Cross-Border Health Care in the European Union: Evaluation of Different Financing Arrangements

This paper analyses the impact of the financing arrangements for planned cross-border health care within the European Union. A financial arrangement is taken to provide a financial incentive but may also involve payment risks and administrative burden. For the pathways given by the Social Security Regulations (883/2004 and 987/2009) and the EU Directive 2011/24/EU, we investigate how the associated financial arrangements act on providers, patients and on publicly funded health insurance. First, the Regulations can induce cross-border health care that will increase domestic health care expenditure and may threaten national health policy by setting an incentive for patients to go abroad for health care not covered by domestic health insurance. Second, the financial arrangement of the Directive may induce cross-border health care which will lower domestic health care expenditure. However, due to considerable payment risks and administrative burden on both patients and providers, these benefits will not be reaped in full. Moreover, in the presence of national cost containment policies, the Directive may provide an incentive for cross-border health care that is too strong. Finally, due to the requirement to pay upfront, the financial arrangement also suffers from a lack of equity of access to health care provision abroad

[Stammbuch Frantz Carl Ernst Wilhelm von Rau]

[STAMMBUCH FRANTZ CARL ERNST WILHELM VON RAU] [Stammbuch Frantz Carl Ernst Wilhelm von Rau] ( - ) Einband ( - ) Exlibris: Hans Stula ( - ) Besitzvermerk ([1]) Einträge, S. 19 - 39 (19) Einträge, S. 43 - 78 (43) Einträge, S. 79 - 108 (79) Einträge, S. 111 - 135 (111) Einträge, S. 143 - 172 (143) Einträge, S. 173 - 218 (173) Einträge, S. 226 - 241 (226) Register ([1]

Case Study: Assessing The COVID-19 Pandemic’s Potential for A More Climate-Friendly Work-Related Mobility

The switch from working in-office to working from home in the context of the COVID-19 pandemic had a significant impact on people’s mobility behavior. In view of the need for action arising from the ongoing challenge of climate change, these changes should be seen as an opportunity to reduce emissions in the traffic sector. The aim of this study was to analyze changes in work-related mobility that occurred during the COVID-19 pandemic using the case of a multinational medium-sized retail chain situated in semi-rural Germany. The case study allowed us to examine those changes in connection with individual attitudes and perspectives of the company and its employees. Thus, we quantitatively recorded the mobility behavior of the company’s employees, followed by an expert interview to ascertain the company’s perspective. We found a reduction in the frequency of commuting and business trips made by employees, which seemed to continue beyond the COVID-19 crisis. However, according to our findings these changes were not based on individual motivation to act in a climate-aware manner but are subject to the framework conditions created by employers for the adoption of climate-friendly behavior. The results of this work could be used by companies and policymakers to create such favorable framework conditions

A systematic review to assess the evidence-based effectiveness, content, and success factors of behavior change interventions for enhancing pro-environmental behavior in individuals

To reduce global greenhouse gas emissions in order to limit global warming to 1.5°C, individuals and households play a key role. Behavior change interventions to promote pro-environmental behavior in individuals are needed to reduce emissions globally. This systematic literature review aims to assess the a) evidence-based effectiveness of such interventions and b) the content of very successful interventions without limiting the results to specific emitting sectors or countries. Based on the “PICOS” mnemonic and PRISMA statement, a search strategy was developed, and eligibility criteria were defined. Three databases (Embase, PsycInfo, and Web of Science) were searched to retrieve and review potential literature. As a result, 54 publications from 2010 to 2021 were included in the analysis. The results show that most interventions only have small positive effects or none at all. A total of 15 very successful interventions focused on the sectors of mobility, energy, and waste and incorporated improved (infra-) structures, education, feedback, enablement or made the sustainable option the default. Six evidence-based recommendations for content, timing, and setting are deducted and given for interventions on enhancing pro-environmental behavior (PEB). In summary, although the various interventions and intervention types to promote PEB differ in their effectiveness, very successful interventions have common elements. Future research should focus on high-/low-impact and high-/low-cost behavior to develop interventions that aim at high-impact but low-cost behavior changes, or avoid low-impact but high-cost behavior

Pushing the Frontiers of Service Research – A Taxonomy of Proactive Services

Rapid advancements in digital technologies and data analysis led to a new service type. With their push-rationale, proactive services (PAS) are pushing the frontiers of traditional and even digital or smart services. Such PAS anticipate consumer needs and address them proactively. For instance, a smart fridge replenishes groceries in line with the consumer’s preferences, based on anticipated demand, and without the consumer’s intervention. In this paper, we contribute to a better understanding of the PAS phenomenon. Therefore, we propose a literature-backed and empirically validated multi-layer taxonomy of PAS along the layers consumer, data, and interaction. Further, we compile a list of 45 PAS examples, demonstrate our taxonomy with three illustrative scenarios, and evaluate their understandability and applicability in seven interviews with domain and method experts. Based on gained insights on this rapidly emerging and important phenomenon, we highlight implications for both researchers and practitioners, and suggest future research directions

Immunological properties of recombinant classical swine fever virus NS3 protein in vitro and in vivo

Classical swine fever (CSF) is a highly contagious and often fatal disease of pigs characterised by fever, severe leukopenia and haemorrhages. With vaccines having an importance in disease control, studies are seeking improved protein-based subunit vaccine against the virus (CSFV). In this respect, recombinant viral NS3 protein was analysed for its immunopotentiating capacity, particularly in terms of cytotoxic immune responses. NS3 was effective at inducing in vitro responses, quantified by lymphoproliferation, IFN-$\gamma$ ELISPOT, flow cytometric detection of activated T cell subsets, and cytotoxic T cell assays. Peripheral blood mononuclear cells from CSFV-immune pigs could be stimulated, but not cells from naïve animals. In addition to the IFN-$\gamma$ responses, induction of both CD4+ T helper cell and CD8+ cytotoxic T cells (CTL) were discernible – activation of the latter was confirmed in a virus-specific cytolytic assay. Attempts were made to translate this to the in vivo situation, by vaccinating pigs with an E2/NS3-based vaccine compared with an E2 subunit vaccine. Both vaccines were similar in their abilities to stimulate specific immune responses and protect pigs against lethal CSFV infection. Although the E2/NS3 vaccine appeared to have an advantage in terms of antibody induction, this was not statistically significant when group studies were performed. It was also difficult to visualise the NS3 capacity to promote T-cell responses in vivo. These results show that NS3 has potential for promoting cytotoxic defences, but the formulation of the vaccine requires optimisation for ensuring that NS3 is correctly delivered to antigen presenting cells for efficient activation of CTL

Cholera toxin promotes the generation of semi-mature porcine monocyte-derived dendritic cells that are unable to stimulate T cells

Cholera toxin (Ctx) is a powerful mucosal adjuvant with potential applications for oral vaccination of swine. Dendritic cells (DC) play a key role in the decision between immunity and tolerance, and are likely target cells for mediating Ctx functions in vivo. Therefore, we examined the capacity of Ctx to enhance stimulatory activity of porcine monocyte-derived DC (MoDC). Ctx promoted the development of a semi-mature DC phenotype, with decreased levels of MHC class II and CD40, but increased CD80/86 expression. These changes were associated with activation of extracellular signal-regulated kinase (ERK), but not NF${\kappa}$B or c-Jun N-terminal kinase (JNK). Functionally, Ctx-priming greatly diminished T cell stimulatory capacity both in antigen-specific and superantigen-induced proliferation assays. The lower proliferation rate was not due to increased apoptosis of either DC or T cells. Ctx suppressed TNF${\alpha}$ secretion by MoDC, but induced IL-10 production. The observed effects on T cell proliferation could only be partially mimicked by IL-10 alone. However, addition of recombinant TNF${\alpha}$ to co-cultures of Ctx-primed MoDC and lymphocytes restored lymphocyte proliferation in a concentration-dependent manner. Ctx-primed DC were not actively tolerogenic, since they could not suppress proliferative T cell reactions induced by untreated DC

Toolbox for Research, or how to facilitate a central data management in small-scale research projects

Abstract Background In most research projects budget, staff and IT infrastructures are limiting resources. Especially for small-scale registries and cohort studies professional IT support and commercial electronic data capture systems are too expensive. Consequently, these projects use simple local approaches (e.g. Excel) for data capture instead of a central data management including web-based data capture and proper research databases. This leads to manual processes to merge, analyze and, if possible, pseudonymize research data of different study sites. Results To support multi-site data capture, storage and analyses in small-scall research projects, corresponding requirements were analyzed within the MOSAIC project. Based on the identified requirements, the Toolbox for Research was developed as a flexible software solution for various research scenarios. Additionally, the Toolbox facilitates data integration of research data as well as metadata by performing necessary procedures automatically. Also, Toolbox modules allow the integration of device data. Moreover, separation of personally identifiable information and medical data by using only pseudonyms for storing medical data ensures the compliance to data protection regulations. This pseudonymized data can then be exported in SPSS format in order to enable scientists to prepare reports and analyses. Conclusions The Toolbox for Research was successfully piloted in the German Burn Registry in 2016 facilitating the documentation of 4350 burn cases at 54 study sites. The Toolbox for Research can be downloaded free of charge from the project website and automatically installed due to the use of Docker technology