Europeanisation through the Back Door: EU Social Policy and the Member States

The article aims at broadly delineating the division of labour in social policy between the EU and the member states; in other words, at showing to what extent the social policy of the member states has been Europeanised. Our understanding of Europeanisation is broad. Europeanisation can be a rather subtle and invisible process rather than an abrupt modification of the national institutional architecture. The Union’s legal and juridical competences in the social area have been restricted to issues related to the single market, such as labour law, the free movement of workers, health and safety at the working place, and non-discrimination. In addition, the social OMC is a case of subtle and indirect Europeanisation influencing above all values, norms and ways of thinking about social policy. Moreover, national social systems are also influenced by other EU processes, such as the European macro-economic policy, the single market, the common currency, and the European Employment Strategy

Investigating Barriers for the Adoption of the German Contact-Tracing App and the Influence of a Video Intervention on User Acceptance

Despite the efforts that were put into data protection and data security, the overall adoption rate of the German contact-tracing app falls behind the estimated threshold of 60 percent which would be needed to suppress the virus effectively. Therefore, we conducted a questionnaire-based study to analyze barriers for the acceptance and to investigate the effect of a video intervention on the acceptance. Acceptance was measured using the technology acceptance model [15]. TAM measures were collected before and after watching the video intervention. Qualitative data on attitudes about the app was gathered through open questions and attitudinal items. 81 datasets from users with no prior experience were included in the further analysis. Results show that the video intervention did not increase behavioral intention (BI) significantly. However, the average scores of two important determinants of BI, Perceived Ease of Use (PEOU) and Perceived Usefulness (PU) increased significantly from 4.00 to 4.61 for PEOU (p<.00) and from 1.93 to 2.16 for PU (p<.001) with high and medium effect sizes. Qualitative data analysis indicates that the main barriers for adoption are perceived high risks and costs but low perceived personal benefits. One third of respondents (27/81) have privacy concerns and more than 40 percent of participants state they see "no benefits"(36/81)

The probiotic Escherichia coli strain Nissle 1917 (EcN) stops acute diarrhoea in infants and toddlers

In most cases, acute diarrhoea will become self-limiting during the first few days after onset. For young children, however, health risks may develop when the disease lasts longer than 3 days. The purpose of the present trial was to determine whether the stool frequency of infants and toddlers suffering from acute diarrhoea could be normalised more quickly by administering the probiotic Escherichia coli Nissle 1917 (EcN) solution than by administering a placebo. The safety of EcN were also assessed. A total of 113 children (aged 2–47 months) with acute diarrhoea (> three watery or loose stools in 24 h) were randomised to either a group receiving the probiotic EcN suspension (n = 55) or a group receiving the placebo suspension (n = 58) in a confirmative, double-blind clinical trial. Depending on the age of patients, 1–3 ml per day of verum suspension (10(8) viable EcN cells per millilitre) or placebo were administered orally. The causes of the diarrhoea were viral rather than bacterial, but they were mainly unspecific infections. The median onset of treatment response (reduction of daily stool frequency to ≤ three watery or loose stools over at least 2 consecutive days) occurred more rapidly in the children receiving the EcN solution (2.5 days) than in those receiving the placebo (4.8 days), a significant difference (2.3 days; p = 0.0007). The number of patients showing a response was clearly higher (p < 0.0001) in the EcN group (52/55; 94.5%) than in the placebo group (39/58; 67.2%). EcN was found to be safe and well-tolerated, and it showed a significant superiority compared to the placebo in the treatment of acute diarrhoea in infants and toddlers. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:http://dx.doi.org/10.1007/s00431-007-0419-x) contains supplementary material, which is available to authorized users

Prevalence and prognostic value of neurological affections in hospitalized patients with moderate to severe COVID-19 based on objective assessments.

Neurological manifestations of coronavirus disease 2019 (COVID-19) have been frequently described. In this prospective study of hospitalized COVID-19 patients without a history of neurological conditions, we aimed to analyze their prevalence and prognostic value based on established, standardized and objective methods. Patients were investigated using a multimodal electrophysiological approach, accompanied by neuropsychological and neurological examinations. Prevalence rates of central (CNS) and peripheral (PNS) nervous system affections were calculated and the relationship between neurological affections and mortality was analyzed using Firth logistic regression models. 184 patients without a history of neurological diseases could be enrolled. High rates of PNS affections were observed (66% of 138 patients receiving electrophysiological PNS examination). CNS affections were less common but still highly prevalent (33% of 139 examined patients). 63% of patients who underwent neuropsychological testing (n = 155) presented cognitive impairment. Logistic regression models revealed pathology in somatosensory evoked potentials as an independent risk factor of mortality (Odds Ratio: 6.10 [1.01-65.13], p = 0.049). We conclude that hospitalized patients with moderate to severe COVID-19 display high rates of PNS and CNS affection, which can be objectively assessed by electrophysiological examination. Electrophysiological assessment may have a prognostic value and could thus be helpful to identify patients at risk for deterioration

Classifying asthma control using salivary and fecal bacterial microbiome in children with moderate-to-severe asthma

Background: Uncontrolled asthma can lead to severe exacerbations and reduced quality of life. Research has shown that the microbiome may be linked with asthma characteristics; however, its association with asthma control has not been explored. We aimed to investigate whether the gastrointestinal microbiome can be used to discriminate between uncontrolled and controlled asthma in children. Methods: 143 and 103 feces samples were obtained from 143 children with moderate-to-severe asthma aged 6 to 17 years from the SysPharmPediA study. Patients were classified as controlled or uncontrolled asthmatics, and their microbiome at species level was compared using global (alpha/beta) diversity, conventional differential abundance analysis (DAA, analysis of compositions of microbiomes with bias correction), and machine learning [Recursive Ensemble Feature Selection (REFS)]. Results: Global diversity and DAA did not find significant differences between controlled and uncontrolled pediatric asthmatics. REFS detected a set of taxa, including Haemophilus and Veillonella, differentiating uncontrolled and controlled asthma with an average classification accuracy of 81% (saliva) and 86% (feces). These taxa showed enrichment in taxa previously associated with inflammatory diseases for both sampling compartments, and with COPD for the saliva samples. Conclusion: Controlled and uncontrolled children with asthma can be differentiated based on their gastrointestinal microbiome using machine learning, specifically REFS. Our results show an association between asthma control and the gastrointestinal microbiome. This suggests that the gastrointestinal microbiome may be a potential biomarker for treatment responsiveness and thereby help to improve asthma control in children

Working together, working better? The European Commission and functional representation in the social Open Method of Coordination

Tutkimuksessa analysoidaan niitä demokratiakäsitteitä, joihin Euroopan komission näkemykset kansalaisjärjestöjen osallistumisesta Euroopan unionin sosiaalipolitiikkaan perustuvat. Lähtökohtana on, että osallistuminen ei sinänsä tee politiikasta demokraattisempaa, vaan vaikutus riippuu siitä, miten osallistumisprosessi järjestetään. Tämä taas pohjautuu siihen, miten päättäjät ymmärtävät osallistumisen ja mitä he sillä tavoittelevat. Tutkimus osoittaa, että komissiolle kansalaisjärjestöjen osallistuminen ei ole ensisijaisesti keino vahvistaa kansalaisten vaikutusta politiikan sisältöihin, vaan väline oman asemansa vahvistamiseen. Vaikka komissio perustelee osallistumista vahvasti demokratialla, sen käyttämät demokratiakäsitteet huolestuttavat. Sen argumentaatiossa osallistumisprosessin lähtökohtana on pääasiassa se, että oletetaan ihmisten luottavan siihen, että kansalaisjärjestöt ovat omistautuneet hyvälle asialle. Sen sijaan kansalaisille ei anneta mahdollisuutta vaikuttaa siihen, mitkä järjestöt osallistuvat. Lisäksi jää epäselväksi, miten ihmisten näkemyksiä on tarkoitus välittää järjestöjen kautta paikalliselta tasolta EU:hun. Lyhyesti sanottuna komission mallissa demokratia ei perustu erilaisten näkemysten vuorovaikutukseen ja kansalaisten mahdollisuuteen valvoa poliittista valtaa vaan siihen, että ihmiset luottaisivat poliittisiin toimijoihin ja tukisivat talkoohengessä komission poliittista projektia. Tutkimuksella on kaksi tavoitetta. Ensinnäkin se valaisee yksityiskohtaisesti, millaisiin käsityksiin komission kannattama demokratiamalli perustuu. Tällaiset politiikan toimijoiden ajamat käsitykset ovat itse osa sitä, miten hyvin demokratia toimii. Toiseksi tutkimus edistää edustusteorioiden kehittämistä välineeksi, jolla pystytään tutkimaan monitahoisia hallintoasetelmia demokratian näkökulmasta.It has become a commonplace that involving the affected ( stakeholders ) renders policymaking more democratic. However, the closer one looks at the issue, the more questions arise. Who should be involved, and who makes this choice according to what criteria? What should be the relationship between those who participate and those who do not? What role should the different actors play? Who is accountable for which parts of the process, to whom, and by what procedures? There are no simple or obvious answers to these questions. This case study looks at the specific model offered by the European Commission for democratic governance in the Open Method of Coordination (OMC) in social protection and social inclusion. The Commission uses its cooperation with NGOs as an argument to legitimise its activities and positions; it thus claims that this cooperation adds to the democratic quality of its initiatives. With the help of an in-depth rhetorical analysis, I look into the concepts of democracy underlying this argumentation. How exactly is the involvement of the affected linked to legitimacy, and what kind of legitimacy is this to be? To systematically analyse the involvement of the affected in terms of democracy, this involvement is here conceived as functional representation, i.e. the representation of functional groups. Hence, the study contributes to the development of theories of representation as a tool for normative analyses of complex governance settings. The Commission s way to conceptualise democratic governance raises serious concerns. Legitimacy is mainly to be based on a presupposed generalised trust in NGOs commitment to a good cause, rather than on inputs from citizens. The latter are assigned no influence on the choice of involved NGOs, and it remains unclear how views are to be mediated from the local to the EU level. Overall, functional representatives are meant to contribute to the efficient accomplishment of a political project in partnership with the Commission, who also provides chosen organisations with the necessary resources for this task. Promoting these views means promoting a particular vision of how European governance processes should be organised, which is why the concepts of democracy advanced by political actors are themselves part of how democratically a political system works. However, the study also indicates that involving civil society on the European level in democratic ways faces important structural difficulties. Hence, civil society participation is no panacea for democratising the EU