Gender inequalities in mental wellbeing in 26 European countries: do welfare regimes matter?

PubMed

Dreger, Stefanie; Gerlinger, Thomas; Bolte, Gabriele

2016-10-01

Nature and extent of welfare regimes and social policies are important determinants of health and health inequalities. This study examines the association of gender and mental wellbeing in European countries and investigates whether type of welfare regime plays a role in this association. Data of 19 366 women and 14 338 men of the third round of the European Quality of Life Survey (2011-12) was used to analyse mental wellbeing, assessed by the World Health Organization 5-Mental Wellbeing Index. Multilevel logistic regression analyses were performed to analyse the association between gender and good mental wellbeing first at country-level, and secondly the between country variation was analysed and welfare regimes were included as explanatory variables. We observed cross-national variation in good mental wellbeing. At country levels gender inequalities in good mental wellbeing were observed in 7 out of 26 countries. In analyses considering all countries together gender inequalities in good mental wellbeing were identified independent of further individual socio-demographic variables and independent of the welfare regimes that people lived in [women vs. men: OR = 0.76; (95% CI = 0.71-0.81)]. Gender inequalities in good mental wellbeing were not modified by welfare regimes. There are cross-national differences in good mental wellbeing between European countries. Gender inequalities with a lower prevalence of good mental wellbeing among women are common in European countries. This study suggests that welfare regimes do not modify these gender inequalities in mental wellbeing. © The Author 2016. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Immigrants' health in Europe: a cross-classified multilevel approach to examine origin country, destination country, and community effects.

PubMed

Huijts, Tim; Kraaykamp, Gerbert

2012-01-01

In this study, we examined origin, destination, and community effects on first- and second-generation immigrants' health in Europe. We used information from the European Social Surveys (2002–2008) on 19,210 immigrants from 123 countries of origin, living in 31 European countries. Cross-classified multilevel regression analyses reveal that political suppression in the origin country and living in countries with large numbers of immigrant peers have a detrimental influence on immigrants' health. Originating from predominantly Islamic countries and good average health among natives in the destination country appear to be beneficial. Additionally, the results point toward health selection mechanisms into migration.

Cross-national comparability of burden of disease estimates: the European Disability Weights Project.

PubMed Central

Essink-Bot, Marie-Louise; Pereira, Joaquin; Packer, Claire; Schwarzinger, Michael; Burstrom, Kristina

2002-01-01

OBJECTIVE: To investigate the sources of cross-national variation in disability-adjusted life-years (DALYs) in the European Disability Weights Project. METHODS: Disability weights for 15 disease stages were derived empirically in five countries by means of a standardized procedure and the cross-national differences in visual analogue scale (VAS) scores were analysed. For each country the burden of dementia in women, used as an illustrative example, was estimated in DALYs. An analysis was performed of the relative effects of cross-national variations in demography, epidemiology and disability weights on DALY estimates. FINDINGS: Cross-national comparison of VAS scores showed almost identical ranking orders. After standardization for population size and age structure of the populations, the DALY rates per 100000 women ranged from 1050 in France to 1404 in the Netherlands. Because of uncertainties in the epidemiological data, the extent to which these differences reflected true variation between countries was difficult to estimate. The use of European rather than country-specific disability weights did not lead to a significant change in the burden of disease estimates for dementia. CONCLUSIONS: Sound epidemiological data are the first requirement for burden of disease estimation and relevant between-countries comparisons. DALY estimates for dementia were relatively insensitive to differences in disability weights between European countries. PMID:12219156

European downstream oil industry safety performance : statistical summary of reported incidents, 1998

DOT National Transportation Integrated Search

1999-07-01

This report is the fifth by CONCAWE reviewing the safety performance of the downstream oil industry in Europe. The area of coverage is primarily the EU, EEA and Hungary, but for some companies the data for other European countries such as Poland, Cze...

Common measure of quality of life for people with systemic sclerosis across seven European countries: a cross-sectional study.

PubMed

Ndosi, Mwidimi; Alcacer-Pitarch, Begonya; Allanore, Yannick; Del Galdo, Francesco; Frerix, Marc; García-Díaz, Sílvia; Hesselstrand, Roger; Kendall, Christine; Matucci-Cerinic, Marco; Mueller-Ladner, Ulf; Sandqvist, Gunnel; Torrente-Segarra, Vicenç; Schmeiser, Tim; Sierakowska, Matylda; Sierakowska, Justyna; Sierakowski, Stanslaw; Redmond, Anthony

2018-02-20

The aim of this study was to adapt the Systemic Sclerosis Quality of Life Questionnaire (SScQoL) into six European cultures and validate it as a common measure of quality of life in systemic sclerosis (SSc). This was a seven-country (Germany, France, Italy, Poland, Spain, Sweden and UK) cross-sectional study. A forward-backward translation process was used to adapt the English SScQoL into target languages. SScQoL was completed by patients with SSc, then data were validated against the Rasch model. To correct local response dependency, items were grouped into the following subscales: function, emotion, sleep, social and pain and reanalysed for fit to the model, unidimensionality and cross-cultural equivalence. The adaptation of the SScQoL was seamless in all countries except Germany. Cross-cultural validation included 1080 patients with a mean age 58.0 years (SD 13.9) and 87% were women. Local dependency was evident in individual country data. Grouping items into testlets corrected the local dependency in most country specific data. Fit to the model, reliability and unidimensionality was achieved in six-country data after cross-cultural adjustment for Italy in the social subscale. The SScQoL was then calibrated into an interval level scale. The individual SScQoL items have translated well into five languages and overall, the scale maintained its construct validity, working well as a five-subscale questionnaire. Measures of quality of life in SSc can be directly compared across five countries (France, Poland Spain, Sweden and UK). Data from Italy are also comparable with the other five countries although require an adjustment. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Measuring hospital efficiency--comparing four European countries.

PubMed

Mateus, Céu; Joaquim, Inês; Nunes, Carla

2015-02-01

Performing international comparisons on efficiency usually has two main drawbacks: the lack of comparability of data from different countries and the appropriateness and adequacy of data selected for efficiency measurement. With inpatient discharges for four countries, some of the problems of data comparability usually found in international comparisons were mitigated. The objectives are to assess and compare hospital efficiency levels within and between countries, using stochastic frontier analysis with both cross-sectional and panel data. Data from English (2005-2008), Portuguese (2002-2009), Spanish (2003-2009) and Slovenian (2005-2009) hospital discharges and characteristics are used. Weighted hospital discharges were considered as outputs while the number of employees, physicians, nurses and beds were selected as inputs of the production function. Stochastic frontier analysis using both cross-sectional and panel data were performed, as well as ordinary least squares (OLS) analysis. The adequacy of the data was assessed with Kolmogorov-Smirnov and Breusch-Pagan/Cook-Weisberg tests. Data available results were redundant to perform efficiency measurements using stochastic frontier analysis with cross-sectional data. The likelihood ratio test reveals that in cross-sectional data stochastic frontier analysis (SFA) is not statistically different from OLS in Portuguese data, while SFA and OLS estimates are statistically different for Spanish, Slovenian and English data. In the panel data, the inefficiency term is statistically different from 0 in the four countries in analysis, though for Portugal it is still close to 0. Panel data are preferred over cross-section analysis because results are more robust. For all countries except Slovenia, beds and employees are relevant inputs for the production process. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Essential oil diversity of European Origanum vulgare L. (Lamiaceae).

PubMed

Lukas, Brigitte; Schmiderer, Corinna; Novak, Johannes

2015-11-01

This investigation focused on the qualitative and quantitative composition of essential oil compounds of European Origanum vulgare. Extracts of 502 individual O. vulgare plants from 17 countries and 51 populations were analyzed via GC. Extracts of 49 plants of 5 populations of Israeli Origanum syriacum and 30 plants from 3 populations of Turkish Origanum onites were included to exemplify essential oil characteristics of 'high-quality' oregano. The content of essential oil compounds of European O. vulgare ranged between 0.03% and 4.6%. The monoterpenes were primarily made up of sabinene, myrcene, p-cymene, 1,8-cineole, β-ocimene, γ-terpinene, sabinene hydrate, linalool, α-terpineol, carvacrol methyl ether, linalyl acetate, thymol and carvacrol. Among the sesquiterpenes β-caryophyllene, germacrene D, germacrene D-4-ol, spathulenol, caryophyllene oxide and oplopanone were often present in higher amounts. According to the proportions of cymyl-compounds, sabinyl-compounds and the acyclic linalool/linalyl acetate three different main monoterpene chemotypes were defined. The cymyl- and the acyclic pathway were usually active in plants from the Mediterranean climate whereas an active sabinyl-pathway was a characteristic of plants from the Continental climate. Copyright © 2015 Elsevier Ltd. All rights reserved.

Smoking behaviour and health care costs coverage: a European cross-country comparison.

PubMed

Rezayatmand, Reza; Groot, Wim; Pavlova, Milena

2017-12-01

The empirical evidence about the effect of smoking on health care cost coverage is not consistent with the expectations based on the notion of adverse selection. This evidence is mostly based on correlational studies which cannot isolate the adverse selection effect from the moral hazard effect. Exploiting data from the Survey of Health, Aging, and Retirement in Europe, this study uses an instrumental variable strategy to identify the causal effect of daily smoking on perceived health care cost coverage of those at age 50 or above in 12 European countries. Daily smoking is instrumented by a variable indicating whether or not there is any other daily smoker in the household. A self-assessment of health care cost coverage is used as the outcome measure. Among those who live with a partner (72% of the sample), the result is not statistically significant which means we find no effect of smoking on perceived health care cost coverage. However, among those who live without a partner, the results show that daily smokers have lower self-assessed perceived health care cost coverage. This finding replicates the same counter-intuitive relationship between smoking and health insurance presented in previous studies, but in a language of causality. In addition to this, we contribute to previous studies by a cross-country comparison which brings in different institutional arrangements, and by using the self-assessed perceived health care cost coverage which is broader than health insurance coverage.

Motives for sickness presence among students at secondary school: a cross-sectional study in five European countries

PubMed Central

Johansen, Vegard

2018-01-01

Objectives This article investigates various motives for sickness presence (SP) among students in secondary school. Design Cross-sectional study. Setting 25 secondary schools in Belgium, Estonia, Finland, Italy and Latvia. Participants 5002 students between 16 and 19 years of age, 49% female. Results Almost half of the students reported two or more incidents of SP. The study indicated that the practice of SP was mainly extrinsically motivated. The most often reported motives for SP were that absence could affect grades negatively, that important curriculum material was explained at the school and attendance requirements. Some students practising SP expressed intrinsic motivation, such as maintaining their social network and interest in what was learnt at school. Conclusion The study investigated various motives for SP in secondary schools in five European countries. Extrinsic motivation for SP was more often reported than intrinsic motivation for SP. Multivariate analyses indicated that boys, students in vocational education, immigrants and students with low-educated parents more often reported intrinsic motivation for SP, while girls and students with high absence more often reported extrinsic motivation. There were also notable cross-country differences regarding reported motives for SP. PMID:29371281

Population health and status of epidemiology in Western European, Balkan and Baltic countries.

PubMed

Seniori Costantini, Adele; Gallo, Federica; Pega, Frank; Saracci, Rodolfo; Veerus, Piret; West, Robert

2015-02-01

This article is part of a series commissioned by the International Epidemiological Association, aimed at describing population health and epidemiological resources in the six World Health Organization (WHO) regions. It covers 32 of the 53 WHO European countries, namely the Western European countries, the Balkan countries and the Baltic countries. The burdens of mortality and morbidity and the patterns of risk factors and inequalities have been reviewed in order to identify health priorities and challenges. Literature and internet searches were conducted to stock-take epidemiological teaching, research activities, funding and scientific productivity. These countries have among the highest life expectancies worldwide. However, within- and between-country inequalities persist, which are largely due to inequalities in distribution of main health determinants. There is a long tradition of epidemiological research and teaching in most countries, in particular in the Western European countries. Cross-national networks and collaborations are increasing through the support of the European Union which fosters procedures to standardize educational systems across Europe and provides funding for epidemiological research through framework programmes. The number of Medline-indexed epidemiological research publications per year led by Western European countries has been increasing. The countries accounts for nearly a third of the global epidemiological publication. Although population health has improved considerably overall, persistent within- and between-country inequalities continue to challenge national and European health institutions. More research, policy and action on the social determinants of health are required in the region. Epidemiological training, research and workforce in the Baltic and Balkan countries should be strengthened. European epidemiologists can play pivotal roles and must influence legislation concerning production and access to high-quality data. © The

Internet addictive behavior in adolescence: a cross-sectional study in seven European countries.

PubMed

Tsitsika, Artemis; Janikian, Mari; Schoenmakers, Tim M; Tzavela, Eleni C; Olafsson, Kjartan; Wójcik, Szymon; Macarie, George Florian; Tzavara, Chara; Richardson, Clive

2014-08-01

A cross-sectional school-based survey study (N=13,284; 53% females; mean age 15.8±0.7) of 14-17-year-old adolescents was conducted in seven European countries (Greece, Spain, Poland, Germany, Romania, the Netherlands, and Iceland). The aim of the study was to investigate the prevalence of Internet addictive behavior (IAB) and related psychosocial characteristics among adolescents in the participating countries. In the study, we distinguish two problematic groups: adolescents with IAB, characterized by a loss of control over their Internet use, and adolescents "at risk for IAB," showing fewer or weaker symptoms of IAB. The two groups combined form a group of adolescents with dysfunctional Internet behavior (DIB). About 1% of adolescents exhibited IAB and an additional 12.7% were at risk for IAB; thus, in total, 13.9% displayed DIB. The prevalence of DIB was significantly higher among boys than among girls (15.2% vs. 12.7%, p<0.001) and varied widely between countries, from 7.9% in Iceland to 22.8% in Spain. Frequent use of specific online activities (e.g., gambling, social networking, gaming) at least 6 days/week was associated with greater probability of displaying DIB. Multiple logistic regression analysis indicated that DIB was more frequent among adolescents with a lower educational level of the parents, earlier age at first use of the Internet, and greater use of social networking sites and gaming sites. Multiple linear regression analysis showed that externalizing (i.e., behavioral) and internalizing (i.e., emotional) problems were associated with the presence of DIB.

Meal patterns across ten European countries - results from the European Prospective Investigation into Cancer and Nutrition (EPIC) calibration study.

PubMed

Huseinovic, E; Winkvist, A; Slimani, N; Park, M K; Freisling, H; Boeing, H; Buckland, G; Schwingshackl, L; Weiderpass, E; Rostgaard-Hansen, A L; Tjønneland, A; Affret, A; Boutron-Ruault, M C; Fagherazzi, G; Katzke, V; Kühn, T; Naska, A; Orfanos, P; Trichopoulou, A; Pala, V; Palli, D; Ricceri, F; Santucci de Magistris, M; Tumino, R; Engeset, D; Enget, T; Skeie, G; Barricarte, A; Bonet, C B; Chirlaque, M D; Amiano, P; Quirós, J R; Sánchez, M J; Dias, J A; Drake, I; Wennberg, M; Boer, Jma; Ocké, M C; Verschuren, Wmm; Lassale, C; Perez-Cornago, A; Riboli, E; Ward, H; Forslund, H Bertéus

2016-10-01

To characterize meal patterns across ten European countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) calibration study. Cross-sectional study utilizing dietary data collected through a standardized 24 h diet recall during 1995-2000. Eleven predefined intake occasions across a 24 h period were assessed during the interview. In the present descriptive report, meal patterns were analysed in terms of daily number of intake occasions, the proportion reporting each intake occasion and the energy contributions from each intake occasion. Twenty-seven centres across ten European countries. Women (64 %) and men (36 %) aged 35-74 years (n 36 020). Pronounced differences in meal patterns emerged both across centres within the same country and across different countries, with a trend for fewer intake occasions per day in Mediterranean countries compared with central and northern Europe. Differences were also found for daily energy intake provided by lunch, with 38-43 % for women and 41-45 % for men within Mediterranean countries compared with 16-27 % for women and 20-26 % for men in central and northern European countries. Likewise, a south-north gradient was found for daily energy intake from snacks, with 13-20 % (women) and 10-17 % (men) in Mediterranean countries compared with 24-34 % (women) and 23-35 % (men) in central/northern Europe. We found distinct differences in meal patterns with marked diversity for intake frequency and lunch and snack consumption between Mediterranean and central/northern European countries. Monitoring of meal patterns across various cultures and populations could provide critical context to the research efforts to characterize relationships between dietary intake and health.

Motives for sickness presence among students at secondary school: a cross-sectional study in five European countries.

PubMed

Johansen, Vegard

2018-01-24

This article investigates various motives for sickness presence (SP) among students in secondary school. Cross-sectional study. 25 secondary schools in Belgium, Estonia, Finland, Italy and Latvia. 5002 students between 16 and 19 years of age, 49% female. Almost half of the students reported two or more incidents of SP. The study indicated that the practice of SP was mainly extrinsically motivated. The most often reported motives for SP were that absence could affect grades negatively, that important curriculum material was explained at the school and attendance requirements. Some students practising SP expressed intrinsic motivation, such as maintaining their social network and interest in what was learnt at school. The study investigated various motives for SP in secondary schools in five European countries. Extrinsic motivation for SP was more often reported than intrinsic motivation for SP. Multivariate analyses indicated that boys, students in vocational education, immigrants and students with low-educated parents more often reported intrinsic motivation for SP, while girls and students with high absence more often reported extrinsic motivation. There were also notable cross-country differences regarding reported motives for SP. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Consensus-based cross-European recommendations for the identification, measurement and valuation of costs in health economic evaluations: a European Delphi study.

PubMed

van Lier, Lisanne I; Bosmans, Judith E; van Hout, Hein P J; Mokkink, Lidwine B; van den Hout, Wilbert B; de Wit, G Ardine; Dirksen, Carmen D; Nies, Henk L G R; Hertogh, Cees M P M; van der Roest, Henriëtte G

2017-12-19

Differences between country-specific guidelines for economic evaluations complicate the execution of international economic evaluations. The aim of this study was to develop cross-European recommendations for the identification, measurement and valuation of resource use and lost productivity in economic evaluations using a Delphi procedure. A comprehensive literature search was conducted to identify European guidelines on the execution of economic evaluations or costing studies as part of economic evaluations. Guideline recommendations were extracted by two independent reviewers and formed the basis for the first round of the Delphi study, which was conducted among European health economic experts. During three written rounds, consensus (agreement of 67% or higher) was sought on items concerning the identification, measurement and valuation of costs. Recommendations from 18 guidelines were extracted. Consensus among 26 panellists from 17 European countries was reached on 61 of 68 items. The recommendations from the Delphi study are to adopt a societal perspective, to use patient report for measuring resource use and lost productivity, to value both constructs with use of country-specific standardized/unit costs and to use country-specific discounting rates. This study provides consensus-based cross-European recommendations on how to measure and value resource use and lost productivity in economic evaluations. These recommendations are expected to support researchers, healthcare professionals, and policymakers in executing and appraising economic evaluations performed in international contexts.

Review of Progress in Vocational Education and Training Reform of the Candidate Countries for Accession to the European Union in the Light of Developments in European Policy on Vocational Training.

ERIC Educational Resources Information Center

European Training Foundation, Turin (Italy).

This document reviews progress in vocational education and training (VET) reform in the candidate countries for accession to the European Union in light of developments in European policy on vocational training. The document consists of a cross-country overview and individual overviews of VET in 12 candidate countries: Bulgaria, the Czech…

Using reduced rank regression methods to identify dietary patterns associated with obesity: a cross-country study among European and Australian adolescents.

PubMed

Huybrechts, Inge; Lioret, Sandrine; Mouratidou, Theodora; Gunter, Marc J; Manios, Yannis; Kersting, Mathilde; Gottrand, Frederic; Kafatos, Anthony; De Henauw, Stefaan; Cuenca-García, Magdalena; Widhalm, Kurt; Gonzales-Gross, Marcela; Molnar, Denes; Moreno, Luis A; McNaughton, Sarah A

2017-01-01

This study aims to examine repeatability of reduced rank regression (RRR) methods in calculating dietary patterns (DP) and cross-sectional associations with overweight (OW)/obesity across European and Australian samples of adolescents. Data from two cross-sectional surveys in Europe (2006/2007 Healthy Lifestyle in Europe by Nutrition in Adolescence study, including 1954 adolescents, 12-17 years) and Australia (2007 National Children's Nutrition and Physical Activity Survey, including 1498 adolescents, 12-16 years) were used. Dietary intake was measured using two non-consecutive, 24-h recalls. RRR was used to identify DP using dietary energy density, fibre density and percentage of energy intake from fat as the intermediate variables. Associations between DP scores and body mass/fat were examined using multivariable linear and logistic regression as appropriate, stratified by sex. The first DP extracted (labelled 'energy dense, high fat, low fibre') explained 47 and 31 % of the response variation in Australian and European adolescents, respectively. It was similar for European and Australian adolescents and characterised by higher consumption of biscuits/cakes, chocolate/confectionery, crisps/savoury snacks, sugar-sweetened beverages, and lower consumption of yogurt, high-fibre bread, vegetables and fresh fruit. DP scores were inversely associated with BMI z-scores in Australian adolescent boys and borderline inverse in European adolescent boys (so as with %BF). Similarly, a lower likelihood for OW in boys was observed with higher DP scores in both surveys. No such relationships were observed in adolescent girls. In conclusion, the DP identified in this cross-country study was comparable for European and Australian adolescents, demonstrating robustness of the RRR method in calculating DP among populations. However, longitudinal designs are more relevant when studying diet-obesity associations, to prevent reverse causality.

Socio-economic factors, cultural values, national personality and antibiotics use: A cross-cultural study among European countries.

PubMed

Gaygısız, Ümmügülsüm; Lajunen, Timo; Gaygısız, Esma

There are considerable cross-national differences in public attitudes towards antibiotics use, use of prescribed antibiotics, and self-medication with antibiotics even within Europe. This study was aimed at investigating the relationships between socio-economic factors, cultural values, national personality characteristics and the antibiotic use in Europe. Data included scores from 27 European countries (14 countries for personality analysis). Correlations between socio-economic variables (Gross National Income per capita, governance quality, life expectancy, mean years of schooling, number of physicians), Hofstede's cultural value dimensions (power distance, individualism, masculinity, uncertainty avoidance, long-term orientation, indulgence), national personality characteristic (extraversion, neuroticism, social desirability) and antibiotic use were calculated and three regression models were constructed. Governance quality (r=-.51), mean years of schooling (r=-.61), power distance (r=.59), masculinity (r=.53), and neuroticism (r=.73) correlated with antibiotic use. The highest amount of variance in antibiotic use was accounted by the cultural values (65%) followed by socio-economic factors (63%) and personality factors (55%). Results show that socio-economic factors, cultural values and national personality characteristics explain cross-national differences in antibiotic use in Europe. In particular, governance quality, uncertainty avoidance, masculinity and neuroticism were important factors explaining antibiotics use. The findings underline the importance of socio-economic and cultural context in health care and in planning public health interventions. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Labor force participation, unemployment and occupational attainment among immigrants in West European countries

PubMed Central

Semyonov, Moshe

2017-01-01

The present paper examines modes of immigrants' labor market incorporation into European societies with specific emphasis on the role played by immigrant status (i.e. first-generation immigrants, immigrant descendants and native born without migrant background), region of origin, and gender. The data were obtained from the European Union Labour Forces Survey 2008 Ad-Hoc Module for France, Belgium, UK and Sweden. In order to supplement the results from the country-specific analysis, we replicated the analysis using pooled data from the five rounds of the European Social Survey conducted between 2002 and 2010, for nine 'old immigration' Western European countries together. The analysis centered on two aspects of incorporation: labor force status and occupation. Multinominal, binary logistic as well as linear probability regression models were estimated. The findings suggest that in all countries non-European origin is associated with greater disadvantage in finding employment not only among first-generation immigrants, but also among sons and daughters of immigrants (i.e. second-generation). Moreover, the relative employment disadvantage among immigrant men of non-European origin is especially pronounced in the second-generation. The likelihood of attaining a high-status job is influenced mostly by immigrant status, regardless of region of origin and gender. The results of the study reveal that patterns of labor force incorporation vary considerably across origin groups and across generations. The patterns do not vary as much across countries, despite cross-country differences in welfare state regimes, migration integration policy and composition of migration flows. PMID:28475632

Labor force participation, unemployment and occupational attainment among immigrants in West European countries.

PubMed

Gorodzeisky, Anastasia; Semyonov, Moshe

2017-01-01

The present paper examines modes of immigrants' labor market incorporation into European societies with specific emphasis on the role played by immigrant status (i.e. first-generation immigrants, immigrant descendants and native born without migrant background), region of origin, and gender. The data were obtained from the European Union Labour Forces Survey 2008 Ad-Hoc Module for France, Belgium, UK and Sweden. In order to supplement the results from the country-specific analysis, we replicated the analysis using pooled data from the five rounds of the European Social Survey conducted between 2002 and 2010, for nine 'old immigration' Western European countries together. The analysis centered on two aspects of incorporation: labor force status and occupation. Multinominal, binary logistic as well as linear probability regression models were estimated. The findings suggest that in all countries non-European origin is associated with greater disadvantage in finding employment not only among first-generation immigrants, but also among sons and daughters of immigrants (i.e. second-generation). Moreover, the relative employment disadvantage among immigrant men of non-European origin is especially pronounced in the second-generation. The likelihood of attaining a high-status job is influenced mostly by immigrant status, regardless of region of origin and gender. The results of the study reveal that patterns of labor force incorporation vary considerably across origin groups and across generations. The patterns do not vary as much across countries, despite cross-country differences in welfare state regimes, migration integration policy and composition of migration flows.

Health system factors influencing management of multidrug-resistant tuberculosis in four European Union countries - learning from country experiences.

PubMed

de Vries, Gerard; Tsolova, Svetla; Anderson, Laura F; Gebhard, Agnes C; Heldal, Einar; Hollo, Vahur; Cejudo, Laura Sánchez-Cambronero; Schmid, Daniela; Schreuder, Bert; Varleva, Tonka; van der Werf, Marieke J

2017-04-19

In the European Union and European Economic Area only 38% of multidrug-resistant tuberculosis patients notified in 2011 completed treatment successfully at 24 months' evaluation. Socio-economic factors and patient factors such as demographic characteristics, behaviour and attitudes are associated with treatment outcomes. Characteristics of healthcare systems also affect health outcomes. This study was conducted to identify and better understand the contribution of health system components to successful treatment of multidrug-resistant tuberculosis. We selected four European Union countries to provide for a broad range of geographical locations and levels of treatment success rates of the multidrug-resistant tuberculosis cohort in 2009. We conducted semi-structured interviews following a conceptual framework with representatives from policy and planning authorities, healthcare providers and civil society organisations. Responses were organised according to the six building blocks of the World Health Organization health systems framework. In the four included countries, Austria, Bulgaria, Spain, and the United Kingdom, the following healthcare system factors were perceived as key to achieving good treatment results for patients with multidrug-resistant tuberculosis: timely diagnosis of drug-resistant tuberculosis; financial systems that ensure access to a full course of treatment and support for multidrug-resistant tuberculosis patients; patient-centred approaches with strong intersectoral collaboration that address patients' emotional and social needs; motivated and dedicated healthcare workers with sufficient mandate and means to support patients; and cross-border management of multidrug-resistant tuberculosis to secure continuum of care between countries. We suggest that the following actions may improve the success of treatment for multidrug-resistant tuberculosis patients: deployment of rapid molecular diagnostic tests; development of context-specific treatment

Culture and end of life care: a scoping exercise in seven European countries.

PubMed

Gysels, Marjolein; Evans, Natalie; Meñaca, Arantza; Andrew, Erin; Toscani, Franco; Finetti, Sylvia; Pasman, H Roeline; Higginson, Irene; Harding, Richard; Pool, Robert

2012-01-01

Culture is becoming increasingly important in relation to end of life (EoL) care in a context of globalization, migration and European integration. We explore and compare socio-cultural issues that shape EoL care in seven European countries and critically appraise the existing research evidence on cultural issues in EoL care generated in the different countries. We scoped the literature for Germany, Norway, Belgium, The Netherlands, Spain, Italy and Portugal, carrying out electronic searches in 16 international and country-specific databases and handsearches in 17 journals, bibliographies of relevant papers and webpages. We analysed the literature which was unearthed, in its entirety and by type (reviews, original studies, opinion pieces) and conducted quantitative analyses for each country and across countries. Qualitative techniques generated themes and sub-themes. A total of 868 papers were reviewed. The following themes facilitated cross-country comparison: setting, caregivers, communication, medical EoL decisions, minority ethnic groups, and knowledge, attitudes and values of death and care. The frequencies of themes varied considerably between countries. Sub-themes reflected issues characteristic for specific countries (e.g. culture-specific disclosure in the southern European countries). The work from the seven European countries concentrates on cultural traditions and identities, and there was almost no evidence on ethnic minorities. This scoping review is the first comparative exploration of the cultural differences in the understanding of EoL care in these countries. The diverse body of evidence that was identified on socio-cultural issues in EoL care, reflects clearly distinguishable national cultures of EoL care, with differences in meaning, priorities, and expertise in each country. The diverse ways that EoL care is understood and practised forms a necessary part of what constitutes best evidence for the improvement of EoL care in the future.

Culture and End of Life Care: A Scoping Exercise in Seven European Countries

PubMed Central

Gysels, Marjolein; Evans, Natalie; Meñaca, Arantza; Andrew, Erin; Toscani, Franco; Finetti, Sylvia; Pasman, H. Roeline; Higginson, Irene; Harding, Richard; Pool, Robert

2012-01-01

Aim Culture is becoming increasingly important in relation to end of life (EoL) care in a context of globalization, migration and European integration. We explore and compare socio-cultural issues that shape EoL care in seven European countries and critically appraise the existing research evidence on cultural issues in EoL care generated in the different countries. Methods We scoped the literature for Germany, Norway, Belgium, the Netherlands, Spain, Italy and Portugal, carrying out electronic searches in 16 international and country-specific databases and handsearches in 17 journals, bibliographies of relevant papers and webpages. We analysed the literature which was unearthed, in its entirety and by type (reviews, original studies, opinion pieces) and conducted quantitative analyses for each country and across countries. Qualitative techniques generated themes and sub-themes. Results A total of 868 papers were reviewed. The following themes facilitated cross-country comparison: setting, caregivers, communication, medical EoL decisions, minority ethnic groups, and knowledge, attitudes and values of death and care. The frequencies of themes varied considerably between countries. Sub-themes reflected issues characteristic for specific countries (e.g. culture-specific disclosure in the southern European countries). The work from the seven European countries concentrates on cultural traditions and identities, and there was almost no evidence on ethnic minorities. Conclusion This scoping review is the first comparative exploration of the cultural differences in the understanding of EoL care in these countries. The diverse body of evidence that was identified on socio-cultural issues in EoL care, reflects clearly distinguishable national cultures of EoL care, with differences in meaning, priorities, and expertise in each country. The diverse ways that EoL care is understood and practised forms a necessary part of what constitutes best evidence for the improvement of Eo

Piloting a generic cancer consumer quality index in six European countries.

PubMed

Wind, Anke; Roeling, Mark Patrick; Heerink, Jana; Sixma, Herman; Presti, Pietro; Lombardo, Claudio; van Harten, Wim

2016-09-02

Accounting for patients' perspective has become increasingly important. Based on the Consumer Quality Index method (founded on Consumer Assessment of Healthcare Providers and Systems) a questionnaire was recently developed for Dutch cancer patients. As a next step, this study aimed to adapt and pilot this questionnaire for international comparison of cancer patients experience and satisfaction with care in six European countries. The Consumer Quality Index was translated into the local language at the participating pilot sites using cross-translation. A minimum of 100 patients per site were surveyed through convenience sampling. Data from seven pilot sites in six countries was collected through an online and paper-based survey. Internal consistency was tested by calculating Cronbach's alpha and validity by means of cognitive interviews. Demographic factors were compared as possible influencing factors. A total of 698 patients from six European countries filled the questionnaire. Cronbach's alpha was good or satisfactory in 8 out of 10 categories. Patient satisfaction significantly differed between the countries. We observed no difference in patient satisfaction for age, gender, education, and tumor type, but satisfaction was significantly higher in patients with a higher level of activation. This European Cancer Consumer Quality Index(ECCQI) showed promising scores on internal consistency (reliability) and a good internal validity. The ECCQI is to our knowledge the first to measure and compare experiences and satisfaction of cancer patients on an international level, it may enable healthcare providers to improve the quality of cancer care.

Nuclear medicine technologist training in European countries.

PubMed

Lass, Piotr

2002-08-01

This article overviews the training of nuclear medicine technologists in chosen European countries, the United States and Canada. There are basically two types of training: at medical schools following secondary school, without any university degree, usually on a 2- or 3-year basis, or else as a university course, leading to a BSc degree after 3 years, and in some countries to an MSc degree after an additional 2 years. In the United States both systems coexist, while in Europe the picture varies from country to country. The number of hours devoted to nuclear medicine also varies between curricula. Some efforts are being made to unify this system by transition to the university model of education in many European countries.

Variation in population levels of sedentary time in European adults according to cross-European studies: a systematic literature review within DEDIPAC.

PubMed

Loyen, Anne; Verloigne, Maïté; Van Hecke, Linde; Hendriksen, Ingrid; Lakerveld, Jeroen; Steene-Johannessen, Jostein; Koster, Annemarie; Donnelly, Alan; Ekelund, Ulf; Deforche, Benedicte; De Bourdeaudhuij, Ilse; Brug, Johannes; van der Ploeg, Hidde P

2016-06-28

Sedentary behaviour is increasingly recognized as a public health risk that needs to be monitored at the population level. Across Europe, there is increasing interest in assessing population levels of sedentary time. This systematic literature review aims to provide an overview of all existing cross-European studies that measure sedentary time in adults, to describe the variation in population levels across these studies and to discuss the impact of assessment methods. Six literature databases (PubMed, EMBASE, CINAHL, PsycINFO, SportDiscus and OpenGrey) were searched, supplemented with backward- and forward tracking and searching authors' and experts' literature databases. Articles were included if they reported on observational studies measuring any form of sedentary time in the general population in two or more European countries. Each record was reviewed, extracted and assessed by two independent researchers, and disagreements were resolved by a third researcher. The review protocol of this review is registered in the PROSPERO database under registration number CRD42014010335. Of the 9,756 unique articles that were identified in the search, twelve articles were eligible for inclusion in this review, reporting on six individual studies and three Eurobarometer surveys. These studies represented 2 to 29 countries, and 321 to 65,790 participants. Eleven studies focused on total sedentary time, while one studied screen time. The majority of studies used questionnaires to assess sedentary time, while two studies used accelerometers. Total sedentary time was reported most frequently and varied from 150 (median) to 620 (mean) minutes per day across studies and countries. One third of European countries were not included in any of the studies. Objective measures of European adults are currently limited, and most studies used single-item self-reported questions without assessing sedentary behaviour types or domains. Findings varied substantially between studies, meaning

Relationships between food consumption and living arrangements among university students in four European countries - A cross-sectional study

PubMed Central

2012-01-01

Background The transition of young people from school to university has many health implications. Food choice at the university can differ because of childhood food consumption patterns, sex and the living arrangements. Food consumption may change especially if students are living away from home. We aimed to assess food consumption patterns among university students from four European countries and how they differ by their living arrangements. Methods We analysed data from a cross-country survey assessing health and health behaviours of students. The sample comprised a total of 2402 first year undergraduate students from one university in each of the countries of Germany, Denmark, Poland and Bulgaria. Food consumption was assessed by means of a food frequency questionnaire with 9 food groups (indicators). Results Students’ food consumption patterns differed across the countries. Frequent consumption of unhealthy items was common. Bulgarian students reported most often frequent consumption of sweets and cakes and snacks (e.g. chips and fast food). Polish students reported the least frequent consumption of vegetables and a low consumption of fruits. Across all countries except Bulgaria, men reported substantially more often frequent consumption of snacks than women. Students living at parental home consumed more fruit, vegetables, and meat than those who resided outside of their family home in all studied countries. There was more variation with regard to cakes and salads with more frequent consumption of cakes among Bulgarian female students and Danish male students and more frequent consumption of salads among Danish female students not living at parental home, compared to students from other countries. Conclusions Nutrition habits of university students differed across countries and by sex. Students living at parental home displayed more healthy nutrition habits, with some exceptions. PMID:22531503

Pharmaceutical policies in European countries.

PubMed

Barros, Pedro Pita

2010-01-01

Pharmaceutical expenditures have an important role in Europe. The attempts to control expenditure have used a wide range of policy measures. We reviewed the main measures adopted by the European Union countries, especially in countries where governments are the largest third-party payers. To complement a literature review on the topic, data was gathered from national reviews of health systems and direct inquiries to several government bodies. Almost all countries regulate prices of pharmaceutical products. Popular policy measures include international referencing to set prices (using as benchmark countries that have set lower prices), internal reference pricing systems to promote price competition in domestic markets, and positive lists for reimbursement to promote consumption of generics (including in some cases substitution by pharmacists of drugs prescribed by physicians). Despite the wide range of policy measures, it is not possible to identify a "silver bullet" to control pharmaceutical expenditures. We also identified two main policy challenges: policy coordination among countries within the European Union to maintain incentives for R&D at the global level, and the development of new relationships with the pharmaceutical industry; namely, the so-called risk-sharing agreements between the pharmaceutical industry and governments/regulators (or large third-party payers).

Health of Immigrants in European countries

PubMed Central

Solé-Auró, Aïda; Crimmins, Eileen M.

2010-01-01

The health of older immigrants can have important consequences for needed social support and demands placed on health systems. This paper examines health differences between immigrants and the native-born populations aged 50 years and older in 11 European countries. We examine differences in functional ability, disability, disease presence and behavioral risk factors, for immigrants and non-immigrants using data from the Survey of Health, Aging and Retirement in Europe (SHARE) database. Among the 11 European countries, migrants generally have worse health than the native population. In these countries, there is a little evidence of the “healthy migrant” at ages 50 years and over. In general, it appears that growing numbers of immigrants may portend more health problems in the population in subsequent years. PMID:21048888

The Icatibant Outcome Survey: experience of hereditary angioedema management from six European countries.

PubMed

Caballero, T; Aberer, W; Longhurst, H J; Maurer, M; Zanichelli, A; Perrin, A; Bouillet, L; Andresen, I

2017-07-01

Hereditary angioedema (HAE) due to C1-inhibitor deficiency (C1-INH-HAE) is a rare, potentially fatal, bradykinin-mediated disease. Icatibant is a bradykinin B2 receptor antagonist originally approved in 2008 in the European Union and 2011 in the United States as an acute therapy option for HAE attacks in adults. To compare demographics, disease characteristics and treatment outcomes of icatibant-treated HAE attacks in patients with C1-INH-HAE enrolled in the Icatibant Outcome Survey across six European countries: Austria, France, Germany, Italy, Spain and the UK. The Icatibant Outcome Survey [IOS; Shire, Zug, Switzerland (NCT01034969)] is an international observational study monitoring the safety and effectiveness of icatibant. Descriptive, retrospective analyses compared IOS country data derived during July 2009-April 2015. Overall, 481 patients with C1-INH-HAE provided demographic data. A significant difference across countries in age at onset (P = 0.003) and baseline attack frequency (P < 0.001) was found although no significant differences were found with respect to gender (majority female; P = 0.109), age at diagnosis (P = 0.182) or delay in diagnosis (P = 0.059). Icatibant was used to treat 1893 attacks in 325 patients with majority self-administration in all countries. Overall, significant differences (all P < 0.001) were found across countries in time to treatment [median 1.8 h; median range: 0.0 (Germany-Austria) to 4.4 (France) h], time to resolution [median 6.5 h; median range: 3 (Germany-Austria) to 12 (France) h] and attack duration [median 10.5 h; median range: 3.1 (Germany-Austria) to 18.5 (France) h]. These data form the first European cross-country comparison of disease characteristics and icatibant use in patients with C1-INH-HAE who are enrolled in IOS. International variation in icatibant practice and treatment outcomes across the six European countries assessed highlight the need to further investigate the range of country-specific parameters

Arab-American trade: performance and prospects. [With oil group and non-oil group countries

DOE Office of Scientific and Technical Information (OSTI.GOV)

Al-Bustany, B.

1980-03-01

Twenty Arab countries were examined by dividing them into two groups depending on the relative share of oil exports (excluding re-exports) in total exports as an annual average for 1972-1978, with a demarcation line of 50%. The oil group (OG) comprises eight countries while the non-oil group covers twelve countries. The level of Arab exports and imports increased during the period between 1972 and 1978. Oil was the dominant export but NOG countries diversified with exports of cotton and phosphate. The balance of trade of the Arab countries was positive during this period despite the persistent, and increasing, deficit ofmore » the NOG countries, Combined Arab-American trade increased substantially during the 1970's but particularly after 1974. Oil has been the major factor affecting the size and pattern of Arab-American trade. Export earnings of the OG increased while import capacity of the NOG, supported by increased financial aid received from the OG, also increased. The American balance of trade will continue to be closely linked to Arab influence. (SAC)« less

Attitudes of women from five European countries regarding tobacco control policies.

PubMed

Dresler, Carolyn; Wei, Mei; Heck, Julia E; Allwright, Shane; Haglund, Margaretha; Sanchez, Sara; Kralikova, Eva; Stücker, Isabelle; Tamang, Elizabeth; Gritz, Ellen R; Hashibe, Mia

2013-03-01

Tobacco-related cancers and, in particular, lung cancer still represents a substantial public health epidemic across Europe as a result of high rates of smoking prevalence. Countries in Europe have proposed and implemented tobacco control policies to reduce smoking prevalence, with some countries being more progressive than others. The aim of this study was to examine factors that influenced women's attitudes across five European countries relative to comprehensive smokefree laws in their countries. A cross-sectional landline telephone survey on attitudes towards tobacco control laws was conducted in five European countries: France, Ireland, Italy, the Czech Republic, and Sweden. Attitudinal scores were determined for each respondent relative to questions about smokefree laws. Logistic regression models were used to obtain odds ratios with 95% confidence intervals. A total of 5000 women were interviewed (1000 women from each country). The majority of women, regardless of smoking history, objected to smoking in public buses, enclosed shopping centers, hospitals, and other indoor work places. More women who had quit smoking believed that new tobacco control laws would prompt cessation - as compared with women who still smoked. In general, there is very high support for national smokefree laws that cover bars, restaurants, and public transport systems. As such laws are implemented, attitudes do change, as demonstrated by the differences between countries such as Ireland and the Czech Republic. Implementing comprehensive smokefree laws will gain high approval and will be associated with prompting people to quit.

Acne prevalence and associations with lifestyle: a cross-sectional online survey of adolescents/young adults in 7 European countries.

PubMed

Wolkenstein, P; Machovcová, A; Szepietowski, J C; Tennstedt, D; Veraldi, S; Delarue, A

2018-02-01

Although acne vulgaris is a common skin disorder, limited epidemiological data exist specifically for European populations. To determine the prevalence of self-reported acne among young people in Europe and evaluate the effect of lifestyle on acne. We conducted a cross-sectional population-based online survey in representative samples of individuals aged 15-24 years in Belgium, Czech and Slovak Republics, France, Italy, Poland and Spain (n = 10 521), identified by a quota sampling method based on age, geographic location and socio-professional category. The overall adjusted prevalence of self-reported acne was 57.8% (95% confidence interval 56.9% to 58.7%). The rates per country ranged from 42.2% in Poland to 73.5% in the Czech and Slovak Republics. The prevalence of acne was highest at age 15-17 years and decreased with age. On multivariate analysis, a history of maternal or paternal acne was associated with an increased probability of having acne (odds ratio 3.077, 95% CI 2.743 to 3.451, and 2.700, 95% CI 2.391 to 3.049, respectively; both P < 0.0001), as was the consumption of chocolate (OR 1.276, 95% CI 1.094 to 1.488, for quartile 4 vs. quartile 1). Increasing age (OR 0.728, 95% CI 0.639 to 0.830 for age 21-24 years vs. 15-17 years) and smoking tobacco (OR 0.705, 95% CI 0.616 to 0.807) were associated with a reduced probability of acne. The overall prevalence of self-reported acne was high in adolescents/young adults in the European countries investigated. Heredity was the main risk factor for developing acne. © 2017 European Academy of Dermatology and Venereology.

Variation in population levels of physical activity in European adults according to cross-European studies: a systematic literature review within DEDIPAC.

PubMed

Loyen, Anne; Van Hecke, Linde; Verloigne, Maïté; Hendriksen, Ingrid; Lakerveld, Jeroen; Steene-Johannessen, Jostein; Vuillemin, Anne; Koster, Annemarie; Donnelly, Alan; Ekelund, Ulf; Deforche, Benedicte; De Bourdeaudhuij, Ilse; Brug, Johannes; van der Ploeg, Hidde P

2016-06-28

Physical inactivity is a well-known public health risk that should be monitored at the population level. Physical activity levels are often surveyed across Europe. This systematic literature review aims to provide an overview of all existing cross-European studies that assess physical activity in European adults, describe the variation in population levels according to these studies, and discuss the impact of the assessment methods. Six literature databases (PubMed, EMBASE, CINAHL, PsycINFO, SportDiscus and OpenGrey) were searched, supplemented with backward- and forward tracking and searching authors' and experts' literature databases. Articles were included if they reported on observational studies measuring total physical activity and/or physical activity in leisure time in the general population in two or more European countries. Each record was reviewed, extracted and assessed by two independent researchers and disagreements were resolved by a third researcher. The review protocol of this review is registered in the PROSPERO database under registration number CRD42014010334. Of the 9,756 unique identified articles, twenty-five were included in this review, reporting on sixteen different studies, including 2 to 35 countries and 321 to 274,740 participants. All but two of the studies used questionnaires to assess physical activity, with the majority of studies using the IPAQ-short questionnaire. The remaining studies used accelerometers. The percentage of participants who either were or were not meeting the physical activity recommendations was the most commonly reported outcome variable, with the percentage of participants meeting the recommendations ranging from 7% to 96% across studies and countries. The included studies showed substantial variation in the assessment methods, reported outcome variables and, consequently, the presented physical activity levels. Because of this, absolute population levels of physical activity in European adults are currently

Country-level economic disparity and child mortality related to housing and injuries: a study in 26 European countries.

PubMed

Sengoelge, Mathilde; Elling, Berty; Laflamme, Lucie; Hasselberg, Marie

2013-10-01

Adverse living standards are associated with poorer child health and safety. This study investigates whether adverse housing and neighbourhood conditions contribute to explain country-level associations between a country's economic level and income inequality and child mortality, specifically injury mortality. Ecological, cross-sectional study. Twenty-six European countries were grouped according to two country-level economic measures from Eurostat: gross domestic product (GDP) and income inequality. Adverse country-level housing and neighbourhood conditions were assessed using data from the 2006 European Union Income Social Inclusion and Living Conditions Database (n=203 000). Child mortality incidence rates were derived for children aged 1-14 years for all causes, all injuries, road traffic injuries and unintentional injuries excluding road traffic. Linear regression analysis was applied to measure whether housing or neighbourhood conditions have a significant association with child mortality and whether a strain modified the association between GDP/income inequality and mortality. Country-level income inequality and GDP demonstrated a significant association with child mortality for all outcomes. A significant association was also found between housing strain and all child mortality outcomes, but not for neighbourhood strain. Housing strain partially modified the relationship between income inequality and GDP and all child mortality outcomes, with the exception of income inequality and road traffic injury mortality showing full mediation by housing strain. Adverse housing conditions are a likely pathway in the country-level association between income inequality and economic GDP and child injury mortality.

Pregnancy intendedness and the association with physical, sexual and emotional abuse - a European multi-country cross-sectional study.

PubMed

Lukasse, Mirjam; Laanpere, Made; Karro, Helle; Kristjansdottir, Hildur; Schroll, Anne-Mette; Van Parys, An-Sofie; Wangel, Anne-Marie; Schei, Berit

2015-05-26

Unintended pregnancies are common and when not resulting in a termination of pregnancy may lead to unintended childbirth. Unintended pregnancies are associated with increased health risks, also for women for whom pregnancy continues to childbirth. Our objective was to present the prevalence of unintended pregnancy in six European countries among pregnant women attending routine antenatal care, and to investigate the association with a history of physical, sexual and emotional abuse. A prospective cross-sectional study, of 7102 pregnant women who filled out a questionnaire during pregnancy as part of a multi-country cohort study (Bidens) with the participating countries: Belgium, Iceland, Denmark, Estonia, Norway and Sweden. A validated instrument, the Norvold Abuse Questionnaire (NorAq) consisting of 10 descriptive questions measured abuse. Pregnancy intendedness was assessed using a single question asking women if this pregnancy was planned. Cross-tabulation, Chi-square tests and binary logistic regression analysis were used. Approximately one-fifth (19.2 %) of all women reported their current pregnancy to be unintended. Women with an unintended pregnancy were significantly younger, had less education, suffered economic hardship, had a different ethnic background from the regional majority and more frequently were not living with their partner. The prevalence of an unintended pregnancy among women reporting any lifetime abuse was 24.5 %, and 38.5 % among women reporting recent abuse. Women with a history of any lifetime abuse had significantly higher odds of unintended pregnancy, also after adjusting for confounding factors, AOR for any lifetime abuse 1.41 (95 % CI 1.23-1.60) and for recent abuse AOR 2.03 (95 % CI 1.54-2.68). Women who have experienced any lifetime abuse are significantly more likely to have an unintended pregnancy. This is particularly true for women reporting recent abuse, suggesting that women living in a violent relationship have less control

Mortality Amenable to Health Care in European Union Countries and Its Limitations.

PubMed

Jarčuška, Peter; Janičko, Martin; Barták, Miroslav; Gavurová, Beáta; Vagašová, Tatiana

2017-12-01

The concept of amenable mortality is intended to assess health care system performance. It is defined as "premature deaths that should not occur in the presence of timely and effective health care". The purpose of paper is to analyse differences in amenable mortality across European Union countries and to determine the associations between amenable mortality and life expectancy at birth. This is a cross-country and time trend analysis. Data on deaths by cause, and five-year age groups were obtained from the World Health Organization database for the 20 European Union countries, throughout the period from 2002 to 2013. The rates of amenable mortality were expressed by the age-standardised death rates per 100,000 inhabitants. We applied the method of direct standardisation using the European Standard Population. Throughout the explored period, the statistically significant variations of the age-standardised death rates in a relation to the European Union average fluctuated from 78.7 per 100,000 inhabitants (95% CI 72.4-84.9) in France to 374.3 per 100,000 inhabitants (95% CI 350.8-397.7) in Latvia. The leading causes of amenable mortality were ischaemic heart disease, cerebrovascular diseases, and colorectal cancer that accounted for, respectively, 42.2%, 19.5%, and 11.3% of overall amenable mortality. As expected, statistically significant strong negative relationship (R 2 =0.95; ρ=-0.98) between amenable mortality and life expectancy at birth was proved by linear regression. The concept has several limitations relating to the selection of causes of death and setting age threshold over time, not consideration actually available health care resources in each country, as well as differences in the prevalence of diseases among countries. We found an explicit divide in amenable mortality rates between more developed countries of Western, Northern and Southern Europe, and less developed countries of Central and Eastern Europe. Increasing of amenable mortality may

Sensory determinants of stated liking for vegetable names and actual liking for canned vegetables: A cross-country study among European adolescents.

PubMed

Dinnella, Caterina; Morizet, David; Masi, Camilla; Cliceri, Danny; Depezay, Laurence; Appleton, Katherine M; Giboreau, Agnés; Perez-Cueto, Federico J A; Hartwell, Heather; Monteleone, Erminio

2016-12-01

Sensory properties are reported as one of the main factors hindering an appropriate vegetable intake by the young. In the present work the sensory determinants of likings for vegetables were explored in adolescents of four European countries (Denmark, n = 88; France, n = 206; Italy, n = 110 and United Kingdom, n = 93). A questionnaire was designed to study cross country differences in stated liking for and familiarity with a list of vegetables popular among European markets (between-vegetable approach). A within-vegetable comparison approach with actual tasting was used to analyze differences and similarities in liking for canned pea and sweet corn samples across the countries. A close positive relationship between stated liking and familiarity was found. Irrespective of the country, one group of highly liked vegetables (carrots, tomatoes, green salad) was identified, characterized by innately liked tastes (sweet, umami), delicate flavour and bright appealing colour. A second group of highly disliked vegetables consists of cauliflowers and broccoli, characterized by disliked sensations such as bitter taste and objectionable flavour. Internal Preference Maps from actual liking scores indicate that the generally disliked tastes (bitter, sour), are clearly correlated with a negative hedonic response for both peas and sweet corn. The hedonic valence of a generally well accepted taste such as salty and texture descriptors depends on the type of vegetable. Internal preference maps from actual liking data indicate that flavour and appearance descriptors of the distinct sensory properties of each type of vegetable positively affect liking, while the intensity of unusual flavours is related to sample disliking. Copyright © 2016 Elsevier Ltd. All rights reserved.

E-cigarettes Associated With Depressed Smoking Cessation: A Cross-sectional Study of 28 European Union Countries.

PubMed

Kulik, Margarete C; Lisha, Nadra E; Glantz, Stanton A

2018-04-01

Electronic cigarettes (e-cigarettes) are often promoted to assist with cigarette smoking cessation. In 2016-2017, the relationship between e-cigarette use and having stopped smoking among ever (current and former) smokers was assessed in the European Union and Great Britain by itself. Cross-sectional logistic regression of the association between being a former smoker and e-cigarette use was applied to the 2014 Eurobarometer survey of 28 European Union countries controlling for demographics. Among all ever smokers, any regular ever use of nicotine e-cigarettes was associated with lower odds of being a former smoker (unadjusted OR=0.34, 95% CI=0.26, 0.43, AOR=0.43, 95% CI=0.32, 0.58) compared with smokers who had never used e-cigarettes. In unadjusted models, daily use (OR=0.42, 95% CI=0.31, 0.56); occasional use (OR=0.25, 95% CI=0.18, 0.35); and experimentation (OR=0.24, 95% CI=0.19, 0.30) of nicotine e-cigarettes were associated with lower odds of being a former smoker compared with having never used nicotine-containing e-cigarettes. Comparable results were found in adjusted models. Results were similar in Great Britain alone. Among current smokers, daily cigarette consumption was 15.6 cigarettes/day (95% CI=14.5, 16.7) among those who also used e-cigarettes versus 14.4 cigarettes/day (95% CI=13.4, 15.4) for those who did not use them (p<0.05). These results suggest that e-cigarettes are associated with inhibiting rather than assisting in smoking cessation. On the population level, the net effect of the entry of e-cigarettes into the European Union (and Great Britain) is associated with depressed smoking cessation of conventional cigarettes. Copyright © 2018 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

European public acceptance of euthanasia: socio-demographic and cultural factors associated with the acceptance of euthanasia in 33 European countries.

PubMed

Cohen, Joachim; Marcoux, Isabelle; Bilsen, Johan; Deboosere, Patrick; van der Wal, Gerrit; Deliens, Luc

2006-08-01

In many European countries, the last decade has been marked by an increasing debate about the acceptability and regulation of euthanasia and other end-of-life decisions in medical practice. Growing public sensibility to a 'right to die' for terminally ill patients has been one of the main constituents of these debates. Within this context, we sought to describe and compare acceptance of euthanasia among the general public in 33 European countries. We used the European Values Study data of 1999-2000 with a total of 41125 respondents (63% response rate) in 33 European countries. The main outcome measure concerned the acceptance of euthanasia (defined as 'terminating the life of the incurably sick', rated on a scale from 1 to 10). Results showed that the acceptance of euthanasia tended to be high in some countries (e.g. the Netherlands, Denmark, France, Sweden), while a markedly low acceptance was found in others (e.g. Romania, Malta and Turkey). A multivariate ordinal regression showed that weaker religious belief was the most important factor associated with a higher acceptance; however, there were also socio-demographic differences: younger cohorts, people from non-manual social classes, and people with a higher educational level tended to have a higher acceptance of euthanasia. While religious belief, socio-demographic factors, and also moral values (i.e. the belief in the right to self-determination) could largely explain the differences between countries, our findings suggest that perceptions regarding euthanasia are probably also influenced by national traditions and history (e.g. Germany). Thus, we demonstrated clear cross-national differences with regard to the acceptance of euthanasia, which can serve as an important basis for further debate and research in the specific countries.

Mathematics Teaching in Four European Countries

ERIC Educational Resources Information Center

Andrews, Paul; Sayers, Judy

2006-01-01

This article discusses a comparative study, funded by the European Union, of the teaching of mathematics in five European countries, (Flanders, England, Finland, Hungary and Spain) to students in the upper primary (ages 10-12) and lower secondary (12-14) years. These ages were chosen as they represent a time when many students' experiences of…

Is tuberculosis crossing borders at the Eastern boundary of the European Union?

PubMed Central

van der Werf, Marieke J.; Hollo, Vahur; Noori, Teymur

2013-01-01

Background: The Eastern border of the European Union (EU) consists of 10 countries after the expansion of the EU in 2004 and 2007. These 10 countries border to the East to countries with high tuberculosis (TB) notification rates. We analyzed the notification data of Europe to quantify the impact of cross-border TB at the Eastern border of the EU. Methods: We used TB surveillance data of 2010 submitted by 53 European Region countries to the European Centre for Disease Prevention and Control and the World Health Organization Regional Office for Europe. Notified TB cases were stratified by origin of the case (national/foreign). We calculated the contribution of foreign to overall TB notification. Results: In the 10 EU countries located at the EU Eastern border, 618 notified TB cases (1.7% of all notified TB cases) were of foreign origin. Of those 618 TB cases, 173 (28.0%) were from countries bordering the EU to the East. More specifically, 90 (52.0%) were from Russia, 33 (19.1%) from Belarus, 33 (19.1%) from Ukraine, 13 (7.5%) from Moldova and 4 (2.3%) from Turkey. Conclusions: Currently, migrants contribute little to TB notifications in the 10 EU countries at the Eastern border of the EU, but changes in migration patterns may result in an increasing contribution. Therefore, EU countries at the Eastern border of the EU should strive to provide prompt diagnostic services and adequate treatment of migrants. PMID:23813718

Association between stricter alcohol advertising regulations and lower hazardous drinking across European countries.

PubMed

Bosque-Prous, Marina; Espelt, Albert; Guitart, Anna M; Bartroli, Montserrat; Villalbí, Joan R; Brugal, M Teresa

2014-10-01

To analyse the association between alcohol advertising restrictions and the prevalence of hazardous drinking among people aged 50-64 years in 16 European countries, taking into account both individual and contextual-level factors (alcohol taxation, availability, etc.). Cross-sectional study based on SHARE project surveys. A total of 27 773 subjects, aged 50-64 years, from 16 European countries who participated in wave 4 of the SHARE (Survey of Health, Ageing and Retirement in Europe) project. We estimated the prevalence of hazardous drinking (through adaptation of the SHARE questions to the scheme used by the Alcohol Use Disorders Identification Test Consumption (AUDIT-C) for each country. To determine whether the degree of advertising restrictions was associated with prevalence of hazardous drinking, we fitted robust variance multi-level Poisson models, adjusting for various individual and contextual variables. Prevalence ratios (PR) and their 95% confidence intervals (95% CI) were obtained. The observed prevalence of hazardous drinking was 24.1%, varying by sex and country. Countries with greater advertising restrictions had lower prevalence of hazardous drinking: 30.6% (95% CI = 29.3-31.8) in countries with no restrictions, 20.3% (95% CI = 19.3-21.2) in countries with some restrictions and 14.4% (95% CI = 11.9-16.8) in those with greatest restrictions. The PR found (with respect to countries with greatest restrictions) were 1.36 (95% CI = 0.90-2.06) for countries with some restrictions and 1.95 (95% CI = 1.31-2.91) for those with no advertising restrictions. The extent of advertising restrictions in European countries is associated inversely with prevalence of hazardous drinking in people aged 50-64 years. © 2014 Society for the Study of Addiction.

Strategies for public health research in European Union countries.

PubMed

Grimaud, Olivier; McCarthy, Mark; Conceição, Claudia

2013-11-01

'Health' is an identifiable theme within the European Union multi-annual research programmes. Public Health Innovation and Research in Europe (PHIRE), led by the European Public Health Association, sought to identify public health research strategies in EU member states. Within PHIRE, national public health associations reviewed structures for health research, held stakeholder workshops and produced reports. This information, supplemented by further web searches, including using assisted translation, was analysed for national research strategies and health research strategies. All countries described general research strategies, outlining organizational and capacity objectives. Thematic fields, including health, are mentioned in some strategies. A health research strategy was identified for 15 EU countries and not for 12. Ministries of health led research strategies for nine countries. Public health research was identified in only three strategies. National research strategies did not refer to the European Union's health research programme. Public health research strategies of European countries need to be developed by ministries of health, working with the research community to achieve the European Research Area.

Cross-Country Skiing Today.

ERIC Educational Resources Information Center

Caldwell, John

This book presents changes in cross country skiing which have taken place in the last several years and is directed toward both beginning and seasoned tour skiers. Discussed are the following topics: (1) the cross-country revolution (new fiberglass skis); (2) equipment (how to choose from the new waxless touring skis); (3) care of equipment; (4)…

Psychosocial working conditions and psychological well-being among employees in 34 European countries.

PubMed

Schütte, Stefanie; Chastang, Jean-François; Malard, Lucile; Parent-Thirion, Agnès; Vermeylen, Greet; Niedhammer, Isabelle

2014-11-01

The aim of this study was to explore the associations between psychosocial working conditions and psychological well-being among employees in 34 European countries. Another objective was to examine whether these associations varied according to occupation and country. The study was based on data from the European Working Conditions Survey 2010 including 33,443 employees, 16,512 men and 16,931 women, from 34 European countries. Well-being was measured by the WHO-5 well-being index. Twenty-five psychosocial work factors were constructed including job demands, role stressors, work hours, job influence and freedom, job promotion, job insecurity, social support, quality of leadership, discrimination and violence at work, and work-life imbalance. The associations between these factors and well-being were examined using multilevel logistic regression analyses. Different models were performed including interaction tests. When all 25 psychosocial work factors were studied simultaneously in the same model with adjustment variables, 13 showed a significant association with poor well-being among both genders: quantitative demands, demands for hiding emotions, low possibilities for development, low meaning of work, low role conflict, low quality of leadership, low social support, low sense of community, job insecurity, low job promotion, work-life imbalance, discrimination, and bullying. The association with low sense of community on poor well-being was particularly strong. A large number of psychosocial work factors were associated with poor well-being. Almost no country and occupational differences were found in these associations. This study gave a first European overview and could be useful to inform cross-national policy debate.

The European Research Elite: A Cross-National Study of Highly Productive Academics in 11 Countries

ERIC Educational Resources Information Center

Kwiek, Marek

2016-01-01

In this paper, we focus on a rare scholarly theme of highly productive academics, statistically confirming their pivotal role in knowledge production across 11 systems studied. The upper 10% of highly productive academics in 11 European countries studied (N = 17,211) provide on average almost half of all academic knowledge production. In contrast…

Cultural Influences on the Professions in European Union Countries and Their Implications for Continuing Professional Development.

ERIC Educational Resources Information Center

Hughes, Anna; Thomas, Edward

1996-01-01

Although the European Union encourages professional mobility, the practice of continuing professional development (CPD) in pharmacy and law in various countries shows that cultural differences may hinder cross-border mobility. It is also surprising that universities are relatively little involved in CPD. (SK)

Socioeconomic and country variations in cross-border cigarette purchasing as tobacco tax avoidance strategy. Findings from the ITC Europe Surveys

PubMed Central

Nagelhout, Gera E.; van den Putte, Bas; Allwright, Shane; Mons, Ute; McNeill, Ann; Guignard, Romain; Beck, François; Siahpush, Mohammad; Joossens, Luk; Fong, Geoffrey T.; de Vries, Hein; Willemsen, Marc C.

2014-01-01

Background Legal tobacco tax avoidance strategies such as cross-border cigarette purchasing may attenuate the impact of tax increases on tobacco consumption. Little is known about socioeconomic and country variations in cross-border purchasing. Objective To describe socioeconomic and country variations in cross-border cigarette purchasing in six European countries. Methods Cross-sectional data from adult smokers (n = 7,873) from the International Tobacco Control (ITC) Surveys in France (2006/7), Germany (2007), Ireland (2006), the Netherlands (2008), Scotland (2006), and the rest of the United Kingdom (2007/8) were used. Respondents were asked whether they had bought cigarettes outside their country in the last six months and how often. Findings In French and German provinces/states bordering countries with lower cigarette prices, 24% and 13% of smokers respectively reported purchasing cigarettes frequently outside their country. In non-border regions of France and Germany and in Ireland, Scotland, the rest of the United Kingdom, and the Netherlands, frequent purchasing of cigarettes outside the country was reported by 2% to 7% of smokers. Smokers with higher levels of education or income, younger smokers, daily smokers, heavier smokers, and smokers not planning to quit smoking were more likely to purchase cigarettes outside their country. Conclusion Cross-border cigarette purchasing is more common in European regions bordering countries with lower cigarette prices and is more often reported by smokers with higher education and income. Increasing taxes in countries with lower cigarette prices and reducing the number of cigarettes that can be legally imported across borders could help to avoid cross-border purchasing. PMID:23644287

Socioeconomic and country variations in cross-border cigarette purchasing as tobacco tax avoidance strategy. Findings from the ITC Europe Surveys.

PubMed

Nagelhout, Gera E; van den Putte, Bas; Allwright, Shane; Mons, Ute; McNeill, Ann; Guignard, Romain; Beck, François; Siahpush, Mohammad; Joossens, Luk; Fong, Geoffrey T; de Vries, Hein; Willemsen, Marc C

2014-03-01

Legal tobacco tax avoidance strategies such as cross-border cigarette purchasing may attenuate the impact of tax increases on tobacco consumption. Little is known about socioeconomic and country variations in cross-border purchasing. To describe socioeconomic and country variations in cross-border cigarette purchasing in six European countries. Cross-sectional data from adult smokers (n=7873) from the International Tobacco Control (ITC) Surveys in France (2006/2007), Germany (2007), Ireland (2006), The Netherlands (2008), Scotland (2006) and the rest of the UK (2007/2008) were used. Respondents were asked whether they had bought cigarettes outside their country in the last 6 months and how often. In French and German provinces/states bordering countries with lower cigarette prices, 24% and 13% of smokers, respectively, reported purchasing cigarettes frequently outside their country. In non-border regions of France and Germany, and in Ireland, Scotland, the rest of the UK and The Netherlands, frequent purchasing of cigarettes outside the country was reported by 2-7% of smokers. Smokers with higher levels of education or income, younger smokers, daily smokers, heavier smokers and smokers not planning to quit smoking were more likely to purchase cigarettes outside their country. Cross-border cigarette purchasing is more common in European regions bordering countries with lower cigarette prices and is more often reported by smokers with higher education and income. Increasing taxes in countries with lower cigarette prices, and reducing the number of cigarettes that can be legally imported across borders could help to avoid cross-border purchasing.

Nursing care for stroke patients: A survey of current practice in 11 European countries.

PubMed

Tulek, Zeliha; Poulsen, Ingrid; Gillis, Katrin; Jönsson, Ann-Cathrin

2018-02-01

To conduct a survey of the clinical nursing practice in European countries in accordance with the European Stroke Strategies 2006 and to examine to what extent the European Stroke Strategies have been implemented in stroke care nursing in Europe. Stroke is a leading cause of death and disability globally. Optimal organisation of interdisciplinary stroke care is expected to ameliorate outcome after stroke. Consequently, universal access to stroke care based on evidence-based guidelines is a priority. This study is a descriptive cross-sectional survey. A questionnaire comprising 61 questions based on the European Stroke Strategies and scientific evidence in nursing practice was distributed to representatives of the European Association of Neuroscience Nurses, who sent the questionnaire to nurses active in stroke care. The questionnaire covered the following areas of stroke care: organisation of stroke services, management of acute stroke and prevention including basic care and nursing, and secondary prevention. Ninety-two nurses in stroke care in 11 European countries participated in the survey. Within the first 48 hr after stroke onset, 95% monitor patients regularly, 94% start mobilisation after 24 hr when patients are stable, and 89% assess patients' ability to swallow. Change of position for immobile patients is followed by 73%, and postvoid residual urine volume is measured by 85%. Some aspects needed improvement, for example, staff education (70%), education for patients/families/carers (55%) and individual care plans in secondary prevention (62%). The participating European countries comply well with the European Stroke Strategies guidelines, particularly in the acute stroke care, but not all stroke units have reached optimal development in all aspects of stroke care nursing. Our study may provide clinical administrators and nurses in stroke care with information that may contribute to improved compliance with the European Stroke Strategies and evidence

75 FR 28058 - Certain Oil Country Tubular Goods From China; Determination

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-19

... INTERNATIONAL TRADE COMMISSION [Investigation No. 731-TA-1159 (Final)] Certain Oil Country Tubular... threatened with material injury by reason of imports from China of certain oil country tubular goods (``OCTG... are contained in USITC Publication 4152 (May 2010), entitled Certain Oil Country Tubular Goods From...

Unemployment and health selection in diverging economic conditions: Compositional changes? Evidence from 28 European countries.

PubMed

Heggebø, Kristian; Dahl, Espen

2015-11-04

Unemployment and health selection in diverging economic conditions: Compositional changes? Evidence from 28 european countries. People with ill health tend to be overrepresented among the unemployment population. The relationship between health and unemployment might, however, be sensitive to the overall economic condition. Specifically, the health composition of the unemployment population could change dramatically when the economy takes a turn for the worse. Using EU-SILC cross sectional data from 2007 (pre-crisis) and 2011 (during crisis) and linear regression models, this paper investigates the relationship between health and unemployment probabilities under differing economic conditions in 28 European countries. The countries are classified according to (i) the level of and (ii) increase in unemployment rate (i.e. >10 percent and doubling of unemployment rate = crisis country). Firstly, the unemployment likelihood for people with ill health is remarkably stable over time in Europe: the coefficients are very similar in pre-crisis and crisis years. Secondly, people with ill health have experienced unemployment to a lesser extent than those with good health status in the crisis year (when we pool the data and compare 2007 and 2011), but only in the countries with a high and rising unemployment rate. The health composition of the unemployment population changes significantly for the better, but only in those European countries that have been severely hit by the current economic crisis.

What is new about covered interest parity condition in the European Union? Evidence from fractal cross-correlation regressions

NASA Astrophysics Data System (ADS)

Ferreira, Paulo; Kristoufek, Ladislav

2017-11-01

We analyse the covered interest parity (CIP) using two novel regression frameworks based on cross-correlation analysis (detrended cross-correlation analysis and detrending moving-average cross-correlation analysis), which allow for studying the relationships at different scales and work well under non-stationarity and heavy tails. CIP is a measure of capital mobility commonly used to analyse financial integration, which remains an interesting feature of study in the context of the European Union. The importance of this features is related to the fact that the adoption of a common currency is associated with some benefits for countries, but also involves some risks such as the loss of economic instruments to face possible asymmetric shocks. While studying the Eurozone members could explain some problems in the common currency, studying the non-Euro countries is important to analyse if they are fit to take the possible benefits. Our results point to the CIP verification mainly in the Central European countries while in the remaining countries, the verification of the parity is only residual.

Pharmaceutical industry interactions of psychiatric trainees from 20 European countries.

PubMed

Riese, F; Guloksuz, S; Roventa, C; Fair, J D; Haravuori, H; Rolko, T; Flynn, D; Giacco, D; Banjac, V; Jovanovic, N; Bayat, N; Palumbo, C; Rusaka, M; Kilic, O; Augėnaitė, J; Nawka, A; Zenger, M; Kekin, I; Wuyts, P; Barrett, E; Bausch-Becker, N; Mikaliūnas, J; Del Valle, E; Feffer, K; Lomax, G A; Marques, J G; Jauhar, S

2015-02-01

Interactions between the pharmaceutical industry (PI) and psychiatrists have been under scrutiny recently, though there is little empirical evidence on the nature of the relationship and its intensity at psychiatry trainee level. We therefore studied the level of PI interactions and the underlying beliefs and attitudes in a large sample of European psychiatric trainees. One thousand four hundred and forty-four psychiatric trainees in 20 European countries were assessed cross-sectionally, with a 62-item questionnaire. The total number of PI interactions in the preceding two months varied between countries, with least interactions in The Netherlands (M (Mean)=0.92, SD=1.44, range=0-12) and most in Portugal (M=19.06, SD=17.44, range=0-100). Trainees were more likely to believe that PI interactions have no impact on their own prescribing behaviour than that of other physicians (M=3.30, SD=1.26 vs. M=2.39, SD=1.06 on a 5-point Likert scale: 1 "completely disagree" to 5 "completely agree"). Assigning an educational role to the pharmaceutical industry was associated with more interactions and higher gift value (IRR (incidence rate ratio)=1.21, 95%CI=1.12-1.30 and OR=1.18, 95%CI=1.02-1.37). There are frequent interactions between European psychiatric trainees and the PI, with significant variation between countries. We identified several factors affecting this interaction, including attribution of an educational role to the PI. Creating alternative educational opportunities and specific training dedicated to PI interactions may therefore help to reduce the impact of the PI on psychiatric training. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Prevalence and associated factors of fear of childbirth in six European countries.

PubMed

Lukasse, Mirjam; Schei, Berit; Ryding, Elsa Lena

2014-10-01

This study set out to compare the prevalence, content and associated factors of fear of childbirth in six European countries. A cross-sectional study of 6870 pregnant women attending routine antenatal care in Belgium, Iceland, Denmark, Estonia, Norway and Sweden (Bidens). Severe fear of childbirth, defined as a Wijma Delivery Expectancy Questionnaire score of ≥85. Eleven percent of all women reported severe fear of childbirth, 11.4% among primiparous and 11.0% among multiparous women. There were significant differences between the countries for prevalence of severe fear of childbirth, varying from 4.5% in Belgium to 15.6% in Estonia for primiparous women and from 7.6% in Iceland to 15.2% in Sweden for multiparous women. After adjusting for age, education and gestational age, only primiparous women from Belgium had significantly less fear of childbirth, AOR 0.35 (0.19-0.52) compared to Norway (largest participating group). Exploratory factor analyses revealed significant differences between the countries for the six factors extracted. FOC appears to be an international phenomenon, existing with similar proportions in the participating European countries, except for primiparous women in Belgium who in our study reported significantly less severe fear of childbirth. Our study suggests that the content of fear of childbirth may differ between countries. Copyright © 2014 Elsevier B.V. All rights reserved.

Exposure to psychosocial work factors in 31 European countries.

PubMed

Niedhammer, I; Sultan-Taïeb, H; Chastang, J-F; Vermeylen, G; Parent-Thirion, A

2012-04-01

Although psychosocial work factors are recognized as major occupational risk factors, little information is available regarding the prevalence of exposure to these factors and the differences in exposure between countries. To explore the differences in various psychosocial work exposures between 31 European countries. The study was based on a sample of 14,881 male and 14,799 female workers from the 2005 European Working Conditions Survey. Eighteen psychosocial work factors were studied: low decision latitude (skill discretion and decision authority), high psychological demands, job strain, low social support, iso-strain, physical violence, sexual harassment, bullying, discrimination, work-family imbalance, long working hours, high effort, job insecurity, low job promotion, low reward and effort-reward imbalance. Covariates were age, number of workers in household, occupation, economic activity, self-employed/employee, public/private sector and part/full time work. Statistical analysis was performed using multilevel logistic regression analysis. Significant differences in all psychosocial work factors were observed between countries. The rank of the countries varied according to the exposure considered. However, some countries, especially Denmark, Netherlands and Norway, displayed a significantly lower prevalence of exposure to four factors or more, while some Southern and Eastern countries, especially Czech Republic, Greece, Lithuania and Turkey, had a higher prevalence. Differences in psychosocial work exposures were found between countries. This study is the first to compare a large set of psychosocial work exposures between 31 European countries. These findings may be useful to guide prevention policies at European level.

Cross-correlations between crude oil and exchange markets for selected oil rich economies

NASA Astrophysics Data System (ADS)

Li, Jianfeng; Lu, Xinsheng; Zhou, Ying

2016-07-01

Using multifractal detrended cross-correlation analysis (MF-DCCA), this paper studies the cross-correlation behavior between crude oil market and five selected exchange rate markets. The dataset covers the period of January 1,1996-December 31,2014, and contains 4,633 observations for each of the series, including daily closing prices of crude oil, Australian Dollars, Canadian Dollars, Mexican Pesos, Russian Rubles, and South African Rand. Our empirical results obtained from cross-correlation statistic and cross-correlation coefficient have confirmed the existence of cross-correlations, and the MF-DCCA results have demonstrated a strong multifractality between cross-correlated crude oil market and exchange rate markets in both short term and long term. Using rolling window analysis, we have also found the persistent cross-correlations between the exchange rates and crude oil returns, and the cross-correlation scaling exponents exhibit volatility during some time periods due to its sensitivity to sudden events.

Science's disparate responsibilities: Patterns across European countries.

PubMed

Mejlgaard, Niels

2018-04-01

It is a distinctive feature of European science policy that science is expected to meet economic and broader societal objectives simultaneously. Science should be governed democratically and take significant responsibilities towards the economy, the political system and civil society, but the coherency of these multiple claims is underexplored. Using metrics that emerge from both quantitative and qualitative studies, we examine the interrelatedness of different responsibilities at the level of countries. A total of 33 European Union member states and associated countries are included in the analysis. We find no trade-off between economic and broader societal contributions. Europe is, however, characterised by major divisions in terms of the location of science in society. There is a significant East-West divide, and Europe appears to be far from accomplishing an integrated European Research Area.

Cultural and gender convergence in adolescent drunkenness: evidence from 23 European and North American countries.

PubMed

Kuntsche, Emmanuel; Kuntsche, Sandra; Knibbe, Ronald; Simons-Morton, Bruce; Farhat, Tilda; Hublet, Anne; Bendtsen, Pernille; Godeau, Emmanuelle; Demetrovics, Zsolt

2011-02-01

To investigate time-trend changes in the frequency of drunkenness among European and North American adolescents. Cross-sectional surveys in the 1997/1998 and 2005/2006 Health Behaviour in School-Aged Children Study (HBSC). High schools in 23 countries. A sample of 77 586 adolescents aged 15 years was analyzed by means of hierarchical linear modeling. The frequency of drunkenness. We observed a significant increase of about 40% in the mean frequency of drunkenness in all 7 participating Eastern European countries. This increase was evident among both genders, but most consistently among girls. Meanwhile, it declined in 13 of 16 Western countries, about 25% on average. Declines in Western countries were particularly notable among boys and in North America, Scandinavia, the United Kingdom, and Ireland. Despite this gender convergence, with few exceptions (Greenland, Norway, United Kingdom) boys continued to have a higher frequency of drunkenness in 2005/2006 than girls. The confirmed cultural convergence implies that adoption and implementation of evidence-based measures to mitigate the frequency of adolescent drunkenness such as tax increases and restricting alcohol access and advertisement should get the same priority in Eastern European countries as in Western countries. Policy measures that might facilitate decreases in drunkenness such as server training and the promotion of alcohol-free leisure-time activities should be reinforced in Western countries. The gender convergence implies that prevention policy should be less exclusively focused on male adolescents.

Task shifting from physicians to nurses in primary care in 39 countries: a cross-country comparative study.

PubMed

Maier, Claudia B; Aiken, Linda H

2016-12-01

Primary care is in short supply in many countries. Task shifting from physicians to nurses is one strategy to improve access, but international research is scarce. We analysed the extent of task shifting in primary care and policy reforms in 39 countries. Cross-country comparative research, based on an international expert survey, plus literature scoping review. A total of 93 country experts participated, covering Europe, USA, Canada, Australia and New Zealand (response rate: 85.3%). Experts were selected according to pre-defined criteria. Survey responses were triangulated with the literature and analysed using policy, thematic and descriptive methods to assess developments in country-specific contexts. Task shifting, where nurses take up advanced roles from physicians, was implemented in two-thirds of countries (N = 27, 69%), yet its extent varied. Three clusters emerged: 11 countries with extensive (Australia, Canada, England, Northern Ireland, Scotland, Wales, Finland, Ireland, Netherlands, New Zealand and USA), 16 countries with limited and 12 countries with no task shifting. The high number of policy, regulatory and educational reforms, such as on nurse prescribing, demonstrate an evolving trend internationally toward expanding nurses' scope-of-practice in primary care. Many countries have implemented task-shifting reforms to maximise workforce capacity. Reforms have focused on removing regulatory and to a lower extent, financial barriers, yet were often lengthy and controversial. Countries early on in the process are primarily reforming their education. From an international and particularly European Union perspective, developing standardised definitions, minimum educational and practice requirements would facilitate recognition procedures in increasingly connected labour markets. © The Author 2016. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Competitive funding and structures for public health research in European countries.

PubMed

McCarthy, Mark; Conceição, Claudia; Grimaud, Olivier; Katreniakova, Zuzana; Saliba, Amanda; Sammut, Marvic; Narkauskaité, Laura

2013-11-01

The European Union is giving increasing emphasis to research as a driver for innovation and economic development. The European collaborative study PHIRE (Public Health Innovation and Research in Europe) investigated the funding and structures of public health research at national level in European countries. Background materials were prepared for national public health associations of European countries to hold workshops or discussions with research and policy stakeholders on their public health research systems. The reports, supplemented from internet sources for 23 EU countries (four did not contribute), provided information for framework analysis. All countries have public funding and administrative structures for research, but structures for public health research are more varied. In most countries, competitive health research funding is controlled by the Ministry of Science, with little input from the Ministry of Health. In four countries, Ministries of Health provide competitive funding alongside Ministries of Science, and in two countries there is a single health research council. There is no comparative reporting of public health research funding, and little connection with European public health research programmes. Europe needs a comprehensive picture of national and regional systems of public health research, in order to critically assess them and better adapt to changes and challenges, and to achieve a European Research Area for public health.

High levels of postmigration HIV acquisition within nine European countries.

PubMed

Alvarez-Del Arco, Debora; Fakoya, Ibidun; Thomadakis, Christos; Pantazis, Nikos; Touloumi, Giota; Gennotte, Anne-Francoise; Zuure, Freke; Barros, Henrique; Staehelin, Cornelia; Göpel, Siri; Boesecke, Christoph; Prestileo, Tullio; Volny-Anne, Alain; Burns, Fiona; Del Amo, Julia

2017-09-10

We aimed to estimate the proportion of postmigration HIV acquisition among HIV-positive migrants in Europe. To reach HIV-positive migrants, we designed a cross-sectional study performed in HIV clinics. The study was conducted from July 2013 to July 2015 in 57 clinics (nine European countries), targeting individuals over 18 years diagnosed in the preceding 5 years and born abroad. Electronic questionnaires supplemented with clinical data were completed in any of 15 languages. Postmigration HIV acquisition was estimated through Bayesian approaches combining extensive information on migration and patients' characteristics. CD4 cell counts and HIV-RNA trajectories from seroconversion were estimated by bivariate linear mixed models fitted to natural history data. Postmigration acquisition risk factors were investigated with weighted logistic regression. Of 2009 participants, 46% were MSM and a third originated from sub-Saharan Africa and Latin America & Caribbean, respectively. Median time in host countries was 8 years. Postmigration HIV acquisition was 63% (95% confidence interval: 57-67%); 72% among MSM, 58 and 51% in heterosexual men and women, respectively. Postmigration HIV acquisition was 71% for Latin America and Caribbean migrants and 45% for people from sub-Saharan Africa. Factors associated with postmigration HIV acquisition among heterosexual women and MSM were age at migration, length of stay in host country and HIV diagnosis year and among heterosexual men, length of stay in host country and HIV diagnosis year. A substantial proportion of HIV-positive migrants living in Europe acquired HIV postmigration. This has important implications for European public health policies.

[New international migrations and migratory models in South European countries].

PubMed

De Filippo, E; Pugliese, E

1996-01-01

Trends in international migration in the Mediterranean European countries over the course of the 1980s are reviewed. "Particular attention is paid to the different factors that explain the arrival of these migratory fluxes during a period of economic recession and in areas where there is a co-presence of immigration, emigration and unemployment. The involvement of southern European countries as target countries for immigration is not seen as a simple consequence of the [restrictive policies] practiced in the Seventies by European countries with traditional immigration; the push towards these countries as well as the pull to the same are also considered, particularly the acceleration of the internationalization process of the labor markets, the characteristics of the labor markets, and processes of segmentation and tertiarization." (EXCERPT)

Oil prices, fiscal policy, and economic growth in oil-exporting countries

NASA Astrophysics Data System (ADS)

El-Anshasy, Amany A.

This dissertation argues that in oil-exporting countries fiscal policy could play an important role in transmitting the oil shocks to the economy and that the indirect effects of the changes in oil prices via the fiscal channel could be quite significant. The study comprises three distinct, yet related, essays. In the first essay, I try to study the fiscal policy response to the changes in oil prices and to their growing volatility. In a dynamic general equilibrium framework, a fiscal policy reaction function is derived and is empirically tested for a panel of 15 oil-exporters covering the period 1970--2000. After the link between oil price shocks and fiscal policy is established, the second essay tries to investigate the impact of the highly volatile oil prices on economic growth for the same sample, controlling for the fiscal channel. In both essays the study employs recent dynamic panel-data estimation techniques: System GMM. This approach has the potential advantages of minimizing the bias resulting from estimating dynamic panel models, exploiting the time series properties of the data, controlling for the unobserved country-specific effects, and correcting for any simultaneity bias. In the third essay, I focus on the case of Venezuela for the period 1950--2001. The recent developments in the cointegrating vector autoregression, CVAR technique is applied to provide a suitable framework for analyzing the short-run dynamics and the long-run relationships among oil prices, government revenues, government consumption, investment, and output.

Prevalence of fragrance contact allergy in the general population of five European countries: a cross-sectional study.

PubMed

Diepgen, T L; Ofenloch, R; Bruze, M; Cazzaniga, S; Coenraads, P J; Elsner, P; Goncalo, M; Svensson, Å; Naldi, L

2015-12-01

Contact allergy to fragrances is assessed mostly in clinical populations of patients. Studies in the general population are scarce and vary in their methodology across countries. To determine the prevalence of fragrance contact allergy in the European general population and to assess the clinical relevance of positive patch test reactions to different fragrances. In five European countries (Germany, Italy, the Netherlands, Portugal and Sweden) a random sample from the general population aged 18-74 years was drawn. In total, 12 377 subjects were interviewed in this cross-sectional study and a random sample (n = 3119) was patch tested using the TRUE Test and Finn Chamber techniques. Patch test procedures were harmonized by mandatory training before the study and monitoring during the study. The highest prevalence for contact allergy of 2·6% [95% confidence interval (CI) 2·1-3·2] was found for fragrance mix (FM) I in petrolatum, with a high content of atranol and chloratranol, followed by 1·9% (95% CI 1·5-2·4) for FM II in petrolatum. The conservatively estimated prevalence of fragrance contact allergy was 1·9% (95% CI 1·5-2·5). This is defined as the existence of a positive patch test to FM I or FM II; any of their individual materials; Myroxylon pereirae; sesquiterpene lactones or 3- and 4-hydroxyisohexyl 3-cyclohexene carboxaldehyde that show clinical relevance, defined conservatively as lifetime avoidance of scented products and an itchy skin rash lasting > 3 days in a lifetime. Using the reported lifetime prevalence of any contact dermatitis instead of the lifetime prevalence of any itchy skin rash, the prevalence is 0·8% (95% CI 0·5-1·2). The prevalence rates of contact allergy to fragrances in women are about twice those in men. This study helps to identify targets for prevention of fragrance allergy. © 2015 British Association of Dermatologists.

When will European countries exceed the 2°C temperature increase?

NASA Astrophysics Data System (ADS)

Caminade, C.; Morse, A. P.

2012-04-01

Climatologists all agree that an increase of 2°C at global scale could have serious socio-economic consequences for the future. The Cancun agreement in 2010 officially stated that "With a view to reducing global greenhouse gas emissions so as to hold the increase in global average temperature below 2 °C above pre- industrial levels . . . Parties should take urgent action to meet this long-term goal." Recent studies highlighted that this threshold is likely to be reached by 2060 at global scale if we follow the higher greenhouse gases emission scenarios. However, this threshold might be crossed earlier over lands, by 2040, for Europe, Asia, North Africa and Canada. This study aims to highlight when this threshold might be reached at the country level for members states of the European Union. A large ensemble of regional climate model simulations driven by the SRESA1B emission scenario carried out within the ENSEMBLES project framework for the European continent is employed to achieve such a task. Results corroborate that the European continent is likely to warm faster than the global average temperatures, with the multi-model ensemble mean crossing the 2°C threshold by 2045-2055. Regionally, Eastern Europe, Scandinavia and the Mediterranean basin are likely to cross that threshold earlier than northwestern/central Europe. As an example of these regional differences, Cyprus is likely to experience a 2°C increase during the mid 2040s while this might happen over Ireland during the late 21st century.

Emotional support, education and self-rated health in 22 European countries.

PubMed

von dem Knesebeck, Olaf; Geyer, Siegfried

2007-10-01

The analyses focus on three aims: (1) to explore the associations between education and emotional support in 22 European countries, (2) to explore the associations between emotional support and self-rated health in the European countries, and (3) to analyse whether the association between education and self-rated health can be partly explained by emotional support. The study uses data from the European Social Survey 2003. Probability sampling from all private residents aged 15 years and older was applied in all countries. The European Social Survey includes 42,359 cases. Persons under age 25 were excluded to minimise the number of respondents whose education was not complete. Education was coded according to the International Standard Classification of Education. Perceived emotional support was assessed by the availability of a confidant with whom one can discuss intimate and personal matters with. Self-rated health was used as health indicator. Results of multiple logistic regression analyses show that emotional support is positively associated with education among women and men in most European countries. However, the magnitude of the association varies according to country and gender. Emotional support is positively associated with self-rated health. Again, gender and country differences in the association were observed. Emotional support explains little of the educational differences in self-rated health among women and men in most European countries. Results indicate that it is important to consider socio-economic factors like education and country-specific contexts in studies on health effects of emotional support.

Analysis of Medicine Prices in New Zealand and 16 European Countries.

PubMed

Vogler, Sabine; Kilpatrick, Kate; Babar, Zaheer-Ud-Din

2015-06-01

To compare prices of medicines, both originators and generics, in New Zealand and 16 European countries. Ex-factory price data as of December 2012 from New Zealand and 16 European countries were compared for a basket of 14 medicines, most of which were at least partially funded by the state in the 17 countries. Five medicines had, at least in some countries, generic versions on the market whose prices were also analyzed. Medicine price data for the 16 European countries were provided by the Pharma Price Information service. New Zealand medicine prices were retrieved from the New Zealand Pharmaceutical Schedule. Unit prices converted into euro were compared at the ex-factory price level. For the 14 medicines surveyed, considerable price differences at the ex-factory price level were identified. Within the European countries, prices in Greece, Portugal, the United Kingdom, and Spain ranked at the lower end, whereas prices in Switzerland, Germany, Denmark, and Sweden were at the upper end. The results for New Zealand compared with Europe were variable. New Zealand prices were found in the lowest quartile for five medicines and in the highest quartile for seven other products. Price differences between the originator products and generic versions ranged from 0% to 90% depending on the medicine and the country. Medicine prices varied considerably between European countries and New Zealand as well as among the European countries. These differences are likely to result from national pricing and reimbursement policies. Copyright © 2015 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Nurses’ Shift Length and Overtime Working in 12 European Countries

PubMed Central

Dall’Ora, Chiara; Simon, Michael; Ball, Jane; Lindqvist, Rikard; Rafferty, Anne-Marie; Schoonhoven, Lisette; Tishelman, Carol; Aiken, Linda H.

2014-01-01

Background: Despite concerns as to whether nurses can perform reliably and effectively when working longer shifts, a pattern of two 12- to 13-hour shifts per day is becoming common in many hospitals to reduce shift to shift handovers, staffing overlap, and hence costs. Objectives: To describe shift patterns of European nurses and investigate whether shift length and working beyond contracted hours (overtime) is associated with nurse-reported care quality, safety, and care left undone. Methods: Cross-sectional survey of 31,627 registered nurses in general medical/surgical units within 488 hospitals across 12 European countries. Results: A total of 50% of nurses worked shifts of ≤8 hours, but 15% worked ≥12 hours. Typical shift length varied between countries and within some countries. Nurses working for ≥12 hours were more likely to report poor or failing patient safety [odds ratio (OR)=1.41; 95% confidence interval (CI), 1.13–1.76], poor/fair quality of care (OR=1.30; 95% CI, 1.10–1.53), and more care activities left undone (RR=1.13; 95% CI, 1.09–1.16). Working overtime was also associated with reports of poor or failing patient safety (OR=1.67; 95% CI, 1.51–1.86), poor/fair quality of care (OR=1.32; 95% CI, 1.23–1.42), and more care left undone (RR=1.29; 95% CI, 1.27–1.31). Conclusions: European registered nurses working shifts of ≥12 hours and those working overtime report lower quality and safety and more care left undone. Policies to adopt a 12-hour nursing shift pattern should proceed with caution. Use of overtime working to mitigate staffing shortages or increase flexibility may also incur additional risk to quality. PMID:25226543

Hep-CORE: a cross-sectional study of the viral hepatitis policy environment reported by patient groups in 25 European countries in 2016 and 2017.

PubMed

Lazarus, Jeffrey V; Stumo, Samya R; Harris, Magdalena; Hendrickx, Greet; Hetherington, Kristina L; Maticic, Mojca; Jauffret-Roustide, Marie; Tallada, Joan; Simojoki, Kaarlo; Reic, Tatjana; Safreed-Harmon, Kelly

2018-04-01

The first World Health Organization (WHO) global health sector strategy on hepatitis B and C viruses (HBV and HCV) has called for the elimination of viral hepatitis as a major public health threat by 2030. This study assesses policies and programmes in support of elimination efforts as reported by patient groups in Europe. In 2016 and 2017, hepatitis patient groups in 25 European countries participated in a cross-sectional survey about their countries' policy responses to HBV and HCV. The English-language survey addressed overall national response; public awareness/engagement; disease monitoring; prevention; testing/diagnosis; clinical assessment; and treatment. We performed a descriptive analysis of data and compared 2016 and 2017 findings. In 2017, 72% and 52% of the 25 European study countries were reported to not have national HBV and HCV strategies respectively. The number of respondents indicating that their governments collaborated with civil society on viral hepatitis control increased from 13 in 2016 to 18 in 2017. In both 2016 and 2017, patient groups reported that 9 countries (36%) have disease registers for HBV and 11 (44%) have disease registers for HCV. The number of countries reported to have needle and syringe exchange programmes available in all parts of the country dropped from 10 (40%) in 2016 to 8 in 2017 (32%). In both 2016 and 2017, patient groups in 5 countries (20%) reported that HCV treatment is available in non-hospital settings. From 2016 to 2017, the reported number of countries with no restrictions on access to direct-acting antivirals for HCV increased from 3 (12%) to 7 (28%), and 5 fewer countries were reported to refuse treatment to people who are currently injecting drugs. The patient-led Hep-CORE study offers a unique perspective on the readiness of study countries to undertake comprehensive viral hepatitis elimination efforts. Viral hepatitis monitoring should be expanded to address policy issues more comprehensively and to

Waterpipe Tobacco Smoking Prevalence and Correlates in 25 Eastern Mediterranean and Eastern European Countries: Cross-Sectional Analysis of the Global Youth Tobacco Survey.

PubMed

Jawad, Mohammed; Lee, John Tayu; Millett, Christopher

2016-04-01

Waterpipe tobacco smoking is highly prevalent among young people in some settings. There is an absence of nationally representative prevalence studies of waterpipe tobacco use and dual use with other tobacco products in young people. We conducted a secondary analysis of the Global Youth Tobacco Survey, a nationally representative cross-sectional study of students aged 13-15 years. Of 180 participating countries, 25 included optional waterpipe tobacco smoking questions: 15 Eastern Mediterranean and 10 Eastern European countries. We calculated the prevalence of current (past 30-day) waterpipe tobacco use, including dual waterpipe and other tobacco use, and used logistic regression models to identify sociodemographic correlates of waterpipe tobacco smoking. Individual country results were combined in a random effects meta-analysis. Waterpipe tobacco smoking prevalence was highest in Lebanon (36.9%), the West Bank (32.7%) and parts of Eastern Europe (Latvia 22.7%, the Czech Republic 22.1%, Estonia 21.9%). These countries also recorded greater than 10% prevalence of dual waterpipe and cigarette use. In a meta-analysis, higher odds of waterpipe tobacco smoking were found among males (Adjusted odds ratio [AOR] = 1.37, 95% confidence interval [CI] = 1.18% to 1.59%), cigarette users (AOR = 6.95, 95% CI = 5.74% to 8.42%), those whose parents (AOR = 1.54, 95% CI = 1.31% to 1.82%) or peers smoked (AOR = 3.53, 95% CI = 2.97% to 4.20%) and those whose parents had higher educational attainment (Father, AOR = 1.47, 95% CI = 1.14% to 1.89%; Mother, AOR = 1.62, 95% CI = 1.07% to 2.46%). We report on regional- and country income-level differences. Waterpipe tobacco smoking, including dual waterpipe and cigarette use, is alarmingly high in several Eastern Mediterranean and Eastern European countries. Ongoing waterpipe tobacco smoking surveillance is warranted. © The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All

Consumption of predefined 'Nordic' dietary items in ten European countries - an investigation in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort.

PubMed

Roswall, Nina; Olsen, Anja; Boll, Katja; Christensen, Jane; Halkjær, Jytte; Sørensen, Thorkild I A; Dahm, Christina C; Overvad, Kim; Clavel-Chapelon, Françoise; Boutron-Ruault, Marie C; Cottet, Vanessa; Teucher, Birgit; Kaaks, Rudolf; Boeing, Heiner; von Ruesten, Anne; Trichopoulou, Antonia; Oikonomou, Eleni; Vasilopoulou, Effie; Pala, Valeria; Sacerdote, Carlotta; Mattiello, Amalia; Masala, Giovanna; Peeters, Petra H M; Bueno-de-Mesquita, H Bas; Engeset, Dagrun; Skeie, Guri; Asli, Lene A; Amiano, Pilar; Jakszyn, Paula; Ardanaz, Eva; Huerta, José M; Quirós, José R; Molina-Montes, Esther; Nilsson, Lena M; Johansson, Ingegerd; Wirfält, Elisabet; Drake, Isabel; Mulligan, Angela A; Khaw, Kay T; Romaguera, Dora; Vergnaud, Anne-Claire; Key, Tim; Riboli, Elio; Tjønneland, Anne

2014-12-01

Health-beneficial effects of adhering to a healthy Nordic diet index have been suggested. However, it has not been examined to what extent the included dietary components are exclusively related to the Nordic countries or if they are part of other European diets as well, suggesting a broader preventive potential. The present study describes the intake of seven a priori defined healthy food items (apples/pears, berries, cabbages, dark bread, shellfish, fish and root vegetables) across ten countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) and examines their consumption across Europe. Cross-sectional study. A 24 h dietary recall was administered through a software program containing country-specific recipes. Sex-specific mean food intake was calculated for each centre/country, as well as percentage of overall food groups consumed as healthy Nordic food items. All analyses were weighted by day and season of data collection. Multi-centre, European study. Persons (n 36 970) aged 35-74 years, constituting a random sample of 519 978 EPIC participants. The highest intakes of the included diet components were: cabbages and berries in Central Europe; apples/pears in Southern Europe; dark bread in Norway, Denmark and Greece; fish in Southern and Northern countries; shellfish in Spain; and root vegetables in Northern and Central Europe. Large inter-centre variation, however, existed in some countries. Dark bread, root vegetables and fish are strongly related to a Nordic dietary tradition. Apples/pears, berries, cabbages, fish, shellfish and root vegetables are broadly consumed in Europe, and may thus be included in regional public health campaigns.

Consumer satisfaction with dry-cured ham in five European countries.

PubMed

Resano, H; Pérez-Cueto, F J A; Sanjuán, A I; de Barcellos, M D; Grunert, K G; Verbeke, W

2011-04-01

The objective is to investigate consumer satisfaction with dry-cured ham in five European countries. A logistic regression model has been fitted using data collected through a cross-sectional web-based survey carried out in Belgium, Germany, Denmark, Poland and Greece during January 2008 (n=2437 of which 2156 were dry-cured ham consumers). Satisfaction was evaluated as overall satisfaction, as well as specific satisfaction with healthfulness, price, convenience and taste. The findings show that the main determinant of overall satisfaction is taste satisfaction, hence, producers are recommended to focus on matching sensory acceptability of dry-cured ham. No significant between-country differences were found, reflecting the wide availability of this product in all countries. Consumer characteristics influenced their level of satisfaction. Men, older (age > 52 years) and frequent consumers of dry-cured ham consumption were more likely to be satisfied with dry-cured ham. Consumers trust the butcher's advice and they preferred purchasing dry-cured ham at a butcher shop rather than in a supermarket. © 2010 The American Meat Science Association. Published by Elsevier Ltd. All rights reserved.

Bologna Process and Basic Nursing Education in 21 European Countries.

PubMed

Humar, L; Sansoni, J

2017-01-01

The Bologna Process and the Directives of the European Union have had a profound impact on nursing education in Europe. The aim of this study was to identify the similarities and differences within nursing education framework at entry level in 2014 in European countries. A questionnaire was devised by the researchers and distributed via e-mail to the nursing associations/nursing regulatory bodies of 30 European countries. Data were collected from January to May 2014. Responses were received from 21 European Countries. Results indicated that while a completion of 12 years of general education was a requirement to access nursing education in almost all respondent countries, other admission requirements differed between countries. Nursing courses were offered mostly by Faculties of Nursing and Faculties of Health Sciences (in higher education Institutions) and lecturers and management staff were mainly nurses. The results indicated significant different educational requirements for nurse educators. A foreign language was mandatory in half of the respondent countries. Nursing profession was represented at government level in just over half of the respondent countries, often with a Directorate position. The Bologna Process has helped harmonise initial nursing education in Europe but clear standards for nursing education need to be set up. Therefore, the research about the influence of the Bologna process on the development of the nursing profession should be further encouraged.

Social welfare support and homicide: longitudinal analyses of European countries from 1994 to 2010.

PubMed

McCall, Patricia L; Brauer, Jonathan R

2014-11-01

The purpose of this research is to explore the extent to which retrenchment in welfare support is related to homicide trends across European countries between 1994 and 2010. Using a longitudinal decomposition design that allows for stronger causal inferences compared to typical cross-sectional designs, we examine these potential linkages between social support spending and homicide with data collected from a heterogeneous sample of European nations, including twenty Western nations and nine less frequently analyzed East-Central nations, during recent years in which European nations generally witnessed substantial changes in homicide rates as well as both economic prosperity and fiscal crisis. Results suggest that even incremental, short-term changes in welfare support spending are associated with short-term reductions in homicide-specifically, impacting homicide rates within two to three years for this sample of European nations. Copyright © 2014 Elsevier Inc. All rights reserved.

Physical Activity Patterns Among Older Adults With and Without Knee Osteoarthritis in Six European Countries.

PubMed

Herbolsheimer, Florian; Schaap, Laura A; Edwards, Mark H; Maggi, Stefania; Otero, Ángel; Timmermans, Erik J; Denkinger, Michael D; van der Pas, Suzan; Dekker, Joost; Cooper, Cyrus; Dennison, Elaine M; van Schoor, Natasja M; Peter, Richard

2016-02-01

To investigate patterns of physical activity in older adults with knee osteoarthritis (OA) compared to older adults without knee OA across 6 European countries. We expect country-specific differences in the physical activity levels between persons with knee OA compared to persons without knee OA. A varying degree of physical activity levels across countries would express a facilitating or impeding influence of the social, environmental, and other contextual factors on a physically active lifestyle. Baseline cross-sectional data from the European Project on Osteoarthritis were analyzed. In total, 2,551 participants from 6 European countries (Germany, Italy, The Netherlands, Spain, Sweden, and the UK) were included. Participants with knee OA were less likely to follow physical activity recommendations and had poorer overall physical activity profiles than those without knee OA (mean 62.9 versus 81.5 minutes/day, respectively; P = 0.015). The magnitude of this difference varied across countries. Detailed analysis showed that low physical activity levels in persons with knee OA could be attributed to less everyday walking time (odds ratio 1.31, 95% confidence interval 1.07-1.62). This study highlighted the fact that having knee OA is associated with a varying degree of physical activity patterns in different countries. This national variation implies that low levels of physical activity among persons with knee OA cannot be explained exclusively by individual or disease-specific factors, but that social, environmental, and other contextual factors should also be taken into account. © 2016, American College of Rheumatology.

Comparing Efficiency in a Cross-Country Perspective: The Case of Italian and Spanish State Universities

ERIC Educational Resources Information Center

Agasisti, Tommaso; Perez-Esparrells, Carmen

2010-01-01

The growing internationalization of European Higher Education requires more emphasis on cross-country comparisons. In this paper, an efficiency analysis of Italian and Spanish universities is conducted; as well as from a comparative perspective. The efficiency scores are obtained using data envelopment analysis. The results demonstrate a good…

Libya Country Analysis Brief

EIA Publications

2015-01-01

Libya joined the Organization of the Petroleum Exporting Countries (OPEC) in 1962, a year after Libya began exporting oil. Libya holds the largest amount of proved crude oil reserves in Africa, the fifth-largest amount of proved natural gas reserves on the continent, and in past years was an important contributor to the global supply of light, sweet (low sulfur) crude oil, which Libya mostly exports to European markets.

Usage of Plant Food Supplements across Six European Countries: Findings from the PlantLIBRA Consumer Survey

PubMed Central

Garcia-Alvarez, Alicia; Egan, Bernadette; de Klein, Simone; Dima, Lorena; Maggi, Franco M.; Isoniemi, Merja; Ribas-Barba, Lourdes; Raats, Monique M.; Meissner, Eva Melanie; Badea, Mihaela; Bruno, Flavia; Salmenhaara, Maija; Milà-Villarroel, Raimon; Knaze, Viktoria; Hodgkins, Charo; Marculescu, Angela; Uusitalo, Liisa; Restani, Patrizia; Serra-Majem, Lluís

2014-01-01

Background The popularity of botanical products is on the rise in Europe, with consumers using them to complement their diets or to maintain health, and products are taken in many different forms (e.g. teas, juices, herbal medicinal products, plant food supplements (PFS)). However there is a scarcity of data on the usage of such products at European level. Objective To provide an overview of the characteristics and usage patterns of PFS consumers in six European countries. Design Data on PFS usage were collected in a cross-sectional, retrospective survey of PFS consumers using a bespoke frequency of PFS usage questionnaire. Subjects/setting A total sample of 2359 adult PFS consumers from Finland, Germany, Italy, Romania, Spain and the United Kingdom. Data analyses Descriptive analyses were conducted, with all data stratified by gender, age, and country. Absolute frequencies, percentages and 95% confidence intervals are reported. Results Overall, an estimated 18.8% of screened survey respondents used at least one PFS. Characteristics of PFS consumers included being older, well-educated, never having smoked and self-reporting health status as “good or very good”. Across countries, 491 different botanicals were identified in the PFS products used, with Ginkgo biloba (Ginkgo), Oenothera biennis (Evening primrose) and Cynara scolymus (Artichoke) being most frequently reported; the most popular dose forms were capsules and pills/tablets. Most consumers used one product and half of all users took single-botanical products. Some results varied across countries. Conclusions The PlantLIBRA consumer survey is unique in reporting on usage patterns of PFS consumers in six European countries. The survey highlights the complexity of measuring the intake of such products, particularly at pan-European level. Incorporating measures of the intake of botanicals in national dietary surveys would provide much-needed data for comprehensive risk and benefit assessments at the European

Pricing Policies And Control of Tobacco in Europe (PPACTE) project: cross-national comparison of smoking prevalence in 18 European countries.

PubMed

Gallus, Silvano; Lugo, Alessandra; La Vecchia, Carlo; Boffetta, Paolo; Chaloupka, Frank J; Colombo, Paolo; Currie, Laura; Fernandez, Esteve; Fischbacher, Colin; Gilmore, Anna; Godfrey, Fiona; Joossens, Luk; Leon, Maria E; Levy, David T; Nguyen, Lien; Rosenqvist, Gunnar; Ross, Hana; Townsend, Joy; Clancy, Luke

2014-05-01

Limited data on smoking prevalence allowing valid between-country comparison are available in Europe. The aim of this study is to provide data on smoking prevalence and its determinants in 18 European countries. In 2010, within the Pricing Policies And Control of Tobacco in Europe (PPACTE) project, we conducted a face-to-face survey on smoking in 18 European countries (Albania, Austria, Bulgaria, Czech Republic, Croatia, England, Finland, France, Greece, Hungary, Ireland, Italy, Latvia, Poland, Portugal, Romania, Spain and Sweden) on a total of 18 056 participants, representative for each country of the population aged 15 years or older. Overall, 27.2% of the participants were current smokers (30.6% of men and 24.1% of women). Smoking prevalence was highest in Bulgaria (40.9%) and Greece (38.9%) and lowest in Italy (22.0%) and Sweden (16.3%). Smoking prevalence ranged between 15.7% (Sweden) and 44.3% (Bulgaria) for men and between 11.6% (Albania) and 38.1% (Ireland) for women. Multivariate analysis showed a significant inverse trend between smoking prevalence and the level of education in both sexes. Male-to-female smoking prevalence ratios ranged from 0.85 in Spain to 3.47 in Albania and current-to-ex prevalence ratios ranged from 0.68 in Sweden to 4.28 in Albania. There are considerable differences across Europe in smoking prevalence, and male-to-female and current-to-ex smoking prevalence ratios. Eastern European countries, lower income countries and those with less advanced tobacco control policies have less favourable smoking patterns and are at an earlier stage of the tobacco epidemic.

Country-level and individual correlates of overweight and obesity among primary school children: a cross-sectional study in seven European countries.

PubMed

Olaya, Beatriz; Moneta, Maria Victoria; Pez, Ondine; Bitfoi, Adina; Carta, Mauro Giovanni; Eke, Ceyda; Goelitz, Dietmar; Keyes, Katherine M; Kuijpers, Rowella; Lesinskiene, Sigita; Mihova, Zlatka; Otten, Roy; Fermanian, Christophe; Haro, Josep Maria; Kovess, Viviane

2015-05-08

The present study aims to estimate childhood overweight and obesity prevalence and their association with individual and population-level correlates in Eastern and Western European countries. Data were obtained from the School Children Mental Health in Europe, a cross-sectional survey conducted in 2010 in Italy, Germany, the Netherlands, Romania, Bulgaria, Lithuania and Turkey. The sample consists of 5,206 school children aged 6 to 11 years old. Information on socio-demographics, children's height and weight, life-style and parental attitude were reported by the mothers. Country-level indicators were obtained through several data banks. Overweight and obesity in children were calculated according to the international age and gender-specific child Body Mass Index cut-off points. Multivariable logistic regression models included socio-demographic, lifestyle, mothers' attitude, and country-level indicators to examine the correlates of overweight. Overall prevalence was 15.6% (95% CI = 19.3-21.7%) for overweight and 4.9% (95% CI = 4.3-5.6%) for obesity. In overweight (including obesity), Romanian children had the highest prevalence (31.4%, 95% CI = 28.1-34.6%) and Italian the lowest (10.4%, 95% CI = 8.1-12.6%). Models in the pooled sample showed that being younger (aOR = 0.93, 95% = CI 0.87-0.97), male (aOR = 1.24, 95% CI = 1.07-1.43), an only child (aOR = 1.40, 95% CI = 1.07-1.84), spending more hours per week watching TV (aOR = 1.01, 95% CI =1.002-1.03), and living in an Eastern Country were associated with greater risk of childhood overweight (including obesity). The same predictors were significantly associated with childhood overweight in the model conducted in the Eastern region, but not in the West. Higher Gross Domestic Product and Real Domestic Product, greater number of motor and passenger vehicles, higher percentage of energy available from fat, and more public sector expenditure on health were also associated with lower risk for childhood overweight after

Sedentary Time and Physical Activity Surveillance Through Accelerometer Pooling in Four European Countries.

PubMed

Loyen, Anne; Clarke-Cornwell, Alexandra M; Anderssen, Sigmund A; Hagströmer, Maria; Sardinha, Luís B; Sundquist, Kristina; Ekelund, Ulf; Steene-Johannessen, Jostein; Baptista, Fátima; Hansen, Bjørge H; Wijndaele, Katrien; Brage, Søren; Lakerveld, Jeroen; Brug, Johannes; van der Ploeg, Hidde P

2017-07-01

The objective of this study was to pool, harmonise and re-analyse national accelerometer data from adults in four European countries in order to describe population levels of sedentary time and physical inactivity. Five cross-sectional studies were included from England, Portugal, Norway and Sweden. ActiGraph accelerometer count data were centrally processed using the same algorithms. Multivariable logistic regression analyses were conducted to study the associations of sedentary time and physical inactivity with sex, age, weight status and educational level, in both the pooled sample and the separate study samples. Data from 9509 participants were used. On average, participants were sedentary for 530 min/day, and accumulated 36 min/day of moderate to vigorous intensity physical activity. Twenty-three percent accumulated more than 10 h of sedentary time/day, and 72% did not meet the physical activity recommendations. Nine percent of all participants were classified as high sedentary and low active. Participants from Norway showed the highest levels of sedentary time, while participants from England were the least physically active. Age and weight status were positively associated with sedentary time and not meeting the physical activity recommendations. Men and higher-educated people were more likely to be highly sedentary, while women and lower-educated people were more likely to be inactive. We found high levels of sedentary time and physical inactivity in four European countries. Older people and obese people were most likely to display these behaviours and thus deserve special attention in interventions and policy planning. In order to monitor these behaviours, accelerometer-based cross-European surveillance is recommended.

Oil price fluctuations and the Gulf Cooperation Council (GCC) countries, 1960--2004

NASA Astrophysics Data System (ADS)

Alotaibi, Bader

The dissertation examines the effect of oil price fluctuations on GCC economies for the period 1960-2004. The objective of chapter two is to investigate whether oil price fluctuations have asymmetric effects on GDP growth. Does a negative oil price shock have merely an opposite effect as does a positive price shock or are there differences in degrees? Many past studies have examined asymmetries between oil prices and output growth in oil importing countries. A fixed effect model is used. We find that negative oil price shocks dominate positive shocks. The objective of chapter three is to investigate the impact of oil price shocks on real exchange rates and price levels. A structural Vector Autoregression (VAR) model for each country is used containing three and four variables in the first and second specifications, respectively. Oil price shocks are found to be not only important but persistent. In most countries, supply shocks play larger roles than do demand shocks. Nominal shocks have only short-run effects on the real exchange rate and the price level. The objective of chapter four is to investigate fluctuations in budget and trade deficits. Do agents smooth over income shocks due to fluctuations in oil prices or do oil price shocks have large effects? Also, are the budget and trade deficits causally related? If so, what direction does this causal relation take? Many studies have considered links between budget and trade deficits but most have been conducted for countries where oil is not a major concern. A VAR model containing three variables for each country is used. Oil price shocks are found to be persistent. Also, the results support the twin deficits hypothesis. Budget deficit shocks cause deterioration in the trade deficits in GCC countries.

The prevalence of lifetime abuse among older adults in seven European countries.

PubMed

Eslami, Bahareh; Viitasara, Eija; Macassa, Gloria; Melchiorre, Maria Gabriella; Lindert, Jutta; Stankunas, Mindaugas; Torres-Gonzalez, Francisco; Barros, Henrique; Ioannidi-Kapolou, Elisabeth; Soares, Joaquim J F

2016-11-01

To investigate the lifetime prevalence rate of abuse among older persons and to scrutinize the associated factors (e.g. demographics). This cross-sectional population-based study had 4467 participants, aged 60-84, from seven European cities. Abuse (psychological, physical, sexual, financial and injuries) was measured based on The Revised Conflict Tactics Scale, and the UK survey of abuse/neglect of older people. Over 34 % of participants reported experiencing lifetime psychological, 11.5 % physical, 18.5 % financial and 5 % sexual abuse and 4.3 % reported injuries. Lifetime psychological abuse was associated with country, younger age, education and alcohol consumption; physical abuse with country, age, not living in partnership; injuries with country, female sex, age, education, not living in partnership; financial abuse with country, age, not living in partnership, education, benefiting social/partner income, drinking alcohol; and sexual abuse with country, female sex and financial strain. High lifetime prevalence rates confirm that elder abuse is a considerable public health problem warranting further longitudinal studies. Country of residence is an independent factor associated with all types of elder abuse which highlights the importance of national interventions alongside international collaborations.

Epidemiological studies of cognitive impairment and dementia across Eastern and Middle European countries (epidemiology of dementia in Eastern and Middle European Countries).

PubMed

Kiejna, A; Frydecka, D; Adamowski, T; Bickel, H; Reynish, E; Prince, M; Caracciolo, B; Fratiglioni, L; Georges, J

2011-02-01

To determine the availability and the consistency of prevalence findings of epidemiological studies on cognitive impairment and dementia conducted in Eastern and Middle Europe. We adopted a stepwise multimethod study approach consisting of iterative literature searches for epidemiological articles published between 1990 and 2006 and subsequent data analyses of published material, reanalyses of existing accessible epidemiological data sets and expert inquiries in Eastern and Middle European countries. Systematic computer-assisted searches used the keywords: "dementia", "Alzheimer", "cognitive impairment", "incidence", "prevalence", "epidemiology" in combination with the name of the relevant countries or "Europe" in English and Polish language. We supplemented the literature search with a review of the references in the articles that were identified during the initial search. We were able to find few regional and country-specific epidemiological studies of various kinds (population-based, cohort, cross-sectional studies) and conducted on different restricted population groups of patients (from neurological units, out-patients units, residential homes). No studies were identified from most of the countries taken under consideration and the ones we found were characterized by an immense diversity with a considerable degree of clinical and methodological variations. The few studies that there are suggest prevalence rates of dementia in Eastern Europe similar to those in Western Europe. There is strong need for epidemiological studies in Eastern and Middle Europe, as well as for greater coordination and standardization of methods to improve the quality and comparability of epidemiological data to determine the prevalences' rates of dementia in all the EU countries. Copyright © 2010 John Wiley & Sons, Ltd.

Palliative Care Service Use in Four European Countries: A Cross-National Retrospective Study via Representative Networks of General Practitioners

PubMed Central

Pivodic, Lara; Pardon, Koen; Van den Block, Lieve; Van Casteren, Viviane; Miccinesi, Guido; Donker, Gé A.; Alonso, Tomás Vega; Alonso, José Lozano; Aprile, Pierangelo Lora; Onwuteaka-Philipsen, Bregje D.; Deliens, Luc

2013-01-01

Background Due to a rising number of deaths from cancer and other chronic diseases a growing number of people experience complex symptoms and require palliative care towards the end of life. However, population-based data on the number of people receiving palliative care in Europe are scarce. The objective of this study is to examine, in four European countries, the number of people receiving palliative care in the last three months of life and the factors associated with receiving palliative care. Methods Cross-national retrospective study. Over two years (2009–2010), GPs belonging to representative epidemiological surveillance networks in Belgium, the Netherlands, Italy, and Spain registered weekly all deaths of patients (≥18 years) in their practices and the care they received in the last three months of life using a standardized form. Sudden deaths were excluded. Results We studied 4,466 deaths. GPs perceived to have delivered palliative care to 50% of patients in Belgium, 55% in Italy, 62% in the Netherlands, and 65% in Spain (p<.001). Palliative care specialists attended to 29% of patients in the Netherlands, 39% in Italy, 45% in Spain, and 47% in Belgium (p<.001). Specialist palliative care lasted a median (inter-quartile range) of 15 (23) days in Belgium to 30 (70) days in Italy (p<.001). Cancer patients were more likely than non-cancer patients to receive palliative care in all countries as were younger patients in Italy and Spain with regard to specialist palliative care. Conclusions Although palliative care is established in the countries studied, there are considerable differences in its provision. Two potentially underserved groups emerge non-cancer patients in all countries and older people in Italy and Spain. Future research should examine how differences in palliative care use relate to both patient characteristics and existing national health care policies. PMID:24386381

Socioeconomic inequalities in childhood overweight: heterogeneity across five countries in the WHO European Childhood Obesity Surveillance Initiative (COSI-2008).

PubMed

Lissner, L; Wijnhoven, T M A; Mehlig, K; Sjöberg, A; Kunesova, M; Yngve, A; Petrauskiene, A; Duleva, V; Rito, A I; Breda, J

2016-05-01

Excess risk of childhood overweight and obesity occurring in socioeconomically disadvantaged families has been demonstrated in numerous studies from high-income regions, including Europe. It is well known that socioeconomic characteristics such as parental education, income and occupation are etiologically relevant to childhood obesity. However, in the pan-European setting, there is reason to believe that inequalities in childhood weight status may vary among countries as a function of differing degrees of socioeconomic development and equity. In this cross-sectional study, we have examined socioeconomic differences in childhood obesity in different parts of the European region using nationally representative data from Bulgaria, the Czech Republic, Lithuania, Portugal and Sweden that were collected in 2008 during the first round of the World Health Organization (WHO) European Childhood Obesity Surveillance Initiative. Heterogeneity in the association between parental socioeconomic indicators and childhood overweight or obesity was clearly observed across the five countries studied. Positive as well as negative associations were observed between parental socioeconomic indicators and childhood overweight, with statistically significant interactions between country and parental indicators. These findings have public health implications for the WHO European Region and underscore the necessity to continue documenting socioeconomic inequalities in obesity in all countries through international surveillance efforts in countries with diverse geographic, social and economic environments. This is a prerequisite for universal as well as targeted preventive actions.

Programmes and calls for public health research in European countries.

PubMed

Conceição, Claudia; Grimaud, Olivier; McCarthy, Mark; Barnhoorn, Floris; Sammut, Marvic; Saliba, Amanda; Katreniakova, Zuzana; Narkauskaité, Laura

2013-11-01

Public health research, at population and organizational level, needs to be identified independently within 'health' research from biomedicine and life sciences. In PHIRE (Public Health Innovation and Research in Europe), we investigated the extent and character of public health research calls and programmes in European countries. Country respondents, identified through national member associations of the European Public Health Association completed a standardized recording instrument. Public health research was defined, and the call period limited to the latest full year (2010). Of the 30 countries included (EU 27 plus Iceland, Norway and Switzerland), there were reports for 25 countries A simple classification of the calls was developed. There were 75 calls and programmes included. Of these, 41 (55%) together were in France and the UK, and 34 in a further 14 countries, while 9 countries reported there were no calls or programmes opened in 2010. Calls were categorized across diseases, behaviours, determinants, services and methodologies. Some calls were broad, while others--particularly in the countries with several calls--were more detailed towards specific issues. Levels of funding varied markedly and were difficult to define. Where stated, in 32 responses, 19 calls were only open to national applicants and 13 from abroad. Most European countries have competitive programmes and calls relevant for public health research, but they are poorly identified. Only a minority of countries present a wide range of topics and specific fields. Effort is needed to develop classifications for public health programmes and calls for public health research, improve information (including financial) collection to enable systematic comparisons and build greater recognition of public health research within research communities, with national and European research funding organizations, and for practitioners and policymakers.

The role of healthcare system in dental check-ups in 27 European countries: multilevel analysis.

PubMed

Kino, Shiho; Bernabé, Eduardo; Sabbah, Wael

2017-06-01

To examine whether public expenditure on health and Euro Health Consumer Index (EHCI) are associated with dental check-ups in European countries. Individual data were from Eurobarometer 72.3, 2009 a cross-national survey of 27 European countries. Eligible participants were those aged 18 years and older in 27 European countries. Dental check-ups reflected dental visits for oral examination and getting advice on oral health in the last 12 months. Individual factors included age, gender, marital status, urbanisation, education, subjective social status, and difficulty in paying bills. Public expenditure on health as a percentage of gross domestic product (GDP) and EHCI were used as contextual factors. A set of multilevel logistic regression models was used to examine the relationship between dental check-ups and each of healthcare expenditure and EHCI adjusting for demographic factors, GDP per capita and socioeconomic indicators. Total number included in the analysis was 23,842. Participants in countries with greater healthcare expenditure and higher score of EHCI were significantly 1.17 (95% CI: 1.03, 1.32) and 1.30 times (95% CI: 1.04, 1.64) more likely to report dental check-ups within the past 12 months after accounting for demographic characteristics, GDP per capita, and all socioeconomic indicators. The findings suggest that greater governmental support for the healthcare and better characteristics of healthcare system are positively associated with routine dental attendance. © 2017 American Association of Public Health Dentistry.

Azerbaijan Country Analysis Brief

EIA Publications

2016-01-01

Azerbaijan, one of the oldest oil-producing countries in the world, is an important oil and natural gas supplier in the Caspian Sea region, particularly for European markets. Although traditionally it has been a prolific oil producer, Azerbaijan's importance as a natural gas supplier will grow in the future as field development and export infrastructure expand. Conflicting claims over the maritime and seabed boundaries of the Caspian Sea between Azerbaijan and Iran continue to cause uncertainty.

The Richer, the Happier? An Empirical Investigation in Selected European Countries

ERIC Educational Resources Information Center

Seghieri, Chiara; Desantis, Gustavo; Tanturri, Maria Letizia

2006-01-01

This study analyses the relationship between subjective and objective measures of well-being in selected European countries using the data of the European Community Household Panel (ECHP). In the first part of the paper, we develop a random-effect ordered probit model, separately for each country, relating the subjective measure of income…

Multi-Country analysis of palm oil consumption and cardiovascular disease mortality for countries at different stages of economic development: 1980-1997.

PubMed

Chen, Brian K; Seligman, Benjamin; Farquhar, John W; Goldhaber-Fiebert, Jeremy D

2011-12-16

Cardiovascular diseases represent an increasing share of the global disease burden. There is concern that increased consumption of palm oil could exacerbate mortality from ischemic heart disease (IHD) and stroke, particularly in developing countries where it represents a major nutritional source of saturated fat. The study analyzed country-level data from 1980-1997 derived from the World Health Organization's Mortality Database, U.S. Department of Agriculture international estimates, and the World Bank (234 annual observations; 23 countries). Outcomes included mortality from IHD and stroke for adults aged 50 and older. Predictors included per-capita consumption of palm oil and cigarettes and per-capita Gross Domestic Product as well as time trends and an interaction between palm oil consumption and country economic development level. Analyses examined changes in country-level outcomes over time employing linear panel regressions with country-level fixed effects, population weighting, and robust standard errors clustered by country. Sensitivity analyses included further adjustment for other major dietary sources of saturated fat. In developing countries, for every additional kilogram of palm oil consumed per-capita annually, IHD mortality rates increased by 68 deaths per 100,000 (95% CI [21-115]), whereas, in similar settings, stroke mortality rates increased by 19 deaths per 100,000 (95% CI [-12-49]) but were not significant. For historically high-income countries, changes in IHD and stroke mortality rates from palm oil consumption were smaller (IHD: 17 deaths per 100,000 (95% CI [5.3-29]); stroke: 5.1 deaths per 100,000 (95% CI [-1.2-11.0])). Inclusion of other major saturated fat sources including beef, pork, chicken, coconut oil, milk cheese, and butter did not substantially change the differentially higher relationship between palm oil and IHD mortality in developing countries. Increased palm oil consumption is related to higher IHD mortality rates in

"Competence" and Occupational Standards: Observations from Six European Countries

ERIC Educational Resources Information Center

Lester, Stan; Religa, Jolanta

2017-01-01

Purpose: The purpose of this paper is to review the use of "competence" as a concept and through the use of occupational competence standards in six European countries. Design/methodology/approach: Partners in an Erasmus+ project in each of the six countries prepared a review of the use of "competence" in their countries using…

Sustainable development and public health: rating European countries

PubMed Central

2013-01-01

Background Sustainable development and public health quite strongly correlate, being connected and conditioned by one another. This paper therein attempts to offer a representation of Europe’s current situation of sustainable development in the area of public health. Methods A dataset on sustainable development in the area of public health consisting of 31 European countries (formally proposed by the European Union Commission and EUROSTAT) has been used in this paper in order to evaluate said issue for the countries listed thereof. A statistical method which synthesizes several indicators into one quantitative indicator has also been utilized. Furthermore, the applied method offers the possibility to obtain an optimal set of variables for future studies of the problem, as well as for the possible development of indicators. Results According to the results obtained, Norway and Iceland are the two foremost European countries regarding sustainable development in the area of public health, whereas Romania, Lithuania, and Latvia, some of the European Union’s newest Member States, rank lowest. The results also demonstrate that the most significant variables (more than 80%) in rating countries are found to be “healthy life years at birth, females” (r2 = 0.880), “healthy life years at birth, males” (r2 = 0.864), “death rate due to chronic diseases, males” (r2 = 0.850), and “healthy life years, 65, females” (r2 = 0.844). Conclusions Based on the results of this paper, public health represents a precondition for sustainable development, which should be continuously invested in and improved. After the assessment of the dataset, proposed by EUROSTAT in order to evaluate progress towards the agreed goals of the EU Sustainable Development Strategy (SDS), this paper offers an improved set of variables, which it is hoped, may initiate further studies concerning this problem. PMID:23356822

Sustainable development and public health: rating European countries.

PubMed

Seke, Kristina; Petrovic, Natasa; Jeremic, Veljko; Vukmirovic, Jovanka; Kilibarda, Biljana; Martic, Milan

2013-01-28

Sustainable development and public health quite strongly correlate, being connected and conditioned by one another. This paper therein attempts to offer a representation of Europe's current situation of sustainable development in the area of public health. A dataset on sustainable development in the area of public health consisting of 31 European countries (formally proposed by the European Union Commission and EUROSTAT) has been used in this paper in order to evaluate said issue for the countries listed thereof. A statistical method which synthesizes several indicators into one quantitative indicator has also been utilized. Furthermore, the applied method offers the possibility to obtain an optimal set of variables for future studies of the problem, as well as for the possible development of indicators. According to the results obtained, Norway and Iceland are the two foremost European countries regarding sustainable development in the area of public health, whereas Romania, Lithuania, and Latvia, some of the European Union's newest Member States, rank lowest. The results also demonstrate that the most significant variables (more than 80%) in rating countries are found to be "healthy life years at birth, females" (r2 = 0.880), "healthy life years at birth, males" (r2 = 0.864), "death rate due to chronic diseases, males" (r2 = 0.850), and "healthy life years, 65, females" (r2 = 0.844). Based on the results of this paper, public health represents a precondition for sustainable development, which should be continuously invested in and improved.After the assessment of the dataset, proposed by EUROSTAT in order to evaluate progress towards the agreed goals of the EU Sustainable Development Strategy (SDS), this paper offers an improved set of variables, which it is hoped, may initiate further studies concerning this problem.

Disability weights for infectious diseases in four European countries: comparison between countries and across respondent characteristics

PubMed Central

Maertens de Noordhout, Charline; Devleesschauwer, Brecht; Salomon, Joshua A; Turner, Heather; Cassini, Alessandro; Colzani, Edoardo; Speybroeck, Niko; Polinder, Suzanne; Kretzschmar, Mirjam E; Havelaar, Arie H; Haagsma, Juanita A

2018-01-01

Abstract Background In 2015, new disability weights (DWs) for infectious diseases were constructed based on data from four European countries. In this paper, we evaluated if country, age, sex, disease experience status, income and educational levels have an impact on these DWs. Methods We analyzed paired comparison responses of the European DW study by participants’ characteristics with separate probit regression models. To evaluate the effect of participants’ characteristics, we performed correlation analyses between countries and within country by respondent characteristics and constructed seven probit regression models, including a null model and six models containing participants’ characteristics. We compared these seven models using Akaike Information Criterion (AIC). Results According to AIC, the probit model including country as covariate was the best model. We found a lower correlation of the probit coefficients between countries and income levels (range rs: 0.97–0.99, P < 0.01) than between age groups (range rs: 0.98–0.99, P < 0.01), educational level (range rs: 0.98–0.99, P < 0.01), sex (rs = 0.99, P < 0.01) and disease status (rs = 0.99, P < 0.01). Within country the lowest correlations of the probit coefficients were between low and high income level (range rs = 0.89–0.94, P < 0.01). Conclusions We observed variations in health valuation across countries and within country between income levels. These observations should be further explored in a systematic way, also in non-European countries. We recommend future researches studying the effect of other characteristics of respondents on health assessment. PMID:29020343

Compulsory Schooling Laws and Migration Across European Countries.

PubMed

Aparicio Fenoll, Ainhoa; Kuehn, Zoë

2017-12-01

Educational attainment is a key factor for understanding why some individuals migrate and others do not. Compulsory schooling laws, which determine an individual's minimum level of education, can potentially affect migration. We test whether and how increasing the length of compulsory schooling influences migration of affected cohorts across European countries, a context where labor mobility is essentially free. We construct a novel database that includes information for 31 European countries on compulsory education reforms passed between 1950 and 1990. Combining this data with information on recent migration flows by cohorts, we find that an additional year of compulsory education reduces the number of individuals from affected cohorts who migrate in a given year by 9 %. Our results rely on the exogeneity of compulsory schooling laws. A variety of empirical tests indicate that European legislators did not pass compulsory education reforms as a reaction to changes in emigration rates or educational attainment.

Soft drinks: time trends and correlates in twenty-four European countries. A cross-national study using the DAFNE (Data Food Networking) databank.

PubMed

Naska, Androniki; Bountziouka, Vasiliki; Trichopoulou, Antonia

2010-09-01

To evaluate time trends in the availability of soft drinks, to identify food choices associated with their consumption and to assess the relationship between socio-economic status and daily soft drink availability in a wide range of European countries. Data on food and beverage availability collected through the national household budget surveys and harmonized in the DAFNE (Data Food Networking) project were used. Averages and variability of soft drink availability were estimated and tests for time trends were performed. The daily availability of food groups which appear to be correlated with that of soft drinks was further estimated. Multivariate logistic and linear regression models were applied to evaluate the association between socio-economic status and the acquisition of soft drinks. Twenty-four European countries. Nationally representative samples of households. The availability of soft drinks is steadily and significantly increasing. Households in West and North Europe reported higher daily availability of soft drinks in comparison to other European regions. Soft drinks were also found to be correlated with lower availability of plant foods and milk and higher availability of meat and sugar products. Lower socio-economic status was associated with more frequent and higher availability of soft drinks in the household. Data collected in national samples of twenty-four European countries showed disparities in soft drink availability among socio-economic strata and European regions. The correlation of soft drinks with unfavourable dietary choices has public health implications, particularly among children and adolescents.

Comparative appraisal of educational inequalities in overweight and obesity among adults in 19 European countries.

PubMed

Roskam, Albert-Jan R; Kunst, Anton E; Van Oyen, Herman; Demarest, Stefaan; Klumbiene, Jurate; Regidor, Enrique; Helmert, Uwe; Jusot, Florence; Dzurova, Dagmar; Mackenbach, Johan P

2010-04-01

In Western societies, a lower educational level is often associated with a higher prevalence of overweight and obesity. However, there may be important international differences in the strength and direction of this relationship, perhaps in respect of differing levels of socio-economic development. We aimed to describe educational inequalities in overweight and obesity across Europe, and to explore the contribution of level of socio-economic development to cross-national differences in educational inequalities in overweight and obese adults in Europe. Cross-sectional data, based on self-reports, were derived from national health interview surveys from 19 European countries (N = 127 018; age range = 25-44 years). Height and weight data were used to calculate the body mass index (BMI). Multivariate regression analysis was employed to measure educational inequalities in overweight and obesity, based on BMI. Gross domestic product (GDP) per capita was used as a measure of level of socio-economic development. Inverse educational gradients in overweight and obesity (i.e. higher education, less overweight and obesity) are a generalized phenomenon among European men and even more so among women. Baltic and eastern European men were the exceptions, with weak positive associations between education and overweight and obesity. Educational inequalities in overweight and obesity were largest in Mediterranean women. A 10 000-euro increase in GDP was related to a 3% increase in overweight and obesity for low-educated men, but a 4% decrease for high-educated men. No associations with GDP were observed for women. In most European countries, people of lower educational attainment are now most likely to be overweight or obese. An increasing level of socio-economic development was associated with an emergence of inequalities among men, and a persistence of these inequalities among women.

Review of current typhoid fever vaccines, cross-protection against paratyphoid fever, and the European guidelines.

PubMed

Zuckerman, Jane N; Hatz, Christoph; Kantele, Anu

2017-10-01

Typhoid and paratyphoid fever remain a global health problem, which - in non-endemic countries - are mainly seen in travelers, particularly in VFRs (visiting friends and relatives), with occasional local outbreaks occurring. A rise in anti-microbial resistance emphasizes the role of preventive measures, especially vaccinations against typhoid and paratyphoid fever for travelers visiting endemic countries. Areas covered: This state-of-the-art review recapitulates the epidemiology and mechanisms of disease of typhoid and paratyphoid fever, depicts the perspective of non-endemic countries and travelers (VFRs), and collectively presents current European recommendations for typhoid fever vaccination. We provide a brief overview of available (and developmental) vaccines in Europe, present current data on cross-protection to S. Paratyphi, and aim to provide a background for typhoid vaccine decision-making in travelers. Expert commentary: European recommendations are not harmonized. Experts must assess vaccination of travelers based on current country-specific recommendations. Travel health practitioners should be aware of the issues surrounding vaccination of travelers and be motivated to increase awareness of typhoid and paratyphoid fever risks.

Ten-year changes in sun protection behaviors and beliefs of young adults in 13 European countries.

PubMed

Peacey, Victoria; Steptoe, Andrew; Sanderman, Robbert; Wardle, Jane

2006-12-01

Sun protection behaviors are important to the prevention of skin cancers, but little is known about changes over time in attitudes and behavior. Cross-sectional surveys were carried out among university students in thirteen European countries in 1990 (n = 10,241) and 2000 (n = 10,161). Sun protection behavior and beliefs about the importance of sunscreen use for health were measured. There was little change in the proportion of men and women who sunbathed, but use of sun protection increased over the 10-year interval from 52% to 63% in men and 80% to 87% in women. There was wide variation in sun protection use and strength of health beliefs between countries. The association between strength of beliefs and behavior was more marked in 2000 than 1990. Sun protection behavior was positively associated with the socioeconomic background of participants. The use of sunscreen increased among educated young Europeans from several countries over the 1990s, but important sex differences remain. Awareness of the risk to health of unprotected sunbathing is high, but there is scope of strengthening attitudes to sunscreen use.

A survey of nursing documentation, terminologies and standards in European countries

PubMed Central

Thoroddsen, Asta; Ehrenberg, Anna; Sermeus, Walter; Saranto, Kaija

2012-01-01

A survey was carried out to describe the current state of art in the use of nursing documentation, terminologies, standards and education. Key informants in European countries were targeted by the Association for Common European Nursing Diagnoses, Interventions and Outcomes (ACENDIO). Replies were received from key informants in 20 European countries. Results show that the nursing process was most often used to structure nursing documentation. Many standardized nursing terminologies were used in Europe with NANDA, NIC, NOC and ICF most frequently used. In 70% of the countries minimum requirements were available for electronic health records (EHR), but nursing not addressed specifically. Standards in use for nursing terminologies and information systems were lacking. The results should be a major concern to the nursing community in Europe. As a European platform, ACENDIO can play a role in enhancing standardization activities, and should develop its role accordingly. PMID:24199130

Socioeconomic inequalities in childhood overweight: heterogeneity across five countries in the WHO European Childhood Obesity Surveillance Initiative (COSI–2008)

PubMed Central

Lissner, L; Wijnhoven, T M A; Mehlig, K; Sjöberg, A; Kunesova, M; Yngve, A; Petrauskiene, A; Duleva, V; Rito, A I; Breda, J

2016-01-01

Background: Excess risk of childhood overweight and obesity occurring in socioeconomically disadvantaged families has been demonstrated in numerous studies from high-income regions, including Europe. It is well known that socioeconomic characteristics such as parental education, income and occupation are etiologically relevant to childhood obesity. However, in the pan-European setting, there is reason to believe that inequalities in childhood weight status may vary among countries as a function of differing degrees of socioeconomic development and equity. Subjects and Methods: In this cross-sectional study, we have examined socioeconomic differences in childhood obesity in different parts of the European region using nationally representative data from Bulgaria, the Czech Republic, Lithuania, Portugal and Sweden that were collected in 2008 during the first round of the World Health Organization (WHO) European Childhood Obesity Surveillance Initiative. Results: Heterogeneity in the association between parental socioeconomic indicators and childhood overweight or obesity was clearly observed across the five countries studied. Positive as well as negative associations were observed between parental socioeconomic indicators and childhood overweight, with statistically significant interactions between country and parental indicators. Conclusions: These findings have public health implications for the WHO European Region and underscore the necessity to continue documenting socioeconomic inequalities in obesity in all countries through international surveillance efforts in countries with diverse geographic, social and economic environments. This is a prerequisite for universal as well as targeted preventive actions. PMID:27136760

HTA Implementation Roadmap in Central and Eastern European Countries.

PubMed

Kaló, Zoltán; Gheorghe, Adrian; Huic, Mirjana; Csanádi, Marcell; Kristensen, Finn Boerlum

2016-02-01

The opportunity cost of inappropriate health policy decisions is greater in Central and Eastern European (CEE) compared with Western European (WE) countries because of poorer population health and more limited healthcare resources. Application of health technology assessment (HTA) prior to healthcare financing decisions can improve the allocative efficiency of scarce resources. However, few CEE countries have a clear roadmap for HTA implementation. Examples from high-income countries may not be directly relevant, as CEE countries cannot allocate so much financial and human resources for substantiating policy decisions with evidence. Our objective was to describe the main HTA implementation scenarios in CEE countries and summarize the most important questions related to capacity building, financing HTA research, process and organizational structure for HTA, standardization of HTA methodology, use of local data, scope of mandatory HTA, decision criteria, and international collaboration in HTA. Although HTA implementation strategies from the region can be relevant examples for other CEE countries with similar cultural environment and economic status, HTA roadmaps are not still fully transferable without taking into account country-specific aspects, such as country size, gross domestic product per capita, major social values, public health priorities, and fragmentation of healthcare financing. © 2016 The Authors. Health Economics published by John Wiley & Sons Ltd.

Radiology education in Europe: Analysis of results from 22 European countries

PubMed Central

Rehani, Bhavya; Zhang, Yi C; Rehani, Madan M; Palkó, András; Lau, Lawrence; Lette, Miriam N Mikhail; Dillon, William P

2017-01-01

AIM To assess the state of radiology education across Europe by means of a survey study. METHODS A comprehensive 23-item radiology survey was distributed via email to the International Society of Radiology members, national radiological societies, radiologists and medical physicists. Reminders to complete the survey were sent and the results were analyzed over a period of 4 mo (January-April 2016). Survey questions include length of medical school and residency training; availability of fellowship and subspecialty training; number of residency programs in each country; accreditation pathways; research training; and medical physics education. Descriptive statistics were used to analyze and summarize data. RESULTS Radiology residency training ranges from 2-6 years with a median of 5 years, and follows 1 year of internship training in 55% (12 out of 22) European countries. Subspecialty fellowship training is offered in 55% (12 out of 22) European countries. Availability for specialization training by national societies is limited to eight countries. For nearly all respondents, less than fifty percent of radiologists travel abroad for specialization. Nine of 22 (41%) European countries have research requirements during residency. The types of certifying exam show variation where 64% (14 out of 22) European countries require both written and oral boards, 23% (5 out of 22) require oral examinations only, and 5% (1 out of 22) require written examinations only. A degree in medical physics is offered in 59% (13 out of 22) European countries and is predominantly taught by medical physicists. Nearly all respondents report that formal examinations in medical physics are required. CONCLUSION Comparative learning experiences across the continent will help guide the development of comprehensive yet pragmatic infrastructures for radiology education and collaborations in radiology education worldwide. PMID:28298965

Mortality trends for tuberculosis in European Union countries, 2000-2010.

PubMed

Al-Rahamneh, Moad J; Al-Rahamneh, Anas; Guillén-Grima, Francisco; Arnedo-Pena, Alberto; Aguinaga-Ontoso, Inés

The objective of this study was to update and analyze tuberculosis (TB) mortality data in the European Union between 2000 and 2010 separately for men and women and try to detect if there have been any changes in trends in each country and the association with the economic situation and inequalities. Data were extracted for tuberculosis deaths in 2000-2010 for 29 European Union countries and for Switzerland, via the World Health Organization (WHO) European detailed mortality database (DMDB), using the Mortality tabulation list 1 (MTL1) codes for men and women separately for one age group (20-85+). We estimated age-standardised mortality rates, and analyzed data using the Joinpoint Regression Program for men and women separately in the European Union overall and by individual country for each year. Between 2000 and 2010, there were 68,771 recorded tuberculosis deaths in the European Union and the mortality rates were higher for men than women in the entire study zone. Overall, TB mortality rates declined linearly for both genders, but more in women than in men (from 5.43/100,000 in 2000 to 2.59/100,000 in 2010 in men and from 1.37/100,000 in 2000 to 0.51/100,000 in 2010 in women). There was decline in both genders for the entire study period, with a significant Estimated Annual Percentage Change (EAPC) of -8.1 for women and -7 for men when alpha<0.05 and with a 95% confidence interval (CI). A higher tuberculosis mortality was associated with lower economic resources and greater inequalities. TB mortality rates in the European Union decreased overall in 2000-2010 for both genders. Men have higher TB mortality rates than women in all countries. Our findings were consistent with the downward TB mortality trend in many other countries worldwide. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Incidence and Reproduction Numbers of Pertussis: Estimates from Serological and Social Contact Data in Five European Countries

PubMed Central

Kretzschmar, Mirjam; Teunis, Peter F. M.; Pebody, Richard G.

2010-01-01

Background Despite large-scale vaccination programmes, pertussis has remained endemic in all European countries and has been on the rise in many countries in the last decade. One of the reasons that have been discussed for the failure of vaccination to eliminate the disease is continued circulation of the pathogen Bordetella pertussis by mostly asymptomatic and mild infections in adolescents and adults. To understand the impact of asymptomatic and undiagnosed infection on the transmission dynamics of pertussis we analysed serological data from five European countries in combination with information about social contact patterns from five of those countries to estimate incidence and reproduction numbers. Methods and Findings We compared two different methods for estimating incidence from individual data on IgG pertussis toxin (PT) titres. One method combines the cross-sectional surveys of titres with longitudinal information about the distribution of amplitude and decay rate of titres in a back-calculation approach. The second method uses age-dependent contact matrices and cross-sectional surveys of IgG PT titres to estimate a next generation matrix for pertussis transmission among age groups. The next generation approach allows for computation of basic reproduction numbers for five European countries. Our main findings are that the seroincidence of infections as estimated with the first method in all countries lies between 1% and 6% per annum with a peak in the adolescent age groups and a second lower peak in young adults. The incidence of infections as estimated by the second method lies slightly lower with ranges between 1% and 4% per annum. There is a remarkably good agreement of the results obtained with the two methods. The basic reproduction numbers are similar across countries at around 5.5. Conclusions Vaccination with currently used vaccines cannot prevent continued circulation and reinfection with pertussis, but has shifted the bulk of infections to

Energy and the Oil-Importing Developing Countries

NASA Astrophysics Data System (ADS)

Dunkerley, Joy; Ramsay, William

1982-05-01

Oil-importing developing countries will need more energy during the 1980's to sustain development and to support their subsistence sectors. Development plans must be revised to reflect the potentially disastrous effects of high-cost oil on foreign exchange reserves and on national indebtedness. Energy use efficiency must be increased, and wider use must be made of domestic sources of energy--of conventional fossil and hydro sources and of new and renewable options such as biomass and other solar resources. The international community can help by careful management of world financial flows and trade agreements, expansion of capital assistance, and provision of technical assistance. The importance of improving levels of scientific and technical expertise in the less-developed countries is a challege to the worldwide scientific and engineering community.

Cross-correlations between crude oil and agricultural commodity markets

NASA Astrophysics Data System (ADS)

Liu, Li

2014-02-01

In this paper, we investigate cross-correlations between crude oil and agricultural commodity markets. Based on a popular statistical test proposed by Podobnik et al. (2009), we find that the linear return cross-correlations are significant at larger lag lengths and the volatility cross-correlations are highly significant at all of the lag lengths under consideration. Using a detrended cross-correlation analysis (DCCA), we find that the return cross-correlations are persistent for corn and soybean and anti-persistent for oat and soybean. The volatility cross-correlations are strongly persistent. Using a nonlinear cross-correlation measure, our results show that cross-correlations are relatively weak but they are significant for smaller time scales. For larger time scales, the cross-correlations are not significant. The reason may be that information transmission from crude oil market to agriculture markets can complete within a certain period of time. Finally, based on multifractal extension of DCCA, we find that the cross-correlations are multifractal and high oil prices partly contribute to food crisis during the period of 2006-mid-2008.

Country material distribution and adolescents' perceived health: multilevel study of adolescents in 27 countries

PubMed Central

Torsheim, Torbjorn; Currie, Candace; Boyce, Will; Samdal, Oddrun

2006-01-01

Objective To assess the impact of country material distribution on adolescents' perceptions of health. Design Cross sectional multilevel study. Setting Data were collected from the school based health behaviour in school aged children: WHO cross national study 1997/98, which includes students from 27 European and North American countries. Participants 12 0381 students in year 6, 8, and 10 who were attending school classes on the day of data collection. Main result Adolescents in countries with a high dispersion of family affluence were more likely to have self rated poor health even after controlling for individual family level of affluence and family social resources. Conclusion There are substantial inequalities in subjective health across European and North American countries related to the distribution of family material resources in these countries. PMID:16415267

Daily Patterns of Preschoolers' Objectively Measured Step Counts in Six European Countries: Cross-Sectional Results from the ToyBox-Study.

PubMed

Van Stappen, Vicky; Van Dyck, Delfien; Latomme, Julie; De Bourdeaudhuij, Ilse; Moreno, Luis; Socha, Piotr; Iotova, Violeta; Koletzko, Berthold; Manios, Yannis; Androutsos, Odysseas; Cardon, Greet; De Craemer, Marieke

2018-02-07

This study is part of the ToyBox-study, which is conducted in six European countries (Belgium, Bulgaria, Germany, Greece, Poland and Spain), aiming to develop a cost-effective kindergarten-based, family-involved intervention to prevent overweight and obesity in four- to six-year-old preschool children. In the current study, we aimed to examine and compare preschoolers' step count patterns, across the six European countries. A sample of 3578 preschoolers (mean age: 4.8 ± 0.4) was included. Multilevel analyses were performed to take clustering of measurements into account. Based on the average hourly steps, step count patterns for the six European countries were created for weekdays and weekend days. The step count patterns during weekdays were related to the daily kindergarten schedules. Step count patterns during weekdays showed several significant peaks and troughs ( p < 0.01) and clearly reflected the kindergartens' daily schedules, except for Germany. For example, low numbers of steps were observed during afternoon naptimes and high numbers of steps during recess. In Germany, step count patterns did not show clear peaks and troughs, which can be explained by a less structured kindergarten schedule. On weekend days, differences in step count patterns were observed in the absolute number of steps in the afternoon trough and the period in which the evening peak occurred. Differences in step count patterns across the countries can be explained by differences in (school) policy, lifestyle habits, and culture. Therefore, it might be important to respond to these step count patterns and more specifically to tackle the inactive periods during interventions to promote physical activity in preschoolers.

Daily Patterns of Preschoolers’ Objectively Measured Step Counts in Six European Countries: Cross-Sectional Results from the ToyBox-Study

PubMed Central

Van Stappen, Vicky; Latomme, Julie; Moreno, Luis; Socha, Piotr; Iotova, Violeta; Koletzko, Berthold; Manios, Yannis; Androutsos, Odysseas

2018-01-01

This study is part of the ToyBox-study, which is conducted in six European countries (Belgium, Bulgaria, Germany, Greece, Poland and Spain), aiming to develop a cost-effective kindergarten-based, family-involved intervention to prevent overweight and obesity in four- to six-year-old preschool children. In the current study, we aimed to examine and compare preschoolers’ step count patterns, across the six European countries. A sample of 3578 preschoolers (mean age: 4.8 ± 0.4) was included. Multilevel analyses were performed to take clustering of measurements into account. Based on the average hourly steps, step count patterns for the six European countries were created for weekdays and weekend days. The step count patterns during weekdays were related to the daily kindergarten schedules. Step count patterns during weekdays showed several significant peaks and troughs (p < 0.01) and clearly reflected the kindergartens’ daily schedules, except for Germany. For example, low numbers of steps were observed during afternoon naptimes and high numbers of steps during recess. In Germany, step count patterns did not show clear peaks and troughs, which can be explained by a less structured kindergarten schedule. On weekend days, differences in step count patterns were observed in the absolute number of steps in the afternoon trough and the period in which the evening peak occurred. Differences in step count patterns across the countries can be explained by differences in (school) policy, lifestyle habits, and culture. Therefore, it might be important to respond to these step count patterns and more specifically to tackle the inactive periods during interventions to promote physical activity in preschoolers. PMID:29414916

Internalised homonegativity predicts HIV-associated risk behavior in European men who have sex with men in a 38-country cross-sectional study: some public health implications of homophobia

PubMed Central

Ross, Michael W; Berg, Rigmor C; Schmidt, Axel J; Hospers, Harm J; Breveglieri, Michele; Furegato, Martina; Weatherburn, Peter

2013-01-01

Objectives Internalised homonegativity (IH) is hypothesised to be associated with HIV risk behaviour and HIV testing in men who have sex with men (MSM). We sought to determine the social and individual variables associated with IH and the associations between IH and HIV-related behaviours. Design and setting We examined IH and its predictors as part of a larger Internet-delivered, cross-sectional study on HIV and health in MSM in 38 European countries. Participants 181 495 MSM, IH data analysis subsample 144 177. All participants were male, over the age of consent for homosexual activity in their country of domicile, and have had at least one homosexual contact in the past 6 months. Methodology An anonymous Internet-based questionnaire was disseminated in 25 languages through MSM social media, websites and organisations and responses saved to a UK-based server. IH was measured using a standardised, cross-culturally appropriate scale. Results Three clusters of European countries based on the level of experienced discrimination emerged. IH was predicted by country LGB (lesbian, gay and bisexual) legal climate, Gini coefficient and size of place of settlement. Lower IH was associated with degree the respondent was ‘out’ as gay to others and older age. ‘Outness’ was associated with ever having an HIV test and age, education and number of gay friends, while IH (controlling for the number of non-steady unprotected sex partners and perceived lack of control over safe sex) was associated with condom use for anal intercourse. Conclusions IH is associated with LGB legal climate, economic development indices and urbanisation. It is also associated with ‘outness’ and with HIV risk and preventive behaviours including HIV testing, perceived control over sexual risk and condom use. Homonegative climate is associated with IH and higher levels of HIV-associated risk in MSM. Reducing IH through attention to LGB human rights may be appropriate HIV reduction

HTA Implementation Roadmap in Central and Eastern European Countries

PubMed Central

Gheorghe, Adrian; Huic, Mirjana; Csanádi, Marcell; Kristensen, Finn Boerlum

2016-01-01

Abstract The opportunity cost of inappropriate health policy decisions is greater in Central and Eastern European (CEE) compared with Western European (WE) countries because of poorer population health and more limited healthcare resources. Application of health technology assessment (HTA) prior to healthcare financing decisions can improve the allocative efficiency of scarce resources. However, few CEE countries have a clear roadmap for HTA implementation. Examples from high‐income countries may not be directly relevant, as CEE countries cannot allocate so much financial and human resources for substantiating policy decisions with evidence. Our objective was to describe the main HTA implementation scenarios in CEE countries and summarize the most important questions related to capacity building, financing HTA research, process and organizational structure for HTA, standardization of HTA methodology, use of local data, scope of mandatory HTA, decision criteria, and international collaboration in HTA. Although HTA implementation strategies from the region can be relevant examples for other CEE countries with similar cultural environment and economic status, HTA roadmaps are not still fully transferable without taking into account country‐specific aspects, such as country size, gross domestic product per capita, major social values, public health priorities, and fragmentation of healthcare financing. Copyright © 2016 John Wiley & Sons, Ltd. PMID:26763688

Social Network Type and Long-Term Condition Management Support: A Cross-Sectional Study in Six European Countries.

PubMed

Vassilev, Ivaylo; Rogers, Anne; Kennedy, Anne; Wensing, Michel; Koetsenruijter, Jan; Orlando, Rosanna; Portillo, Maria Carmen; Culliford, David

2016-01-01

Network types and characteristics have been linked to the capacity of inter-personal environments to mobilise and share resources. The aim of this paper is to examine personal network types in relation to long-term condition management in order to identify the properties of network types most likely to provide support for those with a long-term condition. A cross-sectional observational survey of people with type 2 diabetes using interviews and questionnaires was conducted between April and October 2013 in six European countries: Greece, Spain, Bulgaria, Norway, United Kingdom, and Netherlands. 1862 people with predominantly lower socio-economic status were recruited from each country. We used k-means clustering analysis to derive the network types, and one-way analysis of variance and multivariate logistic regression analysis to explore the relationship between network type socio-economic characteristics, self-management monitoring and skills, well-being, and network member work. Five network types of people with long-term conditions were identified: restricted, minimal family, family, weak ties, and diverse. Restricted network types represented those with the poorest self-management skills and were associated with limited support from social network members. Restricted networks were associated with poor indicators across self-management capacity, network support, and well-being. Diverse networks were associated with more enhanced self-management skills amongst those with a long-term condition and high level of emotional support. It was the three network types which had a large number of network members (diverse, weak ties, and family) where healthcare utilisation was most likely to correspond to existing health needs. Our findings suggest that type of increased social involvement is linked to greater self-management capacity and potentially lower formal health care costs indicating that diverse networks constitute the optimal network type as a policy in terms of

Common threads? Palliative care service developments in seven European countries.

PubMed

Clark, D; ten Have, H; Janssens, R

2000-11-01

Since the late 1960s hospice and palliative care services have been developing in many European countries. Although attention has been given to patterns of development in specific national contexts, so far we lack a comparative understanding of how these services are organized and delivered. Such a comparison poses certain practical and methodological difficulties. It does, however, allow a wider view of the current provision of palliative care in Europe, together with a consideration of implications for the future. We report on an analysis of palliative care developments in seven European countries which gave attention to early origins, patterns of provision, and structural and policy integration. We conclude that, despite different processes of development, the emergent discipline of palliative care now finds its most congenial home within the structures of the formal health care system. Accordingly, inequities between the seven countries can be more clearly identified, posing continuing challenges to policy makers and planners who operate with a European perspective.

Cross-cultural validation of Lupus Impact Tracker in five European clinical practice settings.

PubMed

Schneider, Matthias; Mosca, Marta; Pego-Reigosa, José-Maria; Gunnarsson, Iva; Maurel, Frédérique; Garofano, Anna; Perna, Alessandra; Porcasi, Rolando; Devilliers, Hervé

2017-05-01

The aim was to evaluate the cross-cultural validity of the Lupus Impact Tracker (LIT) in five European countries and to assess its acceptability and feasibility from the patient and physician perspectives. A prospective, observational, cross-sectional and multicentre validation study was conducted in clinical settings. Before the visit, patients completed LIT, Short Form 36 (SF-36) and care satisfaction questionnaires. During the visit, physicians assessed disease activity [Safety of Estrogens in Lupus Erythematosus National Assessment (SELENA)-SLEDAI], organ damage [SLICC/ACR damage index (SDI)] and flare occurrence. Cross-cultural validity was assessed using the Differential Item Functioning method. Five hundred and sixty-nine SLE patients were included by 25 specialists; 91.7% were outpatients and 89.9% female, with mean age 43.5 (13.0) years. Disease profile was as follows: 18.3% experienced flares; mean SELENA-SLEDAI score 3.4 (4.5); mean SDI score 0.8 (1.4); and SF-36 mean physical and mental component summary scores: physical component summary 42.8 (10.8) and mental component summary 43.0 (12.3). Mean LIT score was 34.2 (22.3) (median: 32.5), indicating that lupus moderately impacted patients' daily life. A cultural Differential Item Functioning of negligible magnitude was detected across countries (pseudo- R 2 difference of 0.01-0.04). Differences were observed between LIT scores and Physician Global Assessment, SELENA-SLEDAI, SDI scores = 0 (P < 0.035) and absence of flares (P = 0.004). The LIT showed a strong association with SF-36 physical and social role functioning, vitality, bodily pain and mental health (P < 0.001). The LIT was well accepted by patients and physicians. It was reliable, with Cronbach α coefficients ranging from 0.89 to 0.92 among countries. The LIT is validated in the five participating European countries. The results show its reliability and cultural invariability across countries. They suggest that LIT can be used in routine

Educational inequalities in smoking among men and women aged 16 years and older in 11 European countries.

PubMed

Huisman, M; Kunst, A E; Mackenbach, J P

2005-04-01

To determine those groups who are at increased risk of smoking related diseases, we assessed in which male and female generations smoking was more prevalent among lower educated groups than among the higher educated, in 11 European countries. Cross sectional analysis of data on smoking, covering the year 1998, from a social survey designed for all member states of the European Union. Higher and lower educated men and women aged 16 years and older from 11 member states of the European Union. Age standardised prevalence rates by education and prevalence odds ratios of current and ever daily smoking comparing lower educated groups with higher educated groups. A north-south gradient in educational inequalities in current and ever daily smoking was observed for women older than 24 years, showing larger inequalities in the northern countries. Such a gradient was not observed for men. A disadvantage for the lower educated in terms of smoking generally occurred later among women than among men. Indications of inequalities in smoking in the age group 16-24 years were observed for all countries, with the exception of women from Greece and Portugal. Preventing and reducing smoking among lower educated subgroups should be a priority of policies aiming to reduce inequalities in health in Europe. If steps are not taken to control tobacco use among the lower educated groups specifically, inequalities in lung cancer and other smoking related diseases should be anticipated in all populations of the European Union, and both sexes.

Strength of primary care service delivery: a comparative study of European countries, Australia, New Zealand, and Canada.

PubMed

Pavlič, Danica R; Sever, Maja; Klemenc-Ketiš, Zalika; Švab, Igor; Vainieri, Milena; Seghieri, Chiara; Maksuti, Alem

2018-05-01

AimWe sought to examine strength of primary care service delivery as measured by selected process indicators by general practitioners from 31 European countries plus Australia, Canada, and New Zealand. We explored the relation between strength of service delivery and healthcare expenditures. The strength of a country's primary care is determined by the degree of development of a combination of core primary care dimensions in the context of its healthcare system. This study analyses the strength of service delivery in primary care as measured through process indicators in 31 European countries plus Australia, New Zealand, and Canada. A comparative cross-sectional study design was applied using the QUALICOPC GP database. Data on the strength of primary healthcare were collected using a standardized GP questionnaire, which included 60 questions divided into 10 dimensions related to process, structure, and outcomes. A total of 6734 general practitioners participated. Data on healthcare expenditure were obtained from World Bank statistics. We conducted a correlation analysis to analyse the relationship between strength and healthcare expenditures.FindingsOur findings show that the strength of service delivery parameters is less than optimal in some countries, and there are substantial variations among countries. Continuity and comprehensiveness of care are significantly positively related to national healthcare expenditures; however, coordination of care is not.

Why is the 'healthy immigrant effect' different between European countries?

PubMed

Moullan, Yasser; Jusot, Florence

2014-08-01

Even if health status of immigrants constitutes an important public health issue, the literature provides contradictory results on the existence of a 'healthy migrant' effect in Europe. This study proposes to explore the heterogeneity of the health gap between migrants and natives across four European countries. Based on several harmonized national health interview surveys, the association between migratory status and self-assessed health was firstly explored separately in Belgium, France, Spain and Italy. To explore whether differences in health gap between countries reflect differences in health status of immigrants between host countries or whether they are because of differences in health status of natives between host countries, the association between the host country and health was secondly analysed separately among a pooled sample of immigrants and one of natives, controlling for socio-economic status and country of origin. After controlling for socio-economic status, immigrants report a poorer health status than natives in France, Belgium and Spain, whereas they report a better health status than natives in Italy, among both women and men. A North-South gradient in immigrants' health status appears: their health status is better in Italy and in Spain than in France and Belgium. Conversely, health status of natives is poorer in Italy and in Belgium than in France and in Spain. Differences in health gap reflect differences in health status of both natives and immigrants between host countries. This suggests differences in health selection at migration and in immigrants' integration between European countries. © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Place of death of children with complex chronic conditions: cross-national study of 11 countries.

PubMed

Håkanson, Cecilia; Öhlén, Joakim; Kreicbergs, Ulrika; Cardenas-Turanzas, Marylou; Wilson, Donna M; Loucka, Martin; Frache, Sandra; Giovannetti, Lucia; Naylor, Wayne; Rhee, YongJoo; Ramos, Miguel Ruiz; Teno, Joan; Beernaert, Kim; Deliens, Luc; Houttekier, Dirk; Cohen, Joachim

2017-03-01

Cross-national understanding of place of death is crucial for health service systems for their provision of efficient and equal access to paediatric palliative care. The objectives of this population-level study were to examine where children with complex chronic conditions (CCC) die and to investigate associations between places of death and sex, cause of death and country. The study used death certificate data of all deceased 1- to 17-year-old children (n = 40,624) who died in 2008, in 11 European and non-European countries. Multivariable logistic regression was performed to determine associations between place of death and other factors. Between 24.4 and 75.3% of all children 1-17 years in the countries died of CCC. Of these, between 6.7 and 42.4% died at home. In Belgium and the USA, all deaths caused by CCC other than malignancies were less likely to occur at home, whereas in Mexico and South Korea, deaths caused by neuromuscular diseases were more likely to occur at home than malignancies. In Mexico (OR = 0.91, 95% CI: 0.83-1.00) and Sweden (OR = 0.35, 95% CI: 0.15-0.83), girls had a significantly lower chance of dying at home than boys. This study shows large cross-national variations in place of death. These variations may relate to health system-related infrastructures and policies, and differences in cultural values related to place of death, although this needs further investigation. The patterns found in this study can inform the development of paediatric palliative care programs internationally. What is known: • There is a scarcity of population-level studies investigating where children with CCC die in different countries. • Cross-national understanding of place of death provides information to health care systems for providing efficient and equal access to paediatric palliative care. What is new : • There are large cross-national variations in the place of death of children with CCC, with few deathsoccuring at home in some countries

Mediation of parental educational level on fruit and vegetable intake among schoolchildren in ten European countries.

PubMed

Lehto, Elviira; Ray, Carola; Te Velde, Saskia; Petrova, Stefka; Duleva, Vesselka; Krawinkel, Michael; Behrendt, Isabel; Papadaki, Angeliki; Kristjansdottir, Asa; Thorsdottir, Inga; Yngve, Agneta; Lien, Nanna; Lynch, Christel; Ehrenblad, Bettina; Vaz de Almeida, Maria Daniel; Ribic, Cirila Hlastan; Simčic, Irena; Roos, Eva

2015-01-01

To examine which factors act as mediators between parental educational level and children's fruit and vegetable (F&V) intake in ten European countries. Cross-sectional data were collected in ten European countries participating in the PRO GREENS project (2009). Schoolchildren completed a validated FFQ about their daily F&V intake and filled in a questionnaire about availability of F&V at home, parental facilitation of F&V intake, knowledge of recommendations about F&V intake, self-efficacy to eat F&V and liking for F&V. Parental educational level was determined from a questionnaire given to parents. The associations were examined with multilevel mediation analyses. Schools in Bulgaria, Finland, Germany, Greece, Iceland, the Netherlands, Norway, Portugal, Slovenia and Sweden. Eleven-year-old children (n 8159, response rate 72%) and their parents. In five of the ten countries, children with higher educated parents were more likely to report eating fruits daily. This association was mainly mediated by knowledge but self-efficacy, liking, availability and facilitation also acted as mediators in some countries. Parents' education was positively associated with their children's daily vegetable intake in seven countries, with knowledge and availability being the strongest mediators and self-efficacy and liking acting as mediators to some degree. Parental educational level correlated positively with children's daily F&V intake in most countries and the pattern of mediation varied among the participating countries. Future intervention studies that endeavour to decrease the educational-level differences in F&V intake should take into account country-specific features in the relevant determinants of F&V intake.

Understanding parent-teacher agreement of the Strengths and Difficulties Questionnaire (SDQ): Comparison across seven European countries.

PubMed

Cheng, Sabrina; Keyes, Katherine M; Bitfoi, Adina; Carta, Mauro Giovanni; Koç, Ceren; Goelitz, Dietmar; Otten, Roy; Lesinskiene, Sigita; Mihova, Zlatka; Pez, Ondine; Kovess-Masfety, Viviane

2018-03-01

Assessments of child psychopathology are often derived from parental and teacher reports, yet there is substantial disagreement. This study utilized data from 7 European countries to examine parent-teacher agreement and possible explanatory factors for parent-teacher disagreement such as child and family characteristics, parenting dimensions, and maternal distress were explored. Parent-teacher agreement of the Strengths and Difficulties Questionnaire were assessed using a cross-sectional survey of 4,894 school aged children 6-11 from the School Children Mental Health Europe Project. Parent-teacher agreement was low to moderate (Pearson correlation ranging from .24 (Prosocial) to .48 (Hyperactivity) for the 5 subscales across 7 countries); kappa coefficient ranged from .01 (Turkey) to .44 (Italy) for internalizing problems and .19(Romania) to .44(Italy) for externalizing problems. Child's gender and age, mother's employment status, single parent home, number of children in household, and selected parenting dimension were found to be explanatory of informant disagreement. This study not only serves to advance our understanding of parent-teacher agreement of the Strengths and Difficulties Questionnaire in 7 European countries but provides a novel approach to examining the factors that contribute to informant disagreement. Copyright © 2017 John Wiley & Sons, Ltd.

Ethics and the European countries in transition--the past and the future.

PubMed

Borovecki, Ana; ten Have, Henk; Oreskovic, Stiepan

2006-01-01

This paper surveys the situation regarding bioethical issues in the European transitional societies. It aims at exploring past, present and future characteristics of bioethics in the European countries in transitions, analysing similarities, differences and common themes together with the historical development of bioethics. By carefully studying articles published since the early 1990s, one can perceive a number of bioethical issues, varying from specificities for certain countries to similar problems for all transitional European societies. It seems that more than 15 years after the fall of the Berlin Wall, Central and Eastern European societies were able to achieve significant improvements in the development of bioethics. However, looking at the bioethical issues important for European transitional societies, it seems that the invisible wall between eastern and western European societies is still there and that it will take years to remove it.

A survey of perceived problems in orthodontic education in 23 European countries.

PubMed

Sieminska-Piekarczyk, B; Adamidis, J P; Eaton, K A; McDonald, J P; Seeholzer, H

2000-12-01

This paper reports on a survey of perceived problems in the provision of orthodontic education at the stages of undergraduate, postgraduate, and continuing professional education (CPE) in 23 European countries in 1997. A questionnaire, together with an explanatory letter, was mailed to all members of the EUROQUAL II BIOMED project. Answers were validated during a meeting of project participants and by further correspondence, when necessary. The topics covered in the questionnaire were adequacy of funding, numbers of orthodontic teachers, availability of equipment, regulations, training centres, numbers of orthodontists, availability of books, journals, and information technology. Completed questionnaires were returned by orthodontists from all 23 countries. Respondents from seven countries did not answer all questions. Respondents reported a perceived almost universal lack of adequate funding for postgraduate orthodontic training (from 18 out of 20 countries) and, to a lesser extent, at undergraduate (13 out of 20 countries) and CPE levels (17 out of 21 countries). Respondents from 12 of the 20 countries reported adequate numbers of qualified teachers at undergraduate level, but only seven out of 18 at postgraduate level and eight out of 19 for CPE. Lack of suitable equipment was reported as a more frequent problem by central and eastern European countries (six out of 20 countries at undergraduate level, eight out of 20 countries at postgraduate level, and 12 out of 19 at CPE level). Too few or too many regulations were only perceived to be a problem by the respondent from one country out of 19 at undergraduate level, by seven out of 19 at postgraduate level, and by eight out of 16 at CPE level). Lack of training centres was more frequently reported as a problem by respondents from central and eastern European countries, but was generally not perceived as a problem by respondents from west European countries. Respondents from seven countries reported a lack of

[The reference pricing of pharmaceuticals in European countries].

PubMed

Gildeyeva, G N; Starykh, D A

2013-01-01

The article presents the analysis of various approaches to estimation of pharmaceuticals prices in conditions of actual systems of pharmaceuticals support. The pricing is considered in pegging to actual systems of pharmaceuticals support based on the principles of insurance and co-financing. The detailed analysis is presented concerning the methodology of estimation of reference prices of pharmaceuticals in different countries of Europe. The experience of European countries in evaluation of interchangeability of pharmaceuticals is discussed.

Self-reported mental health in children ages 6-12 years across eight European countries.

PubMed

Husky, Mathilde M; Boyd, Anders; Bitfoi, Adina; Carta, Mauro Giovanni; Chan-Chee, Christine; Goelitz, Dietmar; Koç, Ceren; Lesinskiene, Sigita; Mihova, Zlatka; Otten, Roy; Pez, Ondine; Shojaei, Taraneh; Kovess-Masfety, Viviane

2018-06-01

Worldwide, approximately one in eight children or adolescents suffers from a mental disorder. The present study was designed to determine the self-reported prevalence of mental health problems in children aged 6-11 years across eight European countries including Italy, France, Germany, the Netherlands, Lithuania, Bulgaria, Romania, and Turkey. Data were drawn from 6245 children participating in the School Children Mental Health in Europe (SCHME) study and a large cross-sectional survey in France. Self-reported child mental health was assessed using the Dominique Interactive (DI). Overall, 22.0% of children were identified per their own evaluation as having at least one mental disorder, ranging from 16.4% in the Netherlands to 27.9% in Bulgaria. The prevalence of internalizing disorders was 18.4% across countries and ranged from 11.8% in the Netherlands to 24.3% in Turkey. The prevalence of externalizing disorders was lower with an average of 7.8%, ranging from 3.5% in Turkey to 10.5% in Bulgaria. Combining samples across European countries, 1 in 5 children reported internalizing problems and 1 in 12 children externalizing problems. The net completion rates of 4.1-74.3% preclude conclusions about national differences in prevalence rates.

Comparative studies of oil product regulation in polluted soil for several industrialized countries

NASA Astrophysics Data System (ADS)

Paccassoni, F.; Kalnina, D.; Piga, L.

2017-10-01

Oil contaminated sites are the consequence of a long period of industrialization. Oil is a complex mixture including aliphatic and aromatic hydrocarbons, which are known to have negative effects on human health and the environment. Dividing oil products in groups (fractions) of petroleum hydrocarbons that act alike in soil and water, one can better know what happens to them. Being able to understand the behaviour of oil products in soil, it will allow to implement prevention and remediation actions. Interventions on contaminated sites are bound to comply with regulatory limits that each country has set in their own environmental legislation. The different concentration thresholds of oil products in soil for several EU countries and Canada has led to compare: limit values, analytical method, soil characteristics and/or land use. This will allow to evaluate what could be the best regulation approach, assessing if it is better to consider soil matrix in the site or the specific land use or both of them. It will also assess what is the best analytical methodology to be adopted to achieve the pollutant concentrations in the soil in order to have comparable results among different countries, such as: Baltic countries (Latvia, Estonia, Lithuania), Nordic countries (Finland, Sweden, Norway, Denmark), Western countries (Italy and The Netherlands) and Canada, like gaschromatography in the range from C10 - C50. The study presents an overview of environmental regulatory system of several EU countries and Canada and the correlation between different parameters about oil products indicated in each environmental legislation.

Trends in health inequalities in 27 European countries.

PubMed

Mackenbach, Johan P; Valverde, José Rubio; Artnik, Barbara; Bopp, Matthias; Brønnum-Hansen, Henrik; Deboosere, Patrick; Kalediene, Ramune; Kovács, Katalin; Leinsalu, Mall; Martikainen, Pekka; Menvielle, Gwenn; Regidor, Enrique; Rychtaříková, Jitka; Rodriguez-Sanz, Maica; Vineis, Paolo; White, Chris; Wojtyniak, Bogdan; Hu, Yannan; Nusselder, Wilma J

2018-06-19

Unfavorable health trends among the lowly educated have recently been reported from the United States. We analyzed health trends by education in European countries, paying particular attention to the possibility of recent trend interruptions, including interruptions related to the impact of the 2008 financial crisis. We collected and harmonized data on mortality from ca 1980 to ca 2014 for 17 countries covering 9.8 million deaths and data on self-reported morbidity from ca 2002 to ca 2014 for 27 countries covering 350,000 survey respondents. We used interrupted time-series analyses to study changes over time and country-fixed effects analyses to study the impact of crisis-related economic conditions on health outcomes. Recent trends were more favorable than in previous decades, particularly in Eastern Europe, where mortality started to decline among lowly educated men and where the decline in less-than-good self-assessed health accelerated, resulting in some narrowing of health inequalities. In Western Europe, mortality has continued to decline among the lowly and highly educated, and although the decline of less-than-good self-assessed health slowed in countries severely hit by the financial crisis, this affected lowly and highly educated equally. Crisis-related economic conditions were not associated with widening health inequalities. Our results show that the unfavorable trends observed in the United States are not found in Europe. There has also been no discernible short-term impact of the crisis on health inequalities at the population level. Both findings suggest that European countries have been successful in avoiding an aggravation of health inequalities.

Welfare states, the Great Recession and health: Trends in educational inequalities in self-reported health in 26 European countries.

PubMed

Leão, Teresa; Campos-Matos, Inês; Bambra, Clare; Russo, Giuliano; Perelman, Julian

2018-01-01

Although socioeconomic inequalities in health have long been observed in Europe, few studies have analysed their recent patterning. In this paper, we examined how educational inequalities in self-reported health have evolved in different European countries and welfare state regimes over the last decade, which was troubled by the Great Recession. We used cross-sectional data from the EU-SILC survey for adults from 26 European countries, from 2005 to 2014 (n = 3,030,595). We first calculated education-related absolute (SII) and relative (RII) inequalities in poor self-reported health by country-year, adjusting for age, sex, and EU-SILC survey weights. We then regressed the year- and country-specific RII and SII on a yearly time trend, globally and by welfare regime, adjusting for country fixed effects. We further adjusted the analysis for the economic cycle using GDP growth, unemployment, and income inequality. Overall, absolute inequalities persisted and relative inequalities slightly widened (betaRII = 0.0313, p<0.05). There were substantial differences by welfare regime: Anglo-Saxon countries experienced the largest increase in absolute inequalities (betaSII = 0.0032, p<0.05), followed by Bismarkian countries (betaSII = 0.0024, p<0.001), while they reduced in Post-Communist countries (betaSII = -0.0022, p<0.001). Post-Communist countries also experienced a widening in relative inequalities (betaRII = 0.1112, p<0.001), which were found to be stable elsewhere. Adjustment for income inequality only explained such trend in Anglo-Saxon countries. Educational inequalities in health have overall persisted across European countries over the last decade. However, there is considerable variation across welfare regimes, possibly related to underpinning social safety nets and to austerity measures implemented during this 10-year period.

Welfare states, the Great Recession and health: Trends in educational inequalities in self-reported health in 26 European countries

PubMed Central

Campos-Matos, Inês; Bambra, Clare; Russo, Giuliano

2018-01-01

Background Although socioeconomic inequalities in health have long been observed in Europe, few studies have analysed their recent patterning. In this paper, we examined how educational inequalities in self-reported health have evolved in different European countries and welfare state regimes over the last decade, which was troubled by the Great Recession. Methods We used cross-sectional data from the EU-SILC survey for adults from 26 European countries, from 2005 to 2014 (n = 3,030,595). We first calculated education-related absolute (SII) and relative (RII) inequalities in poor self-reported health by country-year, adjusting for age, sex, and EU-SILC survey weights. We then regressed the year- and country-specific RII and SII on a yearly time trend, globally and by welfare regime, adjusting for country fixed effects. We further adjusted the analysis for the economic cycle using GDP growth, unemployment, and income inequality. Results Overall, absolute inequalities persisted and relative inequalities slightly widened (betaRII = 0.0313, p<0.05). There were substantial differences by welfare regime: Anglo-Saxon countries experienced the largest increase in absolute inequalities (betaSII = 0.0032, p<0.05), followed by Bismarkian countries (betaSII = 0.0024, p<0.001), while they reduced in Post-Communist countries (betaSII = -0.0022, p<0.001). Post-Communist countries also experienced a widening in relative inequalities (betaRII = 0.1112, p<0.001), which were found to be stable elsewhere. Adjustment for income inequality only explained such trend in Anglo-Saxon countries. Conclusions Educational inequalities in health have overall persisted across European countries over the last decade. However, there is considerable variation across welfare regimes, possibly related to underpinning social safety nets and to austerity measures implemented during this 10-year period. PMID:29474377

Tuberculosis treatment outcome monitoring in European Union countries: systematic review

PubMed Central

van Hest, Rob; Ködmön, Csaba; Verver, Suzanne; Erkens, Connie G.M.; Straetemans, Masja; Manissero, Davide; de Vries, Gerard

2013-01-01

Treatment success measured by treatment outcome monitoring (TOM) is a key programmatic output of tuberculosis (TB) control programmes. We performed a systematic literature review on national-level TOM in the 30 European Union (EU)/European Economic Areas (EEA) countries to summarise methods used to collect and report data on TOM. Online reference bibliographic databases PubMed/MEDLINE and EMBASE were searched to identify relevant indexed and non-indexed literature published between January 2000 and August 2010. The search strategy resulted in 615 potentially relevant indexed citations, of which 27 full-text national studies (79 data sets) were included for final analysis. The selected studies were performed in 10 EU/EEA countries and gave a fragmented impression of TOM in the EU/EEA. Publication year, study period, sample size, databases, definitions, variables, patient and outcome categories, and population subgroups varied widely, portraying a very heterogeneous picture. This review confirmed previous reports of considerable heterogeneity in publications of TOM results across EU/EEA countries. PubMed/MEDLINE and EMBASE indexed studies are not a suitable instrument to measure representative TOM results for the 30 EU/EEA countries. Uniform and complete reporting to the centralised European Surveillance System will produce the most timely and reliable results of TB treatment outcomes in the EU/EEA. PMID:22790913

[Comparison of medical rehabilitation in various European countries and the impact of European law on rehabilitation practice in Germany].

PubMed

Mittag, Oskar; Welti, Felix

2017-04-01

Medical rehabilitation practice differs substantially among European countries. In most countries, rehabilitation is predominantly carried out on an outpatient basis. It is funded by health care, and rehabilitation facilities are not very specialized in terms of specific indications. In contrast, medical rehabilitation in Germany is mostly carried out on an in-patient basis as a contained 3‑week treatment. European law and European policies merely have an indirect impact on rehabilitation practice in Germany. In this article, the advantages and disadvantages of the various forms of rehabilitation services are discussed.

HIV Strategic Information in Non-European Union Countries in the World Health Organization European Region: Capacity Development Needs

PubMed Central

2017-01-01

Background Capacity building of the national HIV strategic information system is a core component of the response to the HIV epidemic as it enables understanding of the evolving nature of the epidemic, which is critical for program planning and identification of the gaps and deficiencies in HIV programs. Objective The study aims to describe the results of the assessment of the needs for further development of capacities in HIV strategic information systems in the non-European Union (EU) countries in the World Health Organization European Region (EUR). Methods Self-administered questionnaires were distributed to national AIDS programs. The first questionnaire was sent to all countries (N=18) to find out, among other issues, the priority level for strengthening a range of HIV surveillance areas and their key gaps and weaknesses. The second questionnaire was sent to 15 countries to more specifically determine capacities for the analysis of the HIV care cascade. Results Responses to the first questionnaire were received from 10 countries, whereas 13 countries responded to the second questionnaire. Areas that were most frequently marked as being of high to moderate priority for strengthening were national electronic patient monitoring systems, evaluation of HIV interventions and impact analysis, implementation science, and data analysis. Key weaknesseses were lack of electronic reporting of HIV cases, problems with timeliness and completeness of reporting in HIV cases, under-estimates of the reported number of HIV-related deaths, and limited CD4 count testing at the time of HIV diagnosis. Migrant populations, internally displaced persons, and refugees were most commonly mentioned as groups not covered by surveillance, followed by clients of sex workers and men who have sex with men. The majority of countries reported that they were able to provide the number of people diagnosed with HIV who know their HIV status, which is important for the analysis of cross

Educational inequalities in self-rated health across US states and European countries.

PubMed

Präg, Patrick; Subramanian, S V

2017-07-01

The US shows a distinct health disadvantage when compared to other high-income nations. A potential lever to reduce this disadvantage is to improve the health situation of lower socioeconomic groups. Our objective is to explore how the considerable within-US variation in health inequalities compares to the health inequalities across other Western countries. Representative survey data from 44 European countries and the US federal states were obtained from the fourth wave of the European Values Study (EVS) and the 2008 wave of the Behavioral Risk Factor Surveillance System. Using binary logistic regression, we analyze different forms of educational inequalities in self-rated health (SRH), adjusted for age and sex. The extent of educational inequalities in SRH varies considerably over European countries and US states; with US states in general showing greater inequality, however, differences between US states and European countries are less clear than commonly assumed. The US has considerable differences in educational inequalities in SRH across geographic locations. To understand the reasons for the US health disadvantage, comparative research has to take into account the vast variation in health inequalities within the US.

Genital Chlamydia Prevalence in Europe and Non-European High Income Countries: Systematic Review and Meta-Analysis

PubMed Central

Redmond, Shelagh M.; Alexander-Kisslig, Karin; Woodhall, Sarah C.; van den Broek, Ingrid V. F.; van Bergen, Jan; Ward, Helen; Uusküla, Anneli; Herrmann, Björn; Andersen, Berit; Götz, Hannelore M.; Sfetcu, Otilia; Low, Nicola

2015-01-01

Background Accurate information about the prevalence of Chlamydia trachomatis is needed to assess national prevention and control measures. Methods We systematically reviewed population-based cross-sectional studies that estimated chlamydia prevalence in European Union/European Economic Area (EU/EEA) Member States and non-European high income countries from January 1990 to August 2012. We examined results in forest plots, explored heterogeneity using the I2 statistic, and conducted random effects meta-analysis if appropriate. Meta-regression was used to examine the relationship between study characteristics and chlamydia prevalence estimates. Results We included 25 population-based studies from 11 EU/EEA countries and 14 studies from five other high income countries. Four EU/EEA Member States reported on nationally representative surveys of sexually experienced adults aged 18–26 years (response rates 52–71%). In women, chlamydia point prevalence estimates ranged from 3.0–5.3%; the pooled average of these estimates was 3.6% (95% CI 2.4, 4.8, I2 0%). In men, estimates ranged from 2.4–7.3% (pooled average 3.5%; 95% CI 1.9, 5.2, I2 27%). Estimates in EU/EEA Member States were statistically consistent with those in other high income countries (I2 0% for women, 6% for men). There was statistical evidence of an association between survey response rate and estimated chlamydia prevalence; estimates were higher in surveys with lower response rates, (p = 0.003 in women, 0.018 in men). Conclusions Population-based surveys that estimate chlamydia prevalence are at risk of participation bias owing to low response rates. Estimates obtained in nationally representative samples of the general population of EU/EEA Member States are similar to estimates from other high income countries. PMID:25615574

Validation of the educational needs assessment tool as a generic instrument for rheumatic diseases in seven European countries.

PubMed

Ndosi, Mwidimi; Bremander, Ann; Hamnes, Bente; Horton, Mike; Kukkurainen, Marja Leena; Machado, Pedro; Marques, Andrea; Meesters, Jorit; Stamm, Tanja A; Tennant, Alan; de la Torre-Aboki, Jenny; Vliet Vlieland, Theodora P M; Zangi, Heidi A; Hill, Jackie

2014-12-01

To validate the educational needs assessment tool (ENAT) as a generic tool for assessing the educational needs of patients with rheumatic diseases in European Countries. A convenience sample of patients from seven European countries was included comprising the following diagnostic groups: ankylosing spondylitis, psoriatic arthritis, systemic sclerosis, systemic lupus erythematosus, osteoarthritis (OA) and fibromyalgia syndrome. Translated versions of the ENAT were completed through surveys in each country. Rasch analysis was used to assess the construct validity of the adapted ENATs including differential item functioning by culture (cross-cultural DIF). Initially, the data from each country and diagnostic group were fitted to the Rasch model separately, and then the pooled data from each diagnostic group. The sample comprised 3015 patients; the majority, 1996 (66.2%), were women. Patient characteristics (stratified by diagnostic group) were comparable across countries except the educational background, which was variable. In most occasions, the 39-item ENAT deviated significantly from the Rasch model expectations (item-trait interaction χ(2) p<0.05). After correction for local dependency (grouping the items into seven domains and analysing them as 'testlets'), fit to the model was satisfied (item-trait interaction χ(2) p>0.18) in all pooled disease group datasets except OA (χ(2)=99.91; p=0.002). The internal consistency in each group was high (Person Separation Index above 0.90). There was no significant DIF by person characteristics. Cross-cultural DIF was found in some items, which required adjustments. Subsequently, interval-level scales were calibrated to enable transformation of ENAT scores when required. The adapted ENAT is a valid tool with high internal consistency providing accurate estimation of the educational needs of people with rheumatic diseases. Cross-cultural comparison of educational needs is now possible. Published by the BMJ Publishing Group

Association between attendance at religious services and self-reported health in 22 European countries.

PubMed

Nicholson, Amanda; Rose, Richard; Bobak, Martin

2009-08-01

There are consistent reports of protective associations between attendance at religious services and better self-rated health but existing data rarely consider the social or individual context of religious behaviour. This paper investigates whether attendance at religious services is associated with better self-rated health in diverse countries across Europe. It also explores whether the association varies with either individual-level (gender, educational, social contact) or country-level characteristics (overall level of religious practice, corruption, GDP). Cross-sectional data from round 2 of the European Social Survey were used and 18,328 men and 21,373 women from 22 European countries were included in multilevel analyses, with country as higher level. Compared to men who attended religious services at least once a week, men who never attended were almost twice as likely to describe their health as poor, with an age and education adjusted odds ratio of 1.83 [95% CI, 1.49-2.26]. A similar but weaker effect was seen in women, with an age and education adjusted odds ratio of 1.38 [1.19-1.61]. The associations were reduced only marginally in men by controlling for health status, social contact and country-level variables, but weakened in women. The relationships were stronger in people with longstanding illness, less than university education and in more affluent countries with lower levels of corruption and higher levels of religious belief. These analyses confirm that an association between less frequent attendance at religious services and poor health exists across Europe, but emphasise the importance of taking individual and contextual factors into account. It remains unclear to what extent the observed associations reflect reverse causality or are due to differing perceptions of health.

Socioeconomic Gradients in Eastern European Countries: Evidence from PIRLS 2006

ERIC Educational Resources Information Center

Caro, Daniel H.; Mirazchiyski, Plamen

2012-01-01

This article analyses educational inequalities related to socioeconomic status (SES) in 12 Eastern European countries that participated in the International Reading Literacy Study (PIRLS) 2006. Economies and educational systems of these countries have undergone critical transformations since the fall of communism. The authors' analyses, using data…

The 'dark side' of social capital: trust and self-rated health in European countries.

PubMed

Campos-Matos, Inês; Subramanian, S V; Kawachi, Ichiro

2016-02-01

Generalized interpersonal trust (as an indicator of social capital) has been linked to health status at both the individual and ecological level. We sought to examine how changes in contextual and individual trust are associated with changes in self-rated health in the European Social Surveys 2002-12. A multilevel analysis using a variance components model was performed on 203 452 individuals nested within 145 country cohorts covering 35 countries. Conditional on sociodemographic covariates, we sought to examine the association between self-rated health and individual trust, country average trust and a cross-level interaction between the two. Although individual trust perceptions were significantly correlated with self-rated health [OR = 0.95, 95% confidence interval (0.94-0.96)], country-level trust was not associated [OR = 1.12, 95% confidence interval (0.95-1.32)]. There was, however, a strong crosslevel interaction between contextual and individual trust (P < 0.001), such that individuals with high interpersonal trust reported better health in contexts in which other individuals expressed high average interpersonal trust. Conversely, low trust individuals reported worse health in high trust contexts. Our findings suggest that contexts with increasing average trust can be harmful for low trust individuals, which might reflect the negative impact that social capital can have in certain groups. These findings suggest that contextual trust has a complex role in explaining health inequalities and individual self-rated health. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Association between tobacco control policies and smoking behaviour among adolescents in 29 European countries.

PubMed

Hublet, Anne; Schmid, Holger; Clays, Els; Godeau, Emmanuelle; Gabhainn, Saoirse Nic; Joossens, Luk; Maes, Lea

2009-11-01

To investigate the associations between well-known, cost-effective tobacco control policies at country level and smoking prevalence among 15-year-old adolescents. Multi-level modelling based on the 2005-06 Health Behaviour in School-aged Children Study, a cross-national study at individual level, and with country-level variables from the Tobacco Control Scale and published country-level databases. Twenty-nine European countries. A total of 25 599 boys and 26 509 girls. Self-reported regular smoking defined as at least weekly smoking, including daily smoking (dichotomous). Interaction effects between gender and smoking policies were identified, therefore boys and girls were analysed separately. Large cross-national differences in smoking prevalence were documented. Intraclass correlations (ICC) of 0.038 (boys) and 0.035 (girls) were found. In the final multi-level model for boys, besides the significance of the individual variables such as family affluence, country-level affluence and the legality of vending machines were related significantly to regular smoking [b(country affluence) = -0.010; b(partial restriction vending machines) = -0.366, P < 0.05]. Price policy was of borderline significance [b(price policy) = -0.026, P = 0.050]. All relationships were in the expected direction. The model fit is not as good for girls; only the legality of vending machines had a borderline significance in the final model [b(total ban vending machines) = -0.372, P = 0.06]. For boys, some of the currently recommended tobacco control policies may help to reduce smoking prevalence. However, the model is less suitable for girls, indicating gender differences in the potential efficacy of smoking policies. Future research should address this issue.

Can only poorer European countries afford large carnivores?

PubMed

Kojola, Ilpo; Hallikainen, Ville; Helle, Timo; Swenson, Jon E

2018-01-01

One of the classic approaches in environmental economics is the environmental Kuznets curve, which predicts that when a national economy grows from low to medium levels, threats to biodiversity conservation increase, but they decrease when the economy moves from medium to high. We evaluated this approach by examining how population densities of the brown bear (Ursus arctos), gray wolf (Canis lupus), and Eurasian lynx (Lynx lynx) were related to the national economy in 24 European countries. We used forest proportions, the existence of a compensation system, and country group (former socialist countries, Nordic countries, other countries) as covariates in a linear model with the first- and the second-order polynomial terms of per capita gross domestic product (GDP). Country group was treated as a random factor, but remained insignificant and was ignored. All models concerning brown bear and wolf provided evidence that population densities decreased with increasing GDP, but densities of lynx were virtually independent of GDP. Models for the wolf explained >80% of the variation in densities, without a difference between the models with all independent variables and the model with only GDP. For the bear, the model with GDP alone accounted for 10%, and all three variables 33%, of the variation in densities. Wolves exhibit a higher capacity for dispersal and reproduction than bear or lynx, but still exists at the lowest densities in wealthy European countries. We are aware that several other factors, not available for our models, influenced large carnivore densities. Based on the pronounced differences among large carnivore species in their countrywide relationships between densities and GDP, and a strikingly high relationship for the gray wolf, we suggest that our results reflected differences in political history and public acceptance of these species among countries. The compensation paid for the damages caused by the carnivores is not a key to higher carnivore

Food-related lifestyles and their association to obesity in five European countries.

PubMed

Pérez-Cueto, Federico J A; Verbeke, Wim; de Barcellos, Marcia Dutra; Kehagia, Olga; Chryssochoidis, George; Scholderer, Joachim; Grunert, Klaus G

2010-02-01

This paper's objective is to investigate the associations between obesity and Food-Related Lifestyles (FRL) in five European countries. A cross-sectional web-based survey was carried out in Belgium, Denmark, Germany, Greece and Poland, January 2008, with quota samples on gender (male, female), age categories (20-44 and 45-70 years), and locality of residence (urban, rural). A total of 2437 respondents (51% women, 49% men; mean age 41.4 years, SD 13.1) participated. Obtained data included socio-demographic information, measure of the food-related lifestyle scale and self-reported weights and heights. Body Mass Index (in kg/m(2)) was calculated as weight (in kg) divided by the squared height (in m(2)). Individuals were classified as obese if BMI > or = 30. Logistic regressions were fitted for the aggregated sample and then by country with obese as dependent and socio-demographics and FRL were included as independents. The prevalence of obesity in the five countries is 22%. Europeans giving more importance to 'self-fulfilment' (odds = 1.18), 'planning of meals' (odds = 1.15), and preferring 'snacks vs. meals' (odds = 1.24) are more likely to be obese. Respondents were less likely to be obese if they attached lower levels of importance to the use of 'shopping lists' (odds = 0.87). The overall picture is that a stronger interest in health, organic products and freshness, within the FLR domain of quality aspects, is associated with 'not being obese'. This study has identified specific FRL dimensions as potential predictors of obesity. The resulting consumers' profiling can be used for targeted interventions for weight management in Europe. 2009 Elsevier Ltd. All rights reserved.

Trends in cancer mortality in the European Union and accession countries, 1980-2000.

PubMed

Levi, F; Lucchini, F; Negri, E; Zatonski, W; Boyle, P; La Vecchia, C

2004-09-01

Cancer mortality rates and trends over the period 1980-2000 for accession countries to the European Union (EU) in May 2004, which include a total of 75 million inhabitants, were abstracted from the World Health Organization (WHO) database, together with, for comparative purposes, those of the current EU. Total cancer mortality for men was 166/100,000 in the EU, but ranged between 195 (Lithuania) and 269/100,000 (Hungary) in central and eastern European accession countries. This excess related to most cancer sites, including lung and other tobacco-related neoplasms, but also stomach, intestines and liver, and a few neoplasms amenable to treatment, such as testis, Hodgkin's disease and leukaemias. Overall cancer mortality for women was 95/100,000 in the EU, and ranged between 100 and 110/100,000 in several central and eastern European countries, and up to 120/100,000 in the Czech Republic and 138/100,000 in Hungary. The latter two countries had a substantial excess in female mortality for lung cancer, but also for several other sites. Furthermore, for stomach and especially (cervix) uteri, female rates were substantially higher in central and eastern European accession countries. Over the last two decades, trends in mortality were systematically less favourable in accession countries than in the EU. Most of the unfavourable patterns and trends in cancer mortality in accession countries are due to recognised, and hence potentially avoidable, causes of cancer, including tobacco, alcohol, dietary habits, pollution and hepatitis B, plus inadequate screening, diagnosis and treatment. Consequently, the application of available knowledge on cancer prevention, diagnosis and treatment may substantially reduce the disadvantage now registered in the cancer mortality of central and eastern European accession countries.

How have the Eastern European countries of the former Warsaw Pact developed since 1990? A bibliometric study.

PubMed

Kozak, Marcin; Bornmann, Lutz; Leydesdorff, Loet

Did the demise of the Soviet Union in 1991 influence the scientific performance of the researchers in Eastern European countries? Did this historical event affect international collaboration by researchers from the Eastern European countries with those of Western countries? Did it also change international collaboration among researchers from the Eastern European countries? Trying to answer these questions, this study aims to shed light on international collaboration by researchers from the Eastern European countries (Russia, Ukraine, Belarus, Moldova, Bulgaria, the Czech Republic, Hungary, Poland, Romania, and Slovakia). The number of publications and normalized citation impact values are compared for these countries based on InCites (Thomson Reuters), from 1981 up to 2011. The international collaboration by researchers affiliated to institutions in Eastern European countries at the time points of 1990, 2000 and 2011 was studied with the help of Pajek and VOSviewer software, based on data from the Science Citation Index (Thomson Reuters). Our results show that the breakdown of the communist regime did not lead, on average, to a huge improvement in the publication performance of the Eastern European countries and that the increase in international co-authorship relations by the researchers affiliated to institutions in these countries was smaller than expected. Most of the Eastern European countries are still subject to changes and are still awaiting their boost in scientific development.

Discounts and rebates granted to public payers for medicines in European countries

PubMed Central

Vogler, Sabine; Zimmermann, Nina; Habl, Claudia; Piessnegger, Jutta; Bucsics, Anna

2012-01-01

Objective: The objective of this study was to provide an overview about the existence and types of discounts and rebates granted to public payers by the pharmaceutical industry in European countries. Methods: Data were collected via a questionnaire in spring 2011. Officials from public authorities for pharmaceutical pricing and reimbursement represented in the PPRI (Pharmaceutical Pricing and Reimbursement Information) network provided the information and reviewed the compilation. Results: Information is available from 31 European countries. Discounts and rebates granted to public payers by pharmaceutical industry were reported for 25 European countries. Such discounts exist both in the in- and out-patient sectors in 21 countries and in the in-patient sector only in four countries. Six countries reported not having any regulations or agreements regarding the discounts and rebates granted by industry. The most common discounts and rebates are price reductions and refunds linked to sales volume but types such as in-kind support, price-volume and risk-sharing agreements are also in place. A mix of various types of discounts and rebates is common. Many of these arrangements are confidential. Differences regarding types, the organizational and legal framework, validity and frequency of updates and the amount of the discounts and rebates granted exist among the surveyed countries. Conclusions: In Europe, discounts and rebates on medicines granted by pharmaceutical industry to public payers are common tools to contain public pharmaceutical expenditure. They appear to be used as a complimentary measure when price regulation does not achieve the desired results and in the few European countries with no or limited price regulation. The confidential character of many of these arrangements impedes transparency and may lead to a distortion of medicines prices. An analysis of the impact on these measures is recommended. PMID:23093898

International Issues: Cross-border mobility of junior neurologists within and to the European Union.

PubMed

Macerollo, Antonella; Varga, Edina T; Struhal, Walter; Györfi, Orsolya; Kobeleva, Xenia; Sellner, Johann

2014-09-23

To assess the general interest in and motivation for cross-border mobility among residents and junior neurologists from member states of the European Union and neighboring countries. Questionnaire-based paper survey among 118 participants of a neurology course. Ninety-seven (82%) participants returned the survey. Most of them had at one point considered relocating within or to the European Union for postgraduate education (87%) or employment (71%). Common motivations were superior prospects for clinical training (85%), resources at work and academic environment (both 80%), and remuneration (70%). Barely half of the surveyed intended to return to their home country. The attractiveness of Europe as a destination for migration was ranked over other continents. The most common reasons that reduce enthusiasm for relocation were the loss of family connection (55%) and uncertain future prospects (41%), whereas language barriers were less relevant (21%). There is keen interest of the upcoming generation of neurologists to relocate within and to the European Union. The motives include regional differences in training and career opportunities as well as economic welfare. Appropriate steps toward the harmonization of educational and career prospects are urgently required to ensure adequate provision of neurology service and patient care throughout Europe. © 2014 American Academy of Neurology.

Syria Country Analysis Brief

EIA Publications

2015-01-01

Syria's energy sector has encountered a number of challenges as a result of conflict and subsequent sanctions imposed by the United States and the European Union. Damage to energy infrastructure—including oil and natural gas pipelines and electricity transmission networks—hindered the exploration, development, production, and transport of the country's energy resources.

The psychological burden of skin diseases: a cross-sectional multicenter study among dermatological out-patients in 13 European countries.

PubMed

Dalgard, Florence J; Gieler, Uwe; Tomas-Aragones, Lucia; Lien, Lars; Poot, Francoise; Jemec, Gregor B E; Misery, Laurent; Szabo, Csanad; Linder, Dennis; Sampogna, Francesca; Evers, Andrea W M; Halvorsen, Jon Anders; Balieva, Flora; Szepietowski, Jacek; Romanov, Dmitry; Marron, Servando E; Altunay, Ilknur K; Finlay, Andrew Y; Salek, Sam S; Kupfer, Jörg

2015-04-01

The contribution of psychological disorders to the burden of skin disease has been poorly explored, and this is a large-scale study to ascertain the association between depression, anxiety, and suicidal ideation with various dermatological diagnoses. This international multicenter observational cross-sectional study was conducted in 13 European countries. In each dermatology clinic, 250 consecutive adult out-patients were recruited to complete a questionnaire, reporting socio-demographic information, negative life events, and suicidal ideation; depression and anxiety were assessed with the Hospital Anxiety and Depression Scale. A clinical examination was performed. A control group was recruited among hospital employees. There were 4,994 participants--3,635 patients and 1,359 controls. Clinical depression was present in 10.1% patients (controls 4.3%, odds ratio (OR) 2.40 (1.67-3.47)). Clinical anxiety was present in 17.2% (controls 11.1%, OR 2.18 (1.68-2.82)). Suicidal ideation was reported by 12.7% of all patients (controls 8.3%, OR 1.94 (1.33-2.82)). For individual diagnoses, only patients with psoriasis had significant association with suicidal ideation. The association with depression and anxiety was highest for patients with psoriasis, atopic dermatitis, hand eczema, and leg ulcers. These results identify a major additional burden of skin disease and have important clinical implications.

Impact of clinical osteoarthritis of the hip, knee and hand on self-rated health in six European countries: the European Project on OSteoArthritis.

PubMed

van Schoor, N M; Zambon, S; Castell, M V; Cooper, C; Denkinger, M; Dennison, E M; Edwards, M H; Herbolsheimer, F; Maggi, S; Sánchez-Martinez, M; Pedersen, N L; Peter, R; Schaap, L A; Rijnhart, J J M; van der Pas, S; Deeg, D J H

2016-06-01

Osteoarthritis (OA) has been shown to be associated with decreased physical function, which may impact upon a person's self-rated health (SRH). Only a few studies have examined the association between OA and SRH in the general population, but to date none have used a clinical definition of OA. The objectives are: (1) To examine the cross-sectional association between clinical OA and fair-to-poor SRH in the general population; (2) To examine whether this association differs between countries; (3) To examine whether physical function is a mediator in the association between clinical OA and SRH. Baseline data of the European Project on OSteoArthritis (EPOSA) were used, which includes pre-harmonized data from six European cohort studies (n = 2709). Clinical OA was defined according to the American College of Rheumatology criteria. SRH was assessed using one question: How is your health in general? Physical function was assessed using the Western Ontario and McMaster Universities OA Index and Australian/Canadian OA Hand Index. The prevalence of fair-to-poor SRH ranged from 19.8 % in the United Kingdom to 63.5 % in Italy. Although country differences in the strength of the associations were observed, clinical OA of the hip, knee and hand were significantly associated with fair-to-poor SRH in five out of six European countries. In most countries and at most sites, the association between clinical OA and fair-to-poor SRH was partly or fully mediated by physical function. Clinical OA at different sites was related to fair-to-poor SRH in the general population. Most associations were (partly) mediated by physical functioning, indicating that deteriorating physical function in patients with OA should be a point of attention in patient care.

Risk perception, experience, and objective risk: a cross-national study with European emergency survivors.

PubMed

Knuth, Daniela; Kehl, Doris; Hulse, Lynn; Schmidt, Silke

2014-07-01

Understanding public risk perceptions and their underlying processes is important in order to learn more about the way people interpret and respond to hazardous emergency events. Direct experience with an involuntary hazard has been found to heighten the perceived risk of experiencing the same hazard and its consequences in the future, but it remains unclear if cross-over effects are possible (i.e., experience with one hazard influencing perceived risk for other hazards also). Furthermore, the impact of objective risk and country of residence on perceived risk is not well understood. As part of the BeSeCu (Behavior, Security, and Culture) Project, a sample of 1,045 survivors of emergencies from seven European countries (i.e., Germany, the Czech Republic, Poland, Sweden, Spain, Turkey, and Italy) was drawn. Results revealed heightened perceived risk for emergency events (i.e., domestic and public fires, earthquakes, floods, and terrorist attacks) when the event had been experienced previously plus some evidence of cross-over effects, although these effects were not so strong. The largest country differences in perceived risk were observed for earthquakes, but this effect was significantly reduced by taking into account the objective earthquake risk. For fires, floods, terrorist attacks, and traffic accidents, only small country differences in perceived risk were found. Further studies including a larger number of countries are welcomed. © 2013 Society for Risk Analysis.

Selection strategies for newly registered blood donors in European countries

PubMed Central

Lieshout-Krikke, Ryanne W.; Domanovic, Dragoslav; de Kort, Wim; Mayr, Wolfgang; Liumbruno, Giancarlo M.; Pupella, Simonetta; Kurz, Johann; Knutson, Folke; MacLennan, Sheila; Folléa, Gilles

2017-01-01

Background Two selection strategies for newly-registered blood donors are available: a single-visit selection called the standard selection procedure (SSP), and a two-stage selection named predonation and donation screening (PDS). This study reviews the selection strategies for newly-registered donors currently applied in European countries. Material and methods We collected data on donor selection procedures, blood donation, laboratory screening and HIV, HCV and HBV positive donors/donations from 2010 to 2013 in 30 European countries by using questionnaires. We grouped the countries according to the applied selection strategy, and for each country, we calculated the 4-year prevalence of confirmed positive results indicating the presence of overall and recent HIV, HCV and HBV infections among first-time and repeat donations and among newly-registered donors. Results Most of the 24 countries (80%) apply the SSP strategy for selection of newly-registered donors. Twenty-two countries (73.3%) employ a nucleic acid amplification testing in addition to the mandatory serological screening. The survey confirms a higher overall prevalence of HIV, HCV and HBV infections among first-time donations and newly-registered donors than among repeat donations. In contrast, the prevalence of recently acquired HIV and HCV infections was lower among first-time donations and newly-registered donors than among repeat donations, but higher for recent HBV infections (6.7/105 vs 2.6/105 in the SSP setting and 4.3/105 vs 0.5/105 in one country using PDS). The relatively low numbers of infected donors selected by PDS impeded accurate assessment of the prevalence of recent infections in first-time donations. Discussion The data from European countries provide inconclusive evidence that applying PDS reduces the risk of donations being made in the diagnostic window of first-time donors. The impact of PDS on the risk of window-period donations and blood donor management needs further

Social mobility and health in European countries: Does welfare regime type matter?

PubMed

Campos-Matos, Inês; Kawachi, Ichiro

2015-10-01

Health inequalities pose an important public health challenge in European countries, for which increased social mobility has been suggested as a cause. We sought to describe how the relationship between health inequalities and social mobility varies among welfare regime types in the European region. Data from six rounds of the European Social Survey was analyzed using multilevel statistical techniques, stratified by welfare regime type, including 237,535 individuals from 136 countries. Social mobility among individuals was defined according to the discrepancy between parental and offspring educational attainment. For each welfare regime type, the association between social mobility and self-rated health was examined using odds ratios and risk differences, controlling for parental education. Upwardly mobile individuals had between 23 and 44% lower odds of reporting bad or very bad self-rated health when compared to those who remained stable. On an absolute scale, former USSR countries showed the biggest and only significant differences for upward movement, while Scandinavian countries showed the smallest. Downward social mobility tended to be associated with worse health, but the results were less consistent. Upward social mobility is associated with worse health in all European welfare regime types. However, in Scandinavian countries the association of upward mobility was smaller, suggesting that the Nordic model is more effective in mitigating the impact of social mobility on health and/or of health on mobility. Copyright © 2015 Elsevier Ltd. All rights reserved.

Inequalities in utilisation of general practitioner and specialist services in 9 European countries.

PubMed

Stirbu, Irina; Kunst, Anton E; Mielck, Andreas; Mackenbach, Johan P

2011-10-31

The aim of this study is to describe the magnitude of educational inequalities in utilisation of general practitioner (GP) and specialist services in 9 European countries. In addition to West European countries, we have included 3 Eastern European countries: Hungary, Estonia and Latvia. To cover the gap in knowledge we pay a special attention to the magnitude of inequalities among patients with chronic conditions. Data on the use of GP and specialist services were derived from national health surveys of Belgium, Estonia, France, Germany, Hungary, Ireland, Latvia, the Netherlands and Norway. For each country and education level we calculated the absolute prevalence and relative inequalities in utilisation of GP and specialist services. In order to account for the need for care, the results were adjusted by the measure of self-assessed health. People with lower education used GP services equally often in most countries (except Belgium and Germany) compared with those with a higher level of education. At the same time people with a higher education used specialist care services significantly more often in all countries, except in the Netherlands. The general pattern of educational inequalities in utilisation of specialist care was similar for both men and women. Inequalities in utilisation of specialist care were equally large in Eastern European and in Western European countries, except for Latvia where the inequalities were somewhat larger. Similarly, large inequalities were found in the utilisation of specialist care among patients with chronic diseases, diabetes, and hypertension. We found large inequalities in the utilisation of specialist care. These inequalities were not compensated by utilisation of GP services. Of particular concern is the presence of inequalities among patients with a high need for specialist care, such as those with chronic diseases. © 2011 Stirbu et al; licensee BioMed Central Ltd.

Alcohol affordability and alcohol demand: cross-country trends and panel data estimates, 1975 to 2008.

PubMed

Nelson, Jon P

2014-04-01

Relatively little is known about cross-country differences in alcohol affordability or factors that determine differences in affordability over time. This information is potentially important for alcohol policy, especially policies that focus on higher taxes or prices to reduce total alcohol consumption. This study estimates cross-country alcohol consumption relationships using economic models incorporating income and prices and alternative models based on alcohol affordability. The data and analysis are restricted to higher income countries. Data for alcohol consumption per capita (ages 15+) are analyzed for 2 samples: first, 17 countries in the Organisation for Economic Co-operation and Development for the period 1975 to 2000; second, 22 countries in the European Union for the period from 2000 to 2008. Panel data models are utilized, with country and time fixed-effects to control for confounding influences. In economic demand models, covariates are real per capita income and real alcohol price indices. In affordability models, income is divided by prices to yield an index of alcohol affordability. Analysis of data trends reveals that much of the increase in affordability is due to rising real incomes, and not falling real prices. Economic models of demand perform slightly better statistically, but differences are not substantial as income and affordability are highly correlated. For both samples, exogenous rates of growth of alcohol consumption are negative. Price and income elasticities, on average, are within the range of prior estimates. Affordability elasticities are between 0.21 and 0.25. Although alcohol affordability is a valid concept statistically, its use in policy discussions tends to hide underlying causes of changes in affordability. A better approach is a comparison and analysis of trends and cross-country differences in real incomes and real alcohol prices together with the affordability index. Country-level analysis of income and price

The current state of orthopaedic residency in 18 European countries.

PubMed

Madanat, Rami; Mäkinen, Tatu J; Ryan, Daniel; Huri, Gazi; Paschos, Nikolaos; Vide, Joao

2017-04-01

The aim of this study was to compare differences in current orthopaedic and trauma training programs across Europe. A questionnaire was sent to the FORTE (Federation of Orthopaedic Trainees in Europe) representatives of 25 different European countries, of which 18 responded. The questionnaire included demographic information and information concerning the structure of the training programs, including duration, selection, and mandatory training requirements. The number of trainees per specialist varied between countries from a ratio of 1:2 to 1:7. Residency was generally five to six years in all the countries. In more than half of the countries selection was interview-based. Nearly all countries utilized a logbook. About 80% of the participating countries had a final examination. When assessing the components of training it was found that only one country (the United Kingdom) had mandatory minimum requirements for (1) courses, (2) surgical procedures, (3) research and (4) leadership. Nearly 40% of the participating countries had only one or none of these four components as a mandatory training requirement. There are many similarities in training programs, but some important differences remain in overall requirements and final qualification. The main limitation of this study was that we were unable to get data from all the European countries. FORTE will continue to serve as a forum for sharing best practices with the ultimate goal of improving and harmonizing the level of orthopaedic training across Europe. Future studies should aim to include further details about training programs as well as to include data from more countries.

Improved outcome of childhood acute myeloid leukemia in an Eastern European country: Lithuanian experience.

PubMed

Kairiene, Igne; Pasauliene, Ramune; Lipunova, Nadezda; Vaitkeviciene, Goda; Rageliene, Lina; Rascon, Jelena

2017-10-01

The reported treatment outcomes of children treated for cancer in Eastern European countries are inferior to those in Northern/Western Europe. We hypothesized that recent survival rates could be comparable to the current standards and performed a population-based analysis of treatment outcome of childhood acute myeloid leukemia (AML) in Lithuania, a small Eastern European country. Children < 18 years old who were treated for AML from 2000 to 2013 were included (n = 54). Estimates of 5-year event-free (EFS 5y ) and overall survival (OS 5y ) rates were analyzed. Comparing periods 2000-2006 (n = 32) and 2007-2013 (n = 22), the EFS 5y improved from 31 to 63% (p = 0.04), and the OS 5y improved from 31 to 72% (p = 0.02) because of reductions in toxicity-related mortality (42 vs. 15%, p = 0.08) and relapse (43 vs. 25%, p = 0.08). The most significant improvement was demonstrated in high-risk patients (OS 5y improved from 26 to 75%, p = 0.02) who benefited from hematopoietic stem cell transplantation: the post-transplant EFS 5y increased from 13 to 86% (p = 0.01). The current survival rate of Lithuanian children treated for AML was comparable to the expected rate in other parts of Europe. What is Known: • In the last three decades, significant improvement has been achieved in treating childhood cancer, with an overall survival (OS) rate of > 80% in high-income countries. The difference in survival rates between Northern/Western and Eastern European countries as well as between high- and middle-/low-income countries is as much as 20%. Recently, the 5-year event-free survival rate of acute myeloid leukemia (AML) has reached > 60% in high-income countries. The survival rates for myeloproliferative diseases were the lowest in Eastern European countries. • The reported inferior survival rates were calculated based on outcome data of patients treated until 2007. The recent survival rates in Eastern European countries are unknown. What is New: • Being a

Do societal wealth, family affluence and gender account for trends in adolescent cannabis use? A 30 country cross-national study.

PubMed

ter Bogt, Tom F M; de Looze, Margreet; Molcho, Michal; Godeau, Emmanuelle; Hublet, Anne; Kokkevi, Anna; Kuntsche, Emmanuel; Nic Gabhainn, Saoirse; Franelic, Iva Pejnovic; Simons-Morton, Bruce; Sznitman, Sharon; Vieno, Alessio; Vollebergh, Wilma; Pickett, William

2014-02-01

To examine cross-national changes in frequent adolescent cannabis use (40+ times consumed over life-time at age 15) over time and relate these trends to societal wealth, family affluence and gender. Data from three cycles (2002, 2006, 2010) of the Health Behaviour in School-aged Children (HBSC) Study were used for cross-sectional and trend analyses of adolescent cannabis use. Representative surveys in 30 European and North American countries. A total of 160 606 15-year-old students. Respondents' life-time cannabis use, demographics, family affluence (FAS) and frequency of peer contacts were measured individually. Indicators of wealth (gross domestic product per capita, GDP) and perceived availability of cannabis were obtained from national public data bases. The frequency of life-time cannabis use decreased over time among adolescents in Europe and North America, particularly in western European countries and the United States (relative risk (RR) = 0.86: confidence interval (CI) 0.79-0.93). This trend was not observed consistently in rapidly developing countries in eastern, central and southern Europe. Over time (2002-10), cannabis use became: (i) less characteristic of high GDP countries in contrast to lower GDP countries (RR = 0.74: CI 0.57-0.95); (ii) less characteristic of youth from high FAS families in contrast to youth from low FAS families (RR = 0.83: CI 0.72-0.96); and (iii) characterized by an increasing gender gap, i.e. consumption was higher among males (RR 1.26: CI 1.04-1.53). Perceived availability of cannabis and peer contacts remained strong predictors of frequent cannabis use. Among 30 European and North American countries, cannabis use appears to have 'trickled down' over time, with developing countries taking on the former (heavier) use pattern of richer countries, and less affluent youth taking on the former (heavier) use pattern of more affluent youth. Cannabis use continues to be more common among adolescent males than females. �

Health-related quality of life in European women following myocardial infarction: a cross-sectional study.

PubMed

Lidell, Evy; Höfer, Stefan; Saner, Hugo; Perk, Joep; Hildingh, Cathrine; Oldridge, Neil

2015-08-01

Coronary heart disease is a major contributor to women's health problems. Self-perceived social support, well-being and health-related quality of life (HRQL) were documented in the cross-sectional HeartQoL survey of European women one and six months after a myocardial infarction. European women were recruited in 18 European countries and grouped into four geographical regions (Southern Europe, Northern Europe, Western Europe and Eastern Europe). Continuous socio-demographic variables and categorical variables were compared by age and region with ANOVA and χ(2), respectively; multiple regression models were used to identify predictors of social support, well-being and HRQL. Women living in the Eastern European region rated social support, well-being and HRQL significantly lower than women in the other regions. Older women had lower physical HRQL scores than younger women. Eastern European women rated social support, well-being and HRQL significantly lower than women in the other regions. Prediction of the dependent variables (social support, well-being and HRQL) by socio-demographic factors varied by total group, in the older age group, and by region; body mass index and managerial responsibility were the most consistent significant predictors. © The European Society of Cardiology 2014.

EEC oil policy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Evans, A.C.

1983-01-01

The difficulties encountered by the European Economic Community (EEC) in implementing their EEC Oil Policy are discussed. The various directives have been successfully adopted are enumerated and those which have not are fully explained in terms of their political significance. Special emphasis is placed on measures which have been taken in an attempt to mitigate the effects of a temporary oil shortage and those which would reduce the EEC's dependence on imported oil. It is anticipated that the future will see a greater cooperation among the EEC member countries on the subject of an energy policy. 74 references.

Characterization of essential oil distribution in the root cross-section of Valeriana officinalis L. s.l. by using histological imaging techniques.

PubMed

Penzkofer, Michael; Baron, Andrea; Naumann, Annette; Krähmer, Andrea; Schulz, Hartwig; Heuberger, Heidi

2018-01-01

The essential oil is an important compound of the root and rhizome of medicinally used valerian ( Valeriana officinalis L. s.l.), with a stated minimum content in the European pharmacopoeia. The essential oil is located in droplets, of which the position and distribution in the total root cross-section of different valerian varieties, root thicknesses and root horizons are determined in this study using an adapted fluorescence-microscopy and automatic imaging analysis method. The study was initiated by the following facts:A probable negative correlation between essential oil content and root thickness in selected single plants (elites), observed during the breeding of coarsely rooted valerian with high oil content.Higher essential oil content after careful hand-harvest and processing of the roots. In preliminary tests, the existence of oil containing droplets in the outer and inner regions of the valerian roots was confirmed by histological techniques and light-microscopy, as well as Fourier-transform infrared spectroscopy. Based on this, fluorescence-microscopy followed by image analysis of entire root cross-sections, showed that a large number of oil droplets (on average 43% of total oil droplets) are located close to the root surface. The remaining oil droplets are located in the inner regions (parenchyma) and showed varying density gradients from the inner to the outer regions depending on genotype, root thickness and harvesting depth. Fluorescence-microscopy is suitable to evaluate prevalence and distribution of essential oil droplets of valerian in entire root cross-sections. The oil droplet density gradient varies among genotypes. Genotypes with a linear rather than an exponential increase of oil droplet density from the inner to the outer parenchyma can be chosen for better stability during post-harvest processing. The negative correlation of essential oil content and root thickness as observed in our breeding material can be counteracted through a

National sex work policy and HIV prevalence among sex workers: an ecological regression analysis of 27 European countries.

PubMed

Reeves, Aaron; Steele, Sarah; Stuckler, David; McKee, Martin; Amato-Gauci, Andrew; Semenza, Jan C

2017-03-01

Sex workers are disproportionately affected by HIV compared with the general population. Most studies of HIV risk among sex workers have focused on individual-level risk factors, with few studies assessing potential structural determinants of HIV risk. In this Article, we examine whether criminal laws around sex work are associated with HIV prevalence among female sex workers. We estimate cross-sectional, ecological regression models with data from 27 European countries on HIV prevalence among sex workers from the European Centre for Disease Control; sex-work legislation from the US State Department's Country Reports on Human Rights Practices and country-specific legal documents; the rule of law and gross-domestic product per capita, adjusted for purchasing power, from the World Bank; and the prevalence of injecting drug use among sex workers. Although data from two countries include male sex workers, the numbers are so small that the findings here essentially pertain to prevalence in female sex workers. Countries that have legalised some aspects of sex work (n=17) have significantly lower HIV prevalence among sex workers than countries that criminalise all aspects of sex work (n=10; β=-2·09, 95% CI -0·80 to -3·37; p=0·003), even after controlling for the level of economic development (β=-1·86; p=0·038) and the proportion of sex workers who are injecting drug users (-1·93; p=0·026). We found that the relation between sex work policy and HIV among sex workers might be partly moderated by the effectiveness and fairness of enforcement, suggesting legalisation of some aspects of sex work could reduce HIV among sex workers to the greatest extent in countries where enforcement is fair and effective. Our findings suggest that the legalisation of some aspects of sex work might help reduce HIV prevalence in this high-risk group, particularly in countries where the judiciary is effective and fair. European Centre for Disease Prevention and Control. Copyright �

Satisfaction with Job and Income among Older Individuals across European Countries

ERIC Educational Resources Information Center

Bonsang, Eric; van Soest, Arthur

2012-01-01

Using data on individuals of age 50 and older from 11 European countries, we analyze two economic aspects of subjective well-being of older Europeans: satisfaction with household income, and job satisfaction. Both have been shown to contribute substantially to overall well-being (satisfaction with life or happiness). We use anchoring vignettes to…

Depression in Europe: does migrant integration have mental health payoffs? A cross-national comparison of 20 European countries.

PubMed

Levecque, Katia; Van Rossem, Ronan

2015-01-01

Objectives. Depression is a leading cause of ill health and disability. As migrants form an increasing group in Europe, already making up about 8.7% of the population in 2010, knowledge on migrant-related inequalities in depression is of main public health interest. In this study, we first assess whether migrants in Europe are at higher risk for depression compared to the native population. Second, we assess whether the association between migration and depression is dependent on different forms of migrant integration. Migrant integration is looked at both from the individual and from the national level. Design. Hierarchical linear regression analyses based on data for 20 countries in the European Social Survey 2006/2007 (N = 37,076 individuals aged 15 or more). Depression is measured using the center for Epidemiologic Depression Scale. We consider migrant integration over time (first- and second-generation migrants, differentiated according to European Union (EU) or non-EU origin), barriers to integration (low educational level, financial difficulties, being out of the labor market, ethnic minority status, discrimination), and the host country environment (national migrant integration policy). Controls are gender, age, partner relationship, social support, and welfare state regime. Results. Natives and second-generation migrants do not differ significantly in their risk profile for depression. First-generation migrants show higher levels of depression, with those born outside of Europe to be the worst off. This higher risk for depression is not attributable to ethnic minority status but is mainly due to experienced barriers to socioeconomic integration and processes of discrimination. A country's national policy on migrant integration shows not to soften the depressing effect of being a first-generation migrant nor does it have indirect beneficial health effects by reducing barriers to integration. Conclusion. In Europe, first-generation EU and non-EU migrants

Cross-cultural perception of six commercial olive oils: A study with Spanish and US consumers.

PubMed

Vázquez-Araújo, L; Adhikari, K; Chambers, E; Chambers, D H; Carbonell-Barrachina, A A

2015-09-01

A cross-cultural study was conducted with Spanish and US consumers to gain an insight into the preferred characteristics of olive oils in both countries. Six commercial olive oils (four samples from Spain and two samples from the US) were analyzed by a highly trained panel (descriptive analysis) and also by two consumers' groups (100 consumers from Spain and 100 from the US). Demographic, acceptability, and Just-About-Right data were collected to study the preferences of both groups, and the relationships with descriptive data were explored to determine the drivers of like/dislike. The Spanish extra virgin olive oils and the imported US extra virgin olive oil were characterized by having bitter, pungent, and more green notes, and were preferred by the Spanish consumers. The US consumers liked the bland Spanish refined olive oil, and the Californian olive oil that was characterized by fruity, floral, and sweet notes. The results showed that the Spanish consumers were more aware about olive oil quality in general than their US counterparts, maybe because of a higher usage of the product in Spain. The present study provides essential data which might help producers in designing and promoting olive oils matching US consumers' requirements, an emerging market for this Mediterranean product. © The Author(s) 2014.

Livestock-associated meticillin-resistant Staphylococcus aureus (MRSA) among human MRSA isolates, European Union/European Economic Area countries, 2013

PubMed Central

Kinross, Pete; Petersen, Andreas; Skov, Robert; Van Hauwermeiren, Evelyn; Pantosti, Annalisa; Laurent, Frédéric; Voss, Andreas; Kluytmans, Jan; Struelens, Marc J; Heuer, Ole; Monnet, Dominique L

2017-01-01

Currently, surveillance of livestock-associated meticillin-resistant Staphylococcus aureus (LA-MRSA) in humans in Europe is not systematic but mainly event-based. In September 2014, the European Centre for Disease Prevention and Control (ECDC) initiated a questionnaire to collect data on the number of LA-MRSA from human samples (one isolate per patient) from national/regional reference laboratories in European Union/European Economic Area (EU/EEA) countries in 2013. Identification of LA-MRSA as clonal complex (CC) 398 by multilocus sequence typing (MLST) was preferred, although surrogate methods such as spa-typing were also accepted. The questionnaire was returned by 28 laboratories in 27 EU/EEA countries. Overall, LA-MRSA represented 3.9% of 13,756 typed MRSA human isolates, but it represented ≥ 10% in five countries (Belgium, Denmark, Spain, the Netherlands and Slovenia). Seven of the reference laboratories did not type MRSA isolates in 2013. To monitor the dispersion of LA-MRSA and facilitate targeted control measures, we advocate periodic systematic surveys or integrated multi-sectorial surveillance. PMID:29113628

Livestock-associated meticillin-resistant Staphylococcus aureus (MRSA) among human MRSA isolates, European Union/European Economic Area countries, 2013.

PubMed

Kinross, Pete; Petersen, Andreas; Skov, Robert; Van Hauwermeiren, Evelyn; Pantosti, Annalisa; Laurent, Frédéric; Voss, Andreas; Kluytmans, Jan; Struelens, Marc J; Heuer, Ole; Monnet, Dominique L

2017-11-01

Currently, surveillance of livestock-associated meticillin-resistant Staphylococcus aureus (LA-MRSA) in humans in Europe is not systematic but mainly event-based. In September 2014, the European Centre for Disease Prevention and Control (ECDC) initiated a questionnaire to collect data on the number of LA-MRSA from human samples (one isolate per patient) from national/regional reference laboratories in European Union/European Economic Area (EU/EEA) countries in 2013. Identification of LA-MRSA as clonal complex (CC) 398 by multilocus sequence typing (MLST) was preferred, although surrogate methods such as spa -typing were also accepted. The questionnaire was returned by 28 laboratories in 27 EU/EEA countries. Overall, LA-MRSA represented 3.9% of 13,756 typed MRSA human isolates, but it represented ≥ 10% in five countries (Belgium, Denmark, Spain, the Netherlands and Slovenia). Seven of the reference laboratories did not type MRSA isolates in 2013. To monitor the dispersion of LA-MRSA and facilitate targeted control measures, we advocate periodic systematic surveys or integrated multi-sectorial surveillance.

Strategic Purchasing in Practice: Comparing Ten European Countries.

PubMed

Klasa, Katarzyna; Greer, Scott L; van Ginneken, Ewout

2018-02-05

Strategic purchasing of health care services is widely recommended as a policy instrument. We conducted a review of literature of material drawn from the European Observatory on Health Systems and Policies Health Systems in Transition series, other European Observatory databases, and selected country-specific literature to augment the comparative analysis by providing the most recent healthcare trends in ten selected countries. There is little evidence of purchasing being strategic according to any of the established definitions. There is little or no literature suggesting that existing purchasing mechanisms in Europe deliver improved population health, citizen empowerment, stronger governance and stewardship, or develop purchaser organization and capacity. Strategic purchasing has not generally been implemented. Policymakers considering adopting strategic purchasing policies should be aware of this systemic implementation problem. Policymakers in systems with strategic purchasing built into policy should not assume that a purchasing system is strategic or that it is delivering any expected objectives. However, there are individual components of strategic purchasing that are worth pursuing and can provide benefits to health systems. Copyright © 2018. Published by Elsevier B.V.

How is intensive care reimbursed? A review of eight European countries

PubMed Central

2013-01-01

Reimbursement schemes in intensive care are more complex than in other areas of healthcare, due to special procedures and high care needs. Knowledge regarding the principles of functioning in other countries can lead to increased understanding and awareness of potential for improvement. This can be achieved through mutual exchange of solutions found in other countries. In this review, experts from eight European countries explain their respective intensive care unit reimbursement schemes. Important conclusions include the apparent differences in the countries’ reimbursement schemes-despite all of them originating from a DRG system-, the high degree of complexity found, and the difficulties faced in several countries when collecting the data for this collaborative work. This review has been designed to assist the intensivist clinician and researcher in understanding neighbouring countries’ approaches and in putting research into the context of a European perspective. In addition, steering committees and decision makers might find this a valuable source to compare different reimbursement schemes. PMID:24216146

Oil type and cross-linking influence growth of Aureobasidium melanogenum on vegetable oils as a single carbon source.

PubMed

Peeters, Loes H M; Huinink, Hendrik P; Voogt, Benjamin; Adan, Olaf C G

2018-03-12

Aureobasidium melanogenum is the main fungus found in a spontaneously formed biofilm on a oil-treated wood. This dark colored biofilm functions as a protective coating. To better understand biofilm formation, in this study A. melanogenum was cultured on olive oil and raw linseed oil. Metabolic activity and oil conversion were measured. The results show that A. melanogenum is able to grow on linseed oil and olive oil as a single carbon source. The fungus produces the enzyme lipase to convert the oil into fatty acids and glycerol. Metabolic activity and oil conversion were equal on linseed oil and olive oil. The fungus was not able to grow on severe cross-linked linseed oil, meaning that the degree of cross-linking of the oil is important for growth of A. melanogenum. Dark coloring of the colony was seen on linseed oil, which might be a stress response on the presence of autoxidation products in linseed oil. The colony on olive oil showed delayed melanin production indicating an inhibitory effect of olive oil on melanin production. © 2018 The Authors. MicrobiologyOpen published by John Wiley & Sons Ltd.

Wage Inequality and Violent Protests in Oil/Gas Producing Countries

NASA Astrophysics Data System (ADS)

Nuraliyev, Nurlan

This work examines contrasting claims made by academic scholars on the relationship between income inequality and political discontent. Does income inequality directly cause social unrest or is this relationship conditional on the level of democratic development? Using the data from 55 oil/gas producing countries between 2010-2013, the author finds: 1) income disparity between an average income per capita of local population and an average income of foreign labor employed in the oil/gas industry results in higher number of violent protests in more democratic oil/gas producing societies; 2) wage disparity between local and foreign labor in the oil/gas industry is associated with higher number of protests in this industry in more democratic oil/gas producing states.

Sunnier European countries have lower melanoma mortality.

PubMed

Shipman, A R; Clark, A B; Levell, N J

2011-07-01

Doubt has been cast on sunlight as the major causative factor for malignant melanoma. We performed statistical analysis of the average annual sunlight hours in 36 European capital cities compared with the country's melanoma mortality rate. A significant inverse proportionality was identified in both men and women, indicating that sun exposure is unlikely to be the strongest factor affecting mortality from malignant melanoma. © The Author(s). CED © 2011 British Association of Dermatologists.

The spread of European models of engineering education: the challenges faced in emerging countries

NASA Astrophysics Data System (ADS)

Gardelle, Linda; Cardona Gil, Emmanuel; Benguerna, Mohamed; Bolat, Altangul; Naran, Boldmaa

2017-03-01

The major European models of engineering training (the German, the British and the French model) spread throughout the world during the twentieth century. Historical heritage, cultural proximity and languages explain the open expression of faithfulness to one system in some countries. In these countries, the national standards inherited are now completed by international standards or are in direct competition with new influences. This article will attempt, through the existing literature, interviews and on-site investigations, to analyse current engineering training in some emerging countries and its relations with European models, the objective being to analyse the evolution of local systems and so the challenges and issues raised by the dissemination of European models.

The Psychological Burden of Skin Diseases: A Cross-Sectional Multicenter Study among Dermatological Out-Patients in 13 European Countries

PubMed Central

Dalgard, Florence J; Gieler, Uwe; Tomas-Aragones, Lucia; Lien, Lars; Poot, Francoise; Jemec, Gregor B E; Misery, Laurent; Szabo, Csanad; Linder, Dennis; Sampogna, Francesca; Evers, Andrea W M; Halvorsen, Jon Anders; Balieva, Flora; Szepietowski, Jacek; Romanov, Dmitry; Marron, Servando E; Altunay, Ilknur K; Finlay, Andrew Y; Salek, Sam S; Kupfer, Jörg

2015-01-01

The contribution of psychological disorders to the burden of skin disease has been poorly explored, and this is a large-scale study to ascertain the association between depression, anxiety, and suicidal ideation with various dermatological diagnoses. This international multicenter observational cross-sectional study was conducted in 13 European countries. In each dermatology clinic, 250 consecutive adult out-patients were recruited to complete a questionnaire, reporting socio-demographic information, negative life events, and suicidal ideation; depression and anxiety were assessed with the Hospital Anxiety and Depression Scale. A clinical examination was performed. A control group was recruited among hospital employees. There were 4,994 participants––3,635 patients and 1,359 controls. Clinical depression was present in 10.1% patients (controls 4.3%, odds ratio (OR) 2.40 (1.67–3.47)). Clinical anxiety was present in 17.2% (controls 11.1%, OR 2.18 (1.68–2.82)). Suicidal ideation was reported by 12.7% of all patients (controls 8.3%, OR 1.94 (1.33–2.82)). For individual diagnoses, only patients with psoriasis had significant association with suicidal ideation. The association with depression and anxiety was highest for patients with psoriasis, atopic dermatitis, hand eczema, and leg ulcers. These results identify a major additional burden of skin disease and have important clinical implications. PMID:25521458

Job insecurity and health: A study of 16 European countries

PubMed Central

László, Krisztina D.; Pikhart, Hynek; Kopp, Mária S.; Bobak, Martin; Pajak, Andrzej; Malyutina, Sofia; Salavecz, Gyöngyvér; Marmot, Michael

2010-01-01

Although the number of insecure jobs has increased considerably over the recent decades, relatively little is known about the health consequences of job insecurity, their international pattern, and factors that may modify them. In this paper, we investigated the association between job insecurity and self-rated health, and whether the relationship differs by country or individual-level characteristics. Cross-sectional data from 3 population-based studies on job insecurity, self-rated health, demographic, socioeconomic, work-related and behavioural factors and lifetime chronic diseases in 23,245 working subjects aged 45–70 years from 16 European countries were analysed using logistic regression and meta-analysis. In fully adjusted models, job insecurity was significantly associated with an increased risk of poor health in the Czech Republic, Denmark, Germany, Greece, Hungary, Israel, the Netherlands, Poland and Russia, with odds ratios ranging between 1.3 and 2.0. Similar, but not significant, associations were observed in Austria, France, Italy, Spain and Switzerland. We found no effect of job insecurity in Belgium and Sweden. In the pooled data, the odds ratio of poor health by job insecurity was 1.39. The association between job insecurity and health did not differ significantly by age, sex, education, and marital status. Persons with insecure jobs were at an increased risk of poor health in most of the countries included in the analysis. Given these results and trends towards increasing frequency of insecure jobs, attention needs to be paid to the public health consequences of job insecurity. PMID:20060634

Pharmaceutical policies in European countries in response to the global financial crisis.

PubMed

Vogler, Sabine; Zimmermann, Nina; Leopold, Christine; de Joncheere, Kees

2011-12-01

The objective of this paper is to analyze which pharmaceutical policies European countries applied during the global financial crisis. We undertook a survey with officials from public authorities for pharmaceutical pricing and reimbursement of 33 European countries represented in the PPRI (Pharmaceutical Pricing and Reimbursement Information) network based on a questionnaire. The survey was launched in September 2010 and repeated in February 2011 to obtain updated information. During the survey period from January 2010 to February 2011, 89 measures were identified in 23 of the 33 countries surveyed which were implemented to contain public medicines expenditure. Price reductions, changes in the co-payments, in the VAT rates on medicines and in the distribution margins were among the most common measures. More than a dozen countries reported measures under discussion or planned, for the remaining year 2011 and beyond. The largest number of measures were implemented in Iceland, the Baltic states (Estonia, Latvia, Lithuania), Greece, Spain and Portugal, which were hit by the crisis at different times. Cost-containment has been an issue for high-income countries in Europe - no matter if hit by the crisis or not. In recent months, changes in pharmaceutical policies were reported from 23 European countries. Measures which can be implemented rather swiftly (e.g. price cuts, changes in co-payments and VAT rates on medicines) were among the most frequent measures. While the "crisis countries" (e.g. Baltic states, Greece, Spain) reacted with a bundle of measures, reforms in other countries (e.g. Poland, Germany) were not directly linked to the crisis, but also aimed at containing public spending. Since further reforms are under way, we recommend that the monitoring exercise is continued.

Educational differentials in disability vary across and within welfare regimes: a comparison of 26 European countries in 2009.

PubMed

Cambois, Emmanuelle; Solé-Auró, Aïda; Brønnum-Hansen, Henrik; Egidi, Viviana; Jagger, Carol; Jeune, Bernard; Nusselder, Wilma J; Van Oyen, Herman; White, Chris; Robine, Jean-Marie

2016-04-01

Social differentials in disability prevalence exist in all European countries, but their scale varies markedly. To improve understanding of this variation, the article focuses on each end of the social gradient. It compares the extent of the higher disability prevalence in low social groups (referred to as disability disadvantage) and of the lower prevalence in high social groups (disability advantage); country-specific advantages/disadvantages are discussed regarding the possible influence of welfare regimes. Cross-sectional disability prevalence is measured by longstanding health-related activity limitation (AL) in the 2009 European Statistics on Income and Living Conditions (EU-SILC) across 26 countries classified into four welfare regime groups. Logistic models adjusted by country, age and sex (in all 30-79 years and in three age-bands) measured the country-specific ORs across education, representing the AL-disadvantage of low-educated and AL-advantage of high-educated groups relative to middle-educated groups. The relative AL-disadvantage of the low-educated groups was small in Sweden (eg, 1.2 (1.0-1.4)), Finland, Romania, Bulgaria and Spain (youngest age-band), but was large in the Czech Republic (eg, 1.9 (1.7-2.2)), Denmark, Belgium, Italy and Hungary. The high-educated groups had a small relative AL-advantage in Denmark (eg, 0.9 (0.8-1.1)), but a large AL-advantage in Lithuania (eg, 0.5 (0.4-0.6)), half of the Baltic and Eastern European countries, Norway and Germany (youngest age-band). There were notable differences within welfare regime groups. The country-specific disability advantages/disadvantages across educational groups identified here could help to identify determining factors and the efficiency of national policies implemented to tackle social differentials in health. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Association between Integration Policies and Immigrants’ Mortality: An Explorative Study across Three European Countries

PubMed Central

Ikram, Umar Z.; Malmusi, Davide; Juel, Knud; Rey, Grégoire; Kunst, Anton E.

2015-01-01

Background To integrate immigrants into their societies, European countries have adopted different types of policies, which may influence health through both material and psychosocial determinants. Recent studies have suggested poorer health outcomes for immigrants living in countries with poorly rated integration policies. Objective To analyse mortality differences of immigrants from the same country of origin living in countries with distinct integration policy contexts. Methods From the mortality dataset collected in the Migrant Ethnic Health Observatory (MEHO) project, we chose the Netherlands (linked data from 1996-2006), France (unlinked; 2005-2007) and Denmark (linked; 1992-2001) as representatives of the inclusive, assimilationist and exclusionist policy models, respectively, based on the Migrant Integration Policy Index. We calculated for each country sex- and age-standardized mortality rates for Turkish-, Moroccan- and local-born populations aged 20-69 years. Poisson regression was used to estimate the mortality rate ratios (MRRs) for cross-country and within-country comparisons. The analyses were further stratified by age group and cause of death. Results Compared with their peers in the Netherlands, Turkish-born immigrants had higher all-cause mortality in Denmark (MRR men 1.92; 95% CI 1.74-2.13 and women 2.11; 1.80-2.47) but lower in France (men 0.64; 0.59-0.69 and women 0.58; 0.51-0.67). A similar pattern emerged for Moroccan-born immigrants. The relative differences between immigrants and the local-born population were also largest in Denmark and lowest in France (e.g., Turkish-born men MRR 1.52; 95% CI 1.38-1.67 and 0.62; 0.58-0.66, respectively). These patterns were consistent across all age groups, and more marked for cardiovascular diseases. Conclusions Although confounders and data comparability issues (e.g., French cross-sectional data) may affect the findings, this study suggests that different macro-level policy contexts may influence

Association between traditional food consumption and motives for food choice in six European countries.

PubMed

Pieniak, Zuzanna; Verbeke, Wim; Vanhonacker, Filiep; Guerrero, Luis; Hersleth, Margrethe

2009-08-01

This study investigates the association between traditional food consumption and motives for food choice in six European countries. Cross-sectional data were collected through the TRUEFOOD pan-European consumer survey (n = 4828) with samples representative for age, gender and region in Belgium, France, Italy, Norway, Poland and Spain. Importance attached to familiarity with a product is found to be strongly and positively associated with general attitude toward traditional food as well as traditional food consumption. The importance attached to convenience was negatively related to both general attitude toward traditional food and traditional food consumption, while the importance of weight control negatively influenced the general attitude. Natural content of food was positively associated with the attitude toward traditional food and traditional food consumption. The importance of price when purchasing food failed to be significantly related with general attitude and traditional food consumption both for the pooled sample as well as within each country except in Spain. The proposed model contributes to a better understanding of factors shaping the image and influencing the consumption of traditional foods in Europe. General attitude toward traditional foods, familiarity, and importance of food naturalness emerged as drivers for traditional food consumption. Importance attached to convenience and health acted as direct barriers to traditional food consumption, whereas importance of weight control emerged as an indirect barrier through lowering general attitude toward traditional foods.

Antidepressant use in 27 European countries: associations with sociodemographic, cultural and economic factors.

PubMed

Lewer, Dan; O'Reilly, Claire; Mojtabai, Ramin; Evans-Lacko, Sara

2015-09-01

Prescribing of antidepressants varies widely between European countries despite no evidence of difference in the prevalence of affective disorders. To investigate associations between the use of antidepressants, country-level spending on healthcare and country-level attitudes towards mental health problems. We used Eurobarometer 2010, a large general population survey from 27 European countries, to measure antidepressant use and regularity of use. We then analysed the associations with country-level spending on healthcare and country-level attitudes towards mental health problems. Higher country spending on healthcare was strongly associated with regular use of antidepressants. Beliefs that mentally ill people are 'dangerous' were associated with higher use, and beliefs that they 'never recover' or 'have themselves to blame' were associated with lower and less regular use of antidepressants. Contextual factors, such as healthcare spending and public attitudes towards mental illness, may partly explain variations in antidepressant use and regular use of these medications. © The Royal College of Psychiatrists 2015.

Cancer epidemiology in Central and South Eastern European countries

PubMed Central

Vrdoljak, Eduard; Wojtukiewicz, Marek Z; Pienkowski, Tadeusz; Bodoky, Gyorgy; Berzinec, Peter; Finek, Jindrich; Todorović, Vladimir; Borojević, Nenad; Croitoru, Adina

2011-01-01

Aim To collect cancer epidemiology data in South Eastern European countries as a basis for potential comparison of their performance in cancer care. Methods The South Eastern European Research Oncology Group (SEEROG) collected and analyzed epidemiological data on incidence and mortality that reflect cancer management in 8 countries – Croatia, Czech Republic, Hungary, Romania, Poland, Slovakia, and Serbia and Montenegro in the last 20-40 years. Results The most common cancer type in men in all countries was lung cancer, followed by colorectal and prostate cancer, with the exception of the Czech Republic, where prostate cancer and colorectal cancer were more common. The most frequent cancer in women was breast cancer followed by colorectal cancer, with the exceptions of Romania and Central Serbia where cervical cancer was the second most common. Cancer mortality data from the last 20-40 years revealed two different patterns in men. In Romania and in Serbia and Montenegro, there was a trend toward an increase, while in the other countries mortality was declining, after increasing for a number of years. In women, a steady decline was observed over many years in the Czech Republic, Hungary, and Slovakia, while in the other countries it remained unchanged. Conclusions There are striking variations in the risk of different cancers by geographic area. Most of the international variation is due to exposure to known or suspected risk factors which provides a clear challenge to prevention. There are some differences in incidence and mortality that cannot be explained by exposure to known risk factors or treatment availabilities. PMID:21853542

Variation in population levels of physical activity in European children and adolescents according to cross-European studies: a systematic literature review within DEDIPAC.

PubMed

Van Hecke, Linde; Loyen, Anne; Verloigne, Maïté; van der Ploeg, Hidde P; Lakerveld, Jeroen; Brug, Johannes; De Bourdeaudhuij, Ilse; Ekelund, Ulf; Donnelly, Alan; Hendriksen, Ingrid; Deforche, Benedicte

2016-06-28

Regular physical activity is associated with physical, social and mental health benefits, whilst insufficient physical activity is associated with several negative health outcomes (e.g. metabolic problems). Population monitoring of physical activity is important to gain insight into prevalence of compliance to physical activity recommendations, groups at risk and changes in physical activity patterns. This review aims to provide an overview of all existing studies that measure physical activity in youth, in cross-European studies, to describe the variation in population levels of physical activity and to describe and define challenges regarding assessment methods that are used. A systematic search was performed on six databases (PubMed, EMBASE, CINAHL, PsycINFO, SportDiscus and OpenGrey), supplemental forward- and backward tracking was done and authors' and experts' literature databases were searched to identify relevant articles. Journal articles or reports that reported levels of physical activity in the general population of youth from cross-European studies were included. Data were reviewed, extracted and assessed by two researchers, with disagreements being resolved by a third researcher. The review protocol of this review is published under registration number CRD42014010684 in the PROSPERO database. The search resulted in 9756 identified records of which 30 articles were included in the current review. This review revealed large differences between countries in prevalence of compliance to physical activity recommendations (i.e. 60 min of daily moderate- to vigorous-intensity physical activity (MVPA)) measured subjectively (5-47%) and accelerometer measured minutes of MVPA (23-200 min). Overall boys and children were more active than girls and adolescents. Different measurement methods (subjective n = 12, objective n = 18) and reported outcome variables (n = 17) were used in the included articles. Different accelerometer intensity thresholds used

Volunteers in Palliative Care - A Comparison of Seven European Countries: A Descriptive Study.

PubMed

Woitha, Kathrin; Hasselaar, Jeroen; van Beek, Karen; Radbruch, Lukas; Jaspers, Birgit; Engels, Yvonne; Vissers, Kris

2015-07-01

In Europe, volunteers have an important role in the delivery of palliative care. As part of the EU co-funded Europall project, 4 aspects of volunteering in palliative care were studied for 7 European countries (Belgium, England, France, Germany, the Netherlands, Poland, and Spain). These included (1) involvement of volunteers in palliative care, (2) organization of palliative care volunteering, (3) legal regulations concerning volunteering, and (4) education and training of palliative care volunteering. A literature search combined with an interview study. Information from the scientific literature, and country-specific policy documents were obtained and completed, along with data of consecutive semi-structured interviews with experts in the field of palliative care in the participating countries. In all countries, volunteers appeared to be involved in palliative care, yet their involvement across health care settings differed per country. England, for example, has the highest number of volunteers whereas Spain has the lowest number. Volunteering is embedded in law and regulations in all participating countries except for England and the Netherlands. In all participating countries, training programs are available and volunteers are organized, both on a national and a regional level. This study provides a descriptive overview of volunteer work in palliative care in 7 European countries, with a focus on the organizational aspects. Further research should concentrate on the roles and responsibilities of volunteers in the care for the terminally ill in different European health systems. © 2014 World Institute of Pain.

Industry Perspective of Pediatric Drug Development in the United States: Involvement of the European Union Countries.

PubMed

Onishi, Taku; Tsukamoto, Katsura; Matsumaru, Naoki; Waki, Takashi

2018-01-01

Efforts to promote the development of pediatric pharmacotherapy include regulatory frameworks and close collaboration between the US Food and Drug Administration and the European Medicines Agency. We characterized the current status of pediatric clinical trials conducted in the United States by the pharmaceutical industry, focusing on the involvement of the European Union member countries, to clarify the industry perspective. Data on US pediatric clinical trials were obtained from ClinicalTrials.gov . Binary regression analysis was performed to identify what factors influence the likelihood of involvement of European Union countries. A total of 633 US pediatric clinical trials that met inclusion criteria were extracted and surveyed. Of these, 206 (32.5%) involved a European Union country site(s). The results of binary regression analysis indicated that attribution of industry, phase, disease area, and age of pediatric participants influenced the likelihood of the involvement of European Union countries in US pediatric clinical trials. Relatively complicated or large pediatric clinical trials, such as phase II and III trials and those that included a broad age range of participants, had a significantly greater likelihood of the involvement of European Union countries ( P < .05). Our results suggest that (1) the pharmaceutical industry utilizes regulatory frameworks in making business decisions regarding pediatric clinical trials, (2) disease area affects the involvement of European Union countries, and (3) feasibility of clinical trials is mainly concerned by pharmaceutical industry for pediatric drug development. Additional incentives for high marketability may further motivate pharmaceutical industry to develop pediatric drugs.

Genetic analysis of dyslexia candidate genes in the European cross-linguistic NeuroDys cohort.

PubMed

Becker, Jessica; Czamara, Darina; Scerri, Tom S; Ramus, Franck; Csépe, Valéria; Talcott, Joel B; Stein, John; Morris, Andrew; Ludwig, Kerstin U; Hoffmann, Per; Honbolygó, Ferenc; Tóth, Dénes; Fauchereau, Fabien; Bogliotti, Caroline; Iannuzzi, Stéphanie; Chaix, Yves; Valdois, Sylviane; Billard, Catherine; George, Florence; Soares-Boucaud, Isabelle; Gérard, Christophe-Loïc; van der Mark, Sanne; Schulz, Enrico; Vaessen, Anniek; Maurer, Urs; Lohvansuu, Kaisa; Lyytinen, Heikki; Zucchelli, Marco; Brandeis, Daniel; Blomert, Leo; Leppänen, Paavo H T; Bruder, Jennifer; Monaco, Anthony P; Müller-Myhsok, Bertram; Kere, Juha; Landerl, Karin; Nöthen, Markus M; Schulte-Körne, Gerd; Paracchini, Silvia; Peyrard-Janvid, Myriam; Schumacher, Johannes

2014-05-01

Dyslexia is one of the most common childhood disorders with a prevalence of around 5-10% in school-age children. Although an important genetic component is known to have a role in the aetiology of dyslexia, we are far from understanding the molecular mechanisms leading to the disorder. Several candidate genes have been implicated in dyslexia, including DYX1C1, DCDC2, KIAA0319, and the MRPL19/C2ORF3 locus, each with reports of both positive and no replications. We generated a European cross-linguistic sample of school-age children - the NeuroDys cohort - that includes more than 900 individuals with dyslexia, sampled with homogenous inclusion criteria across eight European countries, and a comparable number of controls. Here, we describe association analysis of the dyslexia candidate genes/locus in the NeuroDys cohort. We performed both case-control and quantitative association analyses of single markers and haplotypes previously reported to be dyslexia-associated. Although we observed association signals in samples from single countries, we did not find any marker or haplotype that was significantly associated with either case-control status or quantitative measurements of word-reading or spelling in the meta-analysis of all eight countries combined. Like in other neurocognitive disorders, our findings underline the need for larger sample sizes to validate possibly weak genetic effects.

Initial Career and Work Meanings in Seven European Countries.

ERIC Educational Resources Information Center

Claes, Rita; Quintanilla, S. Antonio R.

1994-01-01

Explores initial careers of two target groups of young adults in seven European countries. Career patterns were constructed through cluster analysis on data gathered via self-report. Six career patterns were identified. Offers suggestions for further research and implications for career counseling, career education, and organizational career…

Statistics on the use of cardiac electronic devices and electrophysiological procedures in the European Society of Cardiology countries: 2014 report from the European Heart Rhythm Association.

PubMed

Raatikainen, M J Pekka; Arnar, David O; Zeppenfeld, Katja; Merino, Jose Luis; Levya, Francisco; Hindriks, Gerhardt; Kuck, Karl-Heinz

2015-01-01

There has been large variations in the use of invasive electrophysiological therapies in the member countries of the European Society of Cardiology (ESC). The aim of this analysis was to provide comprehensive information on cardiac implantable electronic device (CIED) and catheter ablation therapy trends in the ESC countries over the last five years. The European Heart Rhythm Association (EHRA) has collected data on CIED and catheter ablation therapy since 2008. Last year 49 of the 56 ESC member countries provided data for the EHRA White Book. This analysis is based on the current and previous editions of the EHRA White Book. Data on procedure rates together with information on economic aspects, local reimbursement systems and training activities are presented for each ESC country and the five geographical ESC regions. In 2013, the electrophysiological procedure rates per million population were highest in Western Europe followed by the Southern and Northern European countries. The CIED implantation and catheter ablation rate was lowest in the Eastern European and in the non-European ESC countries, respectively. However, in some Eastern European countries with relative low gross domestic product procedure rates exceeded those of some wealthier Western countries, suggesting that economic resources are not the only driver for utilization of arrhythmia therapies. These statistics indicate that despite significant improvements, there still is considerable heterogeneity in the availability of arrhythmia therapies across the ESC area. Hopefully, these data will help identify areas for improvement and guide future activities in cardiac arrhythmia management. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.

Cross-national differences in the gender gap in subjective health in Europe: does country-level gender equality matter?

PubMed

Dahlin, Johanna; Härkönen, Juho

2013-12-01

Multiple studies have found that women report being in worse health despite living longer. Gender gaps vary cross-nationally, but relatively little is known about the causes of comparative differences. Existing literature is inconclusive as to whether gender gaps in health are smaller in more gender equal societies. We analyze gender gaps in self-rated health (SRH) and limiting longstanding illness (LLI) with five waves of European Social Survey data for 191,104 respondents from 28 countries. We use means, odds ratios, logistic regressions, and multilevel random slopes logistic regressions. Gender gaps in subjective health vary visibly across Europe. In many countries (especially in Eastern and Southern Europe), women report distinctly worse health, while in others (such as Estonia, Finland, and Great Britain) there are small or no differences. Logistic regressions ran separately for each country revealed that individual-level socioeconomic and demographic variables explain a majority of these gaps in some countries, but contribute little to their understanding in most countries. In yet other countries, men had worse health when these variables were controlled for. Cross-national variation in the gender gaps exists after accounting for individual-level factors. Against expectations, the remaining gaps are not systematically related to societal-level gender inequality in the multilevel analyses. Our findings stress persistent cross-national variability in gender gaps in health and call for further analysis. Copyright © 2013 Elsevier Ltd. All rights reserved.

Why Do Adults Learn? Developing a Motivational Typology across 12 European Countries

ERIC Educational Resources Information Center

Boeren, Ellen; Holford, John; Nicaise, Ides; Baert, Herman

2012-01-01

Participation in adult education is today generally considered an individual responsibility. However, participation is the result of a complex bounded agency between individuals, educational institutions and regulating governments. This paper explores the motives of 12,000 European adult learners in formal adult education in 12 European countries.…

Recent trends in incidence of five common cancers in 26 European countries since 1988: Analysis of the European Cancer Observatory.

PubMed

Arnold, Melina; Karim-Kos, Henrike E; Coebergh, Jan Willem; Byrnes, Graham; Antilla, Ahti; Ferlay, Jacques; Renehan, Andrew G; Forman, David; Soerjomataram, Isabelle

2015-06-01

Individual country- and cancer site-specific studies suggest that the age-adjusted incidence of many common cancers has increased in European populations over the past two decades. To quantify the extent of these trends and the recent burden of cancer, here we present a comprehensive overview of trends in population-based incidence of the five common cancers across Europe derived from a new web-based portal of the European cancer registries. Data on incidence for cancers of the colon and rectum, prostate, breast, corpus uteri and stomach diagnosed from 1988 to 2008 were obtained from the European Cancer Observatory for cancer registries from 26 countries. Annual age-standardised incidence rates and average annual percentage changes were calculated. Incidence of four common cancers in eastern and central European countries (prostate, postmenopausal breast, corpus uteri and colorectum) started to approach levels in northern and western Europe, where rates were already high in the past but levelled off in some countries in recent years. Decreases in stomach cancer incidence were seen in all countries. Increasing trends in incidence of the most common cancers, except stomach cancer, are bad news to public health but can largely be explained by well-known changes in society in the past decades. Thus, current and future efforts in primary cancer prevention should not only remain focussed on the further reduction of smoking but engage in the long-term efforts to retain healthy lifestyles, especially avoiding excess weight through balanced diets and regular physical exercise. Copyright © 2013 Elsevier Ltd. All rights reserved.

Pharmaceutical regulation in 15 European countries review.

PubMed

Panteli, Dimitra; Arickx, Francis; Cleemput, Irina; Dedet, Guillaume; Eckhardt, Helen; Fogarty, Emer; Gerkens, Sophie; Henschke, Cornelia; Hislop, Jennifer; Jommi, Claudio; Kaitelidou, Daphne; Kawalec, Pawel; Keskimaki, Ilmo; Kroneman, Madelon; Lopez Bastida, Julio; Pita Barros, Pedro; Ramsberg, Joakim; Schneider, Peter; Spillane, Susan; Vogler, Sabine; Vuorenkoski, Lauri; Wallach Kildemoes, Helle; Wouters, Olivier; Busse, Reinhard

2016-10-01

In the context of pharmaceutical care, policy-makers repeatedly face the challenge of balancing patient access to effective medicines with affordability and rising costs. With the aim of guiding the health policy discourse towards questions that are important to actual and potential patients, this study investigates a broad range of regulatory measures, spanning marketing authorization to generic substitution and resulting price levels in a sample of 16 European health systems (Austria, Belgium, Denmark, England, Finland, France, Germany, Greece, Ireland, Italy, the Netherlands, Poland, Portugal, Scotland, Spain and Sweden). All countries employ a mix of regulatory mechanisms to contain pharmaceutical expenditure and ensure quality and efficiency in pharmaceutical care, albeit with varying configurations and rigour. This variation also influences the extent of publicly financed pharmaceutical costs. Overall, observed differences in pharmaceutical expenditure should be interpreted in conjunction with the differing volume and composition of consumption and price levels, as well as dispensation practices and their impact on measurement of pharmaceutical costs. No definitive evidence has yet been produced on the effects of different cost-containment measures on patient outcomes. Depending on the foremost policy concerns in each country, different levers will have to be used to enable the delivery of appropriate care at affordable prices. World Health Organization 2016 (acting as the host organization for, and secretariat of, the European Observatory on Health Systems and Policies).

14 CFR 61.93 - Solo cross-country flight requirements.

Code of Federal Regulations, 2011 CFR

2011-01-01

... preflight planning and preparation is correct and that the student is prepared to make the flight safely... instructor has: (1) Determined that the student's cross-country planning is correct for the flight; (2... 14 Aeronautics and Space 2 2011-01-01 2011-01-01 false Solo cross-country flight requirements. 61...

14 CFR 61.93 - Solo cross-country flight requirements.

Code of Federal Regulations, 2010 CFR

2010-01-01

... preflight planning and preparation is correct and that the student is prepared to make the flight safely... instructor has: (1) Determined that the student's cross-country planning is correct for the flight; (2... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false Solo cross-country flight requirements. 61...

14 CFR 61.93 - Solo cross-country flight requirements.

Code of Federal Regulations, 2014 CFR

2014-01-01

... preflight planning and preparation is correct and that the student is prepared to make the flight safely... instructor has: (1) Determined that the student's cross-country planning is correct for the flight; (2... 14 Aeronautics and Space 2 2014-01-01 2014-01-01 false Solo cross-country flight requirements. 61...

14 CFR 61.93 - Solo cross-country flight requirements.

Code of Federal Regulations, 2013 CFR

2013-01-01

... preflight planning and preparation is correct and that the student is prepared to make the flight safely... instructor has: (1) Determined that the student's cross-country planning is correct for the flight; (2... 14 Aeronautics and Space 2 2013-01-01 2013-01-01 false Solo cross-country flight requirements. 61...

14 CFR 61.93 - Solo cross-country flight requirements.

Code of Federal Regulations, 2012 CFR

2012-01-01

... preflight planning and preparation is correct and that the student is prepared to make the flight safely... instructor has: (1) Determined that the student's cross-country planning is correct for the flight; (2... 14 Aeronautics and Space 2 2012-01-01 2012-01-01 false Solo cross-country flight requirements. 61...

The Benefits of Comparing Grapefruits and Tangerines: A Toolbox for European Cross-Cultural Comparisons in Engineering Education--Using This Toolbox to Study Gendered Images of Engineering among Students

ERIC Educational Resources Information Center

Godfroy-Genin, Anne-Sophie; Pinault, Cloe

2006-01-01

The main objective of the WomEng European research project was to assess when, how and why women decide to or not to study engineering. This question was addressed through an international cross-comparison by an interdisciplinary research team in seven European countries. This article presents, in the first part, the methodological toolbox…

The quality of oncology nursing care: A cross sectional survey in three countries in Europe.

PubMed

Charalambous, Andreas; Adamakidou, Theodoula; Cloconi, Constantina; Charalambous, Melanie; Tsitsi, Theologia; Vondráčková, Lucie; Bužgová, Radka

2017-04-01

The increase in patients diagnosed with and living with cancer calls for the provision of quality nursing care within this paradigm, one that can reflect the complex needs of the patient that cancer and its treatments induce. The study aimed to evaluate the quality of oncology nursing care, as perceived, by hospitalized cancer patients in three European countries. This was a cross-sectional descriptive study. In-patients diagnosed with cancer were selected based on explicit inclusion and exclusion criteria. Data was collected with the Quality of Oncology Nursing Care Scale- QONCS, comprising of 34 items grouped in 5 domains. Sociodemographic data was also retrieved. The sample included 610 patients receiving care in 2 hospitals in Cyprus (n = 274), 1 hospital in Greece (n = 144) and 2 hospitals in the Czech Republic (n = 192). Statistically significant differences were found between the three countries and across all domains of the QONCS, with the exception of the spiritual and religious care (p = 0.136). Age and days of treatment produced statistically significant differences across all the domains of the QONCS, whilst gender did not produced any statistically significant differences (p ranged from (0.136-0.369). This is one of the first studies that provide evidence on the Quality of Nursing Care delivered to patients diagnosed with cancer in various European countries. Discrepancies were found between the participating countries. However, the provision of spiritual and religious care by the nurses received the lowest scores across the three participating countries. Copyright © 2016 Elsevier Ltd. All rights reserved.

[The European countries confronting cancer: a set of indicators assessing public health status].

PubMed

Borella, Laurent

2008-11-01

We now know that efficient public policies for cancer control need to be global and take into account each and all the factors involved: economics and level of development, style of life and risk factors, access to screening, effectiveness of the care-providing system. A very simple scorecard is proposed, based on publicized public health indicators, which allows a comparison between European countries. We extracted 49 indicators from public databases and literature concerning 22 European countries. We made correlation calculations in order to identify relevant indicators from which a global score was extracted. Using a hierarchical clustering method we were then able to identify subsets of homogeneous countries. A 7 indicator scorecard was drawn up: national gross product, scientific production, smoking rate, breast screening participating rate, all cancer mortality rate (male population), 5 years relative survival for colorectal cancer and life expectancy at birth. A global score shows: 1) the better positioned countries: Switzerland, Sweden, Finland and France; 2) the countries where cancer control is less effective: Estonia, Hungary, Poland and Slovakia. Three subsets of countries with a fairly similar profile were identified: a high level of means and results group; a high level of means but a medium level of results group; and a low level of means and results group. This work emphasizes dramatically heterogeneous situations between countries. A follow-up, using a reduced but regularly updated set of public health indicators, would help induce an active European policy for cancer control.

The comparability of the universalism value over time and across countries in the European Social Survey: exact vs. approximate measurement invariance

PubMed Central

Zercher, Florian; Schmidt, Peter; Cieciuch, Jan; Davidov, Eldad

2015-01-01

Over the last decades, large international datasets such as the European Social Survey (ESS), the European Value Study (EVS) and the World Value Survey (WVS) have been collected to compare value means over multiple time points and across many countries. Yet analyzing comparative survey data requires the fulfillment of specific assumptions, i.e., that these values are comparable over time and across countries. Given the large number of groups that can be compared in repeated cross-national datasets, establishing measurement invariance has been, however, considered unrealistic. Indeed, studies which did assess it often failed to establish higher levels of invariance such as scalar invariance. In this paper we first introduce the newly developed approximate approach based on Bayesian structural equation modeling (BSEM) to assess cross-group invariance over countries and time points and contrast the findings with the results from the traditional exact measurement invariance test. BSEM examines whether measurement parameters are approximately (rather than exactly) invariant. We apply BSEM to a subset of items measuring the universalism value from the Portrait Values Questionnaire (PVQ) in the ESS. The invariance of this value is tested simultaneously across 15 ESS countries over six ESS rounds with 173,071 respondents and 90 groups in total. Whereas, the use of the traditional approach only legitimates the comparison of latent means of 37 groups, the Bayesian procedure allows the latent mean comparison of 73 groups. Thus, our empirical application demonstrates for the first time the BSEM test procedure on a particularly large set of groups. PMID:26089811

Macro-environmental factors associated with leisure-time physical activity: a cross-national analysis of EU countries.

PubMed

Van Tuyckom, Charlotte

2011-06-01

Although there is a growing agreement among researchers that the modern environment contributes to the current trend of decreasing leisure-time physical activity (LTPA), there are very few studies addressing environmental and policy correlates of LTPA within a cross-national European context. This study describes LTPA patterns across the European Union and identifies some macro-environmental factors associated with LTPA rates at a national level. Data on LTPA and indicators of the economic, physical, and policy environment were assembled from international databases for the 27 European member states. To examine the association of each of the independent macro-environmental variables and LTPA as a continuous dependent variable, bivariate linear regression models were employed. Separate analyses were done for the overall, male, and female groups. With respect to LTPA, striking differences between European member states and genders were found, with higher rates in Western and Northern European countries, and among males. Statistical significant associations were observed between overall LTPA and variables from the economic (GDP, real GDP, and public expenditures on health), food (available fat, available fruit, and vegetables), urbanisation (urban population, total and new passenger cars), and policy (all governance indicators) domains. Associations for male and female LTPA were similar, except that for males available fruit and vegetables, and for females available fat and urban population were not significant. This exploratory study seeks to plead for the need for cross-nationally comparable LTPA data and more sophisticated research in order to understand the role of macro-economic environments, with a special focus on policy-related variables and gender-specific differences.

Legislative regulation and ethical governance of medical research in different European Union countries.

PubMed

Veerus, Piret; Lexchin, Joel; Hemminki, Elina

2014-06-01

To obtain information about the similarities and differences in regulating different types of medical research in the European Union (EU). Web searches were performed from September 2009 to January 2011. Notes on pre-determined topics were systematically taken down from the web pages. The analysis relied only on documents and reports available on the web, reflecting the situation at the end of 2010. In several countries, regulatory legislation applied only to clinical trials on drugs and medical devices, in other states various types of research were also regulated but by laws different from those concerning trials, and in many countries, some research areas were not controlled by legislation at all. In very few countries was all medical research handled similarly from a legal point of view. The number of research ethics committees (RECs) in a single country varied from one to 264. Their areas of responsibility, working principles and length of time to grant research permission varied as well as the rules for obtaining informed consent from vulnerable groups. In 10 EU countries, there was no appeal mechanism after a negative decision by an REC. The RECs were not accountable to any organisation in five EU countries. There is a need for a fundamental debate regarding whether and which kinds of changes are needed for the further harmonisation of medical research governance in the EU and how cross-country medical research could be facilitated in the future. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Differences in lifetime use of services for mental health problems in six European countries.

PubMed

Kovess-Masfety, Viviane; Alonso, Jordi; Brugha, Traolach S; Angermeyer, Matthias C; Haro, Josep Maria; Sevilla-Dedieu, Christine

2007-02-01

In Europe mental health services vary somewhat in the level of resources available and in their organization. The purpose of this study was to describe lifetime use of mental health services in six European countries, especially by individuals with a DSM-IV-defined psychiatric disorder (psychotic disorders were excluded), and to assess differences between countries as a function of resource availability. Data were obtained from 8,796 noninstitutionalized adults of six European countries by computer-assisted interviews with the Composite International Diagnostic Interview, version 3.0. Lifetime consultation rates varied between countries and according to mental health status. For depression, lifetime consultation rates ranged from 37.0% in Italy to 71.0% in the Netherlands. Among users of services, general practitioners were the professionals most frequently consulted in all countries (64.2% on average), followed by psychiatrists (consultation ranged from 25.5% in the Netherlands to 43.8% in Spain) and psychologists (consultation ranged from 23.3% in France to 64.8% in the Netherlands). The lowest rates were in the countries with the lowest availability of professionals, but the countries with the highest density of professionals did not necessarily have the highest consultation rates. Although there are important differences in mental health care between European countries, they seem to be only partially related to differences in overall health care provision.

Google Trends terms reporting rhinitis and related topics differ in European countries.

PubMed

Bousquet, J; Agache, I; Anto, J M; Bergmann, K C; Bachert, C; Annesi-Maesano, I; Bousquet, P J; D'Amato, G; Demoly, P; De Vries, G; Eller, E; Fokkens, W J; Fonseca, J; Haahtela, T; Hellings, P W; Just, J; Keil, T; Klimek, L; Kuna, P; Lodrup Carlsen, K C; Mösges, R; Murray, R; Nekam, K; Onorato, G; Papadopoulos, N G; Samolinski, B; Schmid-Grendelmeier, P; Thibaudon, M; Tomazic, P; Triggiani, M; Valiulis, A; Valovirta, E; Van Eerd, M; Wickman, M; Zuberbier, T; Sheikh, A

2017-08-01

Google Trends (GT) searches trends of specific queries in Google and reflects the real-life epidemiology of allergic rhinitis. We compared Google Trends terms related to allergy and rhinitis in all European Union countries, Norway and Switzerland from 1 January 2011 to 20 December 2016. The aim was to assess whether the same terms could be used to report the seasonal variations of allergic diseases. Using the Google Trend 5-year graph, an annual and clear seasonality of queries was found in all countries apart from Cyprus, Estonia, Latvia, Lithuania and Malta. Different terms were found to demonstrate seasonality depending on the country - namely 'hay fever', 'allergy' and 'pollen' - showing cultural differences. A single set of terms cannot be used across all European countries, but allergy seasonality can be compared across Europe providing the above three terms are used. Using longitudinal data in different countries and multiple terms, we identified an awareness-related spike of searches (December 2016). © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Immigrant Integration policies and perceived Group Threat: A Multilevel Study of 27 Western and Eastern European Countries.

PubMed

Schlueter, Elmar; Meuleman, Bart; Davidov, Eldad

2013-05-01

Although immigrant integration policies have long been hypothesized to be associated with majority members' anti-immigrant sentiments, systematic empirical research exploring this relationship is largely absent. To address this gap in the literature, the present research takes a cross-national perspective. Drawing from theory and research on group conflict and intergroup norms, we conduct two studies to examine whether preexisting integration policies that are more permissive promote or impede majority group members' subsequent negative attitudes regarding immigrants. For several Western and Eastern European countries, we link country-level information on immigrant integration policies from 2006 with individual-level survey data from the Eurobarometer 71.3 collected in 2009 (Study 1) and from the fourth wave of the European Value Study collected between 2008 and 2009 (Study 2). For both studies, the results from multilevel regression models demonstrate that immigrant integration policies that are more permissive are associated with decreased perceptions of group threat from immigrants. These findings suggest that immigrant integration policies are of key importance in improving majority members' attitudes regarding immigrants, which is widely considered desirable in modern immigrant-receiving societies. Copyright © 2012 Elsevier Inc. All rights reserved.

Essential competencies in prescribing: A first european cross-sectional study among 895 final-year medical students.

PubMed

Brinkman, D J; Tichelaar, J; Schutte, T; Benemei, S; Böttiger, Y; Chamontin, B; Christiaens, T; Likic, R; Maˇiulaitis, R; Marandi, T; Monteiro, E C; Papaioannidou, P; Pers, Y M; Pontes, C; Raskovic, A; Regenthal, R; Sanz, E J; Tamba, B I; Wilson, K; Vries, Tp de; Richir, M C; Agtmael, Ma van

2017-02-01

European medical students should have acquired adequate prescribing competencies before graduation, but it is not known whether this is the case. In this international multicenter study, we evaluated the essential knowledge, skills, and attitudes in clinical pharmacology and therapeutics (CPT) of final-year medical students across Europe. In a cross-sectional design, 26 medical schools from 17 European countries were asked to administer a standardized assessment and questionnaire to 50 final-year students. Although there were differences between schools, our results show an overall lack of essential prescribing competencies among final-year students in Europe. Students had a poor knowledge of drug interactions and contraindications, and chose inappropriate therapies for common diseases or made prescribing errors. Our results suggest that undergraduate teaching in CPT is inadequate in many European schools, leading to incompetent prescribers and potentially unsafe patient care. A European core curriculum with clear learning outcomes and assessments should be urgently developed. © 2016 The Authors. Clinical Pharmacology & Therapeutics published by Wiley Periodicals, Inc. on behalf of The American Society for Clinical Pharmacology and Therapeutics.

Russian Oil and Natural Gas: Strategic Culture and Security Implications of European Dependence

DTIC Science & Technology

2007-12-01

Russia receives from consumption of oil and natural gas exports to Europe on their Gross National Product and economic growth for the future. By...Gross National Product and economic growth for the future. By understanding Russia’s strategic culture and the interdependence of European demand and...EXPORTS ...............66 1. Oil and Natural Gas Reserves and Production ..68 2. Exports to Europe ............................71 3. Revenues

Radiotherapy equipment and departments in the European countries: final results from the ESTRO-HERO survey.

PubMed

Grau, Cai; Defourny, Noémie; Malicki, Julian; Dunscombe, Peter; Borras, Josep M; Coffey, Mary; Slotman, Ben; Bogusz, Marta; Gasparotto, Chiara; Lievens, Yolande; Kokobobo, Arianit; Sedlmayer, Felix; Slobina, Elena; Feyen, Karen; Hadjieva, Tatiana; Odrazka, Karel; Grau Eriksen, Jesper; Jaal, Jana; Bly, Ritva; Chauvet, Bruno; Willich, Normann; Polgar, Csaba; Johannsson, Jakob; Cunningham, Moya; Magrini, Stefano; Atkocius, Vydmantas; Untereiner, Michel; Pirotta, Martin; Karadjinovic, Vanja; Levernes, Sverre; Sladowski, Krystol; Lurdes Trigo, Maria; Šegedin, Barbara; Rodriguez, Aurora; Lagerlund, Magnus; Pastoors, Bert; Hoskin, Peter; Vaarkamp, Jaap; Cleries Soler, Ramon

2014-08-01

Documenting the distribution of radiotherapy departments and the availability of radiotherapy equipment in the European countries is an important part of HERO - the ESTRO Health Economics in Radiation Oncology project. HERO has the overall aim to develop a knowledge base of the provision of radiotherapy in Europe and build a model for health economic evaluation of radiation treatments at the European level. The aim of the current report is to describe the distribution of radiotherapy equipment in European countries. An 84-item questionnaire was sent out to European countries, principally through their national societies. The current report includes a detailed analysis of radiotherapy departments and equipment (questionnaire items 26-29), analyzed in relation to the annual number of treatment courses and the socio-economic status of the countries. The analysis is based on validated responses from 28 of the 40 European countries defined by the European Cancer Observatory (ECO). A large variation between countries was found for most parameters studied. There were 2192 linear accelerators, 96 dedicated stereotactic machines, and 77 cobalt machines reported in the 27 countries where this information was available. A total of 12 countries had at least one cobalt machine in use. There was a median of 0.5 simulator per MV unit (range 0.3-1.5) and 1.4 (range 0.4-4.4) simulators per department. Of the 874 simulators, a total of 654 (75%) were capable of 3D imaging (CT-scanner or CBCT-option). The number of MV machines (cobalt, linear accelerators, and dedicated stereotactic machines) per million inhabitants ranged from 1.4 to 9.5 (median 5.3) and the average number of MV machines per department from 0.9 to 8.2 (median 2.6). The average number of treatment courses per year per MV machine varied from 262 to 1061 (median 419). While 69% of MV units were capable of IMRT only 49% were equipped for image guidance (IGRT). There was a clear relation between socio-economic status, as

Mental health provision in schools: approaches and interventions in 10 European countries.

PubMed

Patalay, P; Gondek, D; Moltrecht, B; Giese, L; Curtin, C; Stanković, M; Savka, N

2017-01-01

The role of schools in providing community-based support for children's mental health and well-being is widely accepted and encouraged. Research has mainly focused on designing and evaluating specific interventions and there is little data available regarding what provision is available, the focus and priorities of schools and the professionals involved in providing this support. The current study presents these data from schools in 10 European countries. Online survey of 1466 schools in France, Germany, Ireland, Netherlands, Poland, Serbia, Spain, Sweden, UK and Ukraine. The participating countries were chosen based on their geographical spread, diversity of political and economic systems, and convenience in terms of access to the research group and presence of collaborators. Schools reported having more universal provision than targeted provision and there was greater reported focus on children who already have difficulties compared with prevention of problems and promotion of student well-being. The most common interventions implemented related to social and emotional skills development and anti-bullying programmes. Learning and educational support professionals were present in many schools with fewer schools reporting involvement of a clinical specialist. Responses varied by country with 7.4-33.5% between-country variation across study outcomes. Secondary schools reported less support for parents and more for staff compared with primary schools, with private schools also indicating more staff support. Schools in rural locations reported less student support and professionals involved than schools in urban locations. The current study provides up-to-date and cross-country insight into the approaches, priorities and provision available for mental health support in schools; highlighting what schools prioritise in providing mental health support and where coverage of provision is lacking.

Kick, Glide, Pole! Cross-Country Skiing Fun (Part II)

ERIC Educational Resources Information Center

Duoos, Bridget A.

2012-01-01

Part I of Kick, Glide, Pole! Cross-Country Skiing Fun, which was published in last issue, discussed how to select cross-country ski equipment, dress for the activity and the biomechanics of the diagonal stride. Part II focuses on teaching the diagonal stride technique and begins with a progression of indoor activities. Incorporating this fun,…

Kick, Glide, Pole! Cross-Country Skiing Fun (Part I)

ERIC Educational Resources Information Center

Duoos, Bridget A.

2011-01-01

Cross-country skiing is a great activity for taking a physical education class outside during the cold winter months. It is also a diverse activity that appeals to students of all ages, and is an excellent cardio-respiratory activity to keep students active. This article has provided the first steps in preparing a cross-country skiing lesson in…

Peak oil and health in low- and middle-income countries: impacts and potential responses.

PubMed

Winch, Peter; Stepnitz, Rebecca

2011-09-01

Peak oil refers to the predicted peak and subsequent decline in global production of petroleum products over the coming decades. We describe how peak oil will affect health, nutrition, and health systems in low- and middle-income countries along 5 pathways. The negative effects of peak oil on health and nutrition will be felt most acutely in the 58 low-income countries experiencing minimal or negative economic growth because of their patterns of sociopolitical, geographic, and economic vulnerability. The global health community needs to take additional steps to build resilience among the residents of low- and middle-income countries and maintain access to maternal and other health services in the face of predicted changes in availability and price of fossil fuels.

Chagas disease in European countries: the challenge of a surveillance system.

PubMed

Basile, L; Jansa, J M; Carlier, Y; Salamanca, D D; Angheben, A; Bartoloni, A; Seixas, J; Van Gool, T; Canavate, C; Flores-Chavez, M; Jackson, Y; Chiodini, P L; Albajar-Vinas, P

2011-09-15

A study of aggregate data collected from the literature and official sources was undertaken to estimate expected and observed prevalence of Trypanosoma cruzi infection, annual incidence of congenital transmission and rate of underdiagnosis of Chagas disease among Latin American migrants in the nine European countries with the highest prevalence of Chagas disease. Formal and informal data sources were used to estimate the population from endemic countries resident in Europe in 2009, diagnosed cases of Chagas disease and births from mothers originating from endemic countries. By 2009, 4,290 cases had been diagnosed in Europe, compared with an estimated 68,000 to 122,000 expected cases. The expected prevalence was very high in undocumented migrants (on average 45% of total expected cases) while the observed prevalence rate was 1.3 cases per 1,000 resident migrants from endemic countries. An estimated 20 to 183 babies with congenital Chagas disease are born annually in the study countries. The annual incidence rate of congenital transmission per 1,000 pregnancies in women from endemic countries was between none and three cases. The index of under diagnosis of T. cruzi infection was between 94% and 96%. Chagas disease is a public health challenge in the studied European countries. Urgent measures need to be taken to detect new cases of congenital transmission and take care of the existing cases with a focus on migrants without legal residency permit and potential difficulty accessing care.

Oil and economic development in OPEC countries, with case studies about Iraq and Algeria

DOE Office of Scientific and Technical Information (OSTI.GOV)

Al-Khalil, M.A.

1984-01-01

This dissertation examines the impact of the increase in oil prices in 1973 and thereafter on economic development in the Organization of Petroleum Exporting Countries (OPEC) in general, and in Iraq and Algeria in particular. It attempts to investigate the extent to which these countries have succeeded in utilizing oil revenues to achieve their projected goals: diversification of their economies in order to reduce dependence on exporting crude oil which is an exhaustible resource; and acceleration of the rate of growth of the non-oil sector in order to increase its contribution to GDP and foreign-exchange earnings as well as tomore » maintain the growth of the economy in the post-oil age. While the increase in oil revenues greatly reduced the capital constraint to growth, it did not remove all other constraints at the same time. Thus, bottlenecks in transportation, institutions, skilled labor, raw and construction materials remained important obstacles. According to the criteria used by this study to judge the performance of the Iraqi and the Algerian economies after 1973, both countries did quite well. However, one of the findings about Iraq is that while the rate of growth of real per capita GDP accelerated after 1973, the rate of growth of real per capita non-oil GDP did not. Algeria succeeded in diversifying her economy, since the rate of growth of non-oil GDP accelerated after 1973, compared to the earlier period.« less

Plasma Carotenoids, Tocopherols, and Retinol in the Age-Stratified (35-74 Years) General Population: A Cross-Sectional Study in Six European Countries.

PubMed

Stuetz, Wolfgang; Weber, Daniela; Dollé, Martijn E T; Jansen, Eugène; Grubeck-Loebenstein, Beatrix; Fiegl, Simone; Toussaint, Olivier; Bernhardt, Juergen; Gonos, Efstathios S; Franceschi, Claudio; Sikora, Ewa; Moreno-Villanueva, María; Breusing, Nicolle; Grune, Tilman; Bürkle, Alexander

2016-09-30

Blood micronutrient status may change with age. We analyzed plasma carotenoids, α-/γ-tocopherol, and retinol and their associations with age, demographic characteristics, and dietary habits (assessed by a short food frequency questionnaire) in a cross-sectional study of 2118 women and men (age-stratified from 35 to 74 years) of the general population from six European countries. Higher age was associated with lower lycopene and α-/β-carotene and higher β-cryptoxanthin, lutein, zeaxanthin, α-/γ-tocopherol, and retinol levels. Significant correlations with age were observed for lycopene ( r = -0.248), α-tocopherol ( r = 0.208), α-carotene ( r = -0.112), and β-cryptoxanthin ( r = 0.125; all p < 0.001). Age was inversely associated with lycopene (-6.5% per five-year age increase) and this association remained in the multiple regression model with the significant predictors (covariables) being country, season, cholesterol, gender, smoking status, body mass index (BMI (kg/m²)), and dietary habits. The positive association of α-tocopherol with age remained when all covariates including cholesterol and use of vitamin supplements were included (1.7% vs. 2.4% per five-year age increase). The association of higher β-cryptoxanthin with higher age was no longer statistically significant after adjustment for fruit consumption, whereas the inverse association of α-carotene with age remained in the fully adjusted multivariable model (-4.8% vs. -3.8% per five-year age increase). We conclude from our study that age is an independent predictor of plasma lycopene, α-tocopherol, and α-carotene.

Pharmaceutical policies in European countries in response to the global financial crisis

PubMed Central

Vogler, Sabine; Zimmermann, Nina; Leopold, Christine; de Joncheere, Kees

2011-01-01

Objective: The objective of this paper is to analyze which pharmaceutical policies European countries applied during the global financial crisis. Methods: We undertook a survey with officials from public authorities for pharmaceutical pricing and reimbursement of 33 European countries represented in the PPRI (Pharmaceutical Pricing and Reimbursement Information) network based on a questionnaire. The survey was launched in September 2010 and repeated in February 2011 to obtain updated information. Results: During the survey period from January 2010 to February 2011, 89 measures were identified in 23 of the 33 countries surveyed which were implemented to contain public medicines expenditure. Price reductions, changes in the co-payments, in the VAT rates on medicines and in the distribution margins were among the most common measures. More than a dozen countries reported measures under discussion or planned, for the remaining year 2011 and beyond. The largest number of measures were implemented in Iceland, the Baltic states (Estonia, Latvia, Lithuania), Greece, Spain and Portugal, which were hit by the crisis at different times. Conclusions: Cost-containment has been an issue for high-income countries in Europe – no matter if hit by the crisis or not. In recent months, changes in pharmaceutical policies were reported from 23 European countries. Measures which can be implemented rather swiftly (e.g. price cuts, changes in co-payments and VAT rates on medicines) were among the most frequent measures. While the “crisis countries” (e.g. Baltic states, Greece, Spain) reacted with a bundle of measures, reforms in other countries (e.g. Poland, Germany) were not directly linked to the crisis, but also aimed at containing public spending. Since further reforms are under way, we recommend that the monitoring exercise is continued. PMID:23093885

What seems to matter in public policy and the health of informal caregivers? A cross-sectional study in 12 European countries.

PubMed

Calvó-Perxas, Laia; Vilalta-Franch, Joan; Litwin, Howard; Turró-Garriga, Oriol; Mira, Pedro; Garre-Olmo, Josep

2018-01-01

In Europe, informal caregiving is frequent and is expected to grow. Caregiving has an impact on caregivers' health, but its effect may vary according to the policies of support that are available to caregivers. The aim of this study was to assess the association between the policies of support to caregivers available in 12 European countries and the health of caregivers, considering separately the policies based on financial help and those based on training and other non- financial services. We used data from 13,507 caregivers from 12 European countries from the fifth wave of the Survey of Health, Ageing and Retirement in Europe (SHARE) to build a path model. Poor health among caregivers was associated with living in a family-based care country (β = 0.50; 95% CI = 0.42-0.59), and with an increased extent of caregiving (β = 0.18; 95% CI = 0.15-0.22). Non-financial support measures seem to have a larger protective impact (β = -0.33; 95% CI = -0.38 - -0.28) on the health of caregivers than do financial support measures (β = 0.03; 95% CI = 0.01-0.04), regardless of the gender of the caregiver. According to our results, the currently available policies of support associated with better health among caregivers are those that: 1) provide them with some free time, 2) help them to deal emotionally with caregiving, and 3) give them skills to both improve the care situation and to deal with it better.

Comparing antibiotic consumption between two European countries: are packages an adequate surrogate for prescriptions?

PubMed

Watier, Laurence; Cavalié, Philippe; Coignard, Bruno; Brun-Buisson, Christian

2017-11-01

Defined daily doses (DDD) are the gold standard indicator for quantifying prescriptions. Since 2014, the European Centre for Disease Prevention and Control (ECDC) has also been using the number of packages per 1,000 inhabitants per day (ipd), as a surrogate for prescriptions, to report antibiotic consumption in the community and to perform comparisons between European Union (EU) countries participating in the European Surveillance of Antimicrobial Consumption Network (ESAC-Net). In 2015, consumption was reported to range across Europe from 1.0 to 4.7 packages per 1,000 ipd. Our analysis showed that consumption of antibiotics for systemic use per 1,000 ipd was on average 1.3 times greater in France than in Belgium when considering prescriptions in the numerator, 2.5 times greater when considering packages and 1.2 times greater when considering DDD. As long as the same metrics are used over time, antibiotic consumption data aggregated and disseminated by ECDC are useful for assessing temporal trends at the European level and within individual countries; these data may also be used for benchmarking across EU countries. While DDD - although imperfect - are the most widely accepted metric for this purpose, antibiotic packages do not appear suitable for comparisons between countries and may be misleading.

Comparing antibiotic consumption between two European countries: are packages an adequate surrogate for prescriptions?

PubMed Central

Watier, Laurence; Cavalié, Philippe; Coignard, Bruno; Brun-Buisson, Christian

2017-01-01

Defined daily doses (DDD) are the gold standard indicator for quantifying prescriptions. Since 2014, the European Centre for Disease Prevention and Control (ECDC) has also been using the number of packages per 1,000 inhabitants per day (ipd), as a surrogate for prescriptions, to report antibiotic consumption in the community and to perform comparisons between European Union (EU) countries participating in the European Surveillance of Antimicrobial Consumption Network (ESAC-Net). In 2015, consumption was reported to range across Europe from 1.0 to 4.7 packages per 1,000 ipd. Our analysis showed that consumption of antibiotics for systemic use per 1,000 ipd was on average 1.3 times greater in France than in Belgium when considering prescriptions in the numerator, 2.5 times greater when considering packages and 1.2 times greater when considering DDD. As long as the same metrics are used over time, antibiotic consumption data aggregated and disseminated by ECDC are useful for assessing temporal trends at the European level and within individual countries; these data may also be used for benchmarking across EU countries. While DDD - although imperfect - are the most widely accepted metric for this purpose, antibiotic packages do not appear suitable for comparisons between countries and may be misleading. PMID:29162212

Alcohol Consumption in Movies and Adolescent Binge Drinking in 6 European Countries

PubMed Central

Sargent, James D.; Poelen, Evelien A. P.; Scholte, Ron; Florek, Ewa; Sweeting, Helen; Hunt, Kate; Karlsdottir, Solveig; Jonsson, Stefan Hrafn; Mathis, Federica; Faggiano, Fabrizio; Morgenstern, Matthis

2012-01-01

OBJECTIVE: The goal of this study was to investigate whether the association between exposure to images of alcohol use in movies and binge drinking among adolescents is independent of cultural context. METHODS: A cross-sectional survey study in 6 European countries (Germany, Iceland, Italy, Netherlands, Poland, and Scotland) was conducted. A total of 16 551 pupils from 114 public schools with a mean (± SD) age of 13.4 (± 1.18) years participated. By using previously validated methods, exposure to alcohol use in movies was estimated from the 250 top-grossing movies of each country (years 2004−2009). Lifetime binge drinking was the main outcome measure. RESULTS: Overall, 27% of the sample had consumed >5 drinks on at least 1 occasion in their life. After controlling for age, gender, family affluence, school performance, television screen time, sensation seeking and rebelliousness, and frequency of drinking of peers, parents, and siblings, the adjusted β-coefficient for lifetime binge drinking in the entire sample was 0.12 (95% confidence interval: 0.10−0.14; P < .001). The crude relationship between movie alcohol use exposure and lifetime binge drinking was significant in all countries; after covariate adjustment, the relationship was still significant in 5 of 6 countries. A sensitivity analysis revealed that the association is content specific, as there was no significant association between lifetime binge drinking and exposure to smoking in movies. CONCLUSIONS: The link between alcohol use in movies and adolescent binge drinking was robust and seems relatively unaffected by cultural contexts. PMID:22392174

Alcohol consumption in movies and adolescent binge drinking in 6 European countries.

PubMed

Hanewinkel, Reiner; Sargent, James D; Poelen, Evelien A P; Scholte, Ron; Florek, Ewa; Sweeting, Helen; Hunt, Kate; Karlsdottir, Solveig; Jonsson, Stefan Hrafn; Mathis, Federica; Faggiano, Fabrizio; Morgenstern, Matthis

2012-04-01

The goal of this study was to investigate whether the association between exposure to images of alcohol use in movies and binge drinking among adolescents is independent of cultural context. A cross-sectional survey study in 6 European countries (Germany, Iceland, Italy, Netherlands, Poland, and Scotland) was conducted. A total of 16 551 pupils from 114 public schools with a mean (± SD) age of 13.4 (± 1.18) years participated. By using previously validated methods, exposure to alcohol use in movies was estimated from the 250 top-grossing movies of each country (years 2004-2009). Lifetime binge drinking was the main outcome measure. Overall, 27% of the sample had consumed >5 drinks on at least 1 occasion in their life. After controlling for age, gender, family affluence, school performance, television screen time, sensation seeking and rebelliousness, and frequency of drinking of peers, parents, and siblings, the adjusted β-coefficient for lifetime binge drinking in the entire sample was 0.12 (95% confidence interval: 0.10-0.14; P < .001). The crude relationship between movie alcohol use exposure and lifetime binge drinking was significant in all countries; after covariate adjustment, the relationship was still significant in 5 of 6 countries. A sensitivity analysis revealed that the association is content specific, as there was no significant association between lifetime binge drinking and exposure to smoking in movies. The link between alcohol use in movies and adolescent binge drinking was robust and seems relatively unaffected by cultural contexts.

Prospects for comparing European hospitals in terms of quality and safety: lessons from a comparative study in five countries

PubMed Central

Burnett, Susan; Renz, Anna; Wiig, Siri; Fernandes, Alexandra; Weggelaar, Anne Marie; Calltorp, Johan; Anderson, Janet E.; Robert, Glenn; Vincent, Charles; Fulop, Naomi

2013-01-01

Purpose Being able to compare hospitals in terms of quality and safety between countries is important for a number of reasons. For example, the 2011 European Union directive on patients' rights to cross-border health care places a requirement on all member states to provide patients with comparable information on health-care quality, so that they can make an informed choice. Here, we report on the feasibility of using common process and outcome indicators to compare hospitals for quality and safety in five countries (England, Portugal, The Netherlands, Sweden and Norway). Main Challenges Identified The cross-country comparison identified the following seven challenges with respect to comparing the quality of hospitals across Europe: different indicators are collected in each country; different definitions of the same indicators are used; different mandatory versus voluntary data collection requirements are in place; different types of organizations oversee data collection; different levels of aggregation of data exist (country, region and hospital); different levels of public access to data exist; and finally, hospital accreditation and licensing systems differ in each country. Conclusion Our findings indicate that if patients and policymakers are to compare the quality and safety of hospitals across Europe, then further work is urgently needed to agree the way forward. Until then, patients will not be able to make informed choices about where they receive their health care in different countries, and some governments will remain in the dark about the quality and safety of care available to their citizens as compared to that available in neighbouring countries. PMID:23292003

Nightlife Violence: A Gender-Specific View on Risk Factors for Violence in Nightlife Settings--A Cross-Sectional Study in Nine European Countries

ERIC Educational Resources Information Center

Schnitzer, Susanne; Bellis, Mark A.; Anderson, Zara; Hughes, Karen; Calafat, Amador; Juan, Montse; Kokkevi, Anna

2010-01-01

Within nightlife settings, youth violence places large burdens on both nightlife users and wider society. Internationally, research has identified risk factors for nightlife violence. However, few empirical studies have assessed differences in risk factors between genders. Here, a pan-European cross-sectional survey of 1,341 nightlife users aged…

In situ oil shale retort with a generally T-shaped vertical cross section

DOEpatents

Ricketts, Thomas E.

1981-01-01

An in situ oil shale retort is formed in a subterranean formation containing oil shale. The retort contains a fragmented permeable mass of formation particles containing oil shale and has a production level drift in communication with a lower portion of the fragmented mass for withdrawing liquid and gaseous products of retorting during retorting of oil shale in the fragmented mass. The principal portion of the fragmented mass is spaced vertically above a lower production level portion having a generally T-shaped vertical cross section. The lower portion of the fragmented mass has a horizontal cross sectional area smaller than the horizontal cross sectional area of the upper principal portion of the fragmented mass above the production level.

76 FR 39071 - Certain Oil Country Tubular Goods From the People's Republic of China: Rescission of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-05

... DEPARTMENT OF COMMERCE International Trade Administration [C-570-944] Certain Oil Country Tubular... administrative review of the countervailing duty order on certain oil country tubular goods (``OCTG'') from the... subject to administrative protective order (``APO'') of their responsibility concerning the disposition of...

European Union's public fishing access agreements in developing countries.

PubMed

Le Manach, Frédéric; Chaboud, Christian; Copeland, Duncan; Cury, Philippe; Gascuel, Didier; Kleisner, Kristin M; Standing, André; Sumaila, U Rashid; Zeller, Dirk; Pauly, Daniel

2013-01-01

The imperative to increase seafood supply while dealing with its overfished local stocks has pushed the European Union (EU) and its Member States to fish in the Exclusive Economic Zones of other countries through various types of fishing agreements for decades. Although European public fishing agreements are commented on regularly and considered to be transparent, this is the first global and historical study on the fee regime that governs them. We find that the EU has subsidized these agreements at an average of 75% of their cost (financial contribution agreed upon in the agreements), while private European business interests paid the equivalent of 1.5% of the value of the fish that was eventually landed. This raises questions of fisheries benefit-sharing and resource-use equity that the EU has the potential to address during the nearly completed reform of its Common Fisheries Policy.

Smoking in movies and adolescent smoking: cross-cultural study in six European countries.

PubMed

Morgenstern, Matthis; Poelen, Evelien A P; Scholte, Ron; Karlsdottir, Solveig; Jonsson, Stefán Hrafn; Mathis, Federica; Faggiano, Fabrizio; Florek, Ewa; Sweeting, Helen; Hunt, Kate; Sargent, James D; Hanewinkel, Reiner

2011-10-01

To investigate whether the association between exposure to smoking in movies and smoking among youth is independent of cultural context. Cross-sectional survey of 16,551 pupils recruited in Germany, Iceland, Italy, the Netherlands, Poland and Scotland with a mean age of 13.4 years (SD=1.18) and an equal gender distribution. School-based surveys were conducted between November 2009 and June 2010. Using previously validated methods, exposure to movie smoking was estimated from the 250 top-grossing movies of each country (years 2004-2009) and related to ever smoking. Overall, 29% of the sample had tried smoking. The sample quartile (Q) of movie smoking exposure was significantly associated with the prevalence of ever smoking: 14% of adolescents in Q1 had tried smoking, 21% in Q2, 29% in Q3 and 36% in Q4. After controlling for age, gender, family affluence, school performance, television screen time, number of movies seen, sensation seeking and rebelliousness and smoking within the social environment (peers, parents and siblings), the adjusted ORs for having tried smoking in the entire sample were 1.3 (95% CI 1.1 to 1.5) for adolescents in Q2, 1.6 (95% CI 1.4 to 1.9) for Q3 and 1.7 (95% CI 1.4 to 2.0) for Q4 compared with Q1. The adjusted relationship between ever smoking and higher movie smoking exposure levels was significant in all countries with a non-linear association in Italy and Poland. The link between smoking in movies and adolescent smoking is robust and transcends different cultural contexts. Limiting young people's exposure to movie smoking could have important public health implications.

Comparison of meal patterns across five European countries using standardized 24-h recall (GloboDiet) data from the EFCOVAL project.

PubMed

Park, Min Kyung; Freisling, Heinz; Huseinovic, Ena; Winkvist, Anna; Huybrechts, Inge; Crispim, Sandra Patricia; de Vries, Jeanne H M; Geelen, Anouk; Niekerk, Maryse; van Rossum, Caroline; Slimani, Nadia

2018-04-01

To examine meal patterns in terms of frequency and circadian timing of eating in five European countries participating in the EFCOVAL project. In this cross-sectional study, 559 men and women, aged 44-65 years, were recruited in Belgium, the Czech Republic, France (Southern part), The Netherlands, and Norway. Dietary data were collected by trained interviewers using standardized computerised 24-h recalls (GloboDiet). Means ± SE of (1) eating frequency, (2) overnight fasting, and (3) time between eating occasions were estimated by country using means from 2 days of 24-h recalls. We also estimated the frequency of eating occasions per hour by country as well as the proportional energy intake of meals/snacks by country compared to the mean energy intake of all countries. Mean eating frequency ranged from 4.3 times/day in France to 7.1 times/day in The Netherlands (p < 0.05). Mean overnight fasting was shortest in the Netherlands (9.2 h) and longest in Czech Republic (10.9 h) (p < 0.05). Mean time between single eating occasions was shortest in The Netherlands (2.4 h) and longest in France (4.3 h) (p < 0.05). Different patterns of energy intake by meals and snacks throughout the day were observed across the five countries. We observed distinct differences in meal patterns across the five European countries included in the current study in terms of frequency and circadian timing of eating, and the proportion of energy intake from eating occasions.

Obesity, the metabolic syndrome, and type 2 diabetes in developing countries: role of dietary fats and oils.

PubMed

Misra, Anoop; Singhal, Neha; Khurana, Lokesh

2010-06-01

Developing countries are undergoing rapid nutrition transition concurrent with increases in obesity, the metabolic syndrome, and type 2 diabetes mellitus (T2DM). From a healthy traditional high-fiber, low-fat, low-calorie diet, a shift is occurring toward increasing consumption of calorie-dense foods containing refined carbohydrates, fats, red meats, and low fiber. Data show an increase in the supply of animal fats and increased intake of saturated fatty acid (SFAs) (obtained from coconut oil, palm oil, and ghee [clarified butter]) in many developing countries, particularly in South Asia and South-East Asia. In some South Asian populations, particularly among vegetarians, intake of n-3 polyunsaturated fatty acids (PUFAs) (obtained from flaxseed, mustard, and canola oils) and long-chain (LC) n-3 PUFAs (obtained from fish and fish oils) is low. Further, the effect of supplementation of n-3 PUFAs on metabolic risk factors and insulin resistance, except for demonstrated benefit in terms of decreased triglycerides, needs further investigation among South Asians. Data also show that intake of monounsaturated fatty acids (MUFAs) ranged from 4.7% to 16.4%en in developing countries, and supplementing it from olive, canola, mustard, groundnut, and rice bran oils may reduce metabolic risk. In addition, in some developing countries, intake of n-6 PUFAs (obtained from sunflower, safflower, corn, soybean, and sesame oils) and trans-fatty acids (TFAs) is increasing. These data show imbalanced consumption of fats and oils in developing countries, which may have potentially deleterious metabolic and glycemic consequences, although more research is needed. In view of the rapid rise of T2DM in developing countries, more aggressive public health awareness programs coupled with governmental action and clear country-specific guidelines are required, so as to promote widespread use of healthy oils, thus curbing intake of SFAs and TFAs, and increasing intake of n-3 PUFAs and MUFAs. Such

Propagation of economic shocks in input-output networks: A cross-country analysis

NASA Astrophysics Data System (ADS)

Contreras, Martha G. Alatriste; Fagiolo, Giorgio

2014-12-01

This paper investigates how economic shocks propagate and amplify through the input-output network connecting industrial sectors in developed economies. We study alternative models of diffusion on networks and we calibrate them using input-output data on real-world inter-sectoral dependencies for several European countries before the Great Depression. We show that the impact of economic shocks strongly depends on the nature of the shock and country size. Shocks that impact on final demand without changing production and the technological relationships between sectors have on average a large but very homogeneous impact on the economy. Conversely, when shocks change also the magnitudes of input-output across-sector interdependencies (and possibly sector production), the economy is subject to predominantly large but more heterogeneous avalanche sizes. In this case, we also find that (i) the more a sector is globally central in the country network, the larger its impact; (ii) the largest European countries, such as those constituting the core of the European Union's economy, typically experience the largest avalanches, signaling their intrinsic higher vulnerability to economic shocks.

What contributes to disparities in the preterm birth rate in European countries?

PubMed Central

Delnord, Marie; Blondel, Béatrice; Zeitlin, Jennifer

2015-01-01

Purpose of review In countries with comparable levels of development and healthcare systems, preterm birth rates vary markedly – a range from 5 to 10% among live births in Europe. This review seeks to identify the most likely sources of heterogeneity in preterm birth rates, which could explain differences between European countries. Recent findings Multiple risk factors impact on preterm birth. Recent studies reported on measurement issues, population characteristics, reproductive health policies as well as medical practices, including those related to subfertility treatments and indicated deliveries, which affect preterm birth rates and trends in high-income countries. We showed wide variation in population characteristics, including multiple pregnancies, maternal age, BMI, smoking, and percentage of migrants in European countries. Summary Many potentially modifiable population factors (BMI, smoking, and environmental exposures) as well as health system factors (practices related to indicated preterm deliveries) play a role in determining preterm birth risk. More knowledge about how these factors contribute to low and stable preterm birth rates in some countries is needed for shaping future policy. It is also important to clarify the potential contribution of artifactual differences owing to measurement. PMID:25692506

[The aims of German medical anthropology in countries of the European Community].

PubMed

Sterly, J

1992-07-01

Medical Anthropology deals with the anthropological conditions of health, illness and health care in different societies and cultures, and has to be distinguished in that respect from Social and Industrial Medicine in German language countries which could be considered a kind of official and governmental medicine. While in North America Medical Anthropology has been established at nearly all universities and medical colleges during the last 25 years, corresponding activities in Germany and most other European countries have not reached university level up to now. After referring to general anthropology during the period of enlightenment and to philosophical and medical anthropology in the first half of our century, both to be considered forerunners of medical anthropology in german-speaking countries, an outline of medical anthropology in German-speaking countries, an outline of medical anthropology in the USA is given followed by a survey of questions and problems with which medical anthropology in German-speaking and other European countries has to cope, and would be confronted after the opening of the EC Market in 1993. The article concludes by briefly going into the circumstance of teaching medical anthropology in the Federal Republic of Germany.

Cross-national evidence for the clustering and psychosocial correlates of adolescent risk behaviours in 27 countries.

PubMed

de Looze, Margaretha; Ter Bogt, Tom F M; Raaijmakers, Quinten A W; Pickett, William; Kuntsche, Emmanuel; Vollebergh, Wilma A M

2015-02-01

According to Jessor's Problem Behaviour Theory (PBT) and Moffitt's theory of adolescence-limited antisocial behaviour, adolescent risk behaviours cluster and can be predicted by various psychosocial factors including parent, peer and school attachment. This study tested the potential influence of the sociocultural, or macro-level, environment on the clustering and correlates of adolescent risk behaviour across 27 European and North American countries. Analyses were based on data from the 2009-10 Health Behaviour in School-aged Children (HBSC) study. Participants compromised 56,090 adolescents (M(age) = 15.5 years) who self-reported on substance use (tobacco, alcohol, cannabis) and early sexual activity as well as on psychosocial factors (parent, peer and school attachment). Multiple group confirmatory factor analyses (with country as grouping variable) showed that substance use and early sexual activity loaded on a single underlying factor across countries. In addition, multiple group path analyses (with country as grouping variable) showed that associations between this factor and parent, peer and school attachment were identical across countries. Cross-national consistencies exist in the clustering and psychosocial correlates of substance use and early sexual activity across western countries. While Jessor's PBT stresses the problematic aspects of adolescent risk behaviours, Moffitt emphasizes their normative character. Although the problematic nature of risk behaviours overall receives more attention in the literature, it is important to consider both perspectives to fully understand why they cluster and correlate with psychosocial factors. This is essential for the development and implementation of prevention programmes aimed at reducing adolescent risk behaviours across Europe and North America. © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Women's attitudes towards mechanisms of action of birth control methods: a cross-sectional study in five European countries.

PubMed

Lopez-del Burgo, Cristina; Mikolajczyk, Rafael T; Osorio, Alfonso; Errasti, Tania; de Irala, Jokin

2013-11-01

To assess women's attitudes towards the mechanisms of action of birth control methods. When addressing women's knowledge of and attitudes towards birth control methods, researchers frequently focus on side effects, effectiveness or correct use. Women's opinions about mechanisms of action have been much less investigated, and research is usually concentrated on the EC pill. Cross-sectional study. Women, aged 18-49, from Germany, France, the UK, Sweden and Romania were randomly selected (n = 1137). They were asked whether they would use a method that may work after fertilisation or after implantation and whether they would continue using it after learning it may have such effects. Logistic regression was performed to evaluate the influence of certain characteristics on women's attitudes. Almost half of women in Romania and Germany would not use methods with postfertilisation effects, while the lowest percentages were found in Sweden and in France. Regarding methods with postimplantation effects, higher percentages were found in all the countries. Highly educated women and those using a highly effective method were more likely to use methods with postfertilisation effects. On the contrary, married women, those who stated that human life begins at fertilisation and women with middle/high religiosity were less likely to consider using methods that may act after fertilisation. One-third of European women reported that they would not consider using a method that may have postfertilisation effects. Given that postfertilisation effects may not be acceptable to some women, informing them of which methods may have these effects is essential to obtaining complete informed consent and to promoting women's autonomy. © 2013 John Wiley & Sons Ltd.

Increasing Incidence of Listeriosis in France and Other European Countries

PubMed Central

Hedberg, Craig; Le Monnier, Alban; de Valk, Henriette

2008-01-01

From 1999 through 2005, the incidence of listeriosis in France declined from 4.5 to 3.5 cases/million persons. In 2006, it increased to 4.7 cases/million persons. Extensive epidemiologic investigations of clusters in France have ruled out the occurrence of large foodborne disease outbreaks. In addition, no increase has occurred in pregnancy-associated cases or among persons <60 years of age who have no underlying disease. Increases have occurred mainly among persons >60 years of age and appear to be most pronounced for persons >70 years of age. In 8 other European countries, the incidence of listeriosis has increased, or remained relatively high, since 2000. As in France, these increases cannot be attributed to foodborne outbreaks, and no increase has been observed in pregnancy-associated cases. European countries appear to be experiencing an increased incidence of listeriosis among persons >60 years of age. The cause of this selective increased incidence is unknown. PMID:18439354

Different trends in euthanasia acceptance across Europe. A study of 13 western and 10 central and eastern European countries, 1981-2008.

PubMed

Cohen, Joachim; Van Landeghem, Paul; Carpentier, Nico; Deliens, Luc

2013-06-01

We examined how acceptance of euthanasia among the general public has changed between 1981 and 2008 in western and central and eastern European (CEE) countries using data of the European Values Surveys. Data were collected in 1981, 1990, 1999 and 2008 for 13 western European countries and in 1990, 1999 and 2008 for 10 CEE countries. Euthanasia acceptance increased each decade up until 2008 in 11 of 13 western European countries; in CEE countries, it decreased or did not increase between 1999-2008 in 8 of 10 countries. A number of explanations for and implications of this apparent east-west polarization are suggested.

Water intake and beverage consumption of pre-schoolers from six European countries and associations with socio-economic status: the ToyBox-study.

PubMed

Pinket, An-Sofie; De Craemer, Marieke; Maes, Lea; De Bourdeaudhuij, Ilse; Cardon, Greet; Androutsos, Odysseas; Koletzko, Berthold; Moreno, Luis; Socha, Piotr; Iotova, Violeta; Manios, Yannis; Van Lippevelde, Wendy

2016-09-01

To study the quantity and quality of water intake from beverages among pre-schoolers and investigate associations with gender and socio-economic status (SES). Kindergarten-based cross-sectional survey within the large-scale European ToyBox-study. A standardized protocol was used and parents/caregivers filled in sociodemographic data and a semi-quantitative FFQ. Kindergartens in six European countries (Belgium, Bulgaria, Germany, Greece, Poland and Spain). European pre-schoolers (aged 3·5-5·5 years) and their parents/caregivers (n 7051). Mean water intake was 1051 ml/d; plain water, 547 ml/d; plain milk, 241 ml/d; other fruit juice, 104 ml/d; pure fruit juice, 59 ml/d; soft drinks, 55 ml/d; tea, 45 ml/d; sugared and chocolate milk, 37 ml/d; smoothies, 15 ml/d; and light soft drinks, 6 ml/d. Boys had a higher water intake than girls due to a higher consumption of plain water, but more importantly to the consumption of beverages of less quality. Lower-SES pre-schoolers scored better on quantity than high-SES pre-schoolers, but as a consequence of consumption of sugared beverages. Nevertheless, the associations differed by country. The water intake from beverages did not meet the European Food Safety Authority standard of 1280 ml/d; especially in Western European countries water intake from beverages was low. The most important water sources were plain water, milk and fruit juices. Interventions aiming at a proper and sufficient water intake should focus on both quantity and quality. Messages about water and water sources should be clear for everyone and interventions should be sufficiently tailored.

The relationship between maternal depression and smoking cessation during pregnancy--a cross-sectional study of pregnant women from 15 European countries.

PubMed

Smedberg, Janne; Lupattelli, Angela; Mårdby, Ann-Charlotte; Øverland, Simon; Nordeng, Hedvig

2015-02-01

Epidemiologic studies have reported an association between depression and continuing smoking during pregnancy. However, differences in study design and methodology challenge study comparability. The purpose of this study was to examine the relationship between maternal depression and continuing smoking among pregnant European women while adjusting for maternal characteristics. This multinational, web-based study evaluated pregnant women in 15 European countries recruited from October 2011 to February 2012. Data on depression status, smoking habits, maternal socio-demographic characteristics, and life-style factors were collected via an anonymous online questionnaire. Associations were estimated with logistic regression. Of 4,295 women included, 1,481 (34.5 %) reported smoking before pregnancy, and 391 (26.4 %) continued smoking during pregnancy whereof 127 (32.5 %) were depressed. The association between depression and continuing smoking during pregnancy were uniform across the European countries (OR 2.02, 95 % CI 1.50-2.71), with about twice the prevalence of continuing smoking among the depressed. There was a strong relationship between continuing smoking in pregnancy and low education level (OR 4.46, 95 % CI 2.72-7.32), which coincided with risky pregnancy behavior such as failure to attend pregnancy/birth preparation courses (OR 1.80, 95 % CI 1.19-2.72) and follow recommended use of folic acid (OR 1.81, 95 % CI 1.23-2.65). Women who perceived the risk for the fetus of continued smoking during pregnancy as higher were the least likely to continue smoking during pregnancy (OR 0.72, 95 % CI 0.68-0.77). This underlines the clustering of risk in some pregnant women, and the results should guide antenatal care of depressed women struggling to quit smoking during pregnancy.

Cross-Sectional and Prospective Relationship Between Low-to-Moderate-Intensity Physical Activity and Chronic Diseases in Older Adults From 13 European Countries.

PubMed

Marques, Adilson; Peralta, Miguel; Martins, João; Gouveia, Élvio Rúbio; Valeiro, Miguel González

2018-05-29

Assess the relationship between low-to-moderate-intensity physical activity (LMPA) in 2011 and chronic diseases in 2011 and 2013 among European older adults. Participants (16157 men, 21260 women) from 13 European countries were interviewed about the presence of chronic conditions and LMPA. The association between LMPA and number of chronic diseases was assessed using logistic regression models. Most of the older adults participated in LMPA more than once a week (81.9%), 8.4% participated once a week and 9.3% did not participated. The prevalence of chronic diseases was significantly lower among those who reported engaging in LMPA. LMPA in 2011 was related with lower odds of having several chronic diseases in 2013. Engaging in LMPA is associated with reduced risk for chronic diseases in European older men and women. Even the practice of LMPA once a week seems to be enough to diminish the risk of having chronic diseases.

Health inequalities according to educational level in different welfare regimes: a comparison of 23 European countries.

PubMed

Eikemo, Terje A; Huisman, Martijn; Bambra, Clare; Kunst, Anton E

2008-05-01

The object of this study was to determine whether the magnitude of educational health inequalities varies between European countries with different welfare regimes. The data source is based on the first and second wave of the European Social Survey. The first health indicator describes people's mental and physical health in general, while the second reports cases of any limiting longstanding illness. Educational inequalities in health were measured as the difference in health between people with an average number of years of education and people whose educational years lay one standard deviation below the national average. Moreover, South European welfare regimes had the largest health inequalities, while countries with Bismarckian welfare regimes tended to demonstrate the smallest. Although the other welfare regimes ranked relatively close to each other, the Scandinavian welfare regimes were placed less favourably than the Anglo-Saxon and East European. Thus, this study shows an evident patterning of magnitudes of health inequalities according to features of European welfare regimes. Although the greater distribution of welfare benefits within the Scandinavian countries are likely to have a protective effect for disadvantaged cities in these countries, other factors such as relative deprivation and class-patterned health behaviours might be acting to widen health inequalities.

A comparative analysis of generics markets in five European countries.

PubMed

Garattini, L; Tediosi, F

2000-04-01

A generic medicine is a faithful copy of a mature drug--no longer under patent marketed with the chemical name of the active ingredient. This article analyses generics markets in five European countries: France, Germany Italy, The Netherlands and the U.K. The study investigate all the main issues--patent, approval to market, pricing and reimbursement, prescription and distribution--which affect the life cycle of a pharmaceutical product. The situation in the five countries varied widely. Because of European harmonization, patent legislation and approval procedures no longer affect much the development of generics. Only national legislation on patent protection approved before the EU directive came into force still plays a role. Approval differences seem to be due mainly to common practice, rather than to the regulations themselves. None of the countries have an efficient public information system on patent expiry. Generics have had more success in countries with more flexible pricing policies. Reimbursement has not yet been used widely to discriminate between generics and proprietary drugs. Financial incentives are based more on physicians' prescribing behaviour than on pharmacists. The freedom of pharmacy ownership and the consequent possibility of dispensing pharmaceuticals through different channels affects dramatically the structure of generics markets. A free market of wholesalers and retailers can enhance a comparative market, through horizontal and vertical integration all along the distribution chain. Such an environment has stimulate the success of unbranded generics by delegating strong purchasing power to distributors.

Smoking in movies and adolescent smoking: cross-cultural study in six European countries

PubMed Central

Morgenstern, Matthis; Poelen, Evelien A P; Scholte, Ron; Karlsdottir, Solveig; Jonsson, Stefán Hrafn; Mathis, Federica; Faggiano, Fabrizio; Florek, Ewa; Sweeting, Helen; Hunt, Kate; Sargent, James D; Hanewinkel, Reiner

2013-01-01

Aim To investigate whether the association between exposure to smoking in movies and smoking among youth is independent of cultural context. Method Cross-sectional survey of 16 551 pupils recruited in Germany, Iceland, Italy, the Netherlands, Poland and Scotland with a mean age of 13.4 years (SD=1.18) and an equal gender distribution. School-based surveys were conducted between November 2009 and June 2010. Using previously validated methods, exposure to movie smoking was estimated from the 250 top-grossing movies of each country (years 2004–2009) and related to ever smoking. Results Overall, 29% of the sample had tried smoking. The sample quartile (Q) of movie smoking exposure was significantly associated with the prevalence of ever smoking: 14% of adolescents in Q1 had tried smoking, 21% in Q2, 29% in Q3 and 36% in Q4. After controlling for age, gender, family affluence, school performance, television screen time, number of movies seen, sensation seeking and rebelliousness and smoking within the social environment (peers, parents and siblings), the adjusted ORs for having tried smoking in the entire sample were 1.3 (95% CI 1.1 to 1.5) for adolescents in Q2, 1.6 (95% CI 1.4 to 1.9) for Q3 and 1.7 (95% CI 1.4 to 2.0) for Q4 compared with Q1. The adjusted relationship between ever smoking and higher movie smoking exposure levels was significant in all countries with a non-linear association in Italy and Poland. Conclusions The link between smoking in movies and adolescent smoking is robust and transcends different cultural contexts. Limiting young people's exposure to movie smoking could have important public health implications. PMID:21873322

Work related stress and European policy--a comparative exploration of contextual stressors in the rehabilitation sector in five European countries.

PubMed

Wells, John; Denny, Margaret; Cunningham, Jennifer

2011-04-01

Dealing with work related stress is a declared priority of European Union mental health policy. A particularly under-researched sector in this regard is the community vocational support sector for people with mental health and intellectual disability problems. To report on the organisational profile of the vocational support and rehabilitation sector for people with mental health and intellectual disabilities as this relates to occupational stress, in five European countries (Austria, Ireland, Italy, Romania and UK). A sector profile questionnaire was distributed to representative organisations in five countries and a short face-to-face survey was conducted with 25 local managers (five from each country) to draw up a profile and facilitate a comparative description and analysis. It was found that there is no national and European data collected at any level in this sector upon which to base effective policy interventions to combat occupational stress specific to professionals working in this sector. Results indicate that the sector in a number of the countries sampled does not have effective mechanisms in place to deal with occupational stress. Developing effective transnational occupational stress management policy that supports staff working in this sector and measuring its success is greatly impaired by a failure to effectively define the purpose of the sector and collect and collate national data to support it. © 2011 Informa UK, Ltd.

Plasma Carotenoids, Tocopherols, and Retinol in the Age-Stratified (35–74 Years) General Population: A Cross-Sectional Study in Six European Countries

PubMed Central

Stuetz, Wolfgang; Weber, Daniela; Dollé, Martijn E. T.; Jansen, Eugène; Grubeck-Loebenstein, Beatrix; Fiegl, Simone; Toussaint, Olivier; Bernhardt, Juergen; Gonos, Efstathios S.; Franceschi, Claudio; Sikora, Ewa; Moreno-Villanueva, María; Breusing, Nicolle; Grune, Tilman; Bürkle, Alexander

2016-01-01

Blood micronutrient status may change with age. We analyzed plasma carotenoids, α-/γ-tocopherol, and retinol and their associations with age, demographic characteristics, and dietary habits (assessed by a short food frequency questionnaire) in a cross-sectional study of 2118 women and men (age-stratified from 35 to 74 years) of the general population from six European countries. Higher age was associated with lower lycopene and α-/β-carotene and higher β-cryptoxanthin, lutein, zeaxanthin, α-/γ-tocopherol, and retinol levels. Significant correlations with age were observed for lycopene (r = −0.248), α-tocopherol (r = 0.208), α-carotene (r = −0.112), and β-cryptoxanthin (r = 0.125; all p < 0.001). Age was inversely associated with lycopene (−6.5% per five-year age increase) and this association remained in the multiple regression model with the significant predictors (covariables) being country, season, cholesterol, gender, smoking status, body mass index (BMI (kg/m2)), and dietary habits. The positive association of α-tocopherol with age remained when all covariates including cholesterol and use of vitamin supplements were included (1.7% vs. 2.4% per five-year age increase). The association of higher β-cryptoxanthin with higher age was no longer statistically significant after adjustment for fruit consumption, whereas the inverse association of α-carotene with age remained in the fully adjusted multivariable model (−4.8% vs. −3.8% per five-year age increase). We conclude from our study that age is an independent predictor of plasma lycopene, α-tocopherol, and α-carotene. PMID:27706032

E-government factors to reduce administrative and finance corruption in Arab countries: Case study Iraqi oil sector

NASA Astrophysics Data System (ADS)

Mohammed, M. A.; Eman, Y.; Hussein, A. H.; Hasson, A. R.

2015-12-01

Arab countries face the corruption issues in its several public organizations. The corruption in these countries is considered as the main challenge. The oil sector is one of the public sectors that have huge level of corruption. However, the Iraqi economy had become dependable on oil sector daring the last three decades, and on the contrary, of what other oil countries did. The capital is considered as one of the essential factor for economic development. The revenues of oil exports will stay the essential source for economic development in Iraq in the future in order to reduce being dependable on oil. Since the beginning of the 3rd thousands, the world witnessed great rise in the demand on oil, but the Iraqi exports of crude oil come to be less than its similarities in the seventeenths of last century. So our oil sector is still in need of deep study. This study focuses on technological technique that can make huge decrease for corruption in oil sector in Iraq. However, e-government is considered as the best techniques that can decrease the corruption. Thus, this study bases on challenges that effect on build successful e-government project in Iraqi oil industry.

Consumer satisfaction with pork meat and derived products in five European countries.

PubMed

Resano, Helena; Perez-Cueto, Federico J A; de Barcellos, Marcia D; Veflen-Olsen, Nina; Grunert, Klaus G; Verbeke, Wim

2011-02-01

This paper investigates consumers' satisfaction level with pork meat and derived products in five European countries. Data were collected through a cross-sectional web-based survey in Belgium, Denmark, Germany, Greece, and Poland during January 2008 with a total sample of 2437 consumers. Data included socio-demographics and questions regarding satisfaction with 27 common pork-based products; classified into fresh pork, processed pork and pork meat products. Satisfaction was evaluated in terms of overall satisfaction, as well as satisfaction with health-giving qualities, price, convenience and taste. Logistic regression analyses showed taste as the main determinant of satisfaction, followed by convenience. Healthfulness is not a significant driver of overall satisfaction. Price influences satisfaction with fresh pork more than with processed products. Tasty pork, easy to prepare and consume, with adequate promotion of its healthfulness, and with a good price/quality relationship appears to be the key factor to satisfy pork consumers. Copyright © 2010 Elsevier Ltd. All rights reserved.

Developing a policy game intervention to enhance collaboration in public health policymaking in three European countries.

PubMed

Spitters, H P E M; van Oers, J A M; Sandu, P; Lau, C J; Quanjel, M; Dulf, D; Chereches, R; van de Goor, L A M

2017-12-19

One of the key elements to enhance the uptake of evidence in public health policies is stimulating cross-sector collaboration. An intervention stimulating collaboration is a policy game. The aim of this study was to describe the design and methods of the development process of the policy game ‘In2Action’ within a real-life setting of public health policymaking networks in the Netherlands, Denmark and Romania. The development of the policy game intervention consisted of three phases, pre intervention, designing the game intervention and tailoring the intervention. In2Action was developed as a role-play game of one day, with main focus to develop in collaboration a cross-sector implementation plan based on the approved strategic local public health policy. This study introduced an innovative intervention for public health policymaking. It described the design and development of the generic frame of the In2Action game focusing on enhancing collaboration in local public health policymaking networks. By keeping the game generic, it became suitable for each of the three country cases with only minor changes. The generic frame of the game is expected to be generalizable for other European countries to stimulate interaction and collaboration in the policy process.

Trends in acceptance of euthanasia among the general public in 12 European countries (1981-1999).

PubMed

Cohen, Joachim; Marcoux, Isabelle; Bilsen, Johan; Deboosere, Patrick; van der Wal, Gerrit; Deliens, Luc

2006-12-01

We wanted to examine how the acceptance of euthanasia among the general public in Western Europe has changed in the last decades, and we wanted to look for possible explanations. We analysed data from the European Values Surveys, held in 1981, 1990, and 1999-2000 in 12 West European countries. In each country, representative samples of the general public were interviewed using the same structured questionnaire in all countries. Euthanasia was explained in the questionnaires as 'terminating the life of the incurably sick'. A total of 46 199 respondents participated in the surveys. A significant increase in acceptance of euthanasia could be observed in all countries except (West) Germany. While the average increase in euthanasia acceptance was 22%, the increase was particularly obvious in Belgium, Italy, Spain, and Sweden. Although changes in several characteristics of respondents, such as decrease in religious beliefs, rising belief in the right to self-determination, and (to a lesser extent) rise in levels of education, were associated with growing acceptance of euthanasia, they could only partly explain the increase of euthanasia acceptance over the years. An increase of euthanasia acceptance among the general public took place over the last two decades in almost all West European countries, possibly indicating a growing support for personal autonomy regarding medical end-of-life decisions. If this trend continues, it is likely to increase the public and political debate about the (legal) regulation of euthanasia under certain conditions of careful medical practice in several West European countries.

Medical practice and legal background of decisions for severely ill newborn infants: viewpoints from seven European countries.

PubMed

Sauer, P J J; Dorscheidt, J H H M; Verhagen, A A E; Hubben, J H

2013-02-01

To comparing attitudes towards end-of-life (EOL) decisions in newborn infants between seven European countries. One paediatrician and one lawyer from seven European countries were invited to attend a conference to discuss the practice of EOL decisions in newborn infants and the legal aspects involved. All paediatricians/neonatologists indicated that the best interest of the child should be the leading principle in all decisions. However, especially when discussing cases, important differences in attitude became apparent, although there are no significant differences between the involved countries with regard to national legal frameworks. Important differences in attitude towards neonatal EOL decisions between European countries exist, but they cannot be explained solely by medical or legal reasons. ©2012 The Author(s)/Acta Paediatrica ©2012 Foundation Acta Paediatrica.

Impact of cigarette price differences across the entire European Union on cross-border purchase of tobacco products among adult cigarette smokers.

PubMed

Agaku, Israel T; Blecher, Evan; Filippidis, Filippos T; Omaduvie, Uyoyo T; Vozikis, Athanassios; Vardavas, Constantine I

2016-05-01

We investigated the impact of cigarette price differences across the European Union (EU) on cross-border tobacco purchasing because of cheaper price among current cigarette smokers. Individual-level tobacco-related data (including cross-border tobacco purchasing behavior) were from the Special Eurobarometer 385 (V.77.1), a cross-sectional survey of persons aged ≥15 years from 27 EU Member States during 2012. Country-specific weighted average prices (WAP) per 1000 cigarettes (as of 1 July 2012) were obtained from the European Commission, and divided by 50 to yield WAP per cigarette pack. The dispersion in EU cigarette prices was measured with the coefficient of variation. Multivariate logistic regression was applied to measure the relationship between EU-wide cigarette price differential and cross-border tobacco purchasing because of cheaper price among current cigarette smokers (n=6896). The coefficient of variation for cigarette WAP within the EU was 0.39 (mean price=€3.99/pack). Of all current cigarette smokers in the EU, 26.2% (27.5 million persons) engaged in a cross-border tobacco purchase within the past 12 months, of which 56.3% did so because of cheaper price in another country. EU-wide cigarette price differential was significantly associated with making a cross-border tobacco purchase because of cheaper price (adjusted OR=1.34; 95% CI 1.22 to 1.47). Reducing differences in cigarette tax and price within the EU, coupled with a stricter limitation on the quantity of cigarettes that it is possible to carry from one Member State to another, may help reduce cross-border tax avoidance strategies. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Study of problem of waste chemical current sources in Russia and in European countries

NASA Astrophysics Data System (ADS)

Zilenina, V. G.; Ulanova, O. V.; Dornack, C.

2017-10-01

This article gives a comparative analysis of handling waste chemical current sources in Russia and in the European countries, presents the effective international documents (Directives, acts) and national legislative acts (state standards, building codes, governmental decrees, etc.), demonstrates the mechanisms for disposal and recycling of waste in the European Union countries. Along with the data of the research works, conducted in other countries during many yearsб it presents the experimental data on leaching out heavy metals from chemical current sources by municipal solid waste landfill filtrate, depending on the morphological composition of domestic waste in the city of Irkutsk. An important point described in the article, is assessment and prediction of negative impact produced on the environment.

Availability of hepatitis C diagnostics and therapeutics in European and Eurasia countries.

PubMed

Leblebicioglu, Hakan; Arends, Joop E; Ozaras, Resat; Corti, Giampaolo; Santos, Lurdes; Boesecke, Christoph; Ustianowski, Andrew; Duberg, Ann-Sofi; Ruta, Simona; Salkic, Nermin N; Husa, Petr; Lazarevic, Ivana; Pineda, Juan A; Pshenichnaya, Natalia Yurievna; Tsertswadze, Tengiz; Matičič, Mojca; Puca, Edmond; Abuova, Gulzhan; Gervain, Judit; Bayramli, Ramin; Ahmeti, Salih; Koulentaki, Mairi; Kilani, Badreddine; Vince, Adriana; Negro, Francesco; Sunbul, Mustafa; Salmon, Dominique

2018-02-01

Treatment with direct acting antiviral agents (DAAs) has provided sustained virological response rates in >95% of patients with chronic hepatitis C virus (HCV) infection. However treatment is costly and market access, reimbursement and governmental restrictions differ among countries. We aimed to analyze these differences among European and Eurasian countries. A survey including 20-item questionnaire was sent to experts in viral hepatitis. Countries were evaluated according to their income categories by the World Bank stratification. Experts from 26 countries responded to the survey. As of May 2016, HCV prevalence was reported as low (≤1%) in Croatia, Czech Republic, Denmark, France, Germany, Hungary, the Netherlands, Portugal, Slovenia, Spain, Sweden, UK; intermediate (1-4%) in Azerbaijan, Bosnia and Herzegovina, Italy, Kosovo, Greece, Kazakhstan, Romania, Russia, Serbia and high in Georgia (6.7%). All countries had national guidelines except Albania, Kosovo, Serbia, Tunisia, and UK. Transient elastography was available in all countries, but reimbursed in 61%. HCV-RNA was reimbursed in 81%. PegIFN/RBV was reimbursed in 54% of the countries. No DAAs were available in four countries: Kazakhstan, Kosovo, Serbia, and Tunisia. In others, at least one DAA combination with either PegIFN/RBV or another DAA was available. In Germany and the Netherlands all DAAs were reimbursed without restrictions: Sofosbuvir and sofosbuvir/ledipasvir were free of charge in Georgia. Prevalence of HCV is relatively higher in lower-middle and upper-middle income countries. DAAs are not available or reimbursed in many Eurasia and European countries. Effective screening and access to care are essential for reducing liver-related morbidity and mortality. Copyright © 2017 Elsevier B.V. All rights reserved.

Use of general practitioners versus mental health professionals in six European countries: the decisive role of the organization of mental health-care systems.

PubMed

Dezetter, Anne; Briffault, X; Bruffaerts, R; De Graaf, R; Alonso, J; König, H H; Haro, J M; de Girolamo, G; Vilagut, G; Kovess-Masféty, V

2013-01-01

To investigate patterns of use of general practitioners (GPs) and/or mental health professionals (MHPs) for mental health reasons, across six European countries, and the extent to which these patterns of use are associated with differences in mental health-care delivering systems. Data are based on the European Study of the Epidemiology of Mental Disorders (ESEMeD): a cross-sectional survey of a representative sample of 8,796 non-institutionalized adults from six European countries, conducted between 2001 and 2003 using computer-assisted interviews with the CIDI-3.0. Countries were classified into: MHP- for countries where access to medical professionals tends to predominate (Belgium, France, Italy), and MHP+ where access to non-medical MHPs predominates (Germany, Spain, The Netherlands). Among respondents consulting GPs and/or MHPs in the past year (n = 1,019), respondents from the MHP- group more often consulted GPs (68 vs. 55 % in MHP+ group), GPs and psychiatrists (23 vs. 14 %). People from the MHP+ group more often used MHPs only (45 vs. 32 %), GPs and non-medical MHPs (16 vs. 8 %). GPs from the MHP+ group were more inclined to refer patients to MHPs. Factors associated with use of GPs versus MHPs were: being over 49 years, not highly educated, lower income and suffering from mood or severe mental disorders. Differences in the use of GPs versus MHPs are markedly linked to individual as well as organizational factors. Interventions are needed, in countries fostering medical access, to reimburse sessions with non-medical MHPs and improve cooperation between professionals to obtain better practice in access to care.

Exercise-based cardiac rehabilitation in twelve European countries results of the European cardiac rehabilitation registry.

PubMed

Benzer, Werner; Rauch, Bernhard; Schmid, Jean-Paul; Zwisler, Ann Dorthe; Dendale, Paul; Davos, Constantinos H; Kouidi, Evangelia; Simon, Attila; Abreu, Ana; Pogosova, Nana; Gaita, Dan; Miletic, Bojan; Bönner, Gerd; Ouarrak, Taoufik; McGee, Hannah

2017-02-01

Results from EuroCaReD study should serve as a benchmark to improve guideline adherence and treatment quality of cardiac rehabilitation (CR) in Europe. Data from 2.054 CR patients in 12 European countries were derived from 69 centres. 76% were male. Indication for CR differed between countries being predominantly ACS in Switzerland (79%), Portugal (62%) and Germany (61%), elective PCI in Greece (37%), Austria (36%) and Spain (32%), and CABG in Croatia and Russia (36%). A minority of patients presented with chronic heart failure (4%). At CR start, most patients already were under medication according to current guidelines for the treatment of CV risk factors. A wide range of CR programme designs was found (duration 3 to 24weeks; total number of sessions 30 to 196). Patient programme adherence after admission was high (85%). With reservations that eCRF follow-up data exchange remained incomplete, patient CV risk profiles experienced only small improvements. CR success as defined by an increase of exercise capacity >25W was significantly higher in young patients and those who were employed. Results differed by countries. After CR only 9% of patients were admitted to a structured post-CR programme. Clinical characteristics of CR patients, indications and programmes in Europe are different. Guideline adherence is poor. Thus, patient selection and CR programme designs should become more evidence-based. Routine eCRF documentation of CR results throughout European countries was not sufficient in its first application because of incomplete data exchange. Therefore better adherence of CR centres to minimal routine clinical standards is requested. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Genetic control of soybean seed oil: I. QTL and genes associated with seed oil concentration in RIL populations derived from crossing moderately high-oil parents.

PubMed

Eskandari, Mehrzad; Cober, Elroy R; Rajcan, Istvan

2013-02-01

Soybean seed is a major source of oil for human consumption worldwide and the main renewable feedstock for biodiesel production in North America. Increasing seed oil concentration in soybean [Glycine max (L.) Merrill] with no or minimal impact on protein concentration could be accelerated by exploiting quantitative trait loci (QTL) or gene-specific markers. Oil concentration in soybean is a polygenic trait regulated by many genes with mostly small effects and which is negatively associated with protein concentration. The objectives of this study were to discover and validate oil QTL in two recombinant inbred line (RIL) populations derived from crosses between three moderately high-oil soybean cultivars, OAC Wallace, OAC Glencoe, and RCAT Angora. The RIL populations were grown across several environments over 2 years in Ontario, Canada. In a population of 203 F(3:6) RILs from a cross of OAC Wallace and OAC Glencoe, a total of 11 genomic regions on nine different chromosomes were identified as associated with oil concentration using multiple QTL mapping and single-factor ANOVA. The percentage of the phenotypic variation accounted for by each QTL ranged from 4 to 11 %. Of the five QTL that were tested in a population of 211 F(3:5) RILs from the cross RCAT Angora × OAC Wallace, a "trait-based" bidirectional selective genotyping analysis validated four QTL (80 %). In addition, a total of seven two-way epistatic interactions were identified for oil concentration in this study. The QTL and epistatic interactions identified in this study could be used in marker-assisted introgression aimed at pyramiding high-oil alleles in soybean cultivars to increase oil concentration for biodiesel as well as edible oil applications.

Task shifting between physicians and nurses in acute care hospitals: cross-sectional study in nine countries.

PubMed

Maier, Claudia B; Köppen, Julia; Busse, Reinhard

2018-05-25

Countries vary in the extent to which reforms have been implemented expanding nurses' Scopes-of-Practice (SoP). There is limited cross-country research if and how reforms affect clinical practice, particularly in hospitals. This study analyses health professionals' perceptions of role change and of task shifting between the medical and nursing professions in nine European countries. Cross-sectional design with surveys completed by 1716 health professionals treating patients with breast cancer (BC) and acute myocardial infarction (AMI) in 161 hospitals across nine countries. Descriptive and bivariate analysis on self-reported staff role changes and levels of independence (with/without physician oversight) by two country groups, with major SoP reforms implemented between 2010 and 2015 (Netherlands, England, Scotland) and without (Czech Republic, Germany, Italy, Norway, Poland, Turkey). Participation in 'medical tasks' was identified using two methods, a data-driven and a conceptual approach. Individual task-related analyses were performed for the medical and nursing professions, and Advanced Practice Nurses/Specialist Nurses (APN/SN). Health professionals from the Netherlands, England and Scotland more frequently reported changes to staff roles over this time period vs. the other six countries (BC 74.0% vs. 38.7%, p < .001; AMI 61.7% vs. 37.3%, p < .001), and higher independence in new roles (BC 58.6% vs. 24.0%, p < .001; AMI 48.9% vs. 29.2%, p < .001). A higher proportion of nurses and APN/SN from these three countries reported to undertake tasks related to BC diagnosis, therapy, prescribing of medicines and information to patients compared to the six countries. Similar cross-country differences existed for AMI on prescribing medications and follow-up care. Tasks related to diagnosis and therapy, however, remained largely within the medical profession's domain. Most tasks were reported to be performed by both professions rather than carried out by

EuropeaN Energy balance Research to prevent excessive weight Gain among Youth (ENERGY) project: Design and methodology of the ENERGY cross-sectional survey.

PubMed

van Stralen, Maartje M; te Velde, Saskia J; Singh, Amika S; De Bourdeaudhuij, Ilse; Martens, Marloes K; van der Sluis, Maria; Manios, Yannis; Grammatikaki, Evangelia; Chinapaw, Mai J M; Maes, Lea; Bere, Elling; Jensen, Jorgen; Moreno, Luis; Jan, Nataša; Molnár, Dénes; Moore, Helen; Brug, Johannes

2011-01-31

Obesity treatment is by large ineffective long term, and more emphasis on the prevention of excessive weight gain in childhood and adolescence is warranted. To inform energy balance related behaviour (EBRB) change interventions, insight in the potential personal, family and school environmental correlates of these behaviours is needed. Studies on such multilevel correlates of EBRB among schoolchildren in Europe are lacking. The ENERGY survey aims to (1) provide up-to-date prevalence rates of measured overweight, obesity, self-reported engagement in EBRBs, and objective accelerometer-based assessment of physical activity and sedentary behaviour and blood-sample biomarkers of metabolic function in countries in different regions of Europe, (2) to identify personal, family and school environmental correlates of these EBRBs. This paper describes the design, methodology and protocol of the survey. A school-based cross-sectional survey was carried out in 2010 in seven different European countries; Belgium, Greece, Hungary, the Netherlands, Norway, Slovenia, and Spain. The survey included measurements of anthropometrics, child, parent and school-staff questionnaires, and school observations to measure and assess outcomes (i.e. height, weight, and waist circumference), EBRBs and potential personal, family and school environmental correlates of these behaviours including the social-cultural, physical, political, and economic environmental factors. In addition, a selection of countries conducted accelerometer measurements to objectively assess physical activity and sedentary behaviour, and collected blood samples to assess several biomarkers of metabolic function. The ENERGY survey is a comprehensive cross-sectional study measuring anthropometrics and biomarkers as well as assessing a range of EBRBs and their potential correlates at the personal, family and school level, among 10-12 year old children in seven European countries. This study will result in a unique dataset

Who donates? Cross-country and periodical variation in blood donor demographics in Europe between 1994 and 2014.

PubMed

Wittock, Nathan; Hustinx, Lesley; Bracke, Piet; Buffel, Veerle

2017-11-01

Ageing European populations put pressure on national blood supplies, increasing the need for blood and donor base rejuvenation. Therefore, we investigate how European countries' blood donor populations differ and how they have evolved over the last 2 decades. Previous comparative research, based on 1994 Eurobarometer data, indicate that the typical donor is an educated, middle-aged, white, married male. Other sociodemographic and socioeconomic correlates, such as employment status and type of community, are less clear. Multilevel analyses are performed on repeated cross-level data from the Eurobarometer (waves 1994, 2002, 2009, and 2014) to compare information on "ever having donated" across sociodemographic categories, countries, and periods. There are consistent but moderate country and period differences. The donor population rose to become largest in most countries by 2009, and stabilized thereafter. Over the studied period, donors were more likely to be higher educated, married men. Nevertheless, changes across time in donor profiles within countries did occur. Women were less likely to donate blood, especially in Southern and Eastern Europe, but this gender gap has declined. Furthermore, educational attainment seems more relevant for women, although, more recently, to a lesser extent. Although there is a promising trend in which women, young people, and students are increasingly likely to donate, more attention is needed to reach the unemployed and the low to medium educated. Because the unemployed may lack structural opportunities to donate, and the low to medium educated may lack relevant knowledge on blood donation necessity, we recommend providing practical opportunities and information on the necessity of blood donation. © 2017 AABB.

Using different physical activity measurements in eight European countries. Results of the European Physical Activity Surveillance System (EUPASS) time series survey.

PubMed

Rütten, A; Ziemainz, H; Schena, F; Stahl, T; Stiggelbout, M; Auweele, Y Vanden; Vuillemin, A; Welshman, J

2003-06-01

The European Physical Activity Surveillance System (EUPASS) research project compared several physical activity (PA) measures (including the International Physical Activity Questionnaire (IPAQ)) in a time series survey in eight countries of the European Union. The present paper describes first results provided by the different instruments regarding PA participation, frequency and duration, both at the European and national levels. The purpose of the present study is to explore and compare the specific quality and usefulness of different indicators rather than to provide valid and reliable prevalence data. Thus, the main focus is on discussion of the methodological implications of the results presented. A time series survey based on computer-aided telephone interviewing (CATI) was carried out in eight European countries over a six-month period. The study provided for about 100 realised interviews per month in each country (i.e. approximately 600 per country). Descriptive statistical analysis was used to: (1) report IPAQ results on vigorous, moderate and light PA and sitting, as well as on the overall measure of calories expenditure (MET min-1), in the different countries; (2) compare these results with national PA indicators tested in EUPASS; and (3) compare IPAQ results with other European studies. First, the scores for the different PA categories as well as for the overall measure of calories expenditure provided by the IPAQ appeared rather high compared with previous studies and public health recommendations. Second, the different PA measurements used in EUPASS provided completely different results. For example, national indicators used in Germany and The Netherlands to date neither corresponded in absolute values (e.g. means of PA or sitting) nor correlated with the IPAQ in any significant way. Third, comparing EU countries, the ranking for vigorous, moderate and light activities by use of the IPAQ differed from that of other European studies. For example, in

Educational differences in disability-free life expectancy: a comparative study of long-standing activity limitation in eight European countries.

PubMed

Mäki, Netta; Martikainen, Pekka; Eikemo, Terje; Menvielle, Gwenn; Lundberg, Olle; Ostergren, Olof; Jasilionis, Domantas; Mackenbach, Johan P

2013-10-01

Healthy life expectancy is a composite measure of length and quality of life and an important indicator of health in aging populations. There are few cross-country comparisons of socioeconomic differences in healthy life expectancy. Most of the existing comparisons focus on Western Europe and the United States, often relying on older data. To address these deficiencies, we estimated educational differences in disability-free life expectancy for eight countries from all parts of Europe in the early 2000s. Long-standing severe disability was measured as a Global Activity Limitation Indicator (GALI) derived from the European Union Statistics on Income and Living Conditions (EU-SILC) survey. Census-linked mortality data were collected by a recent project comparing health inequalities between European countries (the EURO-GBD-SE project). We calculated sex-specific educational differences in disability-free life expectancy between the ages of 30 and 79 years using the Sullivan method. The lowest disability-free life expectancy was found among Lithuanian men and women (33.1 and 39.1 years, respectively) and the highest among Italian men and women (42.8 and 44.4 years, respectively). Life expectancy and disability-free life expectancy were directly related to the level of education, but the educational differences were much greater in the latter in all countries. The difference in the disability-free life expectancy between those with a primary or lower secondary education and those with a tertiary education was over 10 years for males in Lithuania and approximately 7 years for males in Austria, Finland and France, as well as for females in Lithuania. The difference was smallest in Italy (4 and 2 years among men and women, respectively). Highly educated Europeans can expect to live longer and spend more years in better health than those with lower education. The size of the educational difference in disability-free life expectancy varies significantly between countries

Carotenoids concentration of Gac (Momordica cochinchinensis Spreng.) fruit oil using cross-flow filtration technology.

PubMed

Mai, Huỳnh Cang; Truong, Vinh; Debaste, Frédéric

2014-11-01

Gac (Momordica cochinchinensis Spreng.) fruit, a traditional fruit in Vietnam and other countries of eastern Asia, contains an oil rich in carotenoids, especially lycopene and β-carotene. Carotenoids in gac fruit oil were concentrated using cross-flow filtration. In total recycle mode, effect of membrane pore size, temperature, and transmembrane pressure (TMP) on permeate flux and on retention coefficients has been exploited. Resistance of membrane, polarization concentration, and fouling were also analyzed. Optimum conditions for a high permeate flux and a good carotenoids retention are 5 nm, 2 bars, and 40 °C of membrane pore size, TMP, and temperature, respectively. In batch mode, retentate was analyzed through index of acid, phospholipids, total carotenoids content (TCC), total antioxidant activity, total soluble solids, total solid content, color measurement, and viscosity. TCC in retentate is higher 8.6 times than that in feeding oil. Lipophilic antioxidant activities increase 6.8 times, while hydrophilic antioxidant activities reduce 40%. The major part of total resistance is due to polarization (55%) while fouling and intrinsic membrane contribute about 30% and 24%, respectively. © 2014 Institute of Food Technologists®

National physical activity recommendations: systematic overview and analysis of the situation in European countries.

PubMed

Kahlmeier, Sonja; Wijnhoven, Trudy M A; Alpiger, Patrick; Schweizer, Christian; Breda, João; Martin, Brian W

2015-02-12

Developing national physical activity (PA) recommendations is an essential element of an effective national approach to promote PA. Systematic overview and analysis of national PA recommendations across the European Region of the World Health Organization (WHO). The WHO European national information focal points provided information which was complemented through online searches and input from other experts. Information received until summer 2012 from 37 countries was analyzed. Sixteen countries did not have national recommendations while 21 countries did. For 17 countries, the source document was accessible. Seventeen recommendations referred to adults, 14 to young people and 6 to older adults. Most national recommendations for children and young people are quite similar: 12 countries recommend at least 60 minutes of moderate- to vigorous-intensity PA each day, in line with the WHO global recommendation. Three countries recommend longer durations and one a lower one. In some countries, slight variations were found regarding the recommended intensity and minimum bouts. Only one country was fully in line with the WHO recommendations. Two countries have issued separate recommendations for pre-school children. For adults, most countries still follow the 1995 United States recommendations of "at least 30 minutes on 5 days a week". Three countries were fully in line with the WHO recommendations. Four countries give specific recommendations on reducing weight, avoiding weight gain or continuing weight maintenance. The six identified national PA recommendations for older adults are mainly similar to those for adults but underline that particularly for this age group also less activity has important health benefits; four countries also recommend balance training. About half of the countries for which information was available and likely less than 40% of all 53 countries in the WHO European Region have developed national PA recommendations. Further investment is needed to

Overall satisfaction of health care users with the quality of and access to health care services: a cross-sectional study in six Central and Eastern European countries.

PubMed

Stepurko, Tetiana; Pavlova, Milena; Groot, Wim

2016-08-02

The measurement of consumer satisfaction is an essential part of the assessment of health care services in terms of service quality and health care system responsiveness. Studies across Europe have described various strategies health care users employ to secure services with good quality and quick access. In Central and Eastern European countries, such strategies also include informal payments to health care providers. This paper analyzes the satisfaction of health care users with the quality of and access to health care services. The study focuses on six Central and Eastern European countries (Bulgaria, Hungary, Lithuania, Poland, Romania and Ukraine). We use data on past experience with health care use collected in 2010 through uniform national surveys in these countries. Based on these data, we carry out a multi-country analysis to investigate factors associated with the satisfaction of health care users in the six countries. The results indicate that about 10-14 % of the service users are not satisfied with the quality of, or access to health care services they used in the preceding year. However, significant differences across countries and services are observed, e.g. the highest level of dissatisfaction with access to outpatient services (16.4 %) is observed among patients in Lithuania, while in Poland, the level of dissatisfaction with quality of outpatient and inpatient services are much lower than dissatisfaction with access. The study also analyses the association of users' satisfaction with factors such as making informal payments, inability to pay and relative importance of service attributes stated by the service users. These multi-country findings provide evidence for health policy making in the Central and Eastern European countries. Although the average rates of satisfactions per country are relatively high, the results suggest that there is ample room for improvements. Specifically, many service-users still report dissatisfaction especially those

Towards a sampling strategy for the assessment of forest condition at European level: combining country estimates.

PubMed

Travaglini, Davide; Fattorini, Lorenzo; Barbati, Anna; Bottalico, Francesca; Corona, Piermaria; Ferretti, Marco; Chirici, Gherardo

2013-04-01

A correct characterization of the status and trend of forest condition is essential to support reporting processes at national and international level. An international forest condition monitoring has been implemented in Europe since 1987 under the auspices of the International Co-operative Programme on Assessment and Monitoring of Air Pollution Effects on Forests (ICP Forests). The monitoring is based on harmonized methodologies, with individual countries being responsible for its implementation. Due to inconsistencies and problems in sampling design, however, the ICP Forests network is not able to produce reliable quantitative estimates of forest condition at European and sometimes at country level. This paper proposes (1) a set of requirements for status and change assessment and (2) a harmonized sampling strategy able to provide unbiased and consistent estimators of forest condition parameters and of their changes at both country and European level. Under the assumption that a common definition of forest holds among European countries, monitoring objectives, parameters of concern and accuracy indexes are stated. On the basis of fixed-area plot sampling performed independently in each country, an unbiased and consistent estimator of forest defoliation indexes is obtained at both country and European level, together with conservative estimators of their sampling variance and power in the detection of changes. The strategy adopts a probabilistic sampling scheme based on fixed-area plots selected by means of systematic or stratified schemes. Operative guidelines for its application are provided.

Skiing economy and efficiency in recreational and elite cross-country skiers.

PubMed

Ainegren, Mats; Carlsson, Peter; Tinnsten, Mats; Laaksonen, Marko S

2013-05-01

The purpose of this study was to investigate and compare skiing economy and gross efficiency in cross-country skiers of different performance levels, ages and genders; male recreational skiers and elite senior and junior cross-country skiers of both genders. The skiers performed tests involving roller skiing on a treadmill using the gear 3 and diagonal stride techniques. The elite cross-country skiers were found to have better skiing economy and higher gross efficiency (5-18%) compared with the recreational skiers (p < 0.05) and the senior elite had better economy and higher efficiency (4-5%) than their junior counterparts (p < 0.05), whereas no differences could be found between the genders. Also, large ranges in economy and gross efficiency were found in all groups. It was concluded that, in addition to V[Combining Dot Above]O2peak, skiing economy and gross efficiency have a great influence on the differences in performance times between recreational and junior and senior elite cross-country skiers, as well as between individual skiers within the different categories. Thus, we recommend cross-country skiers at all performance levels to test not only V[Combining Dot Above]O2peak, but also skiing economy and efficiency.

Insomnia in long-term care facilities: a comparison of seven European countries and Israel: the Services and Health for Elderly in Long TERm care study.

PubMed

Gindin, Jacob; Shochat, Tamar; Chetrit, Angela; Epstein, Shulamit; Ben Israel, Yehoshua; Levi, Sarah; Onder, Graziano; Carpenter, Ian; Finne-Soveri, Harriet; van Hout, Hein; Henrard, Jean-Claude; Nikolaus, Thorsten; Topinkova, Eva; Fialová, Daniela; Bernabei, Roberto

2014-11-01

To assess insomnia and its correlates as part of the Services and Health for Elderly in Long TERm care (SHELTER) study, funded by the 7th Framework Programme of the European Union. Cross-cultural investigation. Long-term care facilities (LTCFs) in eight European countries (Czech Republic, France, Finland, Germany, England, the Netherlands, Italy) and one non-European country (Israel). Elderly residents (N = 4,156) of 57 LTCFs. Information on insomnia, age, sex, activities of daily living (ADLs), cognitive status, depression, major stressful life events, physical activity, fatigue, pain, and sleep medication use was extracted from the International Resident Assessment Instrument (interRAI)LTCF instrument. Rates of insomnia and its correlates were analyzed. Multivariate logistic regression was used to assess factors associated with insomnia, controlling for demographic variables. The prevalence of insomnia was 24% (range 13-30%), with significant differences between countries (P < .001). More insomnia complaints were reported in older than younger residents (P < .001). Higher rates of insomnia were associated with hypnosedatives and depression in all countries (P < .001) and with stressful life events, fatigue, and pain in most countries (P < .001). No associations were found between insomnia and ADLs, physical activity, or cognitive status. Age, depression, stressful life events, fatigue, pain and hypnosedatives were independent significant predictors of insomnia, controlling for all other variables and for country. Hypnosedatives and depression were strong predictors of insomnia beyond cultural differences. Overall, psychosocial variables were more strongly related to insomnia than functional and mental capacities. © 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.

Inequality dynamics in the workplace among microbiologists and infectious disease specialists: a qualitative study in five European countries.

PubMed

Huttner, A; Cacace, M; d'Andrea, L; Skevaki, C; Otelea, D; Pugliese, F; Tacconelli, E

2017-05-01

To explore the social, cultural, psychological and organizational factors associated with inequality in the workplace among clinical microbiologists (CM) and infectious disease (ID) specialists in European hospitals. We analysed data from 52 interviews and five focus groups involving 82 CM/ID specialists selected from university, research or community hospitals in five countries, one each in Northern, Western, Eastern, Southeastern and Southwestern Europe. The 80 hours of recordings were transcribed, and the anonymous database coding process was cross-checked iteratively by six researchers. Inequality affects all the institutions in all the countries we looked at, denying or reducing access to professional assets with intensity and form that vary largely according to the cultural and organizational context. Discrimination is generally not explicit and uses disrespectful microbehaviours that are hard to respond to when they occur. Inequality affected also loans, distribution of research funds and gender and country representation in boards and conference faculty. Parenthood has a major impact on women's careers, as women are still mainly responsible for family care. Responses to discrimination range from reactive to surrender strategies. Our study offers an effective model for diagnosing discriminatory behaviours in a medical professional setting. Knowledge of inequality's drivers could help national ID/CM societies in collaboration with major European stakeholders to further reduce such discrimination. The effect of discrimination on the quality of healthcare in Europe needs further exploration. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Inclusive Education in Progress: Policy Evolution in Four European Countries

ERIC Educational Resources Information Center

Smyth, Fiona; Shevlin, Michael; Buchner, Tobias; Biewer, Gottfried; Flynn, Paula; Latimier, Camille; Šiška, Jan; Toboso-Martín, Mario; Rodríguez Díaz, Susana; Ferreira, Miguel A. V.

2014-01-01

This paper seeks to compare the evolution of inclusive education policy in the four countries of an EU-funded research project (QualiTYDES) operating under the shared policy environment of the UN, EU and European Commission. A shared policy cannot of course be assumed to result in common legislative or provisional outcomes at national level. The…

Impact of R&D expenditures on research publications, patents and high-tech exports among European countries.

PubMed

Meo, S A; Usmani, A M

2014-01-01

This study aimed to compare the impact of Research&Development (R&D) expenditures on research publications, patents and high-tech exports among European countries. In this study, 47 European countries were included. The information regarding European countries, their per capita Gross Domestic Product (GDP), R&D spending, number of universities, indexed scientific journals, high technology exports and number of patents were collected. We recorded the total number of research documents in various science and social sciences subjects during the period 1996-2011. The main source for information was World Bank, Web of Science, Thomson Reuters and SCImago/Scopus. The mean GDP per capita for all the European countries is 23372.64 ± 3588.42 US$, yearly per capita spending on R&D 1.14 ± 0.13 US$, number of universities 48.17 ± 10.26, mean number of Institute of Scientific Information (ISI) indexed journal per country 90.72 ± 38.47, high technology exports 12.86 ± 1.59 and number of patent applications 61504.23 ± 22961.85. The mean of research documents published in various science and social science subjects among all the European countries during the period 1996-2011 is 213405.70 ± 56493.04. Spending on R&D, number of universities, indexed journals, high technology exports and number of patents have a positive correlation with number of published documents in various science and social science subjects. We found a positive correlation between patent application and high-tech exports. However, there was no association between GDP per capita and research outcomes. It is concluded that, the most important contributing factors towards a knowledge based economy are spending on R&D, number of universities, scientific indexed journals and research publications, which in turn give a boast to patents, high technology exports and ultimately GDP.

Are immigrants and descendants with ill health more prone to unemployment? Evidence from 18 European countries.

PubMed

Heggebø, Kristian

2017-08-01

Previous research has established that both ill health and minority status are associated with unemployment. Less is known, however, about the interplay between having ill health and being from minority background. The present study examines whether immigrants and descendants with ill health are particularly prone to unemployment during an economic downturn in Europe. The European Union Statistics on Income and Living Conditions (EU-SILC) cross-sectional data material is utilized, and linear probability models are estimated. The analysis is run for countries in which the two minority samples are acceptably large (N ≥ 100), resulting in 18 included European countries. The year 2011 is chosen because it is possible to identify both immigrants and descendants in EU-SILC due to a module on intergenerational transfer of disadvantages. The results indicate - as expected - that both ill health and minority status are independently related to higher unemployment likelihood. Immigrants and descendants with ill health, however, are not particularly likely to be unemployed. This finding is robust to a number of sensitivity tests, and the empirical pattern is very similar across the 18 included countries. Both minority status and ill health are associated with high unemployment probability in Europe. However, there does not seem to exist a 'double disadvantage' for immigrants and descendants with ill health, which is in line with a human capital perspective on how employers evaluate potential employees. Both a non-native-sounding name and bad health status are interpreted as a risk factor, but there is no reason to expect ill health to lower the productivity level more if the applicant is a descendant or immigrant.

Exposure to aircraft and road traffic noise and associations with heart disease and stroke in six European countries: a cross-sectional study

PubMed Central

2013-01-01

Background Although a number of studies have found an association between aircraft noise and hypertension, there is a lack of evidence on associations with other cardiovascular disease. For road traffic noise, more studies are available but the extent of possible confounding by air pollution has not been established. Methods This study used data from the Hypertension and Environmental Noise near Airports (HYENA) study. Cross-sectional associations between self-reported ‘heart disease and stroke’ and aircraft noise and road traffic noise were examined using data collected between 2004 and 2006 on 4712 participants (276 cases), who lived near airports in six European countries (UK, Germany, Netherlands, Sweden, Greece, Italy). Data were available to assess potential confounding by NO2 air pollution in a subsample of three countries (UK, Netherlands, Sweden). Results An association between night-time average aircraft noise and ‘heart disease and stroke’ was found after adjustment for socio-demographic confounders for participants who had lived in the same place for ≥ 20 years (odds ratio (OR): 1.25 (95% confidence interval (CI) 1.03, 1.51) per 10 dB (A)); this association was robust to adjustment for exposure to air pollution in the subsample. 24 hour average road traffic noise exposure was associated with ‘heart disease and stroke’ (OR: 1.19 (95% CI 1.00, 1.41), but adjustment for air pollution in the subsample suggested this may have been due to confounding by air pollution. Statistical assessment (correlations and variance inflation factor) suggested only modest collinearity between noise and NO2 exposures. Conclusions Exposure to aircraft noise over many years may increase risks of heart disease and stroke, although more studies are needed to establish how much the risks associated with road traffic noise may be explained by air pollution. PMID:24131577

European Union’s Public Fishing Access Agreements in Developing Countries

PubMed Central

Le Manach, Frédéric; Chaboud, Christian; Copeland, Duncan; Cury, Philippe; Gascuel, Didier; Kleisner, Kristin M.; Standing, André; Sumaila, U. Rashid; Zeller, Dirk; Pauly, Daniel

2013-01-01

The imperative to increase seafood supply while dealing with its overfished local stocks has pushed the European Union (EU) and its Member States to fish in the Exclusive Economic Zones of other countries through various types of fishing agreements for decades. Although European public fishing agreements are commented on regularly and considered to be transparent, this is the first global and historical study on the fee regime that governs them. We find that the EU has subsidized these agreements at an average of 75% of their cost (financial contribution agreed upon in the agreements), while private European business interests paid the equivalent of 1.5% of the value of the fish that was eventually landed. This raises questions of fisheries benefit-sharing and resource-use equity that the EU has the potential to address during the nearly completed reform of its Common Fisheries Policy. PMID:24312191

Quantifying Projected Heat Mortality Impacts under 21st-Century Warming Conditions for Selected European Countries

PubMed Central

Baccini, Michela; Wolf, Tanja; Paunovic, Elizabet; Menne, Bettina

2017-01-01

Under future warming conditions, high ambient temperatures will have a significant impact on population health in Europe. The aim of this paper is to quantify the possible future impact of heat on population mortality in European countries, under different climate change scenarios. We combined the heat-mortality function estimated from historical data with meteorological projections for the future time laps 2035–2064 and 2071–2099, developed under the Representative Concentration Pathways (RCP) 4.5 and 8.5. We calculated attributable deaths (AD) at the country level. Overall, the expected impacts will be much larger than the impacts we would observe if apparent temperatures would remain in the future at the observed historical levels. During the period 2071–2099, an overall excess of 46,690 and 117,333 AD per year is expected under the RCP 4.5 and RCP 8.5 scenarios respectively, in addition to the 16,303 AD estimated under the historical scenario. Mediterranean and Eastern European countries will be the most affected by heat, but a non-negligible impact will be still registered in North-continental countries. Policies and plans for heat mitigation and adaptation are needed and urgent in European countries in order to prevent the expected increase of heat-related deaths in the coming decades. PMID:28678192

Quantifying Projected Heat Mortality Impacts under 21st-Century Warming Conditions for Selected European Countries.

PubMed

Kendrovski, Vladimir; Baccini, Michela; Martinez, Gerardo Sanchez; Wolf, Tanja; Paunovic, Elizabet; Menne, Bettina

2017-07-05

Under future warming conditions, high ambient temperatures will have a significant impact on population health in Europe. The aim of this paper is to quantify the possible future impact of heat on population mortality in European countries, under different climate change scenarios. We combined the heat-mortality function estimated from historical data with meteorological projections for the future time laps 2035-2064 and 2071-2099, developed under the Representative Concentration Pathways (RCP) 4.5 and 8.5. We calculated attributable deaths (AD) at the country level. Overall, the expected impacts will be much larger than the impacts we would observe if apparent temperatures would remain in the future at the observed historical levels. During the period 2071-2099, an overall excess of 46,690 and 117,333 AD per year is expected under the RCP 4.5 and RCP 8.5 scenarios respectively, in addition to the 16,303 AD estimated under the historical scenario. Mediterranean and Eastern European countries will be the most affected by heat, but a non-negligible impact will be still registered in North-continental countries. Policies and plans for heat mitigation and adaptation are needed and urgent in European countries in order to prevent the expected increase of heat-related deaths in the coming decades.

A review of health promotion funding for older adults in Europe: a cross-country comparison.

PubMed

Arsenijevic, Jelena; Groot, Wim; Tambor, Marzena; Golinowska, Stanislawa; Sowada, Christoph; Pavlova, Milena

2016-09-05

Health promotion interventions for older adults are important as they can decrease the onset and evolution of diseases and thus can reduce the medical costs related to those diseases. However, there is no comparative evidence on how those interventions are funded in European countries. The aim of this study is to explore the funding of health promotion interventions in general and health promotion interventions for older adults in particular in European countries. We use desk research to identify relevant sources of information such as official national documents, international databases and scientific articles. Fora descriptive overview on how health promotion is funded, we focus on three dimensions: who is funding health promotion, what are the contribution mechanisms and who are the collecting agents. In addition to general information on funding of health promotion, we explore how programs on health promotion for older population groups are funded. There is a great diversity in funding of health promotion in European countries. Although public sources (tax and social health insurance revenues) are still most often used, other mechanisms of funding such as private donations or European funds are also common. Furthermore, there is no clear pattern in the funding of health promotion for different population groups. This is of particular importance for health promotion for older adults where information is limited across European countries. This study provides an overview of funding of health promotion interventions in European countries. The main obstacles for funding health promotion interventions are lack of information and the fragmentation in the funding of health promotion interventions for older adults.

A novel approach for comparing patterns of foreign body injuries across countries: A case study comparing European Countries and Bosnia and Herzegovina.

PubMed

Lorenzoni, Giulia; Umihanić, Sekib; Azzolina, Danila; Manza, Emiliano; Brkić, Fuad; Gregori, Dario

2018-02-01

The present study aimed at analyzing the characteristics of FB injuries from Bosnia and Herzegovina (B&H), a rapidly growing newly industrialized country, and to compare them with cases from European countries. The analysis is based on FB injury cases included in the Susy Safe registry. Cases from the Ear-Nose-Throat (ENT) Clinic, University Clinical Center of Tuzla (B&H) were compared with cases from European countries participating in the Susy Safe project. Multiple Correspondence Analysis (MCA) was performed to elucidate differences within a large data set regarding mechanisms and objects causing injuries. The results of the MCA showed that the first three dimensions explained 43% of the variability. The first dimension was identified by children hospitalized for FB ingestion, the second one by children hospitalized for FB aspiration (lower airways), and the third one by children with an FB in the ear or in the upper airways. The analysis of the median of coordinates of factors contributing to each dimension showed that the greatest difference between B&H and European countries regarded the third one. Looking at the profile of these patients, it might be suggested that the proportion of males and females and the type of activity in which they were involved at time of injury occurrence are different among the countries considered CONCLUSIONS: This study proposes a simple tool for assessing differences among countries in the distribution of FB injuries. This case study shows that B&H has different patterns of FB injuries in the upper respiratory tract. Copyright © 2017 Elsevier B.V. All rights reserved.

Ageing in Asia and the Pacific. A multidimensional cross-national study in four countries.

PubMed

Andrews, G R

1987-12-01

Although ageing is not yet a high priority issue for health planners, policy makers and clinicians in most developing countries, there will be a growing need in coming years to pay more attention to the important health issues associated with population ageing in the developing world. This paper reports some of the relevant findings of a cross-national study (sponsored by the World Health Organization) of the health and social aspects of ageing in four developing countries: Korea, the Philippines, Fiji and Malaysia. The key findings are compared and contrasted with those of a similar 11-country WHO study in Europe. In broad terms, the overall demographic, physical, mental health and social patterns and trends associated with ageing as demonstrated by age group and sex differences were consistent throughout the four countries studied. Comparisons with European findings in other similar studies underlined the fundamental universality of age-related changes in biophysical, behavioural and social characteristics. The importance of the family in developing countries was evident with about three-quarters of those aged 60 and over in the four countries living with children, often in extended family situations. Levels of adverse health-related behaviour and the prospect of changing patterns of morbidity with further increases in the total and proportional numbers of aged persons point to a need for emphasis on preventive health measures and programmes directed to the maintenance of the physical and mental health of the ageing population.

Perceived blood transfusion safety: a cross-European comparison.

PubMed

Merz, E-M; Zijlstra, B J H; de Kort, W L A M

2016-04-01

During the past decades, blood transfusions have become an ever safer clinical procedure in developed countries. Extensive donor screening together with improved infectious disease testing has led to a minimization of risks for transfusion recipients. Still, the general public perceives the process of blood transfusion as risky. This study tested variation in perceived transfusion safety across countries and explained it with individual and country factors. We examined whether individual demographic and macro-level factors (i.e. Human Development Index and Power Distance Index) explain variation within and across European countries. We applied multilevel models to 2009 Eurobarometer data collected in 26 countries (N = 20 874). Results were largely in line with expectations derived from risk perception and power and status difference theories. Generally, women, older adults, the lower educated and those earning lower incomes perceived heightened risk. Most of the variation across Europe was explained by the Human Development Index. Risk perception regarding blood transfusions was lower in countries with higher Human Development Indices, that is countries with higher average education, life expectancy and Gross Domestic Product. This study provides new insights of how risk perception regarding blood transfusions is shaped within and across Europe. Both individual demographic factors and country characteristics play a role. © 2015 International Society of Blood Transfusion.

Educational inequalities in risky health behaviours in 21 European countries: findings from the European social survey (2014) special module on the social determinants of health.

PubMed

Huijts, Tim; Gkiouleka, Anna; Reibling, Nadine; Thomson, Katie H; Eikemo, Terje A; Bambra, Clare

2017-02-01

It has been suggested that cross-national variation in educational inequalities in health outcomes (e.g. NCDs) is due to cross-national variation in risky health behaviour. In this paper we aim to use highly recent data (2014) to examine educational inequalities in risky health behaviour in 21 European countries from all regions of the continent to map cross-national variation in the extent to which educational level is associated with risky health behaviour. We focus on four dimensions of risky health behaviour: smoking, alcohol use, lack of physical activity and lack of fruit and vegetable consumption. We make use of recent data from the 7th wave of the European Social Survey (2014), which contains a special rotating module on the social determinants of health. We performed logistic regression analyses to examine the associations between educational level and the risky health behaviour indicators. Educational level was measured through a three-category version of the harmonized International Standard Classification of Education (ISCED). Our findings show substantial and mostly significant inequalities in risky health behaviour between educational groups in most of the 21 European countries examined in this paper. The risk of being a daily smoker is higher as respondents’ level of education is lower (Low education (L): OR = 4.24 (95% CI: 3.83–4.68); Middle education (M): OR = 2.91 (95% CI: 2.65–3.19)). Respondents have a lower risk of consuming alcohol frequently if they have a low level of education (L: OR = 0.59 (95% CI: 0.54–0.64); M: OR = 0.70 (95% CI: 0.65–0.76)), but a higher risk of binge drinking frequently (L: OR = 1.29 (95% CI: 1.16–1.44); M: OR = 1.15 (95% CI: 1.04–1.27)). People are more likely to be physically active at least 3 days in the past week when they have a higher level of education (M: OR = 1.42 (95% CI: 1.34–1.50); H: OR = 1.67 (95% CI: 1.55–1.80)). Finally, people are more likely to consume fruit and vegetables at least

A prospective study on the variation in falling and fall risk among community-dwelling older citizens in 12 European countries

PubMed Central

Franse, Carmen B; Rietjens, Judith AC; Burdorf, Alex; van Grieken, Amy; Korfage, Ida J; van der Heide, Agnes; Mattace Raso, Francesco; van Beeck, Ed; Raat, Hein

2017-01-01

Objectives The rate of falling among older citizens appears to vary across different countries, but the underlying aspects causing this variation are unexplained. We aim to describe between-country variation in falling and explore whether intrinsic fall risk factors can explain possible variation. Design Prospective study on data from the cross-national Survey of Health, Ageing and Retirement in Europe (SHARE). Setting Twelve European countries (Austria, Belgium, Czech Republic, Denmark, Estonia, France, Germany, Italy, The Netherlands, Spain, Sweden, Switzerland). Participants Community-dwelling persons aged ≥65 years (n=18 596). Measurements Socio-demographic factors (age, gender, education level and living situation) and intrinsic fall risk factors (less than good self-rated health (SRH), mobility limitations, limitations with activities of daily living (ADL), dizziness, impaired vision, depression and impaired cognition) were assessed in a baseline interview. Falling was assessed 2 years later by asking whether the participant had fallen within the 6 months prior to the follow-up interview. Results There was significant between-country variation in the rate of falling (varying from 7.9% in Switzerland to 16.2% in the Czech Republic). The prevalence of intrinsic fall risk factors varied twofold to fourfold between countries. Associations between factors age ≥80 years, less than good SRH, mobility limitations, ADL limitations, dizziness and depression, and falling were different between countries (p<0.05). Between-country differences in falling largely persisted after adjusting for socio-demographic differences but strongly attenuated after adjusting for differences in intrinsic fall risk factors. Conclusion There is considerable variation in the rate of falling between European countries, which can largely be explained by between-country variation in the prevalence of intrinsic fall risk factors. There are also country-specific variations in the

A prospective study on the variation in falling and fall risk among community-dwelling older citizens in 12 European countries.

PubMed

Franse, Carmen B; Rietjens, Judith Ac; Burdorf, Alex; van Grieken, Amy; Korfage, Ida J; van der Heide, Agnes; Mattace Raso, Francesco; van Beeck, Ed; Raat, Hein

2017-06-30

The rate of falling among older citizens appears to vary across different countries, but the underlying aspects causing this variation are unexplained. We aim to describe between-country variation in falling and explore whether intrinsic fall risk factors can explain possible variation. Prospective study on data from the cross-national Survey of Health, Ageing and Retirement in Europe (SHARE). Twelve European countries (Austria, Belgium, Czech Republic, Denmark, Estonia, France, Germany, Italy, The Netherlands, Spain, Sweden, Switzerland). Community-dwelling persons aged ≥65 years (n=18 596). Socio-demographic factors (age, gender, education level and living situation) and intrinsic fall risk factors (less than good self-rated health (SRH), mobility limitations, limitations with activities of daily living (ADL), dizziness, impaired vision, depression and impaired cognition) were assessed in a baseline interview. Falling was assessed 2 years later by asking whether the participant had fallen within the 6 months prior to the follow-up interview. There was significant between-country variation in the rate of falling (varying from 7.9% in Switzerland to 16.2% in the Czech Republic). The prevalence of intrinsic fall risk factors varied twofold to fourfold between countries. Associations between factors age ≥80 years, less than good SRH, mobility limitations, ADL limitations, dizziness and depression, and falling were different between countries (p<0.05). Between-country differences in falling largely persisted after adjusting for socio-demographic differences but strongly attenuated after adjusting for differences in intrinsic fall risk factors. There is considerable variation in the rate of falling between European countries, which can largely be explained by between-country variation in the prevalence of intrinsic fall risk factors. There are also country-specific variations in the association between these intrinsic risk factors and falling. These findings

Trends in socioeconomic inequalities in self-assessed health in 10 European countries.

PubMed

Kunst, Anton E; Bos, Vivian; Lahelma, Eero; Bartley, Mel; Lissau, Inge; Regidor, Enrique; Mielck, Andreas; Cardano, Mario; Dalstra, Jetty A A; Geurts, José J M; Helmert, Uwe; Lennartsson, Carin; Ramm, Jorun; Spadea, Teresa; Stronegger, Willibald J; Mackenbach, Johan P

2005-04-01

Changes over time in inequalities in self-reported health are studied for increasingly more countries, but a comprehensive overview encompassing several countries is still lacking. The general aim of this article is to determine whether inequalities in self-assessed health in 10 European countries showed a general tendency either to increase or to decrease between the 1980s and the 1990s and whether trends varied among countries. Data were obtained from nationally representative interview surveys held in Finland, Sweden, Norway, Denmark, England, The Netherlands, West Germany, Austria, Italy, and Spain. The proportion of respondents with self-assessed health less than 'good' was measured in relation to educational level and income level. Inequalities were measured by means of age-standardized prevalence rates and odds ratios (ORs). Socioeconomic inequalities in self-assessed health showed a high degree of stability in European countries. For all countries together, the ORs comparing low with high educational levels remained stable for men (2.61 in the 1980s and 2.54 in the 1990s) but increased slightly for women (from 2.48 to 2.70). The ORs comparing extreme income quintiles increased from 3.13 to 3.37 for men and from 2.43 to 2.86 for women. Increases could be demonstrated most clearly for Italian and Spanish men and women, and for Dutch women, whereas inequalities in health in the Nordic countries showed no tendency to increase. The results underscore the persistent nature of socioeconomic inequalities in health in modern societies. The relatively favourable trends in the Nordic countries suggest that these countries' welfare states were able to buffer many of the adverse effects of economic crises on the health of disadvantaged groups.

International health IT benchmarking: learning from cross-country comparisons.

PubMed

Zelmer, Jennifer; Ronchi, Elettra; Hyppönen, Hannele; Lupiáñez-Villanueva, Francisco; Codagnone, Cristiano; Nøhr, Christian; Huebner, Ursula; Fazzalari, Anne; Adler-Milstein, Julia

2017-03-01

To pilot benchmark measures of health information and communication technology (ICT) availability and use to facilitate cross-country learning. A prior Organization for Economic Cooperation and Development-led effort involving 30 countries selected and defined functionality-based measures for availability and use of electronic health records, health information exchange, personal health records, and telehealth. In this pilot, an Organization for Economic Cooperation and Development Working Group compiled results for 38 countries for a subset of measures with broad coverage using new and/or adapted country-specific or multinational surveys and other sources from 2012 to 2015. We also synthesized country learnings to inform future benchmarking. While electronic records are widely used to store and manage patient information at the point of care-all but 2 pilot countries reported use by at least half of primary care physicians; many had rates above 75%-patient information exchange across organizations/settings is less common. Large variations in the availability and use of telehealth and personal health records also exist. Pilot participation demonstrated interest in cross-national benchmarking. Using the most comparable measures available to date, it showed substantial diversity in health ICT availability and use in all domains. The project also identified methodological considerations (e.g., structural and health systems issues that can affect measurement) important for future comparisons. While health policies and priorities differ, many nations aim to increase access, quality, and/or efficiency of care through effective ICT use. By identifying variations and describing key contextual factors, benchmarking offers the potential to facilitate cross-national learning and accelerate the progress of individual countries. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association.

Barriers to oral health across selected European countries and the USA.

PubMed

Manski, Richard; Moeller, John

2017-06-01

In this review we consider oral-health access among older adults within and between the USA and various European countries with regard to possible primary financial and modifiable secondary non-financial factors. For older adults, the likelihood of using dental services has been associated, in the health literature, with a multiplicity of factors. These factors are traditionally classified into predisposing, enabling and need categories, and can be further classified into modifiable and non-modifiable subcategories. This raises the question of which single factor or group of factors has the most influence in keeping older adults from seeking care, and how these influences might differ between the USA and various other (European) countries. As it turns out, there is variation in the magnitude of effects across certain measurable potential barriers, but generally it takes a combination of characteristics associated with non-use to have a substantial impact. © 2017 FDI World Dental Federation.

Minimum package for cross-border TB control and care in the WHO European region: a Wolfheze consensus statement

PubMed Central

Dara, Masoud; de Colombani, Pierpaolo; Petrova-Benedict, Roumyana; Centis, Rosella; Zellweger, Jean-Pierre; Sandgren, Andreas; Heldal, Einar; Sotgiu, Giovanni; Jansen, Niesje; Bahtijarevic, Rankica; Migliori, Giovanni Battista

2012-01-01

The World Health Organization (WHO) European region estimates that more than 400,000 tuberculosis (TB) cases occur in Europe, a large proportion of them among migrants. A coordinated public health mechanism to guarantee TB prevention, diagnosis, treatment and care across borders is not in place. A consensus paper describing the minimum package of cross-border TB control and care was prepared by a task force following a literature review, and with input from the national TB control programme managers of the WHO European region and the Wolfheze 2011 conference. A literature review focused on the subject of TB in migrants was carried out, selecting documents published during the 11-yr period 2001–2011. Several issues were identified in cross-border TB control and care, varying from the limited access to early TB diagnosis, to the lack of continuity of care and information during migration, and the availability of, and access to, health services in the new country. The recommended minimum package addresses the current shortcomings and intends to improve the situation by covering several areas: political commitment (including the implementation of a legal framework for TB cross-border collaboration), financial mechanisms and adequate health service delivery (prevention, infection control, contact management, diagnosis and treatment, and psychosocial support). PMID:22653772

Disparity in dental attendance among older adult populations: a comparative analysis across selected European countries and the USA.

PubMed

Manski, Richard; Moeller, John; Chen, Haiyan; Widström, Eeva; Listl, Stefan

2016-02-01

The current study addresses the extent to which diversity in dental attendance across population subgroups exists within and between the USA and selected European countries. The analyses relied on 2006/2007 data from the Survey of Health, Ageing and Retirement in Europe (SHARE) and 2004-2006 data from the Health and Retirement Study (HRS) in the USA for respondents≥51 years of age. Logistic regression models were estimated to identify impacts of dental-care coverage, and of oral and general health status, on dental-care use. We were unable to discern significant differences in dental attendance across population subgroups in countries with and without social health insurance, between the USA and European countries, and between European countries classified according to social welfare regime. Patterns of diverse dental use were found, but they did not appear predominately in countries classified according to welfare state regime or according to the presence or absence of social health insurance. The findings of this study suggest that income and education have a stronger, and more persistent, correlation with dental use than the correlation between dental insurance and dental use across European countries. We conclude that: (i) higher overall rates of coverage in most European countries, compared with relatively lower rates in the USA, contribute to this finding; and that (ii) policies targeted to improving the income of older persons and their awareness of the importance of oral health care in both Europe and the USA can contribute to improving the use of dental services. © 2015 FDI World Dental Federation.

Impact of hepatitis B vaccination on acute hepatitis B epidemiology in European Union/European Economic Area countries, 2006 to 2014

PubMed Central

Miglietta, Alessandro; Quinten, Chantal; Lopalco, Pier Luigi; Duffell, Erika

2018-01-01

Hepatitis B prevention in European Union/European Economic Area (EU/EEA) countries relies on vaccination programmes. We describe the epidemiology of acute hepatitis B virus (HBV) at country and EU/EEA level during 2006–2014. Using a multi-level mixed-effects Poisson regression model we assessed differences in the acute HBV infection notification rates between groups of countries that started universal HBV vaccination before/in vs after 1995; implemented or not a catch-up strategy; reached a vaccine coverage ≥ 95% vs < 95% and had a hepatitis B surface antigen prevalence ≥ 1% vs < 1%. Joinpoint regression analysis was used to assess trends by groups of countries, and additional Poisson regression models to evaluate the association between three-dose HBV vaccine coverage and acute HBV infection notification rates at country and EU/EEA level. The EU/EEA acute HBV infection notification rate decreased from 1.6 per 100,000 population in 2006 to 0.7 in 2014. No differences (p > 0.05) were found in the acute HBV infection notification rates between groups of countries, while as vaccine coverage increased, such rates decreased (p < 0.01). Countries with universal HBV vaccination before 1995, a catch-up strategy, and a vaccine coverage ≥ 95% had significant decreasing trends (p < 0.01). Ending HBV transmission in Europe by 2030 will require high vaccine coverage delivered through universal programmes, supported, where appropriate, by catch-up vaccination campaigns. PMID:29439751

Production activities and economic dependency by age and gender in Europe: A cross-country comparison

PubMed Central

Hammer, Bernhard; Prskawetz, Alexia; Freund, Inga

2015-01-01

We compare selected European countries using an economic dependency ratio which emphasizes the role of age-specific levels of production and consumption. Our analysis reveals large differences in the age- and gender-specific level and type of production activities across selected European countries and identifies possible strategies to adjust age-specific economic behaviour to an ageing population. The cross-country differences in economic dependency of children and elderly persons are largely determined by the age at which people enter, respectively exit, the labour market. The ability of the working age population to support children and elderly persons in turn is strongly influenced by the participation of women in paid work. We also provide a measure for the age-specific production and consumption in form of unpaid household work. The inclusion of unpaid household work leads to a decrease of the gender differences in production activities and indicates that the working age population supports children and elderly persons not only through monetary transfers but also through services produced by unpaid work (e.g. childcare, cooking, cleaning…). Given the available data, we cannot distinguish the age profile of consumption by gender and have to assume – in case of unpaid work - that each member of the household consumes the same. Hence, our results have to be regarded as a first approximation only. Our paper aims to argue that a reform of the welfare system needs to take into account not only public transfers but also private transfers, in particular the transfers in form of goods and services produced through unpaid household work. PMID:26110107

Production activities and economic dependency by age and gender in Europe: A cross-country comparison.

PubMed

Hammer, Bernhard; Prskawetz, Alexia; Freund, Inga

2015-04-01

We compare selected European countries using an economic dependency ratio which emphasizes the role of age-specific levels of production and consumption. Our analysis reveals large differences in the age- and gender-specific level and type of production activities across selected European countries and identifies possible strategies to adjust age-specific economic behaviour to an ageing population. The cross-country differences in economic dependency of children and elderly persons are largely determined by the age at which people enter, respectively exit, the labour market. The ability of the working age population to support children and elderly persons in turn is strongly influenced by the participation of women in paid work. We also provide a measure for the age-specific production and consumption in form of unpaid household work. The inclusion of unpaid household work leads to a decrease of the gender differences in production activities and indicates that the working age population supports children and elderly persons not only through monetary transfers but also through services produced by unpaid work (e.g. childcare, cooking, cleaning…). Given the available data, we cannot distinguish the age profile of consumption by gender and have to assume - in case of unpaid work - that each member of the household consumes the same. Hence, our results have to be regarded as a first approximation only. Our paper aims to argue that a reform of the welfare system needs to take into account not only public transfers but also private transfers, in particular the transfers in form of goods and services produced through unpaid household work.

Effect of the economic recession on pharmaceutical policy and medicine sales in eight European countries.

PubMed

Leopold, Christine; Mantel-Teeuwisse, Aukje K; Vogler, Sabine; Valkova, Silvia; de Joncheere, Kees; Leufkens, Hubert G M; Wagner, Anita K; Ross-Degnan, Dennis; Laing, Richard

2014-09-01

To identify pharmaceutical policy changes during the economic recession in eight European countries and to determine whether policy measures resulted in lower sales of, and less expenditure on, pharmaceuticals. Information on pharmaceutical policy changes between 2008 and 2011 in eight European countries was obtained from publications and pharmaceutical policy databases. Data on the volume and value of the quarterly sales of products between 2006 and 2011 in the 10 highest-selling therapeutic classes in each country were obtained from a pharmaceutical market research database. We compared these indicators in economically stable countries; Austria, Estonia and Finland, to those in economically less stable countries, Greece, Ireland, Portugal, Slovakia and Spain. Economically stable countries implemented two to seven policy changes each, whereas less stable countries implemented 10 to 22 each. Of the 88 policy changes identified, 33 occurred in 2010 and 40 in 2011. They involved changing out-of-pocket payments for patients in 16 cases, price mark-up schemes in 13 and price cuts in 11. Sales volumes increased moderately in all countries except Greece and Portugal, which experienced slight declines after 2009. Sales values decreased in both groups of countries, but fell more in less stable countries. Less economically stable countries implemented more pharmaceutical policy changes during the recession than economically stable countries. Unexpectedly, pharmaceutical sales volumes increased in almost all countries, whereas sales values declined, especially in less stable countries.

Access to biologicals in Crohn’s disease in ten European countries

PubMed Central

Péntek, Márta; Lakatos, Peter L; Oorsprong, Talitha; Gulácsi, László; Pavlova, Milena; Groot, Wim; Rencz, Fanni; Brodszky, Valentin; Baji, Petra; Crohn’s Disease Research Group

2017-01-01

AIM To analyze access (availability, affordability and acceptability) to biologicals for Crohn’s disease (CD) in ten European countries and to explore the associations between these dimensions, the uptake of biologicals and economic development. METHODS A questionnaire-based survey combined with desk research was carried out in May 2016. Gastroenterologists from the Czech Republic, France, Germany, Hungary, Latvia, Poland, Romania, Slovakia, Spain and Sweden were invited to participate and provide data on the availability of biologicals/biosimilars, reimbursement criteria, clinical practice and prices, and use of biologicals. An availability score was developed to evaluate the restrictiveness of eligibility and administrative criteria applied in the countries. Affordability was defined as the annual cost of treatment as a share of gross domestic product (GDP) per capita. Correlations with the uptake of biologicals, dimensions of access and GDP per capita were calculated. RESULTS At the time of the survey, infliximab and adalimumab were reimbursed in all ten countries, and vedolizumab was reimbursed in five countries (France, Germany, Latvia, Slovakia, Sweden). Reimbursement criteria were the least strict in Sweden and Germany, and the strictest in Hungary, Poland and Slovakia. Between countries, the annual cost of different biological treatments differed 1.6-3.3-fold. Treatments were the most affordable in Sweden (13%-37% of the GDP per capita) and the least affordable in the Central and Eastern European countries, especially in Hungary (87%-124%) and Romania (141%-277%). Biosimilars made treatments more affordable by driving down the annual costs. The number of patients with CD on biologicals per 100000 population was strongly correlated with GDP per capita (0.91), although substantial differences were found in the uptake among countries with similar economic development. Correlation between the number of patients with CD on biologicals per 100000 population and

Health, Well-Being and Energy Poverty in Europe: A Comparative Study of 32 European Countries.

PubMed

Thomson, Harriet; Snell, Carolyn; Bouzarovski, Stefan

2017-05-31

Despite growing pan-European interest in and awareness of the wide-ranging health and well-being impacts of energy poverty-which is characterised by an inability to secure adequate levels of energy services in the home-the knowledge base is largely British-centric and dominated by single-country studies. In response, this paper investigates the relationship between energy poverty, health and well-being across 32 European countries, using 2012 data from the European Quality of Life Survey. We find an uneven concentration of energy poverty, poor health, and poor well-being across Europe, with Eastern and Central Europe worst affected. At the intersection of energy poverty and health, there is a higher incidence of poor health (both physical and mental) amongst the energy poor populations of most countries, compared to non-energy poor households. Interestingly, we find the largest disparities in health and well-being levels between energy poor and non-energy poor households occur within relatively equal societies, such as Sweden and Slovenia. As well as the unique challenges brought about by rapidly changing energy landscapes in these countries, we also suggest the relative deprivation theory and processes of social comparison hold some value in explaining these findings.

The formal-informal patient payment mix in European countries. Governance, economics, culture or all of these?

PubMed

Tambor, Marzena; Pavlova, Milena; Golinowska, Stanisława; Sowada, Christoph; Groot, Wim

2013-12-01

Cost-sharing for health care is high on the policy agenda in many European countries that struggle with deficits in their public budget. However, such policy often meets with public opposition, which might delay or even prevent its implementation. Increased reliance on patient payments may also have adverse equity effects, especially in countries where informal patient payments are widespread. The factors which might influence the presence of both, formal and informal payments can be found in economic, governance and cultural differences between countries. The aim of this paper is to review the formal-informal payment mix in Europe and to outline factors associated with this mix. We use quantitative analyses of macro-data for 35 European countries and a qualitative description of selected country experiences. The results suggest that the presence of obligatory cost-sharing for health care services is associated with governance factors, while informal patient payments are a multi-cause phenomenon. A consensus-based policy, supported by evidence and stakeholders' engagement, might contribute to a more sustainable patient payment policy. In some European countries, the implementation of cost-sharing requires policy actions to reduce other patient payment obligations, including measures to eliminate informal payments. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Factorial validity and measurement equivalence of the Client Assessment of Treatment Scale for psychiatric inpatient care - a study in three European countries.

PubMed

Richardson, Michelle; Katsakou, Christina; Torres-González, Francisco; Onchev, George; Kallert, Thomas; Priebe, Stefan

2011-06-30

Patients' views of inpatient care need to be assessed for research and routine evaluation. For this a valid instrument is required. The Client Assessment of Treatment Scale (CAT) has been used in large scale international studies, but its psychometric properties have not been well established. The structural validity of the CAT was tested among involuntary inpatients with psychosis. Data from locations in three separate European countries (England, Spain and Bulgaria) were collected. The factorial validity was initially tested using single sample confirmatory factor analyses in each country. Subsequent multi-sample analyses were used to test for invariance of the factor loadings, and factor variances across the countries. Results provide good initial support for the factorial validity and invariance of the CAT scores. Future research is needed to cross-validate these findings and to generalise them to other countries, treatment settings, and patient populations. Copyright © 2011 Elsevier Ltd. All rights reserved.

Multifractal detrended cross-correlations between crude oil market and Chinese ten sector stock markets

NASA Astrophysics Data System (ADS)

Yang, Liansheng; Zhu, Yingming; Wang, Yudong; Wang, Yiqi

2016-11-01

Based on the daily price data of spot prices of West Texas Intermediate (WTI) crude oil and ten CSI300 sector indices in China, we apply multifractal detrended cross-correlation analysis (MF-DCCA) method to investigate the cross-correlations between crude oil and Chinese sector stock markets. We find that the strength of multifractality between WTI crude oil and energy sector stock market is the highest, followed by the strength of multifractality between WTI crude oil and financial sector market, which reflects a close connection between energy and financial market. Then we do vector autoregression (VAR) analysis to capture the interdependencies among the multiple time series. By comparing the strength of multifractality for original data and residual errors of VAR model, we get a conclusion that vector auto-regression (VAR) model could not be used to describe the dynamics of the cross-correlations between WTI crude oil and the ten sector stock markets.

Radiotherapy staffing in the European countries: final results from the ESTRO-HERO survey.

PubMed

Lievens, Yolande; Defourny, Noémie; Coffey, Mary; Borras, Josep M; Dunscombe, Peter; Slotman, Ben; Malicki, Julian; Bogusz, Marta; Gasparotto, Chiara; Grau, Cai; Kokobobo, Arianit; Sedlmayer, Felix; Slobina, Elena; Coucke, Philippe; Gabrovski, Roumen; Vosmik, Milan; Eriksen, Jesper Grau; Jaal, Jana; Dejean, Catherine; Polgar, Csaba; Johannsson, Jakob; Cunningham, Moya; Atkocius, Vydmantas; Back, Carlo; Pirotta, Martin; Karadjinovic, Vanja; Levernes, Sverre; Maciejewski, Boguslaw; Trigo, Maria Lurdes; Šegedin, Barbara; Palacios, Amalia; Pastoors, Bert; Beardmore, Charlotte; Erridge, Sara; Smyth, Gaile; Cleries Soler, Ramon

2014-08-01

The ESTRO Health Economics in Radiation Oncology (HERO) project has the overall aim to develop a knowledge base of the provision of radiotherapy in Europe and build a model for health economic evaluation of radiation treatments at the European level. The first milestone was to assess the availability of radiotherapy resources within Europe. This paper presents the personnel data collected in the ESTRO HERO database. An 84-item questionnaire was sent out to European countries, through their national scientific and professional radiotherapy societies. The current report includes a detailed analysis of radiotherapy staffing (questionnaire items 47-60), analysed in relation to the annual number of treatment courses and the socio-economic status of the countries. The analysis was conducted between February and July 2014, and is based on validated responses from 24 of the 40 European countries defined by the European Cancer Observatory (ECO). A large variation between countries was found for most parameters studied. Averages and ranges for personnel numbers per million inhabitants are 12.8 (2.5-30.9) for radiation oncologists, 7.6 (0-19.7) for medical physicists, 3.5 (0-12.6) for dosimetrists, 26.6 (1.9-78) for RTTs and 14.8 (0.4-61.0) for radiotherapy nurses. The combined average for physicists and dosimetrists is 9.8 per million inhabitants and 36.9 for RTT and nurses. Radiation oncologists on average treat 208.9 courses per year (range: 99.9-348.8), physicists and dosimetrists conjointly treat 303.3 courses (range: 85-757.7) and RTT and nurses 76.8 (range: 25.7-156.8). In countries with higher GNI per capita, all personnel categories treat fewer courses per annum than in less affluent countries. This relationship is most evident for RTTs and nurses. Different clusters of countries can be distinguished on the basis of available personnel resources and socio-economic status. The average personnel figures in Europe are now consistent with, or even more favourable than

Lessons learnt to keep Europe polio-free: a review of outbreaks in the European Union, European Economic Area, and candidate countries, 1973 to 2013.

PubMed

Derrough, Tarik; Salekeen, Alexandra

2016-04-21

Between 1973 and 2013, 12 outbreaks of paralytic poliomyelitis with a cumulative total of 660 cases were reported in the European Union, European Economic Area and candidate countries. Outbreaks lasted seven to 90 weeks (median: 24 weeks) and were identified through the diagnosis of cases of acute flaccid paralysis, for which infection with wild poliovirus was subsequently identified. In two countries, environmental surveillance was in place before the outbreaks, but did not detect any wild strain before the occurrence of clinical cases. This surveillance nonetheless provided useful information to monitor the outbreaks and their geographical spread. Outbreaks were predominantly caused by poliovirus type 1 and typically involved unvaccinated or inadequately vaccinated groups within highly immunised communities. Oral polio vaccine was primarily used to respond to the outbreaks with catch-up campaigns implemented either nationwide or in restricted geographical areas or age groups. The introduction of supplementary immunisation contained the outbreaks. In 2002, the European region of the World Health Organization was declared polio-free and it has maintained this status since. However, as long as there are non-vaccinated or under-vaccinated groups in European countries and poliomyelitis is not eradicated, countries remain continuously at risk of reintroduction and establishment of the virus. Continued efforts to reach these groups are needed in order to ensure a uniform and high vaccination coverage.

Potential of geographical variation analysis for realigning providers to value-based care. ECHO case study on lower-value indications of C-section in five European countries.

PubMed

García-Armesto, Sandra; Angulo-Pueyo, Ester; Martínez-Lizaga, Natalia; Mateus, Céu; Joaquim, Inês; Bernal-Delgado, Enrique

2015-02-01

Although C-section is a highly effective procedure, literature abounds with evidence of overuse and particularly misuse, in lower-value indications such as low-risk deliveries. This study aims to quantify utilization of C-section in low-risk cases, mapping out areas showing excess-usage in each country and to estimate excess-expenditure as a proxy of the opportunity cost borne by healthcare systems. Observational, ecologic study on deliveries in 913 sub-national administrative areas of five European countries (Denmark, England, Portugal, Slovenia and Spain) from 2002 to 2009. The study includes a cross-section analysis with 2009 data and a time-trend analysis for the whole period. Main endpoints: age-standardized utilization rates of C-section in low-risk pregnancies and deliveries per 100 deliveries. Secondary endpoints: Estimated excess-cases per geographical unit of analysis in two scenarios of minimized utilization. C-section is widely used in all examined countries (ranging from 19% of Slovenian deliveries to 33% of deliveries in Portugal). With the exception of Portugal, there are no systematic variations in intensity of use across areas in the same country. Cross-country comparison of lower-value C-section leaves Denmark with 10% and Portugal with 2%, the highest and lowest. Such behaviour was stable over the period of analysis. Within each country, the scattered geographical patterns of use intensity speak for local drivers playing a major role within the national trend. The analysis conducted suggests plenty of room for enhancing value in obstetric care and equity in women's access to such within the countries studied. The analysis of geographical variations in lower-value care can constitute a powerful screening tool. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Differential pricing of new pharmaceuticals in lower income European countries.

PubMed

Kaló, Zoltán; Annemans, Lieven; Garrison, Louis P

2013-12-01

Pharmaceutical companies adjust the pricing strategy of innovative medicines to the imperatives of their major markets. The ability of payers to influence the ex-factory price of new drugs depends on country population size and income per capita, among other factors. Differential pricing based on Ramsey principles is a 'second-best' solution to correct the imperfections of the global market for innovative pharmaceuticals, and it is also consistent with standard norms of equity. This analysis summarizes the boundaries of differential pharmaceutical pricing for policymakers, payers and other stakeholders in lower-income countries, with special focus on Central-Eastern Europe, and describes the feasibility and implications of potential solutions to ensure lower pharmaceutical prices as compared to higher-income countries. European stakeholders, especially in Central-Eastern Europe and at the EU level, should understand the implications of increased transparency of pricing and should develop solutions to prevent the limited accessibility of new medicines in lower-income countries.

Granting marketing authorisation for medicines in South East European countries: the point of view of the authority.

PubMed

Tomić, Sinisa; Sucić, Anita Filipović; Martinac, Adrijana Ilić

2010-01-01

European legislation for medicines places the emphasis on an assessment of quality, safety and efficacy during the procedure for the granting of marketing authorisations for medicines, in order to protect patient health. The integrated European regulatory system involves the participation of a network of experts from the agencies of the member states that takes part in the European procedures for the authorisation of medicines. On the way to full membership in the EU, candidate countries and potential candidates have to transpose and implement the European directives for medicinal products; they must also strengthen their scientific and administrative capacities. Croatia acquired good experience in implementing the simplified marketing authorisation procedure for medicines authorised in the EU pursuant to the New Collaboration Agreement between Drug Regulatory Authorities in Central and East European Countries (nCADREAC), which helps it to exchange information and prepare for the implementation of European procedures. However, there are still some provisions to transpose before actual full membership, and also dossier upgrading, in which the marketing authorisation holder has to harmonise its documentation about a medicinal product with the requirements of the directives, if a product already on the market was not previously approved in line with current European legislation. Collaboration with the European Medicines Agency (EMA) through an Instrument for Pre-Accession (IPA) provides candidate countries and potential candidates the opportunity for education and training in some regulatory activities as well as the participation of their representatives as observers in some EMA committees and working groups. Some characteristics of the national regulatory frameworks of the countries of South East Europe in their efforts to achieve harmonisation with EU legislation are presented in this paper. Copyright 2010 Elsevier Inc. All rights reserved.

Associations between vigorous physical activity and chronic diseases in older adults: a study in 13 European countries.

PubMed

Marques, Adilson; Peralta, Miguel; Sarmento, Hugo; Martins, João; González Valeiro, Miguel

2018-05-14

This study aimed to assess cross-sectional and prospective relationships between vigorous physical activity (VPA) and the risk of major chronic diseases among European older adults. Participants were 37 524 older adults who responded to the fourth (in 2011) and fifth (in 2013) wave of the SHARE project, from 13 European countries. Participants answered interview questions about the presence of chronic conditions and VPA. The cross-sectional and prospective association between PA and the number of chronic diseases was assessed using logistic regression models. Among men and women, the prevalence of chronic diseases was significantly lower among those who reported VPA once a week or more than once a week. For men, VPA once a week was prospectively related with lower odds of heart attack, chronic lung disease, Parkinson's disease and Alzheimer's disease. VPA more than once a week was prospectively related with lower odds of having all chronic diseases. Women who engaged in VPA once a week presented lower odds of having chronic diseases, except for hypertension, high blood cholesterol and cancer. For VPA more than once a week, cancer was the only disease not associated with physical activity. VPA is associated with reduced risk of chronic diseases in men and women. Even the practice of VPA once a week seems to be sufficient to reduce risks of chronic diseases.

DRG-based hospital payment systems and technological innovation in 12 European countries.

PubMed

Scheller-Kreinsen, David; Quentin, Wilm; Busse, Reinhard

2011-12-01

To assess how diagnosis-related group-based (DRG-based) hospital payment systems in 12 European countries participating in the EuroDRG project pay and incorporate technological innovation. A standardized questionnaire was used to guide comprehensive DRG system descriptions. Researchers from each country reviewed relevant materials to complete the questionnaire and drafted standardized country reports. Two characteristics of DRG-based hospital payment systems were identified as particularly important: the existence of short-term payment instruments encouraging technological innovation in different countries, and the characteristics of long-term updating mechanisms that assure technological innovation is ultimately incorporated into DRG-based hospital payment systems. Short-term payment instruments and long-term updating mechanisms differ greatly among the 12 European countries included in this study. Some countries operate generous short-term payment instruments that provide additional payments to hospitals for making use of technological innovation (e.g., France). Other countries update their DRG-based hospital payment systems very frequently and use more recent data for updates. Generous short-term payment instruments to promote technological innovation should be applied carefully as they may imply rapidly increasing health-care expenditures. In general, they should be granted only if rigorous analyses have demonstrated their benefits. If the evidence remains uncertain, coverage with evidence development frameworks or frequent updates of the DRG-based hospital systems may provide policy alternatives. Once the data and evidence base is substantially improved, future research should empirically investigate how different policy arrangements affect the adoption and use of technological innovation and health-care expenditures. Copyright © 2011 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Prevalence of frailty in middle-aged and older community-dwelling Europeans living in 10 countries.

PubMed

Santos-Eggimann, Brigitte; Cuénoud, Patrick; Spagnoli, Jacques; Junod, Julien

2009-06-01

Frailty is an indicator of health status in old age. Its frequency has been described mainly for North America; comparable data from other countries are lacking. Here we report on the prevalence of frailty in 10 European countries included in a population-based survey. Cross-sectional analysis of 18,227 randomly selected community-dwelling individuals 50 years of age and older, enrolled in the Survey of Health, Aging and Retirement in Europe (SHARE) in 2004. Complete data for assessing a frailty phenotype (exhaustion, shrinking, weakness, slowness, and low physical activity) were available for 16,584 participants. Prevalences of frailty and prefrailty were estimated for individuals 50-64 years and 65 years of age and older from each country. The latter group was analyzed further after excluding disabled individuals. We estimated country effects in this subset using multivariate logistic regression models, controlling first for age, gender, and then demographics and education. The proportion of frailty (three to five criteria) or prefrailty (one to two criteria) was higher in southern than in northern Europe. International differences in the prevalences of frailty and prefrailty for 65 years and older group persisted after excluding the disabled. Demographic characteristics did not account for international differences; however, education was associated with frailty. Controlling for education, age and gender diminished the effects of residing in Italy and Spain. A higher prevalence of frailty in southern countries is consistent with previous findings of a north-south gradient for other health indicators in SHARE. Our data suggest that socioeconomic factors like education contribute to these differences in frailty and prefrailty.

Questioning Discrimination through Critical Media Literacy. Findings from Seven European Countries

ERIC Educational Resources Information Center

Ranieri, Maria; Fabbro, Francesco

2016-01-01

This paper presents the main findings of an action-research study that took place in seven European countries in order to develop effective educational responses to prevent and combat discrimination. The study entailed the design of media and citizenship education activities, their implementation in the different educational contexts and the…

Medical informatics across Europe: analysis of medical informatics scientific output in 33 European countries.

PubMed

Polašek, Ozren; Kern, Josipa

2012-01-01

To investigate the medical informatics scientific output in 33 European countries. Medical Subject Heading term "medical informatics" was used to identify all relevant articles published in 1998-2007 and indexed in the Medline database. The number of articles was adjusted to the population size of each included country in order to obtain the rates per million inhabitants. A total of 28,604 articles were identified. The highest number per million inhabitants was found for Switzerland and the lowest for Albania. Overall, European Union member states had higher output than non-member states, gross domestic product was strongly associated with the scientific output in the field of medical informatics (r = 0.88, p < 0.001). While most countries had significant increase in the scientific output during the observed period, an adjustment to the European average output trend suggested that Lithuania, Portugal, Serbia and Spain had a greater increase than the rest of Europe. The results suggest large disparities across Europe. Further development of medical informatics as a profession and a clear recognition of the discipline are needed to reduce these disparities and propel further increase in research productivity.

The Impact of Tobacco Control Policies on Smoking Among Socioeconomic Groups in Nine European Countries, 1990-2007.

PubMed

Hu, Yannan; van Lenthe, Frank J; Platt, Stephen; Bosdriesz, Jizzo R; Lahelma, Eero; Menvielle, Gwenn; Regidor, Enrique; Santana, Paula; de Gelder, Rianne; Mackenbach, Johan P

2017-11-07

It is uncertain whether tobacco control policies have contributed to a narrowing or widening of socioeconomic inequalities in smoking in European countries during the past two decades. This paper aims to investigate the impact of price and non-price related population-wide tobacco control policies on smoking by socioeconomic group in nine European countries between 1990 and 2007. Individual-level education, occupation and smoking status were obtained from nationally representative surveys. Country-level price-related tobacco control policies were measured by the relative price of cheapest cigarettes and of cigarettes in the most popular price category. Country-level non-price policies were measured by a summary score covering four policy domains: smoking bans or restrictions in public places and workplaces, bans on advertising and promotion, health warning labels, and cessation services. The associations between policies and smoking were explored using logistic regressions, stratified by education and occupation, and adjusted for age, Gross Domestic Product, period and country fixed effects. The price of popular cigarettes and non-price policies were negatively associated with smoking among men. The price of the cheapest cigarettes was negatively associated with smoking among women. While these favorable effects were generally in the same direction for all socioeconomic groups, they were larger and statistically significant in lower socioeconomic groups only. Tobacco control policies as implemented in nine European countries, have probably helped to reduce the prevalence of smoking in the total population, particularly in lower socioeconomic groups. Widening inequalities in smoking may be explained by other factors. Policies with larger effects on lower socioeconomic groups are needed to reverse this trend. Socioeconomic inequalities in smoking widened between the 1990s and the 2000s in Europe. During the same period, there were intensified tobacco control policies

Comparative study of the methods used for treatment and final disposal of sewage sludge in European countries.

PubMed

Kelessidis, Alexandros; Stasinakis, Athanasios S

2012-06-01

Municipal wastewater treatment results to the production of large quantities of sewage sludge, which requires proper and environmentally accepted management before final disposal. In European Union, sludge management remains an open and challenging issue for the Member States as the relative European legislation is fragmentary and quite old, while the published data concerning sludge treatment and disposal in different European countries are often incomplete and inhomogeneous. The main objective of the current study was to outline the current situation and discuss future perspectives for sludge treatment and disposal in EU countries. According to the results, specific sludge production is differentiated significantly between European countries, ranging from 0.1 kg per population equivalent (p.e.) and year (Malta) to 30.8 kg per p.e. and year (Austria). More stringent legislations comparing to European Directive 86/278/EC have been adopted for sludge disposal in soil by several European countries, setting lower limit values for heavy metals as well as limit values for pathogens and organic micropollutants. A great variety of sludge treatment technologies are used in EU countries, while differences are observed between Member States. Anaerobic and aerobic digestion seems to be the most popular stabilization methods, applying in 24 and 20 countries, respectively. Mechanical sludge dewatering is preferred comparing to the use of drying beds, while thermal drying is mainly applied in EU-15 countries (old Member States) and especially in Germany, Italy, France and UK. Regarding sludge final disposal, sludge reuse (including direct agricultural application and composting) seems to be the predominant choice for sludge management in EU-15 (53% of produced sludge), following by incineration (21% of produced sludge). On the other hand, the most common disposal method in EU-12 countries (new Member States that joined EU after 2004) is still landfilling. Due to the obligations

The Human Immunodeficiency Virus Continuum of Care in European Union Countries in 2013: Data and Challenges.

PubMed

Gourlay, Annabelle; Noori, Teymur; Pharris, Anastasia; Axelsson, Maria; Costagliola, Dominique; Cowan, Susan; Croxford, Sara; d'Arminio Monforte, Antonella; Del Amo, Julia; Delpech, Valerie; Díaz, Asunción; Girardi, Enrico; Gunsenheimer-Bartmeyer, Barbara; Hernando, Victoria; Jose, Sophie; Leierer, Gisela; Nikolopoulos, Georgios; Obel, Niels; Op de Coul, Eline; Paraskeva, Dimitra; Reiss, Peter; Sabin, Caroline; Sasse, André; Schmid, Daniela; Sonnerborg, Anders; Spina, Alexander; Suligoi, Barbara; Supervie, Virginie; Touloumi, Giota; Van Beckhoven, Dominique; van Sighem, Ard; Vourli, Georgia; Zangerle, Robert; Porter, Kholoud

2017-06-15

The Joint United Nations Programme on HIV/AIDS (UNAIDS) has set a "90-90-90" target to curb the human immunodeficiency virus (HIV) epidemic by 2020, but methods used to assess whether countries have reached this target are not standardized, hindering comparisons. Through a collaboration formed by the European Centre for Disease Prevention and Control (ECDC) with European HIV cohorts and surveillance agencies, we constructed a standardized, 4-stage continuum of HIV care for 11 European Union countries for 2013. Stages were defined as (1) number of people living with HIV in the country by end of 2013; (2) proportion of stage 1 ever diagnosed; (3) proportion of stage 2 that ever initiated ART; and (4) proportion of stage 3 who became virally suppressed (≤200 copies/mL). Case surveillance data were used primarily to derive stages 1 (using back-calculation models) and 2, and cohort data for stages 3 and 4. In 2013, 674500 people in the 11 countries were estimated to be living with HIV, ranging from 5500 to 153400 in each country. Overall HIV prevalence was 0.22% (range, 0.09%-0.36%). Overall proportions of each previous stage were 84% diagnosed, 84% on ART, and 85% virally suppressed (60% of people living with HIV). Two countries achieved ≥90% for all stages, and more than half had reached ≥90% for at least 1 stage. European Union countries are nearing the 90-90-90 target. Reducing the proportion undiagnosed remains the greatest barrier to achieving this target, suggesting that further efforts are needed to improve HIV testing rates. Standardizing methods to derive comparable continuums of care remains a challenge. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

The Human Immunodeficiency Virus Continuum of Care in European Union Countries in 2013: Data and Challenges

PubMed Central

Noori, Teymur; Pharris, Anastasia; Axelsson, Maria; Costagliola, Dominique; Cowan, Susan; Croxford, Sara; d’Arminio Monforte, Antonella; del Amo, Julia; Delpech, Valerie; Díaz, Asunción; Girardi, Enrico; Gunsenheimer-Bartmeyer, Barbara; Hernando, Victoria; Jose, Sophie; Leierer, Gisela; Nikolopoulos, Georgios; Obel, Niels; Op de Coul, Eline; Paraskeva, Dimitra; Reiss, Peter; Sabin, Caroline; Sasse, André; Schmid, Daniela; Sonnerborg, Anders; Spina, Alexander; Suligoi, Barbara; Supervie, Virginie; Touloumi, Giota; Van Beckhoven, Dominique; van Sighem, Ard; Vourli, Georgia; Zangerle, Robert; Porter, Kholoud

2017-01-01

Abstract Background. The Joint United Nations Programme on HIV/AIDS (UNAIDS) has set a “90-90-90” target to curb the human immunodeficiency virus (HIV) epidemic by 2020, but methods used to assess whether countries have reached this target are not standardized, hindering comparisons. Methods. Through a collaboration formed by the European Centre for Disease Prevention and Control (ECDC) with European HIV cohorts and surveillance agencies, we constructed a standardized, 4-stage continuum of HIV care for 11 European Union countries for 2013. Stages were defined as (1) number of people living with HIV in the country by end of 2013; (2) proportion of stage 1 ever diagnosed; (3) proportion of stage 2 that ever initiated ART; and (4) proportion of stage 3 who became virally suppressed (≤200 copies/mL). Case surveillance data were used primarily to derive stages 1 (using back-calculation models) and 2, and cohort data for stages 3 and 4. Results. In 2013, 674500 people in the 11 countries were estimated to be living with HIV, ranging from 5500 to 153400 in each country. Overall HIV prevalence was 0.22% (range, 0.09%–0.36%). Overall proportions of each previous stage were 84% diagnosed, 84% on ART, and 85% virally suppressed (60% of people living with HIV). Two countries achieved ≥90% for all stages, and more than half had reached ≥90% for at least 1 stage. Conclusions. European Union countries are nearing the 90-90-90 target. Reducing the proportion undiagnosed remains the greatest barrier to achieving this target, suggesting that further efforts are needed to improve HIV testing rates. Standardizing methods to derive comparable continuums of care remains a challenge. PMID:28369283

Quality and Quality Assurance in Vocational Education and Training in the Mediterranean Countries: Lessons from the European Approach

ERIC Educational Resources Information Center

Masson, Jean-Raymond; Baati, Mounir; Seyfried, Erwin

2010-01-01

This article reflects on the development of the European approach towards quality and quality assurance in vocational education and training (VET) and its relevance for VET reforms in the European Training Foundation (ETF) partner countries. The analysis is based on an ETF project conducted in 2007-2008 in the Mediterranean partner countries to…

European American Therapist Self-Disclosure in Cross-Cultural Counseling

ERIC Educational Resources Information Center

Burkard, Alan W.; Knox, Sarah; Groen, Michael; Perez, Maria; Hess, Shirley A.

2006-01-01

Eleven European American psychotherapists' use of self-disclosure in cross-cultural counseling was studied using consensual qualitative research. As reasons for self-disclosing, therapists reported the intent to enhance the counseling relationship, acknowledge the role of racism/oppression in clients' lives, and acknowledge their own…

Diagnostic issues and capabilities in 48 isolation facilities in 16 European countries: data from EuroNHID surveys.

PubMed

Thiberville, Simon-Djamel; Schilling, Stefan; De Iaco, Giuseppina; Fusco, Francesco Maria; Thomson, Gail; Maltezou, Helen C; Gottschalk, Rene; Brodt, Reinhard H; Bannister, Barbara; Puro, Vincenzo; Ippolito, Giuseppe; Brouqui, Philippe

2012-09-25

Highly infectious diseases (HIDs) are defined as being transmissible from person to person, causing life-threatening illnesses and presenting a serious public health hazard. The sampling, handling and transport of specimens from patients with HIDs present specific bio-safety concerns. The European Network for HID project aimed to record, in a cross-sectional study, the infection control capabilities of referral centers for HIDs across Europe and assesses the level of achievement to previously published guidelines. In this paper, we report the current diagnostic capabilities and bio-safety measures applied to diagnostic procedures in these referral centers. Overall, 48 isolation facilities in 16 European countries were evaluated. Although 81% of these referral centers are located near a biosafety level 3 laboratory, 11% and 31% of them still performed their microbiological and routine diagnostic analyses, respectively, without bio-safety measures. The discrepancies among the referral centers surveyed between the level of practices and the European Network of Infectious Diseases (EUNID) recommendations have multiple reasons of which the interest of the individuals in charge and the investment they put in preparedness to emerging outbreaks. Despite the fact that the less prepared centers can improve by just updating their practice and policies any support to help them to achieve an acceptable level of biosecurity is welcome.

75 FR 3248 - Certain Oil Country Tubular Goods From China

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-20

... Goods From China Determination On the basis of the record \\1\\ developed in the subject investigation... threatened with material injury by reason of imports from China of certain oil country tubular goods (``OCTG... subsidized by the Government of China. 2 3 \\1\\ The record is defined in sec. 207.2(f) of the Commission's...

To What Extent Do Teachers in European Countries Differ in Their Professional Community Practices?

ERIC Educational Resources Information Center

Lomos, Catalina

2017-01-01

Within comparative school effectiveness research facilitated by large-scale data across countries, this article presents the results of the testing for measurement invariance of the latent concept of Professional Community (PC) across 23 European countries and more than 35,000 teachers in secondary schools. The newly proposed Multiple-Group Factor…

The Spread of European Models of Engineering Education: The Challenges Faced in Emerging Countries

ERIC Educational Resources Information Center

Gardelle, Linda; Cardona Gil, Emmanuel; Benguerna, Mohamed; Bolat, Altangul; Naran, Boldmaa

2017-01-01

The major European models of engineering training (the German, the British and the French model) spread throughout the world during the twentieth century. Historical heritage, cultural proximity and languages explain the open expression of faithfulness to one system in some countries. In these countries, the national standards inherited are now…

Exploring the Relationship Between Absolute and Relative Position and Late-Life Depression: Evidence From 10 European Countries

PubMed Central

Ladin, Keren; Daniels, Norman; Kawachi, Ichiro

2010-01-01

Purpose: Socioeconomic inequality has been associated with higher levels of morbidity and mortality. This study explores the role of absolute and relative deprivation in predicting late-life depression on both individual and country levels. Design and Methods: Country- and individual-level inequality indicators were used in multivariate logistic regression and in relative indexes of inequality. Data obtained from the Survey of Health, Ageing and Retirement in Europe (SHARE, Wave 1, Release 2) included 22,777 men and women (aged 50–104 years) from 10 European countries. Late-life depression was measured using the EURO-D scale and corresponding clinical cut point. Absolute deprivation was measured using gross domestic product and median household income at the country level and socioeconomic status at the individual level. Relative deprivation was measured by Gini coefficients at the country level and educational attainment at the individual level. Results: Rates of depression ranged from 18.10% in Denmark to 36.84% in Spain reflecting a clear north–south gradient. Measures of absolute and relative deprivation were significant in predicting depression at both country and individual levels. Findings suggest that the adverse impact of societal inequality cannot be overcome by increased individual-level or country-level income. Increases in individual-level income did not mitigate the effect of country-level relative deprivation. Implications: Mental health disparities persist throughout later life whereby persons exposed to higher levels of country-level inequality suffer greater morbidity compared with those in countries with less inequality. Cross-national variation in the relationship between inequality and depression illuminates the need for further research. PMID:19515635

Effect of the economic recession on pharmaceutical policy and medicine sales in eight European countries

PubMed Central

Mantel-Teeuwisse, Aukje K; Vogler, Sabine; Valkova, Silvia; de Joncheere, Kees; Leufkens, Hubert GM; Wagner, Anita K; Ross-Degnan, Dennis; Laing, Richard

2014-01-01

Abstract Objective To identify pharmaceutical policy changes during the economic recession in eight European countries and to determine whether policy measures resulted in lower sales of, and less expenditure on, pharmaceuticals. Methods Information on pharmaceutical policy changes between 2008 and 2011 in eight European countries was obtained from publications and pharmaceutical policy databases. Data on the volume and value of the quarterly sales of products between 2006 and 2011 in the 10 highest-selling therapeutic classes in each country were obtained from a pharmaceutical market research database. We compared these indicators in economically stable countries; Austria, Estonia and Finland, to those in economically less stable countries, Greece, Ireland, Portugal, Slovakia and Spain. Findings Economically stable countries implemented two to seven policy changes each, whereas less stable countries implemented 10 to 22 each. Of the 88 policy changes identified, 33 occurred in 2010 and 40 in 2011. They involved changing out-of-pocket payments for patients in 16 cases, price mark-up schemes in 13 and price cuts in 11. Sales volumes increased moderately in all countries except Greece and Portugal, which experienced slight declines after 2009. Sales values decreased in both groups of countries, but fell more in less stable countries. Conclusion Less economically stable countries implemented more pharmaceutical policy changes during the recession than economically stable countries. Unexpectedly, pharmaceutical sales volumes increased in almost all countries, whereas sales values declined, especially in less stable countries. PMID:25378754

Encapsulated eucalyptus oil in ionically cross-linked alginate microcapsules and its controlled release.

PubMed

Noppakundilograt, Supaporn; Piboon, Phianghathai; Graisuwan, Wilaiporn; Nuisin, Roongkan; Kiatkamjornwong, Suda

2015-10-20

Sodium alginate microcapsules containing eucalyptus oil were prepared by oil-in-water emulsification via Shirasu porous glass (SPG) membrane and cross-linked by calcium chloride (CaCl2). SPG membrane pore size of 5.2μm was used to control the size of eucalyptus oil microdroplets. Effects of sodium alginate, having a mannuronic acid/guluronic acid (M/G) ratio of 1.13, eucalyptus oil and CaCl2 amounts on microdroplet sizes and size distribution were elucidated. Increasing sodium alginate amounts from 0.1 to 0.5% (wv(-1)) sodium alginate, the average droplets size increased from 42.2±2.0 to 48.5±0.6μm, with CVs of 16.5±2.2 and 30.2±4.5%, respectively. CaCl2 successfully gave narrower size distribution of cross-linked eucalyptus oil microcapsules. The optimum conditions for preparing the microcapsules, oil loading efficiency, and controlled release of the encapsulated eucalyptus oil from the microcapsules as a function of time at 40°C were investigated. Release model for the oil from microcapsules fitted Ritger-Peppas model with non-Fickian transport mechanism. Copyright © 2015 Elsevier Ltd. All rights reserved.

European Surveillance Network for Influenza in Pigs: Surveillance Programs, Diagnostic Tools and Swine Influenza Virus Subtypes Identified in 14 European Countries from 2010 to 2013

PubMed Central

Simon, Gaëlle; Larsen, Lars E.; Dürrwald, Ralf; Foni, Emanuela; Harder, Timm; Van Reeth, Kristien; Markowska-Daniel, Iwona; Reid, Scott M.; Dan, Adam; Maldonado, Jaime; Huovilainen, Anita; Billinis, Charalambos; Davidson, Irit; Agüero, Montserrat; Vila, Thaïs; Hervé, Séverine; Breum, Solvej Østergaard; Chiapponi, Chiara; Urbaniak, Kinga; Kyriakis, Constantinos S.; Brown, Ian H.; Loeffen, Willie

2014-01-01

Swine influenza causes concern for global veterinary and public health officials. In continuing two previous networks that initiated the surveillance of swine influenza viruses (SIVs) circulating in European pigs between 2001 and 2008, a third European Surveillance Network for Influenza in Pigs (ESNIP3, 2010–2013) aimed to expand widely the knowledge of the epidemiology of European SIVs. ESNIP3 stimulated programs of harmonized SIV surveillance in European countries and supported the coordination of appropriate diagnostic tools and subtyping methods. Thus, an extensive virological monitoring, mainly conducted through passive surveillance programs, resulted in the examination of more than 9 000 herds in 17 countries. Influenza A viruses were detected in 31% of herds examined from which 1887 viruses were preliminary characterized. The dominating subtypes were the three European enzootic SIVs: avian-like swine H1N1 (53.6%), human-like reassortant swine H1N2 (13%) and human-like reassortant swine H3N2 (9.1%), as well as pandemic A/H1N1 2009 (H1N1pdm) virus (10.3%). Viruses from these four lineages co-circulated in several countries but with very different relative levels of incidence. For instance, the H3N2 subtype was not detected at all in some geographic areas whereas it was still prevalent in other parts of Europe. Interestingly, H3N2-free areas were those that exhibited highest frequencies of circulating H1N2 viruses. H1N1pdm viruses were isolated at an increasing incidence in some countries from 2010 to 2013, indicating that this subtype has become established in the European pig population. Finally, 13.9% of the viruses represented reassortants between these four lineages, especially between previous enzootic SIVs and H1N1pdm. These novel viruses were detected at the same time in several countries, with increasing prevalence. Some of them might become established in pig herds, causing implications for zoonotic infections. PMID:25542013

European surveillance network for influenza in pigs: surveillance programs, diagnostic tools and Swine influenza virus subtypes identified in 14 European countries from 2010 to 2013.

PubMed

Simon, Gaëlle; Larsen, Lars E; Dürrwald, Ralf; Foni, Emanuela; Harder, Timm; Van Reeth, Kristien; Markowska-Daniel, Iwona; Reid, Scott M; Dan, Adam; Maldonado, Jaime; Huovilainen, Anita; Billinis, Charalambos; Davidson, Irit; Agüero, Montserrat; Vila, Thaïs; Hervé, Séverine; Breum, Solvej Østergaard; Chiapponi, Chiara; Urbaniak, Kinga; Kyriakis, Constantinos S; Brown, Ian H; Loeffen, Willie

2014-01-01

Swine influenza causes concern for global veterinary and public health officials. In continuing two previous networks that initiated the surveillance of swine influenza viruses (SIVs) circulating in European pigs between 2001 and 2008, a third European Surveillance Network for Influenza in Pigs (ESNIP3, 2010-2013) aimed to expand widely the knowledge of the epidemiology of European SIVs. ESNIP3 stimulated programs of harmonized SIV surveillance in European countries and supported the coordination of appropriate diagnostic tools and subtyping methods. Thus, an extensive virological monitoring, mainly conducted through passive surveillance programs, resulted in the examination of more than 9 000 herds in 17 countries. Influenza A viruses were detected in 31% of herds examined from which 1887 viruses were preliminary characterized. The dominating subtypes were the three European enzootic SIVs: avian-like swine H1N1 (53.6%), human-like reassortant swine H1N2 (13%) and human-like reassortant swine H3N2 (9.1%), as well as pandemic A/H1N1 2009 (H1N1pdm) virus (10.3%). Viruses from these four lineages co-circulated in several countries but with very different relative levels of incidence. For instance, the H3N2 subtype was not detected at all in some geographic areas whereas it was still prevalent in other parts of Europe. Interestingly, H3N2-free areas were those that exhibited highest frequencies of circulating H1N2 viruses. H1N1pdm viruses were isolated at an increasing incidence in some countries from 2010 to 2013, indicating that this subtype has become established in the European pig population. Finally, 13.9% of the viruses represented reassortants between these four lineages, especially between previous enzootic SIVs and H1N1pdm. These novel viruses were detected at the same time in several countries, with increasing prevalence. Some of them might become established in pig herds, causing implications for zoonotic infections.

Lung cancer mortality trends in 36 European countries: secular trends and birth cohort patterns by sex and region 1970-2007.

PubMed

Bray, Freddie Ian; Weiderpass, Elisabete

2010-03-15

Smoking is a major contributor to all-cause mortality in Europe and accounts for one-fifth of the cancer-related deaths. Monitoring the tobacco epidemic via an analysis of lung cancer trends is essential in helping countries arrest the effects of tobacco epidemic in the region. The study aims to provide a comprehensive and up-to-date overview of the temporal patterns of lung cancer mortality in Europe, emphasizing country- and sex-specific differences. National lung cancer mortality data were extracted from the WHO mortality databank by age, sex, year of death (1970-2007) for 36 countries in Europe. Trends in lung cancer mortality in men have tended to decrease in many European countries during the last two decades, particularly in North and Western Europe. Among women, mortality rates are still increasing in many countries, although in a few populations, rates are beginning to stabilize, notably in the high-risk countries within Eastern Europe (Hungary, Poland and the Czech Republic), and in Northern Europe (Denmark, Iceland and the United Kingdom). Men and women are clearly in very different phases of the smoking epidemic, and, as reflected in the mortality rates by birth cohort, the stage varies widely by country within each European region. That lung cancer mortality trends in men are on a downwards path in most European countries while female rates continue to rise, points to an urgent need for national and European prevention strategies that target tobacco cessation and prevention among European women.

Barriers to Oral Health Across Selected European Countries and the United States

PubMed Central

Manski, Richard; Moeller, John

2016-01-01

In this review we consider oral health access among older adults within and between the United States and various European countries with regard to possible primary financial and modifiable secondary non-financial factors. For older adults, the likelihood of using dental services has been associated with a multiplicity of factors in the health literature. These factors are traditionally classified into predisposing, enabling, and need categories, and can be further classified into modifiable and non-modifiable sub-categories. This raises the question as to which single factor or group of factors has the most influence in keeping older adults from seeking care, and how might these influences differ between the USA and various other (European) countries. As it turns out, there is variation in the magnitude of effects across certain measurable potential barriers, but generally it takes a combination of characteristics associated with non-use to have a substantial impact. PMID:28083874

Policy interventions related to medicines: Survey of measures taken in European countries during 2010-2015.

PubMed

Vogler, Sabine; Zimmermann, Nina; de Joncheere, Kees

2016-12-01

Policy-makers can use a menu of pharmaceutical policy options. This study aimed to survey these measures that were implemented in European countries between 2010 and 2015. We did bi-annual surveys with competent authorities of the Pharmaceutical Pricing and Reimbursement Information network. Additionally, we consulted posters produced by members of this network as well as further published literature. Information on 32 European countries (all European Union Member States excluding Luxembourg; Iceland, Norway, Serbia, Switzerland, Turkey) was included. 557 measures were reported between January 2010 and December 2015. The most frequently mentioned measure was price reductions and price freezes, followed by changes in patient co-payments, modifications related to the reimbursement lists and changes in distribution remuneration. Most policy measures were identified in Portugal, Greece, Belgium, France, the Czech Republic, Iceland, Spain and Germany. 22% of the measures surveyed could be classified as austerity. Countries that were strongly hit by the financial crisis implemented most policy changes, usually aiming to generate savings and briefly after the emergence of the crisis. Improvements in the economic situation tended to lead to an easing of austerity measures. Countries also implemented policies that aimed to enhance enforcement of existing measures and increase efficiency. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Health, Well-Being and Energy Poverty in Europe: A Comparative Study of 32 European Countries

PubMed Central

Thomson, Harriet; Snell, Carolyn; Bouzarovski, Stefan

2017-01-01

Despite growing pan-European interest in and awareness of the wide-ranging health and well-being impacts of energy poverty—which is characterised by an inability to secure adequate levels of energy services in the home—the knowledge base is largely British-centric and dominated by single-country studies. In response, this paper investigates the relationship between energy poverty, health and well-being across 32 European countries, using 2012 data from the European Quality of Life Survey. We find an uneven concentration of energy poverty, poor health, and poor well-being across Europe, with Eastern and Central Europe worst affected. At the intersection of energy poverty and health, there is a higher incidence of poor health (both physical and mental) amongst the energy poor populations of most countries, compared to non-energy poor households. Interestingly, we find the largest disparities in health and well-being levels between energy poor and non-energy poor households occur within relatively equal societies, such as Sweden and Slovenia. As well as the unique challenges brought about by rapidly changing energy landscapes in these countries, we also suggest the relative deprivation theory and processes of social comparison hold some value in explaining these findings. PMID:28561767

Population size dependency of measles epidemic that was scalable from Japanese prefectures to European countries.

PubMed

Yoshikura, Hiroshi

2018-04-27

Relation between number of measles patients (y) and population size (x) was expressed by an equation y = ax s , where a is a constant and s the slope of the plot; s was 2.04-2.17 for prefectures in Japan, i.e., the number of patients was proportional to square of the prefecture population size. For European countries that joined European Union no later than 2009, the slope was 1.43-1.87. The measles' population dependency found among prefectures in Japan was thus scalable up to European countries. It was surprising because, unlike Japan, population density in EU countries was not uniform and not proportional to the population size. The population size dependency was not observed among Western Pacific and South-East Asian countries probably on account of confounding interacting socioeconomic factors. Correlation between measles incidence and birth rate, infant mortality or GDP per capita was almost insignificant.Size distribution of local infection clusters (LICs) of measles and rubella in Japan followed power law. For measles, though the population dependency remained unchanged after "elimination", there was change in the Zipf-type plot of LIC sizes. After the "elimination", LICs linked to importation-related outbreaks in less populated prefectures emerged as the top-ranked LICs.

Cross-Country Skiing Injuries and Training Methods.

PubMed

Nagle, Kyle B

2015-01-01

Cross-country skiing is a low injury-risk sport that has many health benefits and few long-term health risks. Some concern exists that cross-country skiing may be associated with a higher incidence of atrial fibrillation; however, mortality rates among skiers are lower than those among the general population. While continuing to emphasize aerobic and anaerobic training, training methods also should promote ski-specific strength training to increase maximum force and its rate of delivery and to build muscular endurance to maintain that power through a race. Multiple tests are available to monitor training progress. Which tests are most appropriate depends on the specific events targeted. In addition to laboratory-based tests, there also are many simpler, more cost-effective tests, such as short time trials, that can be used to monitor training progress and predict performance particularly at the junior skier level where access and cost may be more prohibitive.

Psychological determinants of consumer acceptance of personalised nutrition in 9 European countries.

PubMed

Poínhos, Rui; van der Lans, Ivo A; Rankin, Audrey; Fischer, Arnout R H; Bunting, Brendan; Kuznesof, Sharron; Stewart-Knox, Barbara; Frewer, Lynn J

2014-01-01

To develop a model of the psychological factors which predict people's intention to adopt personalised nutrition. Potential determinants of adoption included perceived risk and benefit, perceived self-efficacy, internal locus of control and health commitment. A questionnaire, developed from exploratory study data and the existing theoretical literature, and including validated psychological scales was administered to N=9381 participants from 9 European countries (Germany, Greece, Ireland, Poland, Portugal, Spain, the Netherlands, the UK, and Norway). Structural equation modelling indicated that the greater participants' perceived benefits to be associated with personalised nutrition, the more positive their attitudes were towards personalised nutrition, and the greater their intention to adopt it. Higher levels of nutrition self-efficacy were related to more positive attitudes towards, and a greater expressed intention to adopt, personalised nutrition. Other constructs positively impacting attitudes towards personalised nutrition included more positive perceptions of the efficacy of regulatory control to protect consumers (e.g. in relation to personal data protection), higher self-reported internal health locus of control, and health commitment. Although higher perceived risk had a negative relationship with attitude and an inverse relationship with perceived benefit, its effects on attitude and intention to adopt personalised nutrition was less influential than perceived benefit. The model was stable across the different European countries, suggesting that psychological factors determining adoption of personalised nutrition have generic applicability across different European countries. The results suggest that transparent provision of information about potential benefits, and protection of consumers' personal data is important for adoption, delivery of public health benefits, and commercialisation of personalised nutrition.

Two decades of change in European general practice service profiles: conditions associated with the developments in 28 countries between 1993 and 2012.

PubMed

Schäfer, Willemijn L A; Boerma, Wienke G W; Spreeuwenberg, Peter; Schellevis, François G; Groenewegen, Peter P

2016-01-01

Evidence regarding the benefits of strong primary care has influenced health policy and practice. This study focuses on changes in the breadth of services provided by general practitioners (GPs) in Europe between 1993 and 2012 and offers possible explanations for these changes. Data on the breadth of service profiles were used from two cross-sectional surveys in 28 countries: the 1993 European GP Task Profile study (6321 GPs) and the 2012 QUALICOPC study (6044 GPs). GPs' involvement in four areas of clinical activity (first contact care, treatment of diseases, medical procedures, and prevention) was established using ecometric analyses. The changes were measured by the relative increase in the breadth of service profiles. Associations between changes and national-level conditions were examined though regression analyses. Data on the national conditions were used from various other public databases including the World Databank and the PHAMEU (Primary Health care Activity Monitor) database. A total of 28 European countries. GPs. Changes in the breadth of GP service profiles. A general trend of increased involvement of European GPs in treatment of diseases and decreased involvement in preventive activities was observed. Conditions at the national level were associated with changes in the involvement of GPs in first contact care, treatment of diseases and, to a limited extent, prevention. Especially in countries with stronger growth of health care expenditures between 1993 and 2012 the service profiles have expanded. In countries where family values are more dominant the breadth in service profiles decreased. A stronger professional status of GPs was positively associated with the change in first contact care. GPs in former communist countries and Turkey have increased their involvement in the provision of services. Developments in Western Europe were less evident. The developments in the service profiles could only to a very limited extent be explained by national

Disparity in Dental Attendance Among Older Adult Populations: A Comparative Analysis Across Selected European Countries and the United States

PubMed Central

Manski, Richard; Moeller, John; Chen, Haiyan; Widström, Eeva; Listl, Stefan

2015-01-01

Background The current study addresses the extent to which diversity in dental attendance across population subgroups exists within and between the United States and selected European countries. Method The analyses relied on 2006/2007 data from the Survey of Health, Ageing, and Retirement in Europe (SHARE) and 2004–2006 data from of the Health and Retirement Study (HRS) in the United States for respondents aged 51 years and older. Logistic regression models were estimated to identify impacts of dental care coverage and oral as well as general health status on dental care use. Results We were unable to discern significant differences in dental attendance across population subgroups in countries with and without social health insurance, between the USA and European countries, and between European countries classified by social welfare regime. Patterns of diverse dental use were found, but they did not appear predominately in countries classified by welfare state regime or by presence or absence of social health insurance. Conclusions Findings of this study suggest that income and education have stronger and more persistent correlation with dental use than the correlation between dental insurance and dental use across European countries. We conclude that (1) higher overall rates of coverage in most European countries, compared to relatively lower rates in the USA, contribute to this finding and that (2) policies targeted to improving the income of older persons and their awareness of the importance of oral health care in both Europe and the USA can contribute to improving the use of dental services. PMID:26465093

Extending trust to immigrants: Generalized trust, cross-group friendship and anti-immigrant sentiments in 21 European societies

PubMed Central

van der Linden, Meta; Hooghe, Marc; de Vroome, Thomas; Van Laar, Colette

2017-01-01

The aim of this study is twofold. First, we expand on the literature by testing whether generalized trust is negatively related to anti-immigrant sentiments in Europe. Second, we examine to what extent the relation between generalized trust and anti-immigrant sentiments is dependent upon cross-group friendships. We apply multilevel linear regression modeling to representative survey data enriched with levels of ethnic diversity covering 21 European countries. Results show that both generalized trust and cross-group friendship are negatively related to anti-immigrant sentiments. However, there is a negligible positive relation between generalized trust and cross-group friendship (r = .10), and we can clearly observe that they operate independently from one another. Hence, trusting actors are not more likely to form more cross-group friendships, and cross-group friendship do not lead to the development of more generalized trust. Instead, the findings show that generalized trust leads immigrants too to be included in the radius of trusted others and, as a consequence, the benign effects of generalized trust apply to them as well. We conclude that the strength of generalized trust is a form of generalization, beyond the confines of individual variations in intergroup experiences. PMID:28481925

Extending trust to immigrants: Generalized trust, cross-group friendship and anti-immigrant sentiments in 21 European societies.

PubMed

van der Linden, Meta; Hooghe, Marc; de Vroome, Thomas; Van Laar, Colette

2017-01-01

The aim of this study is twofold. First, we expand on the literature by testing whether generalized trust is negatively related to anti-immigrant sentiments in Europe. Second, we examine to what extent the relation between generalized trust and anti-immigrant sentiments is dependent upon cross-group friendships. We apply multilevel linear regression modeling to representative survey data enriched with levels of ethnic diversity covering 21 European countries. Results show that both generalized trust and cross-group friendship are negatively related to anti-immigrant sentiments. However, there is a negligible positive relation between generalized trust and cross-group friendship (r = .10), and we can clearly observe that they operate independently from one another. Hence, trusting actors are not more likely to form more cross-group friendships, and cross-group friendship do not lead to the development of more generalized trust. Instead, the findings show that generalized trust leads immigrants too to be included in the radius of trusted others and, as a consequence, the benign effects of generalized trust apply to them as well. We conclude that the strength of generalized trust is a form of generalization, beyond the confines of individual variations in intergroup experiences.

European Association for Palliative Care: Forging a Vision of Excellence in Palliative Care in Central and Eastern European and Former Soviet Union Countries.

PubMed

Radbruch, Lukas; Ling, Julie; Hegedus, Katalin; Larkin, Philip

2018-02-01

The European Association for Palliative Care (EAPC) represents many thousands of health care workers and volunteers working in or with an interest in palliative care. In 2016, the EAPC has individual members from 48 nations across the world, and collective members from 57 national palliative care associations in 32 European countries. Throughout its history, the EAPC has produced guidance on a range of palliative care issues. The biennial congresses and research congresses and the comprehensive Web site (www.eapcnet.eu) are renowned and well utilized platforms for dissemination and exchange of palliative care information. The EAPC has also published a newsletter specifically for Eastern European and Central Asian countries that has been available in both English and Russian from 2005 to 2012. In addition, for a period of time, a Russian Web site (www.eapcspeaksrussian.eu) was also available. A survey of palliative care in Central and Eastern European nations sponsored by Open Society Foundation's International Palliative Care Initiative found that in most countries, the national language is preferred rather than using English or Russian for the provision of information. Accordingly, the EAPC Web site provides translations of white papers, position papers, and blog posts in a number of languages. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Cross-Country Variation in Adult Skills Inequality: Why Are Skill Levels and Opportunities so Unequal in Anglophone Countries?

ERIC Educational Resources Information Center

Green, Andy; Green, Francis; Pensiero, Nicola

2015-01-01

This article examines cross-country variations in adult skills inequality and asks why skills in Anglophone countries are so unequal. Drawing on the Organization for Economic Cooperation and Development's recent Survey of Adult Skills and other surveys, it investigates the differences across countries and country groups in inequality in both…

Climate change, future Arctic Sea ice, and the competitiveness of European Arctic offshore oil and gas production on world markets.

PubMed

Petrick, Sebastian; Riemann-Campe, Kathrin; Hoog, Sven; Growitsch, Christian; Schwind, Hannah; Gerdes, Rüdiger; Rehdanz, Katrin

2017-12-01

A significant share of the world's undiscovered oil and natural gas resources are assumed to lie under the seabed of the Arctic Ocean. Up until now, the exploitation of the resources especially under the European Arctic has largely been prevented by the challenges posed by sea ice coverage, harsh weather conditions, darkness, remoteness of the fields, and lack of infrastructure. Gradual warming has, however, improved the accessibility of the Arctic Ocean. We show for the most resource-abundant European Arctic Seas whether and how a climate induced reduction in sea ice might impact future accessibility of offshore natural gas and crude oil resources. Based on this analysis we show for a number of illustrative but representative locations which technology options exist based on a cost-minimization assessment. We find that under current hydrocarbon prices, oil and gas from the European offshore Arctic is not competitive on world markets.

Cost of severe hypoglycaemia in nine European countries.

PubMed

Jakubczyk, Michał; Lipka, Izabela; Pawęska, Justyna; Niewada, Maciej; Rdzanek, Elżbieta; Zaletel, Jelka; Ramírez de Arellano, Antonio; Doležal, Tomáš; Chekorova Mitreva, Biljana; Nagy, Bence; Petrova, Guenka; Šarić, Tereza; Yfantopoulos, John; Czech, Marcin

2016-10-01

Complications contribute largely to the economic gravity of diabetes mellitus (DM). How they arise and are treated differs substantially between countries. This paper assesses the total annual, direct, and indirect cost of severe hypoglycemia events (SHEs) in nine European countries: Bulgaria, Croatia, the Czech Republic, Greece, Hungary, Macedonia/the former Yugoslav Republic of Macedonia (MK), Poland, Slovenia, and Spain. Data was collected on epidemiology, treatment structure, SHE-driven resource consumption, and unit costs. Two systematic reviews-on the SHE rates and the resources used for treatment-and data on the days-of-work lost due to SHE along with salaries and employment rates were used. The total SHE cost in each country was calculated and how the differences are driven by individual parameters was analysed. The annual costs of SHEs varied in absolute terms from €379,951.25 in MK up to €58,429,684.40 in Spain, or-when expressed per one drug-treated DM patient-from €5.47 in Bulgaria up to €17.74 in Spain. Indirect cost constituted between 6.01% (MK) and 26.49% (Hungary) of the total cost. The differences between countries are driven mostly by the cost of treating a single event, and this is related to general differences in prices. The main limitation is the lack of good quality data in some parts, and the necessity to use mean-value imputations, experts' opinions, etc. Additionally, we only considered DM treatment as the SHE driver, while other elements, e.g. style of living, may contribute substantially. A common framework can be applied to estimate the economic burden of SHE in various countries, allowing one to identify the drivers of differences in cost. Treating DM is complex, and so no resolute conclusions ought to be drawn as to whether SHE management is better in one country than another.

Organization of heart failure management in European Society of Cardiology member countries: survey of the Heart Failure Association of the European Society of Cardiology in collaboration with the Heart Failure National Societies/Working Groups.

PubMed

Seferovic, Petar M; Stoerk, Stefan; Filippatos, Gerasimos; Mareev, Viacheslav; Kavoliuniene, Ausra; Ristic, Arsen D; Ponikowski, Piotr; McMurray, John; Maggioni, Aldo; Ruschitzka, Frank; van Veldhuisen, Dirk J; Coats, Andrew; Piepoli, Massimo; McDonagh, Theresa; Riley, Jillian; Hoes, Arno; Pieske, Burkert; Dobric, Milan; Papp, Zoltan; Mebazaa, Alexandre; Parissis, John; Ben Gal, Tuvia; Vinereanu, Dragos; Brito, Dulce; Altenberger, Johann; Gatzov, Plamen; Milinkovic, Ivan; Hradec, Jaromír; Trochu, Jean-Noel; Amir, Offer; Moura, Brenda; Lainscak, Mitja; Comin, Josep; Wikström, Gerhard; Anker, Stefan

2013-09-01

The aim of this document was to obtain a real-life contemporary analysis of the demographics and heart failure (HF) statistics, as well as the organization and major activities of the Heart Failure National Societies (HFNS) in European Society of Cardiology (ESC) member countries. Data from 33 countries were collected from HFNS presidents/representatives during the first Heart Failure Association HFNS Summit (Belgrade, Serbia, 29 October 2011). Data on incidence and/or prevalence of HF were available for 22 countries, and the prevalence of HF ranged between 1% and 3%. In five European and one non-European ESC country, heart transplantation was reported as not available. Natriuretic peptides and echocardiography are routinely applied in the management of acute HF in the median of 80% and 90% of centres, respectively. Eastern European and Mediterranean countries have lower availability of natriuretic peptide testing for acute HF patients, compared with other European countries. Almost all countries have organizations dealing specifically with HF. HFNS societies for HF patients exist in only 12, while in 16 countries HF patient education programmes are active. Most HFNS reported that no national HF registry exists in their country. Fifteen HFNS produced national HF guidelines, while 19 have translated the ESC HF guidelines. Most HFNS (n = 23) participated in the organization of the European HF Awareness Day. This document demonstrated significant heterogeneity in the organization of HF management, and activities of the national HF working groups/associations. High availability of natriuretic peptide and echocardiographic measurements was revealed, with differences between developed countries and countries in transition.

Health Care Expenditure and GDP in Oil Exporting Countries: Evidence From OPEC Data, 1995-2012.

PubMed

Fazaeli, Ali Akbar; Ghaderi, Hossein; Salehi, Masoud; Fazaeli, Ali Reza

2015-06-11

There is a large body of literature examining income in relation to health expenditures. The share of expenditures in health sector from GDP in developed countries is often larger than in non-developed countries, suggesting that as the level of economic growth increases, health spending increase, too. This paper estimates long-run relationships between health expenditures and GDP based on panel data of a sample of 12 countries of the Organization of the Petroleum Exporting Countries (OPEC), using data for the period 1995-2012. We use panel data unit root tests, cointegration analysis and ECM model to find long-run and short-run relation. This study examines whether health is a luxury or a necessity for OPEC countries within a unit root and cointegration framework. Panel data analysis indicates that health expenditures and GDP are co-integrated and have Engle and Granger causality. In addition, in oil countries that have oil export income, the share of government expenditures in the health sector is often greater than in private health expenditures similar developed countries. The findings verify that health care is not a luxury good and income has a robust relationship to health expenditures in OPEC countries.

Cross-sectional and prospective relationship between physical activity and chronic diseases in European older adults.

PubMed

Marques, Adilson; Peralta, Miguel; Martins, João; de Matos, Margarida Gaspar; Brownson, Ross C

2017-05-01

This study examined the relationship between physical activity (PA) and chronic diseases in European older adults, using a prospective analysis with data from 2011 and 2013. Participants were 37,524 older adults (16,204 men) who responded to the fourth (in 2011) and fifth (in 2013) wave of SHARE project, from 13 European countries. Participants' answers to interview questions about the presence of chronic conditions and PA. The cross-sectional and prospective association between PA and the number of chronic diseases was assessed using general linear models. Among men and women, moderate or vigorous physical activity (MVPA) in 2011 was associated with fewer reported chronic diseases in 2011 and 2013. In prospective analysis, MVPA in 2011 was inversely associated with the number of chronic diseases in 2013 in the unadjusted model. In the adjusted model MVPA more than once a week remained as a significant predictor of fewer chronic diseases. PA should be prescribed to older adults in order to prevent and reduce the number of chronic diseases, and, when possible, vigorous intensity PA should be recommended.

Prevalence of Frailty in Middle-Aged and Older Community-Dwelling Europeans Living in 10 Countries

PubMed Central

Cuénoud, Patrick; Spagnoli, Jacques; Junod, Julien

2009-01-01

Background Frailty is an indicator of health status in old age. Its frequency has been described mainly for North America; comparable data from other countries are lacking. Here we report on the prevalence of frailty in 10 European countries included in a population-based survey. Methods Cross-sectional analysis of 18,227 randomly selected community-dwelling individuals 50 years of age and older, enrolled in the Survey of Health, Aging and Retirement in Europe (SHARE) in 2004. Complete data for assessing a frailty phenotype (exhaustion, shrinking, weakness, slowness, and low physical activity) were available for 16,584 participants. Prevalences of frailty and prefrailty were estimated for individuals 50–64 years and 65 years of age and older from each country. The latter group was analyzed further after excluding disabled individuals. We estimated country effects in this subset using multivariate logistic regression models, controlling first for age, gender, and then demographics and education. Results The proportion of frailty (three to five criteria) or prefrailty (one to two criteria) was higher in southern than in northern Europe. International differences in the prevalences of frailty and prefrailty for 65 years and older group persisted after excluding the disabled. Demographic characteristics did not account for international differences; however, education was associated with frailty. Controlling for education, age and gender diminished the effects of residing in Italy and Spain. Conclusions A higher prevalence of frailty in southern countries is consistent with previous findings of a north–south gradient for other health indicators in SHARE. Our data suggest that socioeconomic factors like education contribute to these differences in frailty and prefrailty. PMID:19276189

78 FR 56865 - Certain Oil Country Tubular Goods From India and Turkey: Postponement of Preliminary...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-16

... Country Tubular Goods From India and Turkey: Postponement of Preliminary Determination in the... (202) 482-0189 (Turkey), AD/CVD Operations, Import Administration, International Trade Administration... the countervailing duty investigations of certain oil country tubular goods from India and Turkey.\\1...

Nurses' shift length and overtime working in 12 European countries: the association with perceived quality of care and patient safety.

PubMed

Griffiths, Peter; Dall'Ora, Chiara; Simon, Michael; Ball, Jane; Lindqvist, Rikard; Rafferty, Anne-Marie; Schoonhoven, Lisette; Tishelman, Carol; Aiken, Linda H

2014-11-01

Despite concerns as to whether nurses can perform reliably and effectively when working longer shifts, a pattern of two 12- to 13-hour shifts per day is becoming common in many hospitals to reduce shift to shift handovers, staffing overlap, and hence costs. To describe shift patterns of European nurses and investigate whether shift length and working beyond contracted hours (overtime) is associated with nurse-reported care quality, safety, and care left undone. Cross-sectional survey of 31,627 registered nurses in general medical/surgical units within 488 hospitals across 12 European countries. A total of 50% of nurses worked shifts of ≤ 8 hours, but 15% worked ≥ 12 hours. Typical shift length varied between countries and within some countries. Nurses working for ≥ 12 hours were more likely to report poor or failing patient safety [odds ratio (OR)=1.41; 95% confidence interval (CI), 1.13-1.76], poor/fair quality of care (OR=1.30; 95% CI, 1.10-1.53), and more care activities left undone (RR=1.13; 95% CI, 1.09-1.16). Working overtime was also associated with reports of poor or failing patient safety (OR=1.67; 95% CI, 1.51-1.86), poor/fair quality of care (OR=1.32; 95% CI, 1.23-1.42), and more care left undone (RR=1.29; 95% CI, 1.27-1.31). European registered nurses working shifts of ≥ 12 hours and those working overtime report lower quality and safety and more care left undone. Policies to adopt a 12-hour nursing shift pattern should proceed with caution. Use of overtime working to mitigate staffing shortages or increase flexibility may also incur additional risk to quality.

Perceptions of perioperative nursing competence: a cross-country comparison.

PubMed

Gillespie, Brigid M; Harbeck, Emma B; Falk-Brynhildsen, Karin; Nilsson, Ulrica; Jaensson, Maria

2018-01-01

Throughout many countries, professional bodies rely on yearly self-assessment of competence for ongoing registration; therefore, nursing competence is pivotal to safe clinical practice. Our aim was to describe and compare perioperative nurses' perceptions of competence in four countries, while examining the effect of specialist education and years of experience in the operating room. We conducted a secondary analysis of cross-sectional surveys from four countries including; Australia, Canada, Scotland, and Sweden. The 40-item Perceived Perioperative Competence Scale-Revised (PPCS-R), was used with a total sample of 768 respondents. We used a factorial design to examine the influence of country, years of experience in the operating room and specialist education on nurses' reported perceived perioperative competence. Regardless of country origin, nurses with specialist qualifications reported higher perceived perioperative competence when compared to nurses without specialist education. However, cross-country differences were dependent on nurses' number of years of experience in the operating room. Nurses from Sweden with 6-10 years of experience in the operating room reported lower perceived perioperative competence when compared to Australian nurses. In comparing nurses with > 10 years of experience, Swedish nurses reported significantly lower perceived perioperative competence when compared to nurses from Australia, Canada and Scotland. Researchers need to consider educational level and years of experience in the perioperative context when examining constructs such as competence.

Inequalities in healthy life years in the 25 countries of the European Union in 2005: a cross-national meta-regression analysis.

PubMed

Jagger, Carol; Gillies, Clare; Moscone, Francesco; Cambois, Emmanuelle; Van Oyen, Herman; Nusselder, Wilma; Robine, Jean-Marie

2008-12-20

Although life expectancy in the European Union (EU) is increasing, whether most of these extra years are spent in good health is unclear. This information would be crucial to both contain health-care costs and increase labour-force participation for older people. We investigated inequalities in life expectancies and healthy life years (HLYs) at 50 years of age for the 25 countries in the EU in 2005 and the potential for increasing the proportion of older people in the labour force. We calculated life expectancies and HLYs at 50 years of age by sex and country by the Sullivan method, which was applied to Eurostat life tables and age-specific prevalence of activity limitation from the 2005 statistics of living and income conditions survey. We investigated differences between countries through meta-regression techniques, with structural and sustainable indicators for every country. In 2005, an average 50-year-old man in the 25 EU countries could expect to live until 67.3 years free of activity limitation, and a woman to 68.1 years. HLYs at 50 years for both men and women varied more between countries than did life expectancy (HLY range for men: from 9.1 years in Estonia to 23.6 years in Denmark; for women: from 10.4 years in Estonia to 24.1 years in Denmark). Gross domestic product and expenditure on elderly care were both positively associated with HLYs at 50 years in men and women (p<0.039 for both indicators and sexes); however, in men alone, long-term unemployment was negatively associated (p=0.023) and life-long learning positively associated (p=0.021) with HLYs at 50 years of age. Substantial inequalities in HLYs at 50 years exist within EU countries. Our findings suggest that, without major improvements in population health, the target of increasing participation of older people into the labour force will be difficult to meet in all 25 EU countries. EU Public Health Programme.

The contribution of national disparities to international differences in mortality between the United States and 7 European countries.

PubMed

van Hedel, Karen; Avendano, Mauricio; Berkman, Lisa F; Bopp, Matthias; Deboosere, Patrick; Lundberg, Olle; Martikainen, Pekka; Menvielle, Gwenn; van Lenthe, Frank J; Mackenbach, Johan P

2015-04-01

This study examined to what extent the higher mortality in the United States compared to many European countries is explained by larger social disparities within the United States. We estimated the expected US mortality if educational disparities in the United States were similar to those in 7 European countries. Poisson models were used to quantify the association between education and mortality for men and women aged 30 to 74 years in the United States, Belgium, Denmark, Finland, France, Norway, Sweden, and Switzerland for the period 1989 to 2003. US data came from the National Health Interview Survey linked to the National Death Index and the European data came from censuses linked to national mortality registries. If people in the United States had the same distribution of education as their European counterparts, the US mortality disadvantage would be larger. However, if educational disparities in mortality within the United States equaled those within Europe, mortality differences between the United States and Europe would be reduced by 20% to 100%. Larger educational disparities in mortality in the United States than in Europe partly explain why US adults have higher mortality than their European counterparts. Policies to reduce mortality among the lower educated will be necessary to bridge the mortality gap between the United States and European countries.

Gonorrhoea and gonococcal antimicrobial resistance surveillance networks in the WHO European Region, including the independent countries of the former Soviet Union.

PubMed

Unemo, Magnus; Ison, Catherine A; Cole, Michelle; Spiteri, Gianfranco; van de Laar, Marita; Khotenashvili, Lali

2013-12-01

Antimicrobial resistance (AMR) in Neisseria gonorrhoeae has emerged for essentially all antimicrobials following their introduction into clinical practice. During the latest decade, susceptibility to the last remaining options for antimicrobial monotherapy, the extended-spectrum cephalosporins (ESC), has markedly decreased internationally and treatment failures with these ESCs have been verified. In response to this developing situation, WHO and the European Centre for Disease Prevention and Control (ECDC) have published global and region-specific response plans, respectively. One main component of these action/response plans is to enhance the surveillance of AMR and treatment failures. This paper describes the perspectives from the diverse WHO European Region (53 countries), including the independent countries of the former Soviet Union, regarding gonococcal AMR surveillance networks. The WHO European Region has a high prevalence of resistance to all previously recommended antimicrobials, and most of the first strictly verified treatment failures with cefixime and ceftriaxone were also reported from Europe. In the European Union/European Economic Area (EU/EEA), the European gonococcal antimicrobial surveillance programme (Euro-GASP) funded by the ECDC is running. In 2011, the Euro-GASP included 21/31 (68%) EU/EEA countries, and the programme is further strengthened annually. However, in the non-EU/EEA countries, internationally reported and quality assured gonococcal AMR data are lacking in 87% of the countries and, worryingly, appropriate support for establishment of a GASP is still lacking. Accordingly, national and international support, including political and financial commitment, for gonococcal AMR surveillance in the non-EU/EEA countries of the WHO European Region is essential.

Systematic review on the evaluation criteria of orphan medicines in Central and Eastern European countries.

PubMed

Zelei, Tamás; Molnár, Mária J; Szegedi, Márta; Kaló, Zoltán

2016-06-04

In case of orphan drugs applicability of the standard health technology assessment (HTA) process is limited due to scarcity of good clinical and health economic evidence. Financing these premium priced drugs is more controversial in the Central and Eastern European (CEE) region where the public funding resources are more restricted, and health economic justification should be an even more important aspect of policy decisions than in higher income European countries. To explore and summarize the recent scientific evidence on value drivers related to the health technology assessment of ODs with a special focus on the perspective of third party payers in CEE countries. The review aims to list all potentially relevant value drivers in the reimbursement process of orphan drugs. A systematic literature review was performed; PubMed and Scopus databases were systematically searched for relevant publications until April 2015. Extracted data were summarized along key HTA elements. From the 2664 identified publications, 87 contained relevant information on the evaluation criteria of orphan drugs, but only 5 had direct information from the CEE region. The presentation of good clinical evidence seems to play a key role especially since this should be the basis of cost-effectiveness analyses, which have more importance in resource-constrained economies. Due to external price referencing of pharmaceuticals, the relative budget impact of orphan drugs is expected to be higher in CEE than in Western European (WE) countries unless accessibility of patients remains more limited in poorer European regions. Equity principles based on disease prevalence and non-availability of alternative treatment options may increase the price premium, however, societies must have some control on prices and a rationale based on multiple criteria in reimbursement decisions. The evaluation of orphan medicines should include multiple criteria to appropriately measure the clinical added value of orphan

Psychological Determinants of Consumer Acceptance of Personalised Nutrition in 9 European Countries

PubMed Central

Poínhos, Rui; van der Lans, Ivo A.; Rankin, Audrey; Fischer, Arnout R. H.; Bunting, Brendan; Kuznesof, Sharron; Stewart-Knox, Barbara; Frewer, Lynn J.

2014-01-01

Objective To develop a model of the psychological factors which predict people’s intention to adopt personalised nutrition. Potential determinants of adoption included perceived risk and benefit, perceived self-efficacy, internal locus of control and health commitment. Methods A questionnaire, developed from exploratory study data and the existing theoretical literature, and including validated psychological scales was administered to N = 9381 participants from 9 European countries (Germany, Greece, Ireland, Poland, Portugal, Spain, the Netherlands, the UK, and Norway). Results Structural equation modelling indicated that the greater participants’ perceived benefits to be associated with personalised nutrition, the more positive their attitudes were towards personalised nutrition, and the greater their intention to adopt it. Higher levels of nutrition self-efficacy were related to more positive attitudes towards, and a greater expressed intention to adopt, personalised nutrition. Other constructs positively impacting attitudes towards personalised nutrition included more positive perceptions of the efficacy of regulatory control to protect consumers (e.g. in relation to personal data protection), higher self-reported internal health locus of control, and health commitment. Although higher perceived risk had a negative relationship with attitude and an inverse relationship with perceived benefit, its effects on attitude and intention to adopt personalised nutrition was less influential than perceived benefit. The model was stable across the different European countries, suggesting that psychological factors determining adoption of personalised nutrition have generic applicability across different European countries. Conclusion The results suggest that transparent provision of information about potential benefits, and protection of consumers’ personal data is important for adoption, delivery of public health benefits, and commercialisation of personalised

Ranking of Palliative Care Development in the Countries of the European Union.

PubMed

Woitha, Kathrin; Garralda, Eduardo; Martin-Moreno, Jose María; Clark, David; Centeno, Carlos

2016-09-01

There is growing interest in monitoring palliative care (PC) development internationally. One aspect of this is the ranking of such development for comparative purposes. To generate a ranking classification and to compare scores for PC development in the countries of the European Union, 2007 and 2013. PC "development" in this study is understood as a combination of the existence of relevant services in a country ("resources") plus the capacity to develop further resources in the future ("vitality"). "Resources" comprise indicators of three types of PC services per population (inpatient palliative care units and inpatient hospices, hospital support teams, and home care teams). "Vitality" of PC is estimated by numerical scores for the existence of a national association, a directory of services, physician accreditation, attendances at a key European conference and volume of publications on PC development. The leading country (by raw score) is then considered as the reference point against which all other countries are measured. Different weightings are applied to resources (75%) and vitality (25%). From this, an overall ranking is constructed. The U.K. achieved the highest level of development (86% of the maximum possible score), followed by Belgium and overall The Netherlands (81%), and Sweden (80%). In the resources domain, Luxembourg, the U.K., and Belgium were leading. The top countries in vitality were Germany and the U.K. In comparison to 2007, The Netherlands, Malta, and Portugal showed the biggest improvements, whereas the positions of Spain, France, and Greece deteriorated. The ranking method permitted a comparison of palliative care development between countries and shows changes over time. Recommendations for improving the ranking include improvements to the methodology and greater explanation of the levels and changes it reveals. Copyright © 2016 Universidad Navarra. Published by Elsevier Inc. All rights reserved.

BiomarCaRE: rationale and design of the European BiomarCaRE project including 300,000 participants from 13 European countries.

PubMed

Zeller, Tanja; Hughes, Maria; Tuovinen, Tarja; Schillert, Arne; Conrads-Frank, Annette; Ruijter, Hester den; Schnabel, Renate B; Kee, Frank; Salomaa, Veikko; Siebert, Uwe; Thorand, Barbara; Ziegler, Andreas; Breek, Heico; Pasterkamp, Gerard; Kuulasmaa, Kari; Koenig, Wolfgang; Blankenberg, Stefan

2014-10-01

Biomarkers are considered as tools to enhance cardiovascular risk estimation. However, the value of biomarkers on risk estimation beyond European risk scores, their comparative impact among different European regions and their role towards personalised medicine remains uncertain. Biomarker for Cardiovascular Risk Assessment in Europe (BiomarCaRE) is an European collaborative research project with the primary objective to assess the value of established and emerging biomarkers for cardiovascular risk prediction. BiomarCaRE integrates clinical and epidemiological biomarker research and commercial enterprises throughout Europe to combine innovation in biomarker discovery for cardiovascular disease prediction with consecutive validation of biomarker effectiveness in large, well-defined primary and secondary prevention cohorts including over 300,000 participants from 13 European countries. Results from this study will contribute to improved cardiovascular risk prediction across different European populations. The present publication describes the rationale and design of the BiomarCaRE project.

[Transnational solidarity? Cross-border heath-care in the European Union].

PubMed

Schmucker, R

2010-03-01

The responsibilities of the European Union surrounding public health are concentrated on co-ordinating and complementary practices. A mandatory European harmonization of standards and policies is in effect in only a few areas such as pharmaceutical authorization and health protection at the workplace. The implementation of single market rights over the national health-care systems (negative integration) is growing at the European level. This has ambivalent repercussions. Whilst the rights of patients on the basis of the four fundamental freedoms in the context of cross-border health-care have got stronger, national governments see themselves confronted with a limitation of scope for their health-care policies. The basic principles of the integration project place European pressure on national governments. They are subject to sanctions if their policies are not directly in accordance with the single market concept. Georg Thieme Verlag KG Stuttgart. New York.

Isolation Facilities for Highly Infectious Diseases in Europe – A Cross-Sectional Analysis in 16 Countries

PubMed Central

Schilling, Stefan; Fusco, Francesco Maria; De Iaco, Giuseppina; Bannister, Barbara; Maltezou, Helena C.; Carson, Gail; Gottschalk, Rene; Brodt, Hans-Reinhard; Brouqui, Philippe; Puro, Vincenzo; Ippolito, Giuseppe

2014-01-01

Background Highly Infectious Diseases (HIDs) are (i) easily transmissible form person to person; (ii) cause a life-threatening illness with no or few treatment options; and (iii) pose a threat for both personnel and the public. Hence, even suspected HID cases should be managed in specialised facilities minimizing infection risks but allowing state-of-the-art critical care. Consensus statements on the operational management of isolation facilities have been published recently. The study presented was set up to compare the operational management, resources, and technical equipment among European isolation facilities. Due to differences in geography, population density, and national response plans it was hypothesized that adherence to recommendations will vary. Methods and Findings Until mid of 2010 the European Network for Highly Infectious Diseases conducted a cross-sectional analysis of isolation facilities in Europe, recruiting 48 isolation facilities in 16 countries. Three checklists were disseminated, assessing 44 items and 148 specific questions. The median feedback rate for specific questions was 97.9% (n = 47/48) (range: n = 7/48 (14.6%) to n = 48/48 (100%). Although all facilities enrolled were nominated specialised facilities' serving countries or regions, their design, equipment and personnel management varied. Eighteen facilities fulfilled the definition of a High Level Isolation Unit'. In contrast, 24 facilities could not operate independently from their co-located hospital, and five could not ensure access to equipment essential for infection control. Data presented are not representative for the EU in general, as only 16/27 (59.3%) of all Member States agreed to participate. Another limitation of this study is the time elapsed between data collection and publication; e.g. in Germany one additional facility opened in the meantime. Conclusion There are disparities both within and between European countries regarding the design and equipment

Later-life mental health in Europe: a country-level comparison.

PubMed

Ploubidis, George B; Grundy, Emily

2009-09-01

To investigate the influence of country of residence on depression and well-being among older Europeans, after establishing the between-country measurement invariance of both constructs. We used data from a cross-sectional nationally representative population-based sample of older Europeans, the Survey of Health, Ageing, and Retirement in Europe (SHARE). The analysis sample comprised 13,498 older Europeans from nine countries. The EURO-D was used to measure depression, and a well-being outcome was derived from self-report items available in SHARE. The between-country measurement invariance of both mental health outcomes was established using modern psychometric modeling techniques. After adjustment for demographic characteristics and the presence of chronic illness, Spain was the country scoring highest on depression and Denmark highest on well-being. Optimal mental health was associated with higher educational attainment and being married. There is considerable between-country heterogeneity in later-life mental health in Europe. The Scandinavian countries, the Netherlands, and Austria, do best (low depression/high well-being), followed by Germany and France, whereas residents of Spain, Italy, and Greece report the worst mental health.

Beverage and water intake of healthy adults in some European countries.

PubMed

Nissensohn, Mariela; Castro-Quezada, Itandehui; Serra-Majem, Lluis

2013-11-01

Nutritional surveys frequently collect some data of consumption of beverages; however, information from different sources and different methodologies raises issues of comparability. The main objective of this review was to examine the available techniques used for assessing beverage intake in European epidemiological studies and to describe the most frequent method applied to assess it. Information of beverage intake available from European surveys and nutritional epidemiological investigations was obtained from gray literature. Twelve articles were included and relevant data were extracted. The studies were carried out on healthy adults by different types of assessments. The most frequent tool used was a 7-d dietary record. Only Germany used a specific beverage assessment tool (Beverage Dietary History). From the limited data available and the diversity of the methodology used, the results show that consumption of beverages is different between countries. Current epidemiological studies in Europe focusing on beverage intake are scarce. Further research is needed to clarify the amount of beverage intake in European population.

The stoma appliances market in five European countries: a comparative analysis.

PubMed

Cornago, Dante; Garattini, Livio

2002-01-01

This comparative exercise analysed the domestic market for stoma appliances in five European countries--Denmark, France, Germany, Italy and the United Kingdom. National legislation, prescription procedures, delivery modalities and the market were investigated in each country. The analysis involved reviewing national and international literature on stoma appliances and interviewing a selected expert panel of market operators in each country comprising at least one health authority representative, one distributor of medical devices and one manufacturer. No specific relationship was found between the health care system framework and the stoma market, except for a greater inclination towards home care in national health services. All five countries reimburse stoma bags, but the distribution of these appliances varies widely, ranging from Denmark, where home delivery is mandatory, to Italy, where any channel can be used. The comparative analysis underlined two important features of the stoma bag market: the discretion of enterostomists in directing patients towards a specific brand of bags, and the patients' high brand loyalty. Despite that, the analysis did not identify any single country that could be considered a benchmark for stoma bag regulation. Each country deals with stoma appliances in different ways, making this a very fragmented market.

Some Peculiarities in Training Future Masters in Technology Education in European Countries

ERIC Educational Resources Information Center

Samborska, Olena

2017-01-01

In the article, the importance of studying foreign experience in order to improve quality of future Masters' training in higher education institutions has been justified. The main peculiarities of training Masters in Technology education in European countries, namely, in Germany, Sweden and France have been outlined. It has been revealed that…

Health Care Expenditure and GDP in Oil Exporting Countries: Evidence from OPEC Data, 1995-2012

PubMed Central

Fazaeli, Ali Akbar; Ghaderi, Hossein; Salehi, Masoud; Fazaeli, Ali Reza

2016-01-01

Background: There is a large body of literature examining income in relation to health expenditures. The share of expenditures in health sector from GDP in developed countries is often larger than in non-developed countries, suggesting that as the level of economic growth increases, health spending increase, too. Objectives: This paper estimates long-run relationships between health expenditures and GDP based on panel data of a sample of 12 countries of the Organization of the Petroleum Exporting Countries (OPEC), using data for the period 1995-2012. Patients & Methods: We use panel data unit root tests, cointegration analysis and ECM model to find long-run and short-run relation. This study examines whether health is a luxury or a necessity for OPEC countries within a unit root and cointegration framework. Results: Panel data analysis indicates that health expenditures and GDP are co-integrated and have Engle and Granger causality. In addition, in oil countries that have oil export income, the share of government expenditures in the health sector is often greater than in private health expenditures similar developed countries. Conclusions: The findings verify that health care is not a luxury good and income has a robust relationship to health expenditures in OPEC countries. PMID:26383195

The Geography of Sexual Orientation: Structural Stigma and Sexual Attraction, Behavior, and Identity Among Men Who Have Sex with Men Across 38 European Countries.

PubMed

Pachankis, John E; Hatzenbuehler, Mark L; Mirandola, Massimo; Weatherburn, Peter; Berg, Rigmor C; Marcus, Ulrich; Schmidt, Axel J

2017-07-01

While the prevalence of sexual identities and behaviors of men who have sex with men (MSM) varies across countries, no study has examined country-level structural stigma toward sexual minorities as a correlate of this variation. Drawing on emerging support for the context-dependent nature of MSM's open sexual self-identification cross-nationally, we examined country-level structural stigma as a key correlate of the geographic variation in MSM's sexual attraction, behavior, and identity, and concordance across these factors. Data come from the European MSM Internet Survey, a multi-national dataset containing a multi-component assessment of sexual orientation administered across 38 European countries (N = 174,209). Country-level stigma was assessed using a combination of national laws and policies affecting sexual minorities and a measure of attitudes toward sexual minorities held by the citizens of each country. Results demonstrate that in more stigmatizing countries, MSM were significantly more likely to report bisexual/heterosexual attractions, behaviors, and identities, and significantly less likely to report concordance across these factors, than in less stigmatizing countries. Settlement size moderated associations between country-level structural stigma and odds of bisexual/heterosexual attraction and behavior, such that MSM living in sparsely populated locales within high-structural stigma countries were the most likely to report bisexual or heterosexual behaviors and attractions. While previous research has demonstrated associations between structural stigma and adverse physical and mental health outcomes among sexual minorities, this study was the first to show that structural stigma was also a key correlate not only of sexual orientation identification, but also of MSM's sexual behavior and even attraction. Findings have implications for understanding the ontology of MSM's sexuality and suggest that a comprehensive picture of MSM's sexuality will come

Saliva Cortisol and Exposure to Aircraft Noise in Six European Countries