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In order to support economic development across all European Union regions, €351.8 billion –almost a third of the total EU budget– has been set aside for the Cohesion Policy during the 2014–2020 period. The distribution of this budget is made through five main structural and investment funds, after long and difficult negotiations among the EU member states. This paper analyzes the problem of allocating the limited resources of the European Regional Development Fund as a conflicting claims problem. Specifically, we attempt to show how the conflicting claims approach fits this actual problem, and we propose alternative ways of distributing the budget via (i) claims solutions or (ii) the imposition of bounds (guarantees) to each of the regions. By applying this approach we also show that there is a claims solution that performs better than the others by reducing inequality and promoting convergence to a greater degree. It is clear that political bargaining will always be part of the allocation process. However, having an intuitive initial proposal may help politicians to find the best agreement. To that effect, we propose the use of a claims solution as a way to find an initial proposal for future policy changes concerning the allocations of the EU structural funds. This work is partially supported by Generalitat de Catalunya (2018PFR-URV-B2-53) and Ministerio de Economía y Competitividad (PID2019-105982GB-I00/AEI/10.13039/501100011033 and ECO2016-77200-P). Open Access funding provided thanks to the CRUE-CSIC agreement with Springer Nature.

Objectives: To examine whether areal bone mineral density (aBMD) differs between metabolically healthy (MHO) and unhealthy (MUO) overweight/obese children and to examine the role of moderate-to-vigorous physical activity (MVPA) and cardiorespiratory fitness (CRF) in this association. Methods: A cross-sectional study was developed in 188 overweight/obese children (10.4 ± 1.2 years) from the ActiveBrains and EFIGRO studies. Participants were classified as MHO or MUO based on Jolliffe and Janssen’s metabolic syndrome cut-off points for triglycerides, glucose, high-density cholesterol and blood pressure. MVPA and CRF were assessed by accelerometry and the 20-m shuttle run test, respectively. Body composition was measured by dual-energy X-ray absorptiometry. Results: In model 1 (adjusted for sex, years from peak high velocity, stature and lean mass), MHO children had significantly higher aBMD in total body less head (Cohen’s d effect size, ES = 0.34), trunk (ES = 0.43) and pelvis (ES = 0.33) than MUO children. These differences were attenuated once MVPA was added to model 1 (model 2), and most of them disappeared once CRF was added to the model 1 (model 3). Conclusions: This novel research shows that MHO children have greater aBMD than their MUO peers. Furthermore, both MVPA and more importantly CRF seem to partially explain these findings. This study has been partially funded by the University of Granada, UGR Research and Knowledge Transfer Fund (PPIT) 2016, Excellence Actions Programme: Units of Scientific Excellence; Scientific Unit of Excellence on Exercise and Health (UCEES), and by the Regional Government of Andalusia, Regional Ministry of Economy, Knowledge, Enterprises and University and European Regional Development Fund (ERDF), ref. SOMM17/6107/UGR. The ActiveBrains study was funded by the Spanish Ministry of Economy and Competitiveness (Reference DEP2013-47540, DEP2016-79512-R, and DEP2017-91544-EXP). The EFIGRO study was funded by the Spanish Ministry of Health, 'Fondo de Investigación Sanitaria del Instituto de Salud Carlos III' (PI13/01335), 'Fondos Estructurales de la Unión Europea (FEDER), Una manera de hacer Europa,' and by the University of the Basque Country (GIU14/21). L.G.-M. is supported by 'La Caixa' Foundation within the Junior Leader fellowship programme (ID 100010434); M.M. is supported by the Spanish Ministry of Education, Culture and Sport (FPU14/03329) and EST17/00210; L.A. is supported by the Education Department of the Government of the Basque Country (PRE_2016_1_0057, PRE_2017_2_0224 and PRE_2018_2_0057); J.M.-G. and J.H.M. are supported by the Spanish Ministry of Education, Culture and Sport (FPU14/06837 and FPU15/02645, respectively).

Background: Clinical decision support (CDS) for electronic prescribing systems (computerized physician order entry) should help prescribers in the safe and rational use of medicines. However, the best ways to alert users to unsafe or irrational prescribing are uncertain. Specifically, CDS systems may generate too many alerts, producing unwelcome distractions for prescribers, or too few alerts running the risk of overlooking possible harms. Obtaining the right balance of alerting to adequately improve patient safety should be a priority. Methods: A workshop funded through the European Regional Development Fund was convened by the University Hospitals Birmingham NHS Foundation Trust to assess current knowledge on alerts in CDS and to reach a consensus on a future research agenda on this topic. Leading European researchers in CDS and alerts in electronic prescribing systems were invited to the workshop. Results: We identified important knowledge gaps and suggest research priorities including (1) the need to determine the optimal sensitivity and specificity of alerts; (2) whether adaptation to the environment or characteristics of the user may improve alerts; and (3) whether modifying the timing and number of alerts will lead to improvements. We have also discussed the challenges and benefits of using naturalistic or experimental studies in the evaluation of alerts and suggested appropriate outcome measures. Conclusions: We have identified critical problems in CDS, which should help to guide priorities in research to evaluate alerts. It is hoped that this will spark the next generation of novel research from which practical steps can be taken to implement changes to CDS systems that will ultimately reduce alert fatigue and improve the design of future systems.