%) employed case definitions, most of which considered both neuroborreliosis and erythema migrans (n = 14). Others monitored the number of positive laboratory tests and/or patient consultations. Public participatory systems were only implemented in countries employing either also sentinels or voluntary surveys, or no traditional system, suggesting their use as a complementary tool. Only 56% of EU countries had neuroborreliosis as an indicator., Conclusion: The situation remains similar to 2010 with persisting heterogeneity between systems, suggesting that countries prioritise different surveillance objectives for LD. Without a common indicator in Europe, it is difficult to get a clear epidemiological picture. We discuss four factors that potentially influence LD surveillance strategies: perceptions of severity, burden on resources, two-way communication, and the medical conflicts about LD. Addressing these with countries might help moving towards the adoption of common practices., (© 2022. The Author(s).)

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In the last years an increasing trend has taken place in the universities of the whole world to protecting their inventions across rights of patents. This fact reflects the major usefulness of the university investigation and the intention of transferring these results to the industry. In this work we study the patents that have applied, across the European route, the Japanese, American and European universities, in order to establish a comparative analysis among them. We analyze the level of applications that they present, the technological areas and the extension of the protection of these patents and the ranking of the universities that more patents applied and of the companies that collaborate with these universities. [ABSTRACT FROM AUTHOR]

In terms of strategic developments on the international arena, last year was not characterized by sudden change-ups of the major international actor state's habitual trends: European states continued to be in a process of identification of effective economic recovery solutions within EU, as well as USA, which already implemented the economic stimulus package, succeeding to prevent a prolonged recession; China continued to strengthen its economic position at global level, simultaneously with the identification of new energy resources. Nevertheless, there were some events which could provide us arguments in the support of the idea that there were state-actors which raised their level of aspiration and consequently leading to the modification of their position on the international arena. In this regard, France and Russia' strategic trends seemed to be significant in our opinion. That is why we will further analyze them, both of them presenting, in our opinion, a common element: their actions within and towards NATO. [ABSTRACT FROM AUTHOR]

The article deals with the separation of church and state as the key historical turning point in the creation of one of the fundamental determining factors of contemporary states and political systems. The author gives an account of the contributions of the American and European political traditions, and presents a very comprehensive historical context in which Christianity introduced a new model of relations between church and state. The Western tradition of church-state interrelations is essentially characterized by the problem of separation, and by various legal-political arrangements founded on the principle of separation of church and state. Consequently, the article aims to put forward some of the relevant ideas which contributed to the creation of the church separation principle, as well as some of the basic elements of the relations between church and state in contemporary political systems. [ABSTRACT FROM AUTHOR]

Copyright of Rivista di Studi Politici Internazionali is the property of Edizioni Studium S.r.l and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: In 1975, 50 year-old Americans could expect to live slightly longer than most of their Western European counterparts. By 2005, American life expectancy had fallen behind that of most Western European countries. We find that this growing longevity gap is primarily due to real declines in the health of near-elderly Americans, relative to their Western European peers. We use a microsimulation approach to project what US longevity would look like, if US health trends approximated those in Western Europe. The model implies that differences in health can explain most of the growing gap in remaining life expectancy. In addition, we quantify the public finance consequences of this deterioration in health. The model predicts that gradually moving American cohorts to the health status enjoyed by Western Europeans could save up to $1.1 trillion in discounted total health expenditures from 2004 to 2050. [Copyright &y& Elsevier]

•Media debates after the invasion of Iraq suggested that there was a growing anti-Americanism in Europe and that this contributed to an increasing sense of European identity as representing values that differed from that of the USA. But what if this anti-Americanism was really anti-Bushism, and how shared are the shared values on the European side when it comes to representation of the USA as Other? The articles in this Special Issue focus on the discursive image of the USA in the elite media of five European countries at points in time from a particularly frosty Cold War period under President Reagan until six months after the installation of President Obama. Taken together, there are broad similarities in the paradigms and characteristics used to depict the USA from the post-Cold War period, especially in French, Finnish, Swedish and German media. Below the surface, however, the narratives reveal that each country’s commentators are mainly interested in the USA in relation to domestic concerns or as a prism for its relationships with other countries on the world stage. There is a stark focus on the US presidents as symbols through which the USA as a whole is seen. Both Democratic and Republican presidents are likened to Rambo, the ‘space cowboy’, the ‘trade and cultural warrior’, or Hollywood ‘stars’, which could be interpreted as a measure of cultural disdain towards American popular culture and militarism. • [ABSTRACT FROM PUBLISHER]

Accession to the European Union (EU) constitutes one of Turkey's primary foreign policy objectives. However, to establish whether the country would benefit from becoming part of an integrated Europe, its foreign policy alternatives to EU membership must also be examined. The first part of this article analyses Turkey's changing relations with Europe. Against this backdrop, the article then moves to assess Turkey's partnership with the USA and the potential of maintaining a close relationship independent from Europe. The role of Russia, Turkey's old neighbours and relations with the Turkic states, as well as the potential for attaining a leading role among them, are also considered. The argument is that Turkey may exploit its geostrategic position to pursue its core foreign policy interests and even assume an important regional role. However, Ankara ought to concentrate on what has long been its priority - full Turkish membership of the EU. [ABSTRACT FROM AUTHOR]

The paper aims to discuss if there is any similarity between two distant events like the end of the Napoleonic era and the creation of a new Concert of Power, in 1815, and the fall of the Berlin Wall, in November 1989. Even if at first sight, no direct connection can be found, the fact that both can be analysed as performing important functions in the creation of a new European security order and a new architecture of power allows us to pursue this comparative analysis. From the international relations theory point of view, one can say that both followed hegemonic wars which resulted in the redrawing of European political map and in the creation of a new continental order. The complexity of the long series of events which were triggered off by these important landmarks requires, nevertheless, a deeper analysis of the implications and consequences of both episodes in European history. [ABSTRACT FROM AUTHOR]

Has the global credit crunch shifted the foundations of global financial architecture away from the philosophy of 'neoliberalism'? In this article, we argue that the neoliberal project is most probably dead and buried, despite the apparent commitment, which we detail in this article, to the spirit of neoliberal thinking in economic thought. By analysing three constitutive elements of neoliberalism (its public, private and regulatory components) before and after the credit crunch, we reveal important geopolitical shifts which are likely to prevent a return to 'business as usual' in the world of finance. We find that the defining trend among these changes is the global rise of the Eurozone. Specifically, we argue that the ideal, Anglo-Saxon model of neoliberalism was viable because it was heavily subsidised from around the world. Accordingly, the key to the future of Anglo-Saxon neoliberalism lies with the willingness of European, East Asian and Middle Eastern creditors to continue extending their financial support to the Anglo-Saxon model of finance. We believe that they are unlikely to do so in the future. Spurred by the magnitude of the credit crunch, the rise of Europe is progressively weakening each of the three dimensions of Anglo-Saxon neoliberalism we identify in this article. [ABSTRACT FROM AUTHOR]

Abstract: Limited access to healthcare for vulnerable immigrant children in Europe and North America is increasingly worrisome as immigration policies harden. This paper analyzes the gap between States'' obligations under international human rights law and the disparate local implementations in diverse countries. Studies that are both multidisciplinary and incorporate micro and macro level indicators are needed to reveal discrepancies between entitlements and access. It is argued that the lack of available data on the magnitude of the problem and on its individual and public health consequences stems from the conflicting situation faced by health institutions required to simultaneously protect the best interest of each child and allocate limited resources. Collaboration in research is urgently needed to assist policy-makers and institutions make informed decisions. [Copyright &y& Elsevier]

The national research and development (R&D) base has in the post-cold war era gained increased importance in order to fill new security demands. There is a broadening of the search for security relevant science and technology involving more organizations and interests, scientific disciplines and nations. The question discussed in this article is if the premises of international, free and open R&D will be(come) compromised? Will we see more scientists, in their normal scientific activities, being accused of spying? The article suggests that such risks are not unrealistic to expect. Spy cases in less democratic countries could have consequences for scientists also in other countries. Outcomes depend on, among other things, the relative strengths of academic freedom and a political Identification Friend and Foe (IFF) component. United Nations and European Union resolutions restricting science education for students from Iran and North Korea in an attempt to prevent the spread of nuclear weapons illustrate a strong IFF component. Difficulties with regard to the implementation of these resolutions and other findings are presented in the final section of the article. [ABSTRACT FROM AUTHOR]

The banking industry has one of the most active markets for mergers and acquisitions. However, little is known about the type of operational strategies adopted by banking firms in the years following a deal. For a sample of bidding banks in the USA and Europe, this study compares the design and performance implications of different post-merger strategies in both geographical regions. Using accounting data, we show that European banks pursue a cost-cutting strategy by increasing efficiency levels vis-à-vis non-merging banks and by cutting back on both labour costs and lending activities. US banks, on the other hand, raise both interest and non-interest income in the post-merger period. [ABSTRACT FROM AUTHOR]

Globally the biopharmaceutical industry is characterized by strong competition, research-intensive and protracted new product development (NPD) processes, intensive regulation and extensive alliance activity. Policy regimes and operating environments differ markedly, however. Here we examine how these differences impact on the NPD strategies of biopharmaceutical firms in the USA and three major EU economies (the UK, France and Germany). Our analysis suggests four key differences between firms' NPD strategies in the two areas. First, while levels of R&D intensity and continuity are broadly similar in the two areas, US firms have notably stronger patent profiles, and are significantly more active in technology licensing than their European counterparts. Second, product development cycles are significantly longer in the USA than among our European respondents. Third, the nature of the product development pipeline is very different in the USA and the major European economies covered by our study: US firms conduct early stage development of more compounds than European firms but take only a similar number to market. Fourth, we see broadly similar levels of alliance activity in our US and European respondents at both the early and late stages of the NPD process. These results suggest a greater substitution of “market” for “hierarchy” in US firms' NPD strategies, reflecting differences in the availability and structure of government support in the USA and Europe. [ABSTRACT FROM AUTHOR]

We initiate some comparisons between Japan, Europe and USA on how far there is governmental support for the ethical, legal, social and environmental dimensions of nanotechnology development. It is evident that in the USA and Europe nanotechnology is now firmly embedded in the consideration of ELSI. Yet Japan has not yet adequately recognized the importance of these dimensions. The history of bioethics in Japan is short. In Europe, as early as 2004, a nanotechnology report by the UK's Royal Society referred to the possibility of some nanotubes and fibres having asbestos-like toxicity. The negative history of asbestos in Europe and USA is not yet fully identified as a Japanese problem. Japan is therefore in the process of seeking how best to address societal aspects of nanotechnology. Should the precautionary principle be applied to Japan's nanotechnology initiative as in Europe? Should 5–10% of the government's nanotechnology budget be allocated to ELSI research and measures? We propose that the government and industrial sector in Japan play a much more proactive part in the regional and international growth of research into the wider risk assessment, social, health and environmental context of nanotechnologies, not simply try to borrow lessons from the West at a later date. [ABSTRACT FROM AUTHOR]

Copyright of Društvena Istraživanja is the property of Institute of Social Sciences Ivo Pilar and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: This study aimed to compare property development and increasing investment in real estate by the healthcare system organizations in the USA and Europe. Real estate investments have upsurged in healthcare due to the multiple benefits to patients and medical practitioners. Methods: The approach of acquiring data was through secondary sources and online questionnaires. The researchers applied inclusion and exclusion criteria by exclusively including the articles published after 2014 to ensure the validity and reliability of the information. Results: A total of 53.33% of the articles reviewed focused on the United States, while 46.67% concentrated on Europe. The development of real estate in healthcare is essential in both regions due to the challenges faced with the current infrastructure. Study Limitation: Currently, there are very few studies concentrating on the research topic. Conclusions: The USA and Europe should focus on increasing real estate investments in healthcare by focusing on hospitals and trusts, rehabilitation centers, and nursing homes. [ABSTRACT FROM AUTHOR]

This paper compares the immediate success of the diffusion of punched cards in the United States in 1890 with their hesitant reception in Europe until 1918. This difference has so far been understood as a reflection of European backwardness but, as this paper argues, is better understood as an indication of more efficient European bureaucracies, both public and private. Further, the spread of punched card equipment in Europe until the 1900s was impeded by the absence of agencies in Europe to handle sales and maintenance. The analysis also shows that, even after 1918, the spread of punched cards in Europe was not a simple infusion of US technology. European agencies contributed significantly to the shaping of the technology. [ABSTRACT FROM AUTHOR]