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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]

This paper proposes an adaptive network fuzzy inference system (ANFIS) based decision support system that can provide European policy makers with systematic guidance in allocating and prioritizing scant public resources, whilst accomplishing the best growth performance at a regional level. We do so by taking the stance of the Smart Specialization Strategies, which aim at consolidating the regional strengths and make effective and efficient use of public investment in R&D. By applying the ANFIS method, we were able to understand how—and to what extent—the competitiveness drivers promoted technological development and how the latter contributes to the economic growth of European regions. We used socio–economic, spatial, and patent-based data to train, test, and validate the models. What emerges is that an increase of R&D investments enhances the regional employment rate and the number of patents per capita; in turn, by taking into account the several combinations of specialization and diversification indicators, this leads to an increase of the regional gross domestic product (GDP). [ABSTRACT FROM AUTHOR]

Economic crises carry a substantial impact on population health and health systems, but little is known on how these transmit to health workers (HWs). Addressing such a gap is timely as HWs are pivotal resources, particularly during pandemics or the ensuing recessions. Drawing from the empirical literature, we aimed to provide a framework for understanding the impact of recessions on HWs and their reactions. We use a systematic review and best-fit framework synthesis approach to identify the relevant qualitative, quantitative and mixed-methods evidence, and refine an a priori, theory-based conceptual framework. Eight relevant databases were searched, and four reviewers employed to independently review full texts, extract data and appraise the quality of the evidence retrieved. A total of 57 peer-reviewed publications were included, referring to six economic recessions. The 2010-15 Great Recession in Europe was the subject of most (52%) of the papers. Our consolidated framework suggests that recessions transmit to HWs through three channels: (1) an increase in the demand for services; (2) the impacts of austerity measures; and (3) changes in the health labour market. Some of the evidence appeared specific to the context of crises; demand for health services and employment increased during economic recessions in North America and Oceania, but stagnated or declined in Europe in connection with the austerity measures adopted. Burn-out, lay-offs, migration and multiple jobholding were the reactions observed in Europe, but job opportunities never dwindled for physicians during recessions in North America, with nurses re-entering labour markets during such crises. Loss of motivation, absenteeism and abuse of health systems were documented during recessions in low-income countries. Although the impacts of recessions may vary across economic events, health systems, labour markets and policy responses, our review and framework provide an evidence base for policies to mitigate the effects on HWs. [ABSTRACT FROM AUTHOR]

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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]

The article offers public health news briefs in Europe as of June 2021. The European Union (EU) government launched its "Europe's Beating Cancer Plan" to control and eradicate cancers. Other news include the scheduled 14th European Public Health (EPH) Conference in November, and the need to achieve health equity in the region by establishing well-being economies.

Background In responding to Covid-19, governments have tried to balance protecting health while minimizing gross domestic product (GDP) losses. We compare health-related net benefit (HRNB) and GDP losses associated with government responses of the UK, Ireland, Germany, Spain and Sweden from UK healthcare payer perspective. Methods We compared observed cases, hospitalizations and deaths under 'mitigation' to modelled events under 'no mitigation' to 20 July 2020. We thus calculated healthcare costs, quality adjusted life years (QALYs), and HRNB at £20,000/QALY saved by each country. On per population (i.e. per capita) basis, we compared HRNB with forecast reductions in 2020 GDP growth (overall or compared with Sweden as minimal mitigation country) and qualitatively and quantitatively described government responses. Results The UK saved 3.17 (0.32–3.65) million QALYs, £33 (8–38) billion healthcare costs and £1416 (220–1637) HRNB per capita at £20,000/QALY. Per capita, this is comparable to £1455 GDP loss using Sweden as comparator and offsets 46.1 (7.1–53.2)% of total £3075 GDP loss. Germany, Spain, and Sweden had greater HRNB per capita. These also offset a greater percentage of total GDP losses per capita. Ireland fared worst on both measures. Countries with more mask wearing, testing, and population susceptibility had better outcomes. Highest stringency responses did not appear to have best outcomes. Conclusions Our exploratory analysis indicates the benefit of government Covid-19 responses may outweigh their economic costs. The extent that HRNB offset economic losses appears to relate to population characteristics, testing levels, and mask wearing, rather than response stringency. [ABSTRACT FROM AUTHOR]