SUSTAINABLE COUNTRYSIDE AND COMPETITIVENESS

Sustainability, which is a way of thinking, life, production and consumption, covers all dimensions of human existence, its relation to natural resources, the economy and society. Sustainability can be the solution, beside research and development processes, to global problems like globalising economy and market competition, global warming, poverty and famine. United Nations’ actions from Rio to Johannesburg and EU decisions seem to underpin this. Well intentioned efforts up to the present have been made on global level with few results. Therefore it is necessary to implement sustainability on regional and local sub-regional, company level. Sustainability is getting into the centre of expectations and actions. It is very likely that only regions and subregions recognising the importance of sustainability in time, will be successful and competitive as a result of this advantage. Settlements neglecting sustainability will not be able to keep their inhabitants, the countryside around them will not be able to produce enough products meeting food safety standards, and will exhaust its natural resources fairly quickly. The competitiveness of a region is largely determined by the state and development pattern of its rural areas and settlements. Therefore research has been focused on sustainable countryside and its important elements, sustainable (liveable) settlements. During our investigations we implemented a new indicator and index number set that reflects all dimensions of sustainability, the present situation, and supports the bottom up decision making process of local governments and NGOs in order to promote development. These investigations highlighted the facts that potential competitiveness of a region can only be based on sustainable settlements, subregions and it is essential to eliminate deficiencies that restrain present and future development. XXXXXXXXXXXXXXXXXXXXXXXXXX A fenntarthatóság, amely szemlélet-, gondolkodás-, élet-, termelési-, valamint fogyasztási mód felöleli az emberi létezés valamennyi dimenzióját, a természeti erÅ‘forrásokhoz való viszonyát, a gazdaságot és a társadalmat. A globális kihívá-sok leküzdésében – mint például a globalizálódó gazdaság és piaci verseny, a globális felmelegedés, a szegénység és éhezés leküzdése –, a kutatási – innovációs folyamatok mellett a fenntarthatóság jelentheti a megoldást. Ezt megerÅ‘sítik az ENSZ világrendezvényei Riótól – Johannesburgig, valamint az EU határozatai. Az eddigi jó szándékú próbálkozások globális szinten mozogtak, vajmi kevés eredménnyel. Ezért szükséges a fenntarthatóság regionális és lokális – kistérségi, települési, vállalkozási – szintjein kezdeményezni a megoldást. A fenntarthatóság egyre inkább az elvárások és cselekvések középpontjába kerül, várható, hogy csak azok a régiók, kistérségek, helyi szintek lehetnek eredményesek, versenyké-pesek melyek idÅ‘ben felismerték a fenntarthatóság érvényesítésének szükséges-ségét, s ezzel helyzeti elÅ‘nyre tesznek szert. Ugyanis a fenntarthatóságot mellÅ‘zÅ‘ települések nem tudják megtartani lakosaikat, s a vidék nem képes megfelelÅ‘ minÅ‘ségű, az élelmiszerbiztonsági igényeknek megfelelÅ‘ termékeket kibocsátani, s nem hosszabb távon felélik természeti erÅ‘forrásaikat. A régiók versenyesélyét sokban meghatározzák a régión belüli vidéki térségek és települések helyzete, s fejlÅ‘dése. Ezért a kutatások a fenntartható vidék és ennek lényegi elemére a fenntartható, vagyis élhetÅ‘ településre irányultak. A vizsgálatok erre a célra egy újszerű indikátor és mutatószámrendszert alkalmaztak, amely tükrözte a fenn-tarthatóság dimenzióit, az adott helyzetet, s megalapozzák az alulról építkezÅ‘ te-lepülési és civil szervezeti önkormányzatok a fejlesztés lehetÅ‘ségeit. A vizsgálatok hangsúlyozzák, hogy a fenntartható településekre-kistérségekre épülhet a régió versenyesélye, s mindebben különösen fontos szerepe van a jelent és jövÅ‘t korlá-tozó „hiányok†felszámolásának.Community/Rural/Urban Development, Environmental Economics and Policy, Public Economics, sustainability on regional level, settlements, investigations - fenntarthatóság regionális szintje, települések, beruházások,

Observational cohort study of rilpivirine (RPV) utilization in Europe

INTRODUCTION: Data on safety and effectiveness of RPV from the real-world setting as well as comparisons with other NNRTIs such as efavirenz (EFV) remain scarce. METHODS: Participants of EuroSIDA were included if they had started a RPV- or an EFV-containing regimen over November 2011-December 2017. Statistical testing was conducted using non-parametric Mann-Whitney U test and Chi-square test. A logistic regression model was used to compare participants' characteristics by treatment group. Kaplan-Meier analysis was used to estimate the cumulative risk of virological failure (VF, two consecutive values > 50 copies/mL). RESULTS: 1,355 PLWH who started a RPV-based regimen (11% ART-naïve), as well as 333 initiating an EFV-containing regimen were included. Participants who started RPV differed from those starting EFV for demographics (age, geographical region) and immune-virological profiles (CD4 count, HIV RNA). The cumulative risk of VF for the RPV-based group was 4.5% (95% CI 3.3-5.7%) by 2 years from starting treatment (71 total VF events). Five out of 15 (33%) with resistance data available in the RPV group showed resistance-associated mutations vs. 3/13 (23%) among those in the EFV group. Discontinuations due to intolerance/toxicity were reported for 73 (15%) of RPV- vs. 45 (30%) of EFV-treated participants (p = 0.0001). The main difference was for toxicity of central nervous system (CNS, 3% vs. 22%, p  50 copies/mL and resistance in participants treated with RPV were similar to those reported by other studies. RPV safety profile was favourable with less frequent discontinuation due to toxicity than EFV (especially for CNS)

IMAGE OR MIRROR IMAGE? SOME THOUGHTS ON SUSTAINABILITY

The shortcomings and biases of traditional macroeconomic indicators are even more obvious if we analyse them from the point of view of sustainability. There are different goods and services behind monetary units measuring the economy. Some goods serve life while others can lead to death. Indicators measuring economic growth, e.g. GDP, completely conceal this difference. The growth of GDP is slowly becoming the only goal and in many cases this is not compatible with the idea of sustainability. Mainstream economics still assumes that all goods produced serve welfare. We have to consider the external effects of our activities, realising that negative externalities result in public bad and not public good, and that hidden positive externalities may result in social losses. In the case of negative externalities the growth of positive GDP is misleading, because society has to pay a high price for this positive image (with degradation of the natural and built environment, health problems, loss of biodiversity etc.). The main difference between traditional, growth oriented economic strategies and sustainability is how economic development is seen. Thus, in the case of sustainability, the aim is development instead of simple growth, quality instead of quantity, and the economy serves as a tool. In this context, how coherent and consistent various goals, programmes and strategies are in practice was also investigated. From the point of view of realising sustainable development, we consider the regional level important for several reasons, therefore, in the second part of our study we analyse the relationship of sustainability and convergence

SUSTAINABLE COUNTRYSIDE AND COMPETITIVENESS

Sustainability, which is a way of thinking, life, production and consumption, covers all dimensions of human existence, its relation to natural resources, the economy and society. Sustainability can be the solution, beside research and development processes, to global problems like globalising economy and market competition, global warming, poverty and famine. United Nations’ actions from Rio to Johannesburg and EU decisions seem to underpin this. Well intentioned efforts up to the present have been made on global level with few results. Therefore it is necessary to implement sustainability on regional and local sub-regional, company level. Sustainability is getting into the centre of expectations and actions. It is very likely that only regions and subregions recognising the importance of sustainability in time, will be successful and competitive as a result of this advantage. Settlements neglecting sustainability will not be able to keep their inhabitants, the countryside around them will not be able to produce enough products meeting food safety standards, and will exhaust its natural resources fairly quickly. The competitiveness of a region is largely determined by the state and development pattern of its rural areas and settlements. Therefore research has been focused on sustainable countryside and its important elements, sustainable (liveable) settlements. During our investigations we implemented a new indicator and index number set that reflects all dimensions of sustainability, the present situation, and supports the bottom up decision making process of local governments and NGOs in order to promote development. These investigations highlighted the facts that potential competitiveness of a region can only be based on sustainable settlements, subregions and it is essential to eliminate deficiencies that restrain present and future development. XXXXXXXXXXXXXXXXXXXXXXXXXX A fenntarthatóság, amely szemlélet-, gondolkodás-, élet-, termelési-, valamint fogyasztási mód felöleli az emberi létezés valamennyi dimenzióját, a természeti erőforrásokhoz való viszonyát, a gazdaságot és a társadalmat. A globális kihívá-sok leküzdésében – mint például a globalizálódó gazdaság és piaci verseny, a globális felmelegedés, a szegénység és éhezés leküzdése –, a kutatási – innovációs folyamatok mellett a fenntarthatóság jelentheti a megoldást. Ezt megerősítik az ENSZ világrendezvényei Riótól – Johannesburgig, valamint az EU határozatai. Az eddigi jó szándékú próbálkozások globális szinten mozogtak, vajmi kevés eredménnyel. Ezért szükséges a fenntarthatóság regionális és lokális – kistérségi, települési, vállalkozási – szintjein kezdeményezni a megoldást. A fenntarthatóság egyre inkább az elvárások és cselekvések középpontjába kerül, várható, hogy csak azok a régiók, kistérségek, helyi szintek lehetnek eredményesek, versenyké-pesek melyek időben felismerték a fenntarthatóság érvényesítésének szükséges-ségét, s ezzel helyzeti előnyre tesznek szert. Ugyanis a fenntarthatóságot mellőző települések nem tudják megtartani lakosaikat, s a vidék nem képes megfelelő minőségű, az élelmiszerbiztonsági igényeknek megfelelő termékeket kibocsátani, s nem hosszabb távon felélik természeti erőforrásaikat. A régiók versenyesélyét sokban meghatározzák a régión belüli vidéki térségek és települések helyzete, s fejlődése. Ezért a kutatások a fenntartható vidék és ennek lényegi elemére a fenntartható, vagyis élhető településre irányultak. A vizsgálatok erre a célra egy újszerű indikátor és mutatószámrendszert alkalmaztak, amely tükrözte a fenn-tarthatóság dimenzióit, az adott helyzetet, s megalapozzák az alulról építkező te-lepülési és civil szervezeti önkormányzatok a fejlesztés lehetőségeit. A vizsgálatok hangsúlyozzák, hogy a fenntartható településekre-kistérségekre épülhet a régió versenyesélye, s mindebben különösen fontos szerepe van a jelent és jövőt korlá-tozó „hiányok” felszámolásának

Climate and Energy Policy in Hungary

The energy problem has been redefined as one of the most important elements of sustainable development by climate change, adaptation and mitigation. Meeting energy needs is always a current issue in Hungary, irrespective of climate change because of the country’s high dependency on oil and gas imports, limited opportunities to replace them with domestic production, and the pollution associated with using fossil energy sources. Increasing effectiveness and saving energy can provide relatively short-term solutions with bearable costs and a relatively quick return on investment. The aim of the present paper is to give an overview about the climate and energy policy in Hungary with a special focus on the new energy strategy. Energy policy has a pivotal role in the economic recovery plan of the Hungarian government. The National Energy Strategy 2030 taking shape in Hungary takes climate policy into account with respect to adaptation and mitigation and lists renewable energy sources as the second most important tool for achieving strategic goals. As in most countries, it is also possible in Hungary to introduce climate strategy measures with zero social costs. The expedient management of climate change requires the combination of prevention, adaptation and dissemination initiatives. Strategies must meet a dual requirement: they must face the economic risks associated with premature measures, while also considering the adverse effects of delay

Booster Vaccination Decreases 28-Day All-Cause Mortality of the Elderly Hospitalized Due to SARS-CoV-2 Delta Variant

(1) Background: SARS-CoV-2 infections are associated with an increased risk of hospital admissions especially in the elderly (age ≥ 65 years) and people with multiple comorbid conditions. (2) Methods: We investigated the effect of additional booster vaccinations following the primary vaccination series of mRNA, inactivated whole virus, or vector vaccines on infections with the SARS-CoV-2 delta variant in the total Hungarian elderly population. The infection, hospital admission, and 28-day all-cause mortality of elderly population was assessed. (3) Results: A total of 1,984,176 people fulfilled the criteria of elderly including 299,216 unvaccinated individuals, while 1,037,069 had completed primary vaccination and 587,150 had obtained an additional booster. The primary vaccination series reduced the risk of infection by 48.88%, the risk of hospital admission by 71.55%, and mortality by 79.87%. The booster vaccination had an additional benefit, as the risk of infection, hospital admission, and all-cause mortality were even lower (82.95%; 92.71%; and 94.24%, respectively). Vaccinated patients needing hospitalization suffered significantly more comorbid conditions, indicating a more vulnerable population. (4) Conclusions: Our data confirmed that the primary vaccination series and especially the booster vaccination significantly reduced the risk of the SARS-CoV-2 delta-variant-associated hospital admission and 28-day all-cause mortality in the elderly despite significantly more severe comorbid conditions

Variation in antiretroviral treatment coverage and virological suppression among three HIV key populations

Objectives: We assessed differences in antiretroviral treatment (ART) coverage and virological suppression across three HIV key populations, as defined by self-reported HIV transmission category: sex between men, injection drug use (IDU) and heterosexual transmission. Design: A multinational cohort study. Methods: Within the EuroSIDA study, we assessed region-specific percentages of ART coverage among those in care and virological suppression (<500 copies/ml) among those on ART, and analysed differences between transmission categories using logistic regression. Results: Among 12 872 participants followed from 1 July 2014 to 30 June 2016, the percentages of ART-coverage and virological suppression varied between transmission categories, depending on geographical region (global P for interaction: P = 0.0148 for ART-coverage, P = 0.0006 for virological suppression). In Western [adjusted odds ratio (aOR) 1.41 (95% confidence interval 1.14-1.75)] and Northern Europe [aOR 1.68 (95% confidence interval 1.25-2.26)], heterosexuals were more likely to receive ART than MSM, while in Eastern Europe, there was some evidence that infection through IDU [aOR 0.60 (95% confidence interval 0.31-1.14)] or heterosexual contact [aOR 0.58 (95% confidence interval 0.30-1.10)] was associated with lower odds of receiving ART. In terms of virological suppression, people infected through IDU or heterosexual contact in East Central and Eastern Europe were around half as likely as MSM to have a suppressed viral load on ART, while we observed no differences in virological suppression across transmission categories in Western and Northern Europe. Conclusion: In our cohort, patterns of ART-coverage and virological suppression among key populations varied by geographical region, emphasizing the importance of tailoring HIV programmes to the local epidemic. Copyright (C) 2018 Wolters Kluwer Health, Inc. All rights reserved

Observational cohort study of rilpivirine (RPV) utilization in Europe

Altres ajuts: ViiV Healthcare LLC; Janssen Scientific Affairs; Janssen R&D; Bristol-Myers Squibb Company; Merck Sharp & Dohme Corp; Gilead Sciences; The Swiss National Science Foundation (148522); the Danish National Research Foundation and by the International Cohort Consortium of Infectious Disease (RESPOND) (DNRF126).Introduction: Data on safety and effectiveness of RPV from the real-world setting as well as comparisons with other NNRTIs such as efavirenz (EFV) remain scarce. Methods: Participants of EuroSIDA were included if they had started a RPV- or an EFV-containing regimen over November 2011-December 2017. Statistical testing was conducted using non-parametric Mann-Whitney U test and Chi-square test. A logistic regression model was used to compare participants' characteristics by treatment group. Kaplan-Meier analysis was used to estimate the cumulative risk of virological failure (VF, two consecutive values > 50 copies/mL). Results: 1,355 PLWH who started a RPV-based regimen (11% ART-naïve), as well as 333 initiating an EFV-containing regimen were included. Participants who started RPV differed from those starting EFV for demographics (age, geographical region) and immune-virological profiles (CD4 count, HIV RNA). The cumulative risk of VF for the RPV-based group was 4.5% (95% CI 3.3-5.7%) by 2 years from starting treatment (71 total VF events). Five out of 15 (33%) with resistance data available in the RPV group showed resistance-associated mutations vs. 3/13 (23%) among those in the EFV group. Discontinuations due to intolerance/toxicity were reported for 73 (15%) of RPV- vs. 45 (30%) of EFV-treated participants (p = 0.0001). The main difference was for toxicity of central nervous system (CNS, 3% vs. 22%, p 50 copies/mL and resistance in participants treated with RPV were similar to those reported by other studies. RPV safety profile was favourable with less frequent discontinuation due to toxicity than EFV (especially for CNS)

Observational cohort study of rilpivirine (RPV) utilization in Europe

Introduction: Data on safety and effectiveness of RPV from the real-world setting as well as comparisons with other NNRTIs such as efavirenz (EFV) remain scarce. Methods: Participants of EuroSIDA were included if they had started a RPV- or an EFV-containing regimen over November 2011-December 2017. Statistical testing was conducted using non-parametric Mann–Whitney U test and Chi-square test. A logistic regression model was used to compare participants’ characteristics by treatment group. Kaplan–Meier analysis was used to estimate the cumulative risk of virological failure (VF, two consecutive values > 50 copies/mL). Results: 1,355 PLWH who started a RPV-based regimen (11% ART-naïve), as well as 333 initiating an EFV-containing regimen were included. Participants who started RPV differed from those starting EFV for demographics (age, geographical region) and immune-virological profiles (CD4 count, HIV RNA). The cumulative risk of VF for the RPV-based group was 4.5% (95% CI 3.3–5.7%) by 2 years from starting treatment (71 total VF events). Five out of 15 (33%) with resistance data available in the RPV group showed resistance-associated mutations vs. 3/13 (23%) among those in the EFV group. Discontinuations due to intolerance/toxicity were reported for 73 (15%) of RPV- vs. 45 (30%) of EFV-treated participants (p = 0.0001). The main difference was for toxicity of central nervous system (CNS, 3% vs. 22%, p 50 copies/mL and resistance in participants treated with RPV were similar to those reported by other studies. RPV safety profile was favourable with less frequent discontinuation due to toxicity than EFV (especially for CNS)