Search results for: European%20Central%20Bank%20%28ECB%29
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1652

Search results for: European%20Central%20Bank%20%28ECB%29

1382 A Comparative and Doctrinal Analysis towards the Investigation of a Right to Be Forgotten in Hong Kong

Authors: Jojo Y. C. Mo

Abstract:

Memories are good. They remind us of people, places and experiences that we cherish. But memories cannot be changed and there may well be memories that we do not want to remember. This is particularly true in relation to information which causes us embarrassment and humiliation or simply because it is private – we all want to erase or delete such information. This desire to delete is recently recognised by the Court of Justice of the European Union in the 2014 case of Google Spain SL, Google Inc. v Agencia Española de Protección de Datos, Mario Costeja González in which the court ordered Google to remove links to some information about the complainant which he wished to be removed. This so-called ‘right to be forgotten’ received serious attention and significantly, the European Council and the European Parliament enacted the General Data Protection Regulation (GDPR) to provide a more structured and normative framework for implementation of right to be forgotten across the EU. This development in data protection laws will, undoubtedly, have significant impact on companies and co-operations not just within the EU but outside as well. Hong Kong, being one of the world’s leading financial and commercial center as well as one of the first jurisdictions in Asia to implement a comprehensive piece of data protection legislation, is therefore a jurisdiction that is worth looking into. This article/project aims to investigate the following: a) whether there is a right to be forgotten under the existing Hong Kong data protection legislation b) if not, whether such a provision is necessary and why. This article utilises a comparative methodology based on a study of primary and secondary resources, including scholarly articles, government and law commission reports and working papers and relevant international treaties, constitutional documents, case law and legislation. The author will primarily engage literature and case-law review as well as comparative and doctrinal analyses. The completion of this article will provide privacy researchers with more concrete principles and data to conduct further research on privacy and data protection in Hong Kong and internationally and will provide a basis for policy makers in assessing the rationale and need for a right to be forgotten in Hong Kong.

Keywords: privacy, right to be forgotten, data protection, Hong Kong

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1381 State of Play for the World’s Largest Greenhouse Gas Emitters

Authors: Olivia Meeschaert

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The Conference of the Parties (COP) refers to the countries that signed on to the United Nations Framework Convention on Climate Change. This annual conference provides a platform for countries to voice their major climate concerns, negotiate on a number of global issues, and come to agreements with the world’s largest emitters on how to make incremental changes that will achieve global climate goals. Historically, the outcome of COP includes major climate pledges and international agreements. COP27 will take place in Egypt at the beginning of November 2022. The 197 parties will come together to develop solutions to the dire consequences of climate change that many people around the world are already experiencing. The war in Ukraine will require a different tone from last year’s COP, particularly given that major impacts of the war are being felt throughout Europe and have had a detrimental effect on the region’s progress in achieving the benchmarks set in their climate pledges. Last year’s COP opened with many climate advocates feeling optimistic but the commitments made in Glasgow have so far remained empty promises, and the main contributors to climate change – China, the European Union, and the United States of America – have not moved fast enough.

Keywords: environment, law and policy, climate change, greenhouse gas, conference of the parties, China, United States, European Union

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1380 Measures for Limiting Corruption upon Migration Wave in Europe

Authors: Jordan Georgiev Deliversky

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Fight against migrant smuggling has been put as a priority issues at the European Union policy agenda for more than a decade. The trafficked person, who has been targeted as the object of criminal exploitation, is specifically unique for human trafficking. Generally, the beginning of human trafficking activities is related to profit from the victim’s exploitation. The objective of this paper is to present measures that could result in the limitation of corruption mainly through analyzing the existing legislation framework against corruption in Europe. The analysis is focused on exploring the multiple origins of factors influencing migration processes in Europe, as corruption could be characterized as one of the most significant reasons for refugees to flee their countries. The main results show that law enforcement must turn the focus on the financing of the organized crime groups that are involved in migrant smuggling activities. Corruption has a significant role in managing smuggling operations and in particular when criminal organizations and networks are involved. Illegal migrants and refugees usually represent significant sources of additional income for officials involved in the process of boarding protection and immigration control within the European Union borders.

Keywords: corruption, influence, human smuggling, legislation, migration

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1379 Averting a Financial Crisis through Regulation, Including Legislation

Authors: Maria Krambia-Kapardis, Andreas Kapardis

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The paper discusses regulatory and legislative measures implemented by various nations in an effort to avert another financial crisis. More specifically, to address the financial crisis, the European Commission followed the practice of other developed countries and implemented a European Economic Recovery Plan in an attempt to overhaul the regulatory and supervisory framework of the financial sector. In 2010 the Commission introduced the European Systemic Risk Board and in 2011 the European System of Financial Supervision. Some experts advocated that the type and extent of financial regulation introduced in the European crisis in the wake of the 2008 crisis has been excessive and counterproductive. In considering how different countries responded to the financial crisis, global regulators have shown a more focused commitment to combat industry misconduct and to pre-empt abusive behavior. Regulators have also increased funding and resources at their disposal; have increased regulatory fines, with an increasing trend towards action against individuals; and, finally, have focused on market abuse and market conduct issues. Financial regulation can be effected, first of all, through legislation. However, neither ex ante or ex post regulation is by itself effective in reducing systemic risk. Consequently, to avert a financial crisis, in their endeavor to achieve both economic efficiency and financial stability, governments need to balance the two approaches to financial regulation. Fiduciary duty is another means by which the behavior of actors in the financial world is constrained and, thus, regulated. Furthermore, fiduciary duties extend over and above other existing requirements set out by statute and/or common law and cover allegations of breach of fiduciary duty, negligence or fraud. Careful analysis of the etiology of the 2008 financial crisis demonstrates the great importance of corporate governance as a way of regulating boardroom behavior. In addition, the regulation of professions including accountants and auditors plays a crucial role as far as the financial management of companies is concerned. In the US, the Sarbanes-Oxley Act of 2002 established the Public Company Accounting Oversight Board in order to protect investors from financial accounting fraud. In most countries around the world, however, accounting regulation consists of a legal framework, international standards, education, and licensure. Accounting regulation is necessary because of the information asymmetry and the conflict of interest that exists between managers and users of financial information. If a holistic approach is to be taken then one cannot ignore the regulation of legislators themselves which can take the form of hard or soft legislation. The science of averting a financial crisis is yet to be perfected and this, as shown by the preceding discussion, is unlikely to be achieved in the foreseeable future as ‘disaster myopia’ may be reduced but will not be eliminated. It is easier, of course, to be wise in hindsight and regulating unreasonably risky decisions and unethical or outright criminal behavior in the financial world remains major challenges for governments, corporations, and professions alike.

Keywords: financial crisis, legislation, regulation, financial regulation

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1378 Towards a Mandatory Frame of ADR in Divorce Cases: Key Elements from a Comparative Perspective for Belgium

Authors: Celine Jaspers

Abstract:

The Belgian legal system is slowly evolving to mandatory mediation to promote ADR. One of the reasons for this evolution is the lack of use of alternative methods in relation to their possible benefits. Especially in divorce cases, ADR can play a beneficial role in resolving disputes, since the emotional component is very much present. When children are involved, a solution provided by the parent may be more adapted to the child’s best interest than a court order. In the first part, the lack of use of voluntary ADR and the evolution toward mandatory ADR in Belgium will be indicated by sources of legislation, jurisprudence and social-scientific sources, with special attention to divorce cases. One of the reasons is lack of knowledge on ADR, despite the continuing efforts of the Belgian legislator to promote ADR. One of the last acts of ADR-promotion, was the implementation of an Act in 2018 which gives the judge the possibility to refer parties to mediation if at least one party wants to during the judicial procedure. This referral is subject to some conditions. The parties will be sent to a private mediator, recognized by the Federal Mediation Commission, to try to resolve their conflict. This means that at least one party can be mandated to try mediation (indicated as “semi-mandatory mediation”). The main goal is to establish the factors and elements that Belgium has to take into account in their further development of mandatory ADR, with consideration of the human rights perspective and the EU perspective. Furthermore it is also essential to detect some dangerous pitfalls other systems have encountered with their process design. Therefore, the second part, the comparative component, will discuss the existing framework in California, USA to establish the necessary elements, possible pitfalls and considerations the Belgian legislator can take into account when further developing the framework of mandatory ADR. The contrasting and functional method will be used to create key elements and possible pitfalls, to help Belgium improve its existing framework. The existing mandatory system in California has been in place since 1981 and is still up and running, and can thus provide valuable lessons and considerations for the Belgian system. Thirdly, the key elements from a human rights perspective and from a European Union perspective (e.g. the right to access to a judge, the right to privacy) will be discussed too, since the basic human rights and European legislation and jurisprudence play a significant part in Belgian legislation as well. The main sources for this part will be the international and European treaties, legislation, jurisprudence and soft law. In the last and concluding part, the paper will list the most important elements of a mandatory ADR-system design with special attention to the dangers of these elements (e.g. to include or exclude domestic violence cases in the mandatory ADR-framework and the consequences thereof), and with special attention for the necessary the international and European rights, prohibitions and guidelines.

Keywords: Belgium, divorce, framework, mandatory ADR

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1377 Geographies of Blackness: An Exploration of the Subaltern Public Spheres of the African Diaspora in European Cities

Authors: Teju N. Adisa-Farrar

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In European cities, social, political and cultural geographies of blackness exist. Organizations create spaces to discuss, express, and expose the realities of young people of African descent creating an Afropean lifestyle with transnational affiliations. Focusing on black and brown spaces produced by and for the young people of African descent in Vienna and Brussels, it became clear a multidisciplinary approach would be necessary. Using Cultural Studies frameworks along with Communications Theories on Black Public Spheres and Social-Geography, a basis was created for exploring the creative, political, and economic responses of young people who are apart of the historically (and contemporary) oppressed and excluded groups of the African Diaspora. Through this intrinsic study, it became apparent that spaces created and reclaimed by young people of the African Diaspora were more inclusive and democratic than other spaces. The organizations studied have used city life as the platform to express their struggles and celebrations of their multicultural identity; clearly using historical, global black and Pan-African movements as the basis for local adaptation of an African Diaspora identity.

Keywords: African diaspora, black public sphere, identity, spaces, geographies

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1376 Civic Participation as a Promoter of Active Ageing in Europe

Authors: Andrea Vega-Tinoco, Ana I. Gil-Lacruz, Marta Gil-Lacruz

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The main objective of this research is to acknowledge whether civic participation affects the well-being of the elderly, thus being a key activity of active aging. It is also of interest to recognize any differences among genders, generational cohorts or country of residence. If a positive relationship is found between civic participation and well-being, the actions that promote this participation will benefit the quality of life of senior citizens. Otherwise, independent action must be taken in the improvement of social and human capital. The sample consists of approximately 50.000 individuals from the European Social Survey (2002-2016). Only individuals born before 1965 in 15 European countries were considered. The sample was distributed according to gender, year of birth, country, level of studies and ESS wave to form pseudo-panel data cohorts, leaving a total of 1.318 observations. The data were analyzed through a Cross-Lagged Model using Fixed-Effects. A bidirectional association is observed between the civic participation and well-being variables. However, participating in the past seems to have a higher impact on today’s health, happiness and life satisfaction than the other way around. Furthermore, 26% of the respondents expressed to be satisfied with their life, 27% to be happy and 57% to have good health. On the other hand, 49% have participated civically in the last year, being the most common activities: signing petitions, boycotting products and volunteer work in non-political organizations. A slight trend of BabyBoomers and men towards greater participation can be observed, as well as a higher impact of this participation on their well-being. In addition, international differences exhibit a stronger relation for Nordic, East European and Mediterranean countries. The given results support the hypothesis that civic participation is a promoter of well-being for the elderly. This paper positively highlights the activity of involving in political and non-political organizations, as well as wearing badges. At any rate, almost all forms of civic participation show a positive relationship with well-being and should therefore be promoted, although differences between countries must be taken into consideration.

Keywords: active aging, civic participation, Europe, well-being

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1375 The Need for Including Hepatitis a Vaccine in Routine Childhood Immunization Programs in Europe as a Response to the Influx of Refugees from the Middle East and North Africa (MENA) Regions

Authors: S. Ramia, N. Melhem, K. Kreidieh

Abstract:

The world is facing an unprecedented displacement crisis. Recently, over 1.1 million asylum seekers have been granted protection status in the European Union (EU). The majority of these asylum seekers were from countries of the Middle East and North Africa (MENA) region.This influx carries with it a potential introduction of infectious diseases that have been eliminated in the EU, which poses a challenge for EU health authorities. Compared to MENA region countries where Hepatitis A Virus (HAV) endemicity is high to intermediate, member states of the EU show very low (Western Europe) to low (Eastern Europe) levels of HAV endemicity. Because of this situation, there is an ongoing public health concern in high-income countries, like members of the EU, that many adults remain susceptible to HAV outbreaks. The overwhelming majority of the EU members’ states do not include HAV vaccine in their immunization calendars. Hence, this paper urgently calls for the implementation of new policies regarding HAV in EU members’ states.

Keywords: European union, hepatitis A, MENA region refugees, vaccine preventable diseases

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1374 Socialist Ideology in Africa: A Comparative Study of Pre and Post Socialism

Authors: Haymanot Gebre-Amlak, Selamawit Gebre-Amlak

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Since its original declaration in the 18th century, Karl Marx and Friedrich Engels's Communist Manifesto has become one of the most influential political tracts. Socialism is a political path that leads towards communism by fostering a cooperative economy through the creation of cooperative enterprises, common ownership, state ownership, or shared equity. The ultimate objective of communism is to bring everyone working toward the same collective goal of a healthy, happy, and free society. The European establishment of 19-century colonial rule over the continent of Africa reinforced inflows of European investment and forced a profound change in the operation of labor and land markets. The colonial era and forced labor schemes in Africa lasted for several decades. When exiting from colonialism, these African countries were attracted to socialism’s ideology to bridge the social gap and freedom to their society. In this paper, we compare a pre and post socialist ideology and the impact in various African countries. We analyse the different aspects, which led to inconsistent outcomes. Our finding indicates that while they have some facets in common, each African country had a unique interpretation and influence from the socialist ideology.

Keywords: African politics, socialism in Africa, African history, Africa

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1373 Regulating Information Asymmetries at Online Platforms for Short-Term Vacation Rental in European Union– Legal Conondrum Continues

Authors: Vesna Lukovic

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Online platforms as new business models play an important role in today’s economy and the functioning of the EU’s internal market. In the travel industry, algorithms used by online platforms for short-stay accommodation provide suggestions and price information to travelers. Those suggestions and recommendations are displayed in search results via recommendation (ranking) systems. There has been a growing consensus that the current legal framework was not sufficient to resolve problems arising from platform practices. In order to enhance the potential of the EU’s Single Market, smaller businesses should be protected, and their rights strengthened vis-à-vis large online platforms. The Regulation (EU) 2019/1150 of the European Parliament and of the Council on promoting fairness and transparency for business users of online intermediation services aims to level the playing field in that respect. This research looks at Airbnb through the lenses of this regulation. The research explores key determinants and finds that although regulation is an important step in the right direction, it is not enough. It does not entail sufficient clarity obligations that would make online platforms an intermediary service which both accommodation providers and travelers could use with ease.

Keywords: algorithm, online platforms, ranking, consumers, EU regulation

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1372 Reduction of Process of Evidence in Specific Forms of Criminal Proceeding: Problems and Risks

Authors: Filip Ščerba, Veronika Pochylá

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Performing of the acts within criminal proceedings usually takes too long and thus this phenomenon can be regarded as one of the most burning problems which have plagued the criminal justice not only in the Czech Republic but at least all over Europe for the last few decades. This problem obviously has to be dealt with and thus the need to tackle this issue has resulted in the trend which is sometimes called Criminal Justice Rationalization, i.e. introducing and enforcing methods supporting the increase in efficiency of the criminal justice in order to make the criminal proceedings shorter and administrative procedure easier. This resulted in the introduction of institutes such as e.g. diversions in criminal proceedings or other forms of shortened pre-trial proceedings, which may be used primarily for dealing with less serious crimes. But also the institute, which was originally mentioned in connection with the system of criminal law in the countries belonging to the Anglo-Saxon legal order where it is frequently called of plea bargaining, has been introduced into the criminal law of many European countries, and it may be applied also in cases of serious crimes. All these special and shortened forms of criminal proceedings are connected with limited extent of process of evidence; in fact, some of these specific forms of criminal proceedings are designed for the purpose to simplify the process of evidence. That is also the reason, why some of these procedures are conditioned with the defendant’s confession. Main hypothesis: Limited process of evidence represents also a potential conflict with certain fundamental principles upon which the criminal proceeding in the Continental legal system is based. (A conflict with principle of material truth may be considered as the most important problem. This principle states that the bodies in criminal proceedings must clarify the facts of the case beyond reasonable doubt to such extent that a decision can be made; the defendant’s confession does not mean that these bodies are freed from the duty to review all the circumstances and facts of the case. Such principle is typical for criminal law in Central European region.) Basic methodologies: The paper is going to analyze such a problem of weakening of the principle of material truth in modern criminal law. Such analysis will be provided primarily on the base of the Czech criminal law, but also other legal regulations will be taken into consideration, and its result may have some relevance for all legal regulations belonging to the Continental legal system, so the paper offers also a comparison with legal systems of other Central European countries.

Keywords: burden of proof, central European countries, criminal justice rationalization, criminal proceeding, Czech legislation, Czech republic, defendant, diversions, evidence, fundamental principles, plea bargaining, pre-trial proceedings, principle of material truth, process of evidence, process of evidence

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1371 Enhanced COVID-19 Pharmaceuticals and Microplastics Removal from Wastewater Using Hybrid Reactor System

Authors: Reda Dzingelevičienė, Vytautas Abromaitis, Nerijus Dzingelevičius, Kęstutis Baranauskis, Saulius Raugelė, Malgorzata Mlynska-Szultka, Sergej Suzdalev, Reza Pashaei, Sajjad Abbasi, Boguslaw Buszewski

Abstract:

A unique hybrid technology was developed for the removal of COVID-19 specific contaminants from wastewater. Reactor testing was performed using model water samples contaminated with COVID-19 pharmaceuticals and microplastics. Different hydraulic retention times, concentrations of pollutants and dissolved ozone were tested. Liquid Chromatography-Mass Spectrometry, solid phase extraction, surface area and porosity, analytical tools were used to monitor the treatment efficiency and remaining sorption capacity of the spent adsorbent. The combination of advanced oxidation and adsorption processes was found to be the most effective, with the highest 90-99% and 89-95% molnupiravir and microplastics contaminants removal efficiency from the model wastewater. The research has received funding from the European Regional Development Fund (project No 13.1.1-LMT-K-718-05-0014) under a grant agreement with the Research Council of Lithuania (LMTLT), and it was funded as part of the European Union’s measure in response to the COVID-19 pandemic.

Keywords: adsorption, hybrid reactor system, pharmaceuticals-microplastics, wastewater

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1370 The Assessment of Forest Wood Biomass Potential in Terms of Sustainable Development

Authors: Julija Konstantinavičienė, Vlada Vitunskienė

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The role of sustainable biomass, including wood biomass, is becoming more important because of European Green Deal. The New EU Forest strategy is a flagship element of the European Green Deal and a key action on the EU biodiversity strategy for 2030. The first measure of this strategy is promoting sustainable forest management, including encouraging the sustainable use of wood-based resources. The first aim of this research was to develop and present a new approach to the concept of forest wood biomass potential in terms of sustainable development, distinguishing theoretical, technical and sustainable potential and detailing its constraints. The second aim was to prepare the methodology outline of sustainable forest wood biomass potential assessment and empirically check this methodology, considering economic, social and ecological constraints. The basic methodologies of the research: the review of research (with a combination of semi-systematic and integrative review methodologies), rapid assessment method and statistical data analysis. The developed methodology of assessment of forest wood potential in terms of sustainable development can be used in Lithuania and in other countries and will let us compare this potential a different time and spatial levels. The application of the methodology will be able to serve the development of new national strategies for the wood sector.

Keywords: assessment, constraints, forest wood biomass, methodology, potential, sustainability

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1369 Measuring the Visibility of the European Open Access Journals with Bibliometric Indicators

Authors: Maja Jokić, Andrea Mervar, Stjepan Mateljan

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Peer review journals, as the main communication channel among researchers, fully achieve their objective if they are available to the global research community, which is accomplished through open access. In the EU countries, the idea of open access has spread over the years through various projects, initiatives, and strategic documents. Consequently, in this paper we want to analyze, using various bibliometric indicators, visibility, and significance of open access peer review journals compared to the conventional (non-open access) ones. We examine the sample of open access (OA) journals in 28 EU countries in addition to open access journals in three EU candidate countries (Bosnia and Herzegovina, FYR Macedonia and Serbia), all indexed by Scopus (N=1,522). These journals comprise 42% of the total number of OA journals indexed by Scopus. The distribution of OA journals in our sample according to the subject fields indicates that the largest share has OA journals in Health Sciences, 29% followed by Social Sciences and Physical Sciences with 25%, and 21% in Life Sciences. At the same time, the distribution according to countries (N=31) shows the dominance of EU15 countries with the share of 68.3% (N=1041) while post-socialist European countries (EU11 plus three candidate EU countries) have the share of 31.6% (N=481). Bibliometric indicators are derived from the SCImago Journal Ranking database. The analysis of OA journals according to their quartile scores (that reflect the relation between number of articles and their citations) shows that the largest number of OA journals from our sample was in the third quartile in 2015. For comparison, the majority of all academic journals indexed in Scopus from the countries in our sample were in the same year in the first quartile. The median of SJR indicator (SCImago Journal Rankings) for 2015 that measures the journal's prestige, amounted 0.297 for OA journals from the sample, while it was modestly lower for all OA journals, 0.284. The value of the same indicator for all journals indexed by Scopus (N=11,086) from our group of countries was 0.358, which is significantly different from the one for OA journals. Apart from the number of OA journals we also confirm significant differences between EU15 and post-socialist countries in bibliometric status of OA journals. The median SJR indicator for 2015 for EU15 countries was 0.394, while for post-socialist countries it amounted to 0.226. The changes in bibliometric indicators: quartile score, SJR (SCImago Journal Rankings), SNIP (Sources Normalised Impact by Paper) and IPP (Impact per Publication) of OA journals during 2012-2015 period, as well as H-index for the main four subject fields (Life Sciences, Physical Sciences, Social Sciences and Health Sciences) in the whole sample as well as in two main groups of European countries, show increasing trend of acceptance and visibility of OA journals within the academic community. More comprehensive insights into the visibility of OA journals could be reached by using additional qualitative research methods such as for example, interviews with researchers.

Keywords: bibliometric analysis, European countries, journal evaluation, open access journals

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1368 Investigation of Tourism and Development in Santo Domingo City

Authors: Mary Cruz

Abstract:

Founded from 1496 to 1502, Santo Domingo is the oldest European settlement in the Americas, inhabited without any discontinuity and was the first seat of Spanish power in the new world. Capital of the country since 1932.In this text, we discover Santo Domingo as an international tourist center, Urban Structure, Eco-tourism, Contamination and other issues related to tourism and development of this city. Founded from 1496 to 1502, Santo Domingo is the oldest European settlement in the Americas, inhabited without any discontinuity and was the first seat of Spanish power in the new world. Capital of the country since 1932. Encouraged by the United Nations and the World Bank, many Caribbean governments have encouraged tourism from the 1950s to boost their Third World economies. In this text, we discover Santo Domingo as an international tourist center, Urban Structure, Eco-tourism, Contamination and challenges of the first tourist destination in the Caribbean.

Keywords: eco-tourism, urban structure, contamination, development

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1367 European Hinterland and Foreland: Impact of Accessibility, Connectivity, Inter-Port Competition on Containerization

Authors: Dial Tassadit Rania, Figueiredo De Oliveira Gabriel

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In this paper, we investigate the relationship between ports and their hinterland and foreland environments and the competitive relationship between the ports themselves. These two environments are changing, evolving and introducing new challenges for commercial and economic development at the regional, national and international levels. Because of the rise of the containerization phenomenon, shipping costs and port handling costs have considerably decreased due to economies of scale. The volume of maritime trade has increased substantially and the markets served by the ports have expanded. On these bases, overlapping hinterlands can give rise to the phenomenon of competition between ports. Our main contribution comparing to the existing literature on this issue, is to build a set of hinterland, foreland and competition indicators. Using these indicators? we investigate the effect of hinterland accessibility, foreland connectivity and inter-ports competition on containerized traffic of Europeans ports. For this, we have a 10-year panel database from 2004 to 2014. Our hinterland indicators are given by two indicators of accessibility; they describe the market potential of a port and are calculated using information on population and wealth (GDP). We then calculate population and wealth for different neighborhoods within a distance from a port ranging from 100 to 1000km. For the foreland, we produce two indicators: port connectivity and number of partners for each port. Finally, we compute the two indicators of inter-port competition and a market concentration indicator (Hirshmann-Herfindhal) for different neighborhood-distances around the port. We then apply a fixed-effect model to test the relationship above. Again, with a fixed effects model, we do a sensitivity analysis for each of these indicators to support the results obtained. The econometric results of the general model given by the regression of the accessibility indicators, the LSCI for port i, and the inter-port competition indicator on the containerized traffic of European ports show a positive and significant effect for accessibility to wealth and not to the population. The results are positive and significant for the two indicators of connectivity and competition as well. One of the main results of this research is that the port development given here by the increase of its containerized traffic is strongly related to the development of its hinterland and foreland environment. In addition, it is the market potential, given by the wealth of the hinterland that has an impact on the containerized traffic of a port. However, accessibility to a large population pool is not important for understanding the dynamics of containerized port traffic. Furthermore, in order to continue to develop, a port must penetrate its hinterland at a deep level exceeding 100 km around the port and seek markets beyond this perimeter. The port authorities could focus their marketing efforts on the immediate hinterland, which can, as the results shows, not be captive and thus engage new approaches of port governance to make it more attractive.

Keywords: accessibility, connectivity, European containerization, European hinterland and foreland, inter-port competition

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1366 The Impact of the General Data Protection Regulation on Human Resources Management in Schools

Authors: Alexandra Aslanidou

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The General Data Protection Regulation (GDPR), concerning the protection of natural persons within the European Union with regard to the processing of personal data and on the free movement of such data, became applicable in the European Union (EU) on 25 May 2018 and transformed the way personal data were being treated under the Data Protection Directive (DPD) regime, generating sweeping organizational changes to both public sector and business. A social practice that is considerably influenced in the way of its day-to-day operations is Human Resource (HR) management, for which the importance of GDPR cannot be underestimated. That is because HR processes personal data coming in all shapes and sizes from many different systems and sources. The significance of the proper functioning of an HR department, specifically in human-centered, service-oriented environments such as the education field, is decisive due to the fact that HR operations in schools, conducted effectively, determine the quality of the provided services and consequently have a considerable impact on the success of the educational system. The purpose of this paper is to analyze the decisive role that GDPR plays in HR departments that operate in schools and in order to practically evaluate the aftermath of the Regulation during the first months of its applicability; a comparative use cases analysis in five highly dynamic schools, across three EU Member States, was attempted.

Keywords: general data protection regulation, human resource management, educational system

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1365 Of Rites of Narration and Representation of Orient and Occident in Thomas Heywood's Fair Maid of the West

Authors: Tarik Bouguerba

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Thomas Heywood was an outstanding, prolific playwright of the period, writing both in prose and verse. Unlike Shakespeare in particular, Heywood could be considered as a playwright who was well informed about Morocco and wrote in greater detail about a possible dialogue among cultures. As it is a historical platform for power relations, The Fair Maid of the West recalled the heroism and excitement of English counterattacks against Spain in the Post-Armada period. This paper therefore pins down the acts of narration and representation of Morocco and Moroccans and examines how the Occident has contributed to the production of the Orient and finally attests to the metamorphosis the plot undergoes in Part I and Part II. As an adventure play, The Fair Maid of the West teaches about, informs of and confirms the existing patterns of virtue in European voyagers and at the same time it asserts how honor and chastity are European par excellence whereas villainy and wickedness are Oriental assets. Once taken captive, these virtues and traits are put into task as the plot disentangles. This paper also examines how the play in both parts generates a whole history of stereotypes about Morocco and unexpectedly subverts this stereotype; such a biased mode of narration of the Orient the playwright took up at first was played down at a later phase in the narrative.

Keywords: Heywood, Occident, Orientalism, Stereotype, Virtue

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1364 Database of Pharmacogenetics HLA-A*31:01 Allele in Thai Population and Carbamazepine-Induced SCARs

Authors: Watchawin Ekphinitphithaya, Patompong Satapornpong

Abstract:

Introduction: Carbamazepine (CBZ) is one of the most prescribed antiepileptic drugs (AEDs) by neurologists and non-neurologist worldwide. CBZ is usually prescribed along with other drugs, leading to the possibility of severe cutaneous adverse drug reactions (SCARs). The HLA-B*15:02 is strongly associated with CBZ-induced Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS–TEN) in the Han Chinese and other Asian populations but not in European populations, while HLA-A*31:01 allele has been reported to be associated with CBZ-induced SCARs in European population and Japanese. Objective: The aim of this study is to investigate the distribution of pharmacogenetics HLA-A*31:01 marker in a healthy Thai population associated with Carbamazepine-induced SCARs. Materials and Methods: Prospective study, 350 unrelated healthy Thais were recruited in this study. Human leukocyte antigen-A alleles were genotyped using PCR-sequence specific oligonucleotides (PCR-SSOs). Results: The frequency of HLA-A alleles were HLA-A*11:01 (190 alleles, 27.14%), HLA-A*24:02 (82 alleles, 11.71%), HLA-A*02:03 (80 alleles, 11.43%), HLA-A*33:03 (76 alleles, 10.86%), HLA-A*02:07 (58 alleles, 8.29%), HLA-A*02:01 (35 alleles, 5.00%), HLA-A*24:07 (29 alleles, 4.14%), HLA-A*02:06 – HLA-A*30:01 (15 alleles, 2.14%), and HLA-A*01:01 (14 alleles, 2.00%). Particularly, the number of HLA-A*31:01 alleles was 6 of 700 (0.86%) in the healthy Thai population. Many research presented varying distributions of HLA-A*31:01 in Asians, including 2% of Han Chinese, 9% of Japanese and 5% of Koreans. In addition, this allele was found approximately 2-5% in the Caucasian population. Conclusions: Thus, the pharmacogenetics database is vital to support in many populations, especially in Thais, for screening HLA-A*31:01 allele to avoid CBZ-induced SCARs before initiating treatments in each population.

Keywords: Carbamazepine, HLA-A*31:01, Thai population, pharmacogenetics

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1363 European Standardization in Nanotechnologies and Relation with International Work: The Standardization Can Help Industry and Regulators in Developing Safe Products

Authors: Patrice Conner

Abstract:

Nanotechnologies have enormous potential to contribute to human flourishing in responsible and sustainable ways. They are rapidly developing field of science, technology and innovation. As enabling technologies, their full scope of applications is potentially very wide. Major implications are expected in many areas, e.g. healthcare, information and communication technologies, energy production and storage, materials science/chemical engineering, manufacturing, environmental protection, consumer products, etc. However, nanotechnologies are unlikely to realize their full potential unless their associated societal and ethical issues are adequately attended. Namely nanotechnologies and nanoparticles may expose humans and the environment to new health risks, possibly involving quite different mechanisms of interference with the physiology of human and environmental species. One of the building blocks of the ‘safe, integrated and responsible’ approach is standardization. Both the Economic and Social Committee and the European Parliament have highlighted the importance to be attached to standardization as a means to accompany the introduction on the market of nanotechnologies and nanomaterials, and a means to facilitate the implementation of regulation. ISO and CEN have respectively started in 2005 and 2006 to deal with selected topics related to this emerging and enabling technology. In the beginning of 2010, EC DG ‘Enterprise and Industry’ addressed the mandate M/461 to CEN, CENELEC and ETSI for standardization activities regarding nanotechnologies and nanomaterials. Thus CEN/TC 352 ‘Nanotechnologies’ has been asked to take the leadership for the coordination in the execution of M/461 (46 topics to be standardized) and to contact relevant European and International Technical committees and interested stakeholders as appropriate (56 structures have been identified). Prior requests from M/461 deal with characterization and exposure of nanomaterials and any matters related to Health, Safety and Environment. Answers will be given to: - What are the structures and how they work? - Where are we right now and how work is going from now onwards? - How CEN’s work and targets deal with and interact with global matters in this field?

Keywords: characterization, environmental protection, exposure, health risks, nanotechnologies, responsible and sustainable ways, safety

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1362 Challenges to Developing a Trans-European Programme for Health Professionals to Recognize and Respond to Survivors of Domestic Violence and Abuse

Authors: June Keeling, Christina Athanasiades, Vaiva Hendrixson, Delyth Wyndham

Abstract:

Recognition and education in violence, abuse, and neglect for medical and healthcare practitioners (REVAMP) is a trans-European project aiming to introduce a training programme that has been specifically developed by partners across seven European countries to meet the needs of medical and healthcare practitioners. Amalgamating the knowledge and experience of clinicians, researchers, and educators from interdisciplinary and multi-professional backgrounds, REVAMP has tackled the under-resourced and underdeveloped area of domestic violence and abuse. The team designed an online training programme to support medical and healthcare practitioners to recognise and respond appropriately to survivors of domestic violence and abuse at their point of contact with a health provider. The REVAMP partner countries include Europe: France, Lithuania, Germany, Greece, Iceland, Norway, and the UK. The training is delivered through a series of interactive online modules, adapting evidence-based pedagogical approaches to learning. Capturing and addressing the complexities of the project impacted the methodological decisions and approaches to evaluation. The challenge was to find an evaluation methodology that captured valid data across all partner languages to demonstrate the extent of the change in knowledge and understanding. Co-development by all team members was a lengthy iterative process, challenged by a lack of consistency in terminology. A mixed methods approach enabled both qualitative and quantitative data to be collected, at the start, during, and at the conclusion of the training for the purposes of evaluation. The module content and evaluation instrument were accessible in each partner country's language. Collecting both types of data provided a high-level snapshot of attainment via the quantitative dataset and an in-depth understanding of the impact of the training from the qualitative dataset. The analysis was mixed methods, with integration at multiple interfaces. The primary focus of the analysis was to support the overall project evaluation for the funding agency. A key project outcome was identifying that the trans-European approach posed several challenges. Firstly, the project partners did not share a first language or a legal or professional approach to domestic abuse and neglect. This was negotiated through complex, systematic, and iterative interaction between team members so that consensus could be achieved. Secondly, the context of the data collection in several different cultural, educational, and healthcare systems across Europe challenged the development of a robust evaluation. The participants in the pilot evaluation shared that the training was contemporary, well-designed, and of great relevance to inform practice. Initial results from the evaluation indicated that the participants were drawn from more than eight partner countries due to the online nature of the training. The primary results indicated a high level of engagement with the content and achievement through the online assessment. The main finding was that the participants perceived the impact of domestic abuse and neglect in very different ways in their individual professional contexts. Most significantly, the participants recognised the need for the training and the gap that existed previously. It is notable that a mixed-methods evaluation of a trans-European project is unusual at this scale.

Keywords: domestic violence, e-learning, health professionals, trans-European

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1361 Understanding the Heterogeneity of Polycystic Ovarian Syndrome: The Influence of Ethnicity and Body Mass

Authors: Hamza Ikhlaq, Stephen Franks

Abstract:

Background: Polycystic ovarian syndrome (PCOS) is one of the most common endocrine disorders affecting women of reproductive age. The aetiology behind PCOS is poorly understood but influencing ethnic, environmental, and genetic factors have been recognised. However, literature examining the impact of ethnicity is scarce. We hypothesised Body Mass Index (BMI) and ethnicity influence the clinical, metabolic, and biochemical presentations of PCOS, with an interaction between these factors. Methods: A database of 1081 women with PCOS and a control group of 72 women were analysed. BMIs were grouped using the World Health Organisation classification into normal weight, overweight and obese groups. Ethnicities were classified into European, South Asian, and Afro-Caribbean groups. Biochemical and clinical presentations were compared amongst these groups, and statistical analyses were performed to assess significance. Results: This study revealed ethnicity significantly influences biochemical and clinical presentations of PCOS. A greater proportion of South Asian women are impacted by menstrual cycle disturbances and hirsutism than European and Afro-Caribbean women. South Asian and Afro-Caribbean women show greater measures of insulin resistance and weight gain when compared to their European peers. Women with increased BMI are shown to have an increased prevalence of PCOS phenotypes alongside increased levels of insulin resistance and testosterone. Furthermore, significantly different relationships between the waist-hip ratio and measures of insulin and glucose control for Afro-Caribbean women were identified compared to other ethnic groups. Conclusions: The findings of this study show ethnicity significantly influence the phenotypic and biochemical presentations of PCOS, with an interaction between body habitus and ethnicity found. Furthermore, we provide further data on the influences of BMI on the manifestations of PCOS. Therefore, we highlight the need to consider these factors when reviewing diagnostic criteria and delivering clinical care for these groups.

Keywords: PCOS, ethnicity, BMI, clinical

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1360 The Gender Equality within the European Union Reconciliation of Work and Family Life Policies: Tackling Gender Inequality or Tackling Unemployment

Authors: Nazli Kazanoglu

Abstract:

Reconciliation of work and family life has been an area of interest within the academic as well as in the political debate for more than three decades. With the dramatic changes in the extent to which women and men contribute to unpaid domestic work and paid employment, the reconciliation of work and family life issues have become more prominent than ever before. And they have begun to enjoy an increased attention of policy makers both at the EU and national levels. Over the last three decades the EU has initiated numerous equality programs and strategies and roadmaps regarding reconciliation of work and family life, though particularly because of the crisis and increasing willingness of achieving the EUs target of seventy five per cent of men and women in employment by 2020, those programs, strategies and roadmaps emphasized on eradicating womens familial burdens while entering labor market and providing them as equal opportunities as their male counterparts have. Reconciliation of work and family life policies thus bit by bit moved away from the objectives with a strong commitment to ensuring gender equality towards employment objectives. This paper is thus an endeavor to look at the nature of EU reconciliation of work and family life policies from the angle of gender equality. More precisely relying on the feminist literature, this paper rests on the assumption that reconciliation of work and family policies should provide the sufficient measures indeed with a more emphasis on endorsing gender equality rather than economic concerns and prioritizes two inter-related aspects while evaluating the gender equality of reconciliation of work and family life policies. First providing free choice to women in terms of their family and work lives and second challenge the unequal division of labor at home. In that sense, it investigates the nature of the changing uses and meanings of gender equality in reconciliation of work and family life policies in different stages of the EU social policy development particularly after the introduction of European Employment Strategy which gave a tremendous importance to reconciliation of work and family life during their collaborations with other issues on the EU agenda as well as the major rationale behind their development and implementation and locates them in terms of two inter-related parameters mentioned above.

Keywords: European Union, division of unpaid work, gender equality, rhetoric of free choice

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1359 An Integrative Review on the Experiences of Integration of Quality Assurance Systems in Universities

Authors: Laura Mion

Abstract:

Concepts of quality assurance and management are now part of the organizational culture of the Universities. Quality Assurance (QA) systems are, in large part, provided for by national regulatory dictates or supranational indications (such as, for example, at European level are, the ESG Guidelines "European Standard Guidelines"), but their specific definition, in terms of guiding principles, requirements and methodologies, are often delegated to the national evaluation agencies or to the autonomy of individual universities. For this reason, the experiences of implementation of QA systems in different countries and in different universities is an interesting source of information to understand how quality in universities is understood, pursued and verified. The literature often deals with the treatment of the experiences of implementation of QA systems in the individual areas in which the University's activity is carried out - teaching, research, third mission - but only rarely considers quality systems with a systemic and integrated approach, which allows to correlate subjects, actions, and performance in a virtuous circuit of continuous improvement. In particular, it is interesting to understand how to relate the results and uses of the QA in the triple distinction of university activities, identifying how one can cause the performance of the other as a function of an integrated whole and not as an exploit of specific activities or processes conceived in an abstractly atomistic way. The aim of the research is, therefore, to investigate which experiences of "integrated" QA systems are present on the international scene: starting from the experience of European countries that have long shared the Bologna Process for the creation of a European space for Higher Education (EHEA), but also considering experiences from emerging countries that use QA processes to develop their higher education systems to keep them up to date with international levels. The concept of "integration", in this research, is understood in a double meaning: i) between the different areas of activity, in particular between the didactic and research areas, and possibly with the so-called "third mission" "ii) the functional integration between those involved in quality assessment and management and the governance of the University. The paper will present the results of a systematic review conducted according with a method of an integrative review aimed at identifying best practices of quality assurance systems, in individual countries or individual universities, with a high level of integration. The analysis of the material thus obtained has made it possible to grasp common and transversal elements of QA system integration practices or particularly interesting elements and strengths of these experiences that can, therefore, be considered as winning aspects in a QA practice. The paper will present the method of analysis carried out, and the characteristics of the experiences identified, of which the structural elements will be highlighted (level of integration, areas considered, organizational levels included, etc.) and the elements for which these experiences can be considered as best practices.

Keywords: quality assurance, university, integration, country

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1358 Risk Mitigation of Data Causality Analysis Requirements AI Act

Authors: Raphaël Weuts, Mykyta Petik, Anton Vedder

Abstract:

Artificial Intelligence has the potential to create and already creates enormous value in healthcare. Prescriptive systems might be able to make the use of healthcare capacity more efficient. Such systems might entail interpretations that exclude the effect of confounders that brings risks with it. Those risks might be mitigated by regulation that prevents systems entailing such risks to come to market. One modality of regulation is that of legislation, and the European AI Act is an example of such a regulatory instrument that might mitigate these risks. To assess the risk mitigation potential of the AI Act for those risks, this research focusses on a case study of a hypothetical application of medical device software that entails the aforementioned risks. The AI Act refers to the harmonised norms for already existing legislation, here being the European medical device regulation. The issue at hand is a causal link between a confounder and the value the algorithm optimises for by proxy. The research identifies where the AI Act already looks at confounders (i.a. feedback loops in systems that continue to learn after being placed on the market). The research identifies where the current proposal by parliament leaves legal uncertainty on the necessity to check for confounders that do not influence the input of the system, when the system does not continue to learn after being placed on the market. The authors propose an amendment to article 15 of the AI Act that would require high-risk systems to be developed in such a way as to mitigate risks from those aforementioned confounders.

Keywords: AI Act, healthcare, confounders, risks

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1357 Rethinking the Role of Small States in the Hybrid Era: Shifts in the Cypriot Foreign and Defence Policies, 2004-2019

Authors: Constantinos Adamides, Petros Petrikkos

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In the era of growing hybrid threats, small states find themselves in need to re-evaluate existing foreign and defense policies. The pressure to establishing or maintain a status of a reliable partner in the community in which they belong to, vis-à-vis their multilateral relations with other organisations and entities, small states may need to shift their policies in the field to accommodate security needs that are not only pertinent to their security, but also to that of the organisations (bloc) in which they interact. Unlike potential shortcomings in a small state’s mainstream security and defence framework where the threat would be limited to the state itself, in more contemporary times with dominating hybrid threats, the small states’ security shortcomings may also become a security problem for the bloc in which these states belong to. An indicative example is small states like Cyprus and Malta, which belong and 'interact' in the European Union. As a result, the nature of hybrid threats can be utilised to hurt bigger states in a bloc by exploiting the small states’ vulnerabilities and security gaps. Inevitably, both the defensive and foreign policy collaborations of small states with bigger states have been and are constantly re-evaluated to tackle and prevent such problems. In essence, the goal of this ‘re-evaluation’ aims to achieve a twofold goal: The first is the small states’ quest to appear as a reliable partner within the bloc, while the second is to avoid being the weakest security link in the bloc’s defence against hybrid threats. Indeed, the hybrid arena is a security area where they can excel in the bloc, despite the potential and expected conventional military deficiencies. This new environment prompts us to think security from the perspective of small states differently and in relation to their role as members or big organisations. The paper focuses on the case of Cyprus following its accession to the European Union and examines how a country that has had a very focused security orientation –not least due to its ongoing security problems– altered its foreign and defence policies within the European Union to ensure compliance with the rest of the bloc, while at the same time maximizing its role as a security player. Specifically, it examines the methods through which the country shifted its policies as well as the challenges and opportunities that emerged from these security shifts.

Keywords: Cyprus, defence, foreign policy, hybrid threats, ontological security, small states

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1356 Media, Politics and Power in the Representation of the Refugee and Migration Crisis in Europe

Authors: Evangelia-Matroni Tomara

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This thesis answers the question whether the media representations and reporting in 2015-2016 - especially, after the image of the drowned three-year-old Syrian boy in the Mediterranean Sea which made global headlines in the beginning of September 2015 -, the European Commission regulatory sources material and related reporting, have the power to challenge the conceptualization of humanitarianism or even redefine it. The theoretical foundations of the thesis are based on humanitarianism and its core definitions, the power of media representations and the relative portrayal of migrants, refugees and/or asylum seekers, as well as the dominant migration discourse and EU migration governance. Using content analysis for the media portrayal of migrants (436 newspaper articles) and qualitative content analysis for the European Commission Communication documents from May 2015 until June 2016 that required various depths of interpretation, this thesis allowed us to revise the concept of humanitarianism, realizing that the current crisis may seem to be a turning point for Europe but is not enough to overcome the past hostile media discourses and suppress the historical perspective of security and control-oriented EU migration policies. In particular, the crisis helped to shift the intensity of hostility and the persistence in the state-centric, border-oriented securitization in Europe into a narration of victimization rather than threat where mercy and charity dynamics are dominated and into operational mechanisms, noting the emergency of immediate management of the massive migrations flows, respectively. Although, the understanding of a rights-based response to the ongoing migration crisis, is being followed discursively in both political and media stage, the nexus described, points out that the binary between ‘us’ and ‘them’ still exists, with only difference that the ‘invaders’ are now ‘pathetic’ but still ‘invaders’. In this context, the migration crisis challenges the concept of humanitarianism because rights dignify migrants as individuals only in a discursive or secondary level while the humanitarian work is mostly related with the geopolitical and economic interests of the ‘savior’ states.

Keywords: European Union politics, humanitarianism, immigration, media representation, policy-making, refugees, security studies

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1355 Impact of COVID-19 Pandemic in the European Air Transport Command during 2020-2021

Authors: Martin Gascón Hove, Ralph Vermeltfoort, Alessandro Fiorini, Erwan Dulaurent, Henning von Perbandt

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Introduction: The outbreak of the COVID-19 pandemic has completely changed the global health situation, with more than 400 million cases published and over 5 million deaths. European Air Transport Command (EATC) is integrated by seven nations, and among its capabilities is that of aeromedical evacuation (AM). Material and methods: Impact of novel coronavirus was analysed based on the number and characteristics of patients and executed missions within EATC and, particularly by Spain, during the biennium 2020-2021. Results: One thousand sixty patients were transported in 186 missions. Neither death nor disease contagion was reported during AM performances. Military cases transferred were 986, mostly routine priority (91,4%), and 74 were civilians, who were transported in 17 missions, and 81,1% of which were categorized as urgent. Niger led the list of original countries, with 191 evacuated patients. 76,1% of requests came from Italy and Germany. Airbus A310 was the most used aircraft (32,2%). Germany transported 222 patients of another nationality, while Spain executed eight missions and repatriated 68 cases, 58 of which were from Mali. Conclusions: COVID-19 has led to a surged number of evacuated patients inside EATC, which has proven to be a safe and effective means of transportation, even in critical cases. Spain has gained prominence since its annexation in 2015.

Keywords: COVID-19, SARS-CoV-2, pandemic, aviation, Spain

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1354 A Study of the Impact of the Global Financial Crisis on the Financial Performance of Banks in Mauritius

Authors: Narvada Ramdhany, Reena Bhattu Babajee

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The 2007-2008 Global Financial Crisis which initiated in the US had a global outreach, impacting the financial and banking sectors of several economies; such as European countries, developing and emerging countries in Asia, Latin America and Africa. European countries represent one of the main sources of export earnings for Mauritius and given that Europe has been quite profoundly affected by the crisis, the Mauritian economy also could have been negatively affected. This study is being undertaken to see if the crisis had a spill-over effect on the Mauritian banking system. It will also enable to determine if the measures put in place to counteract the crisis by regulatory authorities have been effective. The study will be carried out on 17 banks and data will be collected over a time frame of seven years; with a pre-crisis period from 2005 to 2007 and a post-crisis period from 2009 to 2011. The impact of the crisis as such will be measured through the financial performance of the banks, using financial ratios and regression analysis. The results show that during the period concerned Mauritian banks have remained solvent and relatively stable. One of the main explanations put forward to explain the resilience of the banking sector to the crisis is that foreign exposure was relatively low. Another explanation put forward is that Mauritian banks normally transact mainly with prime borrowers unlike most the banks which were affected by the financial crisis.  

Keywords: global financial crisis, banking sector, financial performance, Mauritian banks

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1353 The Cost-Effectiveness of Pancreatic Surgical Cancer Care in the US vs. the European Union: Results of a Review of the Peer-Reviewed Scientific Literature

Authors: Shannon Hearney, Jeffrey Hoch

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While all cancers are costly to treat, pancreatic cancer is a notoriously costly and deadly form of cancer. Across the world there are a variety of treatment centers ranging from small clinics to large, high-volume hospitals as well as differing structures of payment and access. It has been noted that centers that treat a high volume of pancreatic cancer patients have higher quality of care, it is unclear if that care is cost-effective. In the US there is no clear consensus on the cost-effectiveness of high-volume centers for the surgical care of pancreatic cancer. Other European countries, like Finland and Italy have shown that high-volume centers have lower mortality rates and can have lower costs, there however, is still a gap in knowledge about these centers cost-effectiveness globally. This paper seeks to review the current literature in Europe and the US to gain a better understanding of the state of high-volume pancreatic surgical centers cost-effectiveness while considering the contextual differences in health system structure. A review of major reference databases such as Medline, Embase and PubMed will be conducted for cost-effectiveness studies on the surgical treatment of pancreatic cancer at high-volume centers. Possible MeSH terms to be included, but not limited to, are: “pancreatic cancer”, “cost analysis”, “cost-effectiveness”, “economic evaluation”, “pancreatic neoplasms”, “surgical”, “Europe” “socialized medicine”, “privatized medicine”, “for-profit”, and “high-volume”. Studies must also have been available in the English language. This review will encompass European scientific literature, as well as those in the US. Based on our preliminary findings, we anticipate high-volume hospitals to provide better care at greater costs. We anticipate that high-volume hospitals may be cost-effective in different contexts depending on the national structure of a healthcare system. Countries with more centralized and socialized healthcare may yield results that are more cost-effective. High-volume centers may differ in their cost-effectiveness of the surgical care of pancreatic cancer internationally especially when comparing those in the United States to others throughout Europe.

Keywords: cost-effectiveness analysis, economic evaluation, pancreatic cancer, scientific literature review

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