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Children are defined as hypertensive when their blood pressure values equal or exceed the 95th percentile of the blood pressure value distribution in a pediatric population, according to gender, age and height. The population on which reference tables are based is of fundamental importance to establish the threshold values for the diagnosis of hypertension in pediatric age. Before 2017, both American and European guidelines used nomograms created in the same reference population which included children of all weight classes. Given the close and well-known association between hypertension and excess weight in childhood, the 2017 American guidelines proposed new reference nomograms excluding subjects with overweight and obesity from the "historical" reference population. Furthermore, the new American guidelines suggested a fixed cut-off of 130/80 mmHg, starting from 13 years and regardless of gender and height, to make the diagnosis of hypertension. In this document, the Italian Hypertension Society (SIIA) and the Italian Pediatric Society (SIP) jointly discuss a number of issues raised by the new American guidelines that involve the entire medical community, and also address the definition of arterial hypertension in the transition phase between childhood and adulthood. [ABSTRACT FROM AUTHOR]

Aims This article explores the care British nurses provided to victims of typhus during the Second World War. Background Typhus is associated with poverty and overcrowding. During wars in the pre-antibiotic era, civilians were particularly susceptible to epidemics, which military governments feared would spread to their troops. Design This discussion paper draws on archival data from three typhus epidemics in the Second World War to examine the expert work of British nurses in caring for victims during these potential public health disasters. Data Sources The published sources for the paper include material from nursing and medical journals published between 1940-1947. Archival sources come from the National Archives in Kew, the Wellcome Library and the Army Medical Services Museum, between 1943-1945. Of particular interest is the correspondence with Dame Katharine Jones from nurses on active service overseas. Implications for Nursing Whilst epidemics of typhus are now rare, nurses in the present day may be required to care for the public in environments of extreme poverty and overcrowding, where life-threatening infectious diseases are prevalent. This article has demonstrated that it is possible for expert and compassionate nursing to alleviate suffering and prevent death, even when medical technologies are unavailable. Conclusion Expert and compassionate care, adequate nutrition and hydration and attention to hygiene needs are crucial when there are limited pharmacological treatments and medical technologies available to treat infectious diseases. The appreciation of this could have implications for nurses working in current global conflicts. [ABSTRACT FROM AUTHOR]

Traumatic wounds are one of the most common problems leading people to the Emergency Department (ED), accounting for approximately 5,4 % of all the visits, and up to 24 % of all the medical lawsuits. In order to provide a standardized method for wound management in the ED, we have organized a workshop, involving several Italian and European experts. Later, all the discussed statements have been submitted for external validation to a multidisciplinary expert team, based on the so called Delphi method. Eight main statements have been established, each of them comprising different issues, covering the fields of wound classification, infectious risk stratification, tetanus and rabies prophylaxis, wound cleansing, pain management, and suture. Here we present the results of this work, shared by the Academy of Emergency Medicine and Care (AcEMC), and the World Society of Emergency Surgery (WSES). [ABSTRACT FROM AUTHOR]

Measurements of total nitrogen and inorganic nitrogen in precipitation samples from Nitro Europe sites across Europe permit the calculation of organic nitrogen concentrations and wet deposition, by difference. The contribution of organic N to total N in precipitation ranged from only a few % to around 40% across sites from Northern Finland to Italy, similar to results from previous individual studies. This paper presents the absolute and relative contributions of organic N to wet N deposition across Europe, and examines seasonal trends. There were only weak correlations with other solutes in precipitation. These simple statistics indicate that sources of organic N in precipitation vary across Europe, and that no single source is responsible. The organic N contributes to total N deposition, yet this input is rarely quantified in nitrogen budgets. [ABSTRACT FROM AUTHOR]

As humanity reaches the 5.0 industrial revolution, education plays a critical role in boosting the quality of human resources. This paper reports bibliometric research on emerging TiP during 1993-2022 in the educational field to analyse its development on any level of education during the last three decades. This study employed a Scopus database. The findings are that the trend of TiP publication in educational fields has tended to increase every year during the past three decades and conference paper became the most published document type, the USA is the country which produces the most publications; "Students" being the most occurrences keyword and total link strength. The publication of the TiP is ranked to the Quartile 1, which implies that a publication with the cited performance is a publication with credibility because the publisher has a good reputation. Researchers can find the topics most relevant to other metadata sources such as Web of Science, Publish, and Perish.

The aim of this paper is to describe the essential points of Italian and European legislation governing the use of animals in biomedical experimentation. A close look will be taken at the principles of the 3Rs, which represent the mainstay of the legal architecture based on which a correct interpretation may be drawn of the legislative documents on animal experimentation. Furthermore, this paper will address the ways in which Directive 2010/63/EU is implemented in Italian legislation on the welfare of laboratory animals. In addition to an assessment of legal issues (such as the scope of jurisdiction of supervisory authorities tasked with issuing authorizations), it will include a discussion of cases of inadequate and insufficient implementation of the requirements laid down by Directive 2010/63/EU. Both the consistency of the interpretation of national legislation with the Directive and the direct effectiveness of the Directive in national law, in which animal testing has been and still is the subject of heated debate between supporters and opponents, will be examined. [ABSTRACT FROM AUTHOR]

Today's academic institutions are strongly involved in the modern globalization process. The aim of the paper is to investigate if small-sized universities face particular challenges and if they obtain some advantages or are adversely affected by the ongoing process. The focus is on Europe and, specifically, on Italy, one of the signatory countries of the Bologna Declaration, that has implemented the European international reform process. Based on official data from the Italian Ministry of University and Research, first we analyse university characteristics and then we calculate performance selected indicators that are informative of a few key aspects, such as teaching quality and internationalisation and look at student satisfaction. Results show that teaching quality in small-sized public universities is similar to that in big-sized public ones whereas small-sized private universities perform better than big-sized private ones. Attractiveness for students abroad is greater for smaller and more specialized universities, and this is especially evident for private universities. Satisfaction as well is higher for students studying in small-sized universities. However, doubts exist for the future due to the possible negative effects of the very complex and strict administrative procedures of the current organization and evaluation system. [ABSTRACT FROM AUTHOR]

This article explores the evolution of unaccompanied minors' (UMs') decisions and migratory experiences after arrival in Italy through Libya. Until now, research has not longitudinally documented UMs' decision-making processes and experiences during their migration in Europe. We draw on data collected within the ERC-ChildMove project, a multi-sited and follow-up study, and used a trajectory approach (Schapendonk et al. [2020]. "Re-Routing Migration Geographies: Migrants, Trajectories and Mobility Regimes." Geoforum; Journal of Physical, Human, and Regional Geosciences 116: 211–216.) to analyse in-depth interviews initially conducted with thirty-nine participants that were followed across Europe over a two-year period. We use the notion of 'mobility-in-migration' (Veale and Donà [2014]. Child and Youth Migration: Mobility-in-Migration in an Era of Globalization. Springer.) to question UMs' migratory decisions and analyse the periods of mobility and immobility experienced during these trajectories. Our findings indicate that UMs' decisions in Europe are heavily influenced by the quality of formal support and care, the length and outcomes of legal procedures, and trans-local support networks. The study analyses how such factors may repeatedly re-route or distort initially planned trajectories, produce involuntary mobility or end the minors' trajectories. Finally, the paper demonstrates that periods of mobility and immobility coexist at different local scales within the overall migration trajectory of unaccompanied minors. [ABSTRACT FROM AUTHOR]

Immigrant minority (IM) languages have a significant presence in certain European regions. Nonetheless, these languages are not usually included in the school curriculum. This paper aims to analyse the studies published between 2010 and 2020 considering IM languages in multilingual European education contexts. The method included a search of academic papers published in the databases ERIC, Web of Science and Scopus, which yielded 42 studies. The studies were analysed by considering: (1) the demographic characteristics of the countries where the studies were conducted, (2) the sociolinguistic or psycholinguistic focus of the papers in relation to the European country, and (3) the characteristics of the bi-multilingual education programme including IM languages. The results indicate that: (1) the demographic characteristics of the country are not strictly related to the number of studies published, (2) most studies have a sociolinguistic approach even though many studies analyse both sociolinguistic and psycholinguistic factors, and (3) only seven multilingual education programmes including IM languages were described in these papers. We conclude that there is a lack of research focusing on IM languages in educational settings and discuss how addressing these gaps could create opportunities for building equitable multilingual communities in Europe.

Aim: The goal of this paper is to analyze the COVID-19 policies of 10 European countries, including Sweden, Finland, Norway, Italy, France, Germany, Poland, Belgium, the Netherlands, and Hungary, with a time-series policy analysis tool. Subject and methods: The results of the COVID-19 policy analysis are based on a single time-series indicator, or daily population mortality rate: the number of COVID-19 daily cumulative deaths divided by the population in millions. The lower the score, the better the policy. Although many experts believe that the COVID-19 policy outcome analysis is premature, time series analysis is an excellent analysis that can provide information on the progress and transition of policy outcomes. In other words, the proposed time series analysis tool allows policymakers to identify and quantify when mistakes were made during the on-going COVID-19 pandemic. Results: The COVID-19 policy analysis discovered many useful facts. Sweden failed due to the herd immunity approach. Hungary made a fundamental mistake in COVID-19 tactics. Countries such as Sweden, Hungary, Belgium, and Poland showed time-series changes that differed from the others. Conclusion: Public health interventions can play a key role in mitigating the COVID-19 pandemic. The proposed policy analysis tool, hiscovid demonstrated the effectiveness of the time-series score behavior for discovering when policymakers made mistakes. [ABSTRACT FROM AUTHOR]

This paper investigates different uses of the Journal Impact Factor (JIF) in national journal rankings and discusses the merits of supplementing metrics with expert assessment. Our focus is national journal rankings used as evidence to support decisions about the distribution of institutional funding or career advancement. The seven countries under comparison are China, Denmark, Finland, Italy, Norway, Poland, and Turkey—and the region of Flanders in Belgium. With the exception of Italy, top‐tier journals used in national rankings include those classified at the highest level, or according to tier, or points implemented. A total of 3,565 (75.8%) out of 4,701 unique top‐tier journals were identified as having a JIF, with 55.7% belonging to the first Journal Impact Factor quartile. Journal rankings in China, Flanders, Poland, and Turkey classify journals with a JIF as being top‐tier, but only when they are in the first quartile of the Average Journal Impact Factor Percentile. Journal rankings that result from expert assessment in Denmark, Finland, and Norway regularly classify journals as top‐tier outside the first quartile, particularly in the social sciences and humanities. We conclude that experts, when tasked with metric‐informed journal rankings, take into account quality dimensions that are not covered by JIFs. [ABSTRACT FROM AUTHOR]

The importance of non-structural elements on the seismic performance of buildings is now widely recognized. A building cannot achieve a life-safety or continuous functionality performance after an earthquake if all its non-structural elements are damaged and/or out of function. Suspended non-structural elements, such as piping and mechanical services, play a crucial role in maintaining life-safety and functionality of a building after an earthquake. The importance of non-structural elements for the seismic performance of buildings have prompted the development of both force-based and displacement-based seismic design methodologies that can be applied to suspended non-structural elements. This paper focuses on appraising force-based and displacement-based seismic design methodologies available in Europe for suspended non-structural elements by comparing fragility functions for a case-study suspended piping trapeze restraint installation layout located in a mid-to-high seismic zone in Italy. The aim of this study is to determine if the seismic design methodologies available for suspended non-structural elements are capable of producing archetypes that achieve a life-safety performance objective for a design level earthquake (return period of 475 years) and maintain a reasonable performance, in terms of life-safety, for other earthquake intensity levels. Advantages and disadvantages of these methodologies are also highlighted. [ABSTRACT FROM AUTHOR]

Whilst the link between young people's well‐being and the creative arts is strengthening, there is a lack of research which focuses on the roles that artists play to help teachers and parents engage young people in the creative arts. This paper explores the benefits of and barriers to artists working in education in six European countries (England, Iceland, Germany, Greece, Italy and Austria). Using the '5A's model of creativity' and a view of professional development taking place within 'landscapes of practice', the data were analysed in order to explain how creativity is operationalised in the different contexts. Our study highlights the need for policy at a national and transnational level to value the creative arts in order to help teachers cross boundaries and utilise the full potential of the creative arts in schools. Our study also highlights that further research is needed into how artists shape teaching and curriculum and how schools engage parents in the creative arts in order to build an evidence‐base relating to young people's positive mental health that can affect policy at these levels. [ABSTRACT FROM AUTHOR]

BACKGROUND: The COVID-19 pandemic has increased the interest in the right to health, which represents a relatively new concept brought about by progress in medical science and the evolution of societies. The Italian Constitution, in article 32, states the right to health without specifications about the parameter of sex, assuming that this fundamental right is property of women and men indiscriminately. OBJECTIVE: To assess whether the right to health has actually been achieved in an equal way from the standpoint of sex, and whether a hypothetically "neutral" approach is actually convincing and profitable in this context. METHODS: This paper analyzes the topic of gender medicine from a scientific and legal perspective, based on current medical literature and its implementation in the Italian and European legal systems. RESULTS: Gender medicine is the only credible response to sex- and gender-based inequalities affecting the right to health, as it provides tools to address persisting inequalities in prevention and treatment, thus pursuing health for all: women and men. CONCLUSIONS: The importance of this path was underlined also by the Summit and the Rome Declaration of 21 May 2021, acknowledging that the topic of sex and gender can no longer be overlooked in focusing a correct and equal healthcare approach. [ABSTRACT FROM AUTHOR]

This article examines young people's experiences of open access youth work in settings in the UK, Finland, Estonia, Italy and France. It analyses 844 individual narratives from young people, which communicate the impact of youthwork on their lives. These accounts are then analysed in the light of the European youth work policy goals. It concludes that it is encouraging that what young people identify as the positive impact of youth work are broadly consistent with many of these goals. There are however some disparities which require attention. These include the importance young people place on the social context of youth work, such as friendship, which is largely absent in EU youth work policy; as well as the importance placed on experiential learning. The paper also highlights a tension between 'top down' policy formulation and the 'youth centric' practices of youth work. It concludes with a reminder to policy makers that for youth work to remain successful the spaces and places for young people must remain meaningful to them 'on their terms'. [ABSTRACT FROM AUTHOR]

This paper explores the changing role of Islam in Europe, via the case of Italy. The focus is on the contemporary geographies of the changing identities and relationships in the Euro-Mediterranean region. The article intends to challenge the continuous representation of Islam in Europe between homogeneity and otherness. Indeed, the approach considers that relationships which shape places (and are shaped by places) do not stem only from media narratives, from powers and ideologies in general, but also from people's everyday inter-ethnic, inter-cultural, and emotional interactions. The latter do not occur in a vacuum, but rather in places and digital communication channels under grids of power. They are sometimes characterized by behaviours of self-caging and last but not least they always develop in light of geographical transformative power of encounters as 'situated' dynamics of people. Encounters are further shaped and have transformative potential within realms of 'moral geographies' of people and society's values and beliefs while dealing with 'difference'. The paper is based on a series of fieldwork carried out by the author over the years including expert interviews (interreligious dialogue associations, religious leaders, and researchers) and surveys/interviews with immigrants from across the Mediterranean, and on available data and literature for Italy. Main findings for policy-making can be summarized as follows: Europe is a periphery for Umma, not a central place, but in contrast to some origin countries, Islam versions as Islam as predominant not a minority religion. Conversely, the European tradition of human rights, universalism, and democracy should be re-examined and practiced not only in the abstract but in the concrete form of engaged human relations with 'empathy', while laissez faire multiculturalism, aggressive assimilation or 'culturalism' exceptions should be avoided. [ABSTRACT FROM AUTHOR]

Purpose: Worker-recuperated enterprises have appeared in Europe with increasing frequency since 2008, following the Great Recession that hit the western economies. The purpose of this paper is to depict the phenomenon of worker-recuperated enterprises in Italy, focusing on two different types of business recovery, that of workers buyouts and that of recovered social spaces. The paper compares these on the basis of four analytical dimensions: resilience/resistance, relationship with the market, relationship with the territory and workplace democracy. Design/methodology/approach: The corpus of the research is based on the cross-sectional analysis of workers' narratives. These were collected, within a small sample of theoretically relevant cases, in order to retrace and analyse the path from the crisis of the former companies to establishment of the workers' cooperatives and their social and economic features. Findings: The collected narratives allowed for a multi-level comparison between different types of worker-recuperated enterprises, providing some insights on their emergence, their features in terms of resilience and resistance, their relationship with the market economy and their outcomes in terms of workplace democracy and support to employment. Originality/value: Worker buyouts are gaining ground in Europe as an effective mechanism to oppose the fall of the employment rate in consequence of economic crises. This research intends to offer some data and arguments to the current international debate on the effectiveness of these mechanisms in coping with economic shocks and opening up to a sustainable and cooperative work-driven economy. [ABSTRACT FROM AUTHOR]

Green Infrastructure (GI) definition, deriving from the United States green infrastructure for hydro-geological rebalancing through imitating the nature stormwater management, was consolidated in Europe by GI Planning Guide. Nowadays GI can be considered a valid and meaningful approach for ameliorating urban complex ecosystems, and could also be considered as mitigation action of land consumption, according to the guidelines on the soil sealing of the European Commission (2012). The metropolitan area of Naples located in south Italy is characterized by an unauthorized and chaotic urban development. The land-use map reported an average of 30% of urbanization in the metropolitan area, rising up to 50–60% and as high as 98% in the north core area of the city. This high level of urbanization is directly related to the habitat fragmentation. The National Biodiversity Conservation Strategy defines several challenges and targets to counteract the biodiversity loss in Italy, identifying urban areas as places exposed to the greatest pressures on ecosystems. Therefore, the integration of different policies limiting habitat fragmentation, heat island effect and natural soil hydro-geological degradation into spatial planning, especially through green corridors and ecosystem enhancement in urban areas is an urgent need for the society. Spatial planning has to be renewed in metropolitan areas, where threats and weaknesses to biodiversity conservation are stronger than in any other place, according to the Law n. 56/2014, (Gazzetta Ufficiale della Repubblica Italiana, 2014) committing metropolitan cities to the enactment of General Territorial Plan. In the current paper, we aim at designing an ecological network for the metropolitan area of Naples one of the biggest city of southern Italy. The analyses include the adopted methodological procedure, i.e., ecological network analysis and design, and the introductory elements of a spatial analysis on a pilot ecological network of several patches. Finally, the paper illustrates the network analysis conceived as a monitoring system and also in future perspective, as a planning support system. [ABSTRACT FROM AUTHOR]

To date photovoltaic energy systems have been widely installed on homes in Europe and all over the world. In Europe and in Italy investments in domestic photovoltaic power plants (PV) were boosted by generous feed-in tariffs that made these investments extremely attractive for small private investors, such as homeowners. It is commonly agreed that the greater the building energy efficiency, the greater the property market value. It is of paramount importance to determine the value that PV systems may add to home sale transactions. The aim of the paper is to investigate whether Smart Grids (SGs) innovation can increase market values due to higher production and consumption flexibility. SGs give de facto producers and consumers, the opportunity to be active in the energy market and strategically decide their optimal production/consumption pattern. In this paper, we provide a model based on the real option theory to determine the value of this flexibility and the related market value increase. We model the homeowner decision to invest in a solar home with a PV plant and connect to an SG by comparison to the decision to invest in a solar home not connected to an SG. We determine the property potential market value increase due to the opportunity to perform active energy management given by smart grids and we compare this value increase to the PV plant value per se. To capture the value of managerial flexibility we implement a real option approach. Results of simulations, performed according to zonal prices' trend and volatility in the North and South of Italy, show that in the North and in the South, being connected to an SG increases by about 5-10% the PV investment's value and this quota increases as energy savings and flexibility increase. The greater the flexibility, the greater the property market value. [ABSTRACT FROM AUTHOR]

What explains regulators’ preferences concerning the Single Supervisory Mechanism (SSM)? The paper answers this question by providing an alternative account of the creation of the SSM using an institutionalist perspective. It is argued that the creation of the SSM does not simply reflect the material interests of governments and domestic financial firms, but that regulators’ positions were also significantly affected by the institutional environment in which they operated. Two characteristics of domestic supervisory governance are identified: the institutional responsibilities of banking regulators (microprudential and/or macroprudential) and the fragmentation of supervisory and monetary policies. The empirical analysis demonstrates the relevance of these factors for shaping regulators’ preferences both within and across countries. [ABSTRACT FROM PUBLISHER]

Purpose - Despite numerous studies on FGM, little is known about belief systems that support FGM in the EU. The purpose of this paper is to explore the dynamic nature of belief systems and enforcement mechanisms that perpetuate FGM among three African migrant communities in the EU. Design/methodology/approach - This paper is based on data collected through community-based participatory action research in three communities: Eritrean and Ethiopian community in Palermo, Italy; Guinea Bissauan community in Lisbon, Portugal; and Senegalese and Gambian community in Banyoles, Spain. A total of 24 FGDs and 70 in-depth narrative interviews were conducted for the research. Findings - The research finds that belief systems supporting the practice of FGM among African migrants in the European diaspora are similar to those in their home countries. Beliefs structured around religion, sexuality, decency, marriage and socialisation are particularly significant in perpetuating FGM in the study migrant communities. These are enforced through sanctions and social expectations from the migrants' home and host communities. Research limitations/implications - Members of the migrant communities that were the focus of this research are ethnically diverse; therefore it is possible that differences in the practice of and views on FGM by various ethnicities may have been masked. Also, due to close linkages between the migrants and their home countries it was hard to delineate beliefs that are specific to the host countries. In addition, it was difficult to assess the level of education of the migrants and how this may have impacted on their beliefs due to their contrasting and inconsistent educational backgrounds. Originality/value - This paper provides evidence to show that the practice of FGM among migrants in the EU is driven by both social norms and individual (parent) behaviour and therefore there is a need for interventions to focus on individual behaviour change and social norm transformation techniques. It also suggests that beliefs around FGM have remained socially significant among migrants despite their exposure to European culture because such beliefs are used to promote the moral standards of girls, marriageability of women, respectability of families, and the assertion of cultural and religious identity in the migrants' new environment. The paper further underscores the role of migrants' European context as well as the home country in strengthening beliefs that perpetuate FGM in the EU. [ABSTRACT FROM AUTHOR]

The outbreak of COVID-19 in early 2020 created dangerous public health conditions which pressured governments and health systems to respond in a rapid and effective manner. However, this type of rapid response required many governments to bypass standing; bureaucratic structures of health sector administration and political governance to quickly take; essential measures against a rapidly evolving public health threat. Each government's particular; configuration of governmental and health system decision-making created specific structural and functional challenges to these necessary centrally developed and coordinated strategies. Most East Asian governments (except Japan) succeeded relatively quickly in centralizing essential disease control and treatment initiatives in a timely manner. In contrast, a number of European countries, especially those with predominantly tax-based financing and politically managed health delivery systems, had greater difficulty in escaping bureaucratic governance and management constraints. Drawing on data about these governments' early stage COVID-19 control experiences, this article suggests that structural changes will be necessary if low-performing governments are to better respond to a pandemic. This paper also summarizes other relatively successful strategies. By adopting such strategies, nations can help overcome structural bureaucratic and administrative obstacles in responding to further waves of COVID-19 or similar future pandemic events. [ABSTRACT FROM AUTHOR]

The growth of a societal base of xenophobia in Europe poses a challenge for the Muslim minorities to alter power relations in the society. In the light of the previous and the current research as well as established theoretical insights, this paper suggests that racial discourse now strategically allows a particular form of pluralism in society, a dominant pluralism, which occludes the possibility for the Muslims to be involved equally in the public and political life. The results of the qualitative analysis, based on interviews conducted with groups holding xenophobic ideas in Austria, Bulgaria and Italy, confirmed earlier observations on contemporary racism, which suggested incommensurability of Muslim minorities with the European culture; their non-assimilative adaptation to society; their expulsion if this adaptation fails and advocating populism. Space is a crucial aspect of exclusion in this discursive frame because minorities are excluded from public and communicative spaces. The discourse is supported by the conceptual sources of a dominant form of pluralism that are found in Michel Foucault and master–slave relationship in philosophy. [ABSTRACT FROM PUBLISHER]

Background: The Sarcoma Policy Checklist was created by a multidisciplinary expert group to provide policymakers with priority areas to improve care for sarcoma patients.Main Body: This paper draws on this research, by looking more closely at how France, Germany, Italy, Spain, Sweden and the United Kingdom are addressing each of these priority areas. It aims to highlight key gaps in research, policy and practice, as well as ongoing initiatives that may impact the future care of sarcoma patients in different European countries. A pragmatic review of the published and web-based literature was undertaken. Telephone interviews were conducted in each country with clinical and patient experts to substantiate findings. Research findings were discussed within the expert group and developed into five core policy recommendations. The five identified priority areas were: the development of designated and accredited centres of reference; more professional training; multidisciplinary care; greater incentives for research and innovation; and more rapid access to effective treatments. Most of the countries studied have ongoing initiatives addressing many of these priorities; however, many are in early stages of development, or require additional funding and resources.Conclusion: Gaps in access to quality care are particularly concerning in many of Europe's lower-resourced countries. Equitable access to information, clinical trials, innovative treatments and quality specialist care should be available to all sarcoma patients. Achieving this across Europe will require close collaboration between all stakeholders at both the national and European level. [ABSTRACT FROM AUTHOR]

Teeth fusion is a developmental anomaly characterized by the union of two and, more rarely, three adjacent teeth. The fusion is caused by the physical pressure between two adjacent teeth during their development due to congenital, inherited, acquired or idiopathic factors. Nowadays, fused teeth occur with a frequency ratio between 0.1% and 1% in permanent dentition and 0.5% and 2.5% in primary dentition, and with an equal distribution between males and females. Fused teeth are a rare clinical finding, so there are not standardized clinical protocols and each case should be treated independently. This condition is rare in archaeological populations, likely due to taphonomic processes that cause the lack of information, as well as for the general low occurrence of the defect itself. In the European archaeological literature, there are no reports of two permanent fused teeth so far. Therefore, the present paper represents the first case study of two fused permanent incisors in the past Europe populations as this anomaly has been recognized in an adult man buried in the Longobard cemetery of Guidizzolo (VI–VII century A.D., northern Italy). [ABSTRACT FROM AUTHOR]

This paper presents cross-national research on news readership diversification. We compare written news (print and free newspapers, online and mobile news services) audiences in the 5 most populous and industrialized European countries (Italy, France, Spain, the UK and Germany). Outlining a sociodemographic portrait of these different news users is important in order to understand the changes undergone inside the world of written news. We draw on a telephone survey carried out in 2009, using a representative population sample (N=7,255). The survey considers sociodemographic variables, including a range of social activities and attitudinal variables, television, computer, and mobile phone ownership, and Internet access and use. Findings show a rich, but volatile relationship between written news, audience behaviors, and community participation. [ABSTRACT FROM AUTHOR]

In the last 30 years, Local Governments all over Europe experienced an intense season of institutional change of unprecedented width and intensity. This paper focuses on a neglected type of institutional change, a more indirect one – here labeled oblique-change – that however strongly influences the overall LG institutional change and local autonomy. Taking 2012 as the climax of the austerity period in Europe and Italy as a pilot case for future comparisons, this article shows that oblique-change matters to a considerable extent, and that it is much more frequent and highly impacting than expected. Moreover, it argues that bradyseismic adjustments provoked by oblique-change may turn out in an equally profound change of the local government's asset, as that induced by major reforms. [ABSTRACT FROM AUTHOR]

The engagement of young people has been a neglected area in youth justice and drug policy and practice. This paper explores the concept of 'engagement' in relation to drug interventions in custodial and community settings in different European countries. Interviews were undertaken with young people (aged 14–25 years) in contact with the criminal justice system who use illegal drugs and with practitioners involved in the delivery of interventions for our target group in Denmark, Italy, Poland, and the UK. The key techniques to engage young people were described in similar terms across the countries. These included forming relationships based on trust, honesty, and empathy, setting goals collaboratively, and employing practitioners with lived experience and understanding. The objectives and activities on offer are often constrained by criminal justice contexts. Despite the differences between the countries in terms of criminal justice systems and the structure of drug interventions, there were remarkable similarities in the ways young people and practitioners described effective engagement. Strong emphasis on operational engagement to ensure positive relationships between young people and practitioners was important in the design and delivery of interventions. Practitioners working in criminal justice contexts need to have flexibility and autonomy to work creatively to find ways to engage, connect, and inspire young people. [ABSTRACT FROM AUTHOR]

Based on research undertaken as part of the EU funded EPPIC project, this paper aims to update and elaborate on the relationship between drug use and offending behaviours by exploring variations within a cross-national sample of drug-experienced young people in touch with criminal justice systems. Adopting a trajectory-based approach, interviews were undertaken with 198 young people aged 15–25 in six European countries (Austria, Denmark, Germany, Italy, Poland, and UK). Data were analysed by applying the Bennett and Holloway categorization of the drugs-crime link, with a focus on the concept of social exclusion as developed by Seddon. Three main types of mechanisms (economic, pharmaceutical, and lifestyles) are used to interpret the data, showing how the relationship between drugs and offending can vary according to type of substances and over time. Furthermore, it can be associated with very different degrees of social exclusion and needs. The results suggest that while economic inequalities still play key roles in explaining drug use and offending, both behaviours can originate from a state of relative deprivation, resulting from the contradictions inherent in 'bulimic societies' that raise aspirations and desires while providing young people scarce opportunities for self-realisation and social recognition. [ABSTRACT FROM AUTHOR]

The paper addresses the issues of admissibility of human embryo research and the legal protection to be recognized, in light of the growing importance that scientific research has been gaining in the clinical and biomedical fields of embryonic stem cells for therapeutic purposes. As for human embryo experimentation, particularly on cryopreserved supernumerary embryos, European legislation varies, since the European Court has granted member States a wide margin of appreciation. Some countries, including Italy, have strict legislation protecting embryos from the fertilisation stage, whereas others have taken permissive approaches, allowing experimentation until 14 days after fertilisation. Science, however, has shown that the 14-day limit can be moved. The author finds it necessary to achieve broad international consensus and shared regulations. Lawmakers, however, need to balance respect for the principle of life, represented by the embryo, against scientific needs, in order to devise sound regulations safeguarding both apparently conflicting fundamental values. [ABSTRACT FROM AUTHOR]

The article presents information on executives of the European Society of Neuroradiology (ESNR) and presents a 2012 and 2013 calendar of events related to the ESNR which includes the sixth European Course of Pediatric Neuroradiology, the 50th annual meeting of the American Society of Neuroradiology and the ESNR XXXVI Congress and 20th Advanced Course.

This paper discusses why there is a need for a more profound analysis of the European SMEs in the context of knowledge transfer within the state of generational change of the managing board. This paper forms basis for a doctoral thesis on this topic. [ABSTRACT FROM AUTHOR]

The current paper presents a preliminary algorithm most commonly used for designing the base isolation devices. The algorithm addresses exclusively the base isolation systems which use Laminated Rubber Bearings (LRBs), one of the most used devices in the world. In the first part of the paper the theoretical aspects will be presented by focusing on two different designing approaches (stress approach and strain approach). The seismic conditions will be defined according to three different seismic codes: the European Code (EUROCODE- 1998), the Italian Code and the Romanian Code. In the second part of the paper, several parametrical studies are performed using the designing procedure presented in the first part. The aim of these studies is to obtain a clear understanding of the design procedures and also to determine the influence of seismic characteristics on studied parameters. Finally, the last part of the paper presents a comparison between different solutions obtained for the base isolation system when we consider the same building (Demonstration building on HDNR isolators situated near Java, Indonesia) and different seismic parameters. The chosen seismic conditions correspond to the seismic parameters defined by the above mentioned codes. [ABSTRACT FROM AUTHOR]

European Parliament elections have often been defined second-order elections, focused on national rather than transnational issues. This paper investigates the combined impact of Eurosceptic populism and social media in the development of the campaign during the 2019 European Parliament elections. It evaluates how populist and non-populist politicians and parties campaigned for the European elections on Twitter by using the case study of Italy. Computer-assisted quantitative analysis and qualitative analysis of social media content are used to assess the relevance of Europe in political communication and the strategies used by different political actors. Findings show that the concept of nation plays a central role in the campaign, with Europe depicted either as an enemy (by nationalist populism) or a saviour (by pro-Europeans). Moreover, there is e tendency towards a "populist shift" in the communication style. [ABSTRACT FROM AUTHOR]

Chikungunya virus (CHIKV) is a mosquito-borne infection that is emerging in temperate areas of Europe, following the expansion of one of its vector species, Aedes albopictus. Although CHIKV fever is a self-limiting disease, with a clinical syndrome often resolving within few days, it can also cause severe sequelae, including chronic polyarthralgia lasting up to 5 years. Additionally, CHIKV outbreaks may limit blood bank donations, adding economic burden on the health system. Public health authorities in Europe need to increase their preparedness against this emerging threat. Two large CHIKV outbreaks occurred in Italy in 2007 and 2017, with hundreds of cases and significant geographical spread. The aim of this paper is to review and compare the 2 Italian outbreaks in terms of available estimates of key epidemiological features, patient clinical presentation, virus and immunological characteristics, and public health response. Recommendations for public health and future directions for research are also discussed and highlighted. Key results: Both outbreaks started in small towns, but cases were also detected in nearby larger cities where transmission was limited to small clusters. The time spans between the first and the last symptom onsets were similar between the 2 outbreaks, and the delay from the symptom onset of the index case and the first case notified was considerable. Comparable infection and transmission rates were observed in laboratory. The basic reproductive number (R0) was estimated in the range of 1.8–6 (2007) and 1.5–2.6 (2017). Clinical characteristics were similar between outbreaks, and no acute complications were reported, though a higher frequency of ocular symptoms, myalgia, and rash was observed in 2017. Very little is known about the immune mediator profile of CHIKV-infected patients during the 2 outbreaks. Regarding public health responses, after the 2007 outbreak, the Italian Ministry of Health developed national guidelines to implement surveillance and good practices to prevent and control autochthonous transmission. However, only a few regional authorities implemented it, and the perception of outbreak risk and knowledge of clinical symptoms and transmission dynamics by general practitioners remained low. Major conclusions: Efforts should be devoted to developing suitable procedures for early detection of virus circulation in the population, possibly through the analysis of medical records in near real time. Increasing the awareness of CHIKV of general practitioners and public health officials through tailored education may be effective, especially in small coastal towns where the outbreak risk may be higher. A key element is also the shift of citizen awareness from considering Aedes mosquitoes not only as a nuisance problem but also as a public health one. We advocate the need of strengthening the surveillance and of promoting the active participation of the communities to prevent and contain future outbreaks. Author summary: In Europe, vector-borne diseases have been increasing during the last decades. CHIKV is an example of a neglected emerging disease transmitted by the alien mosquitoes Ae. albopictus that caused 2 large outbreaks in Italy in 2007 and 2017. It is important to compare the main epidemiological, clinical, virological, and immunological features, as well as the public health responses, to increase preparedness to face future outbreaks. [ABSTRACT FROM AUTHOR]

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Population aging is exacerbating the loss of competences in the workforce and simultaneously young people neither in employment nor in education and training (NEETs) are struggling to be reengaged in employment. These issues, which are deemed priorities for the European policy agenda, could be addressed by triggering active aging dimensions, valuing and exploiting older adult entrepreneurs' knowledge for enhancing youngsters' entrepreneurial attitudes, through mentoring. This paper reports the results of a study based on an intergenerational learning program, carried out in 2018 in Germany, Italy and Slovenia. The study was aimed at developing and testing one training on mentoring addressing 41 older adult entrepreneurs (55 and over), and two intergenerational learning trainings aiming at boosting entrepreneurial competences of 33 NEETs (aged 18–29). The impact of the program on older adult entrepreneurs and NEETs was assessed through a pre and post-evaluation using qualitative and quantitative tools. Findings at country level were treated as national case-studies and then the latter were compared by considering them as a multiple embedded case-study. Results indicated that, to different extent in the study countries, mentors learned and enhanced mentoring competences, e.g. active listening and the capability of orienting, improved well-being and self-esteem, social inclusion and active aging attitude. Moreover, NEETs acquired entrepreneurial and socio-relational competences by benefiting from the full exploitation of mentors' know-how and the trust relationship with them. Companies, trade unions, educational and voluntary organizations should cooperate to adopt intergenerational learning programs as good practices for older adults and NEETs' lifelong learning promotion. [ABSTRACT FROM AUTHOR]

This paper presents Learning@Europe, an educational service, supported by VR, that has involved in year 2004–2005 more than 1,000 students from 6 different European countries. L@E has fostered the creation/reinforcement of three different kinds of communities: (1) the classroom community (reinforcing the bonds among students, and between students and their teachers), (2) communities among different schools competing together through 3D environments, (3) a global community (roughly involving 20% of the total) of all the teachers and students. A similar situation was created, at regional level, in the Italian Region of Lombardy, involving nearly 800 individuals. Given that the behaviours of the different communities in the two projects were very similar, it seems to be arguable that a pattern of community building through virtual environments has been detected. The important facts (detected by surveys of teachers and students, inspection, direct observation, qualitative data analysis) about these communities are: (1) the depth of the pedagogical impact, in terms of increased knowledge (about history and related subjects), skills (use of functional English, use of ICT in learning/teaching processes, group work) and attitudes (more curiosity towards history, increased motivation in school activities, improved respect and interest for other cultures). (2) The engagement of all the participants, with very high level of customer satisfaction. (3) The depth of the social impact, reinforcing existing relationships (within the same class) and creating new ones. The key feature of this success apparently lies in the sense of “social virtual presence”, that is, a feeling of being engaged in a virtual situation, so strong that the technological means become “transparent” and the social situation (meant at different levels and for different time frames) becomes “the king”. The paper will present the project, its main features and its outcomes, eventually discussing the role of social virtual presence into building effective and lively communities. [ABSTRACT FROM AUTHOR]

The dynamic links between stock market indices are analyzed in a GARCH-M framework, using daily data from France, Germany, Italy and the USA. It is shown that indices in the periods before and after the introduction of the Euro as a single currency display a very distinct behaviour. Consistent with the literature, in the earlier period price changes are found to have an impact the next day on other markets. In the latter period this type of co-movement disappeared within Europe. Feedback trading has been shown to induce (negative) autocorrelation in national stock markets. In this paper an international version of the feedback trading model is used to illustrate that the lead-lag relationships across countries and the strength of these links depend on the currency regime. [ABSTRACT FROM AUTHOR]

Background: 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.Method: 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.Results: 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.Conclusion: 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. [ABSTRACT FROM AUTHOR]

Ecoregionalization is the process by which a territory is classified in similar areas according to specific environmental and climatic factors. The climate and the environment strongly influence the presence and distribution of vectors responsible for significant human and animal diseases worldwide. In this paper, we developed a map of the eco-climatic regions of Italy adopting a data-driven spatial clustering approach using recent and detailed spatial data on climatic and environmental factors. We selected seven variables, relevant for a broad set of human and animal vector-borne diseases (VBDs): standard deviation of altitude, mean daytime land surface temperature, mean amplitude and peak timing of the annual cycle of land surface temperature, mean and amplitude of the annual cycle of greenness value, and daily mean amount of rainfall. Principal Component Analysis followed by multivariate geographic clustering using the k-medoids technique were used to group the pixels with similar characteristics into different ecoregions, and at different spatial resolutions (250 m, 1 km and 2 km). We showed that the spatial structure of ecoregions is generally maintained at different spatial resolutions and we compared the resulting ecoregion maps with two datasets related to Bluetongue vectors and West Nile Disease (WND) outbreaks in Italy. The known characteristics of Culicoides imicola habitat were well captured by 2/22 specific ecoregions (at 250 m resolution). Culicoides obsoletus/scoticus occupy all sampled ecoregions, according to its known widespread distribution across the peninsula. WND outbreak locations strongly cluster in 4/22 ecoregions, dominated by human influenced landscape, with intense cultivations and complex irrigation network. This approach could be a supportive tool in case of VBDs, defining pixel-based areas that are conducive environment for VBD spread, indicating where surveillance and prevention measures could be prioritized in Italy. Also, ecoregions suitable to specific VBDs vectors could inform entomological surveillance strategies. [ABSTRACT FROM AUTHOR]

The annual meeting of the European Association of Cardiovascular Imaging, EuroEcho-Imaging, was held in Milan, Italy, in December 2018. In the present paper, we report a summary of the 'Highlights' session. [ABSTRACT FROM AUTHOR]

Aim: This paper introduces the study on the European Union Project on complementary therapies and discusses project outputs and results. The goal of the European Union Project was to improve the professional knowledge and skills of women's health and oncology nurses regarding CT. Background: The increasing and widespread use of complementary therapies in the women's health and oncology population requires nurses to be educated about their suitable and safe use. Many nurses do not have proper training in complementary therapies and therefore should not inform their patients about them. Methods: The 'Improving the Nursing Care with Best Complementary Therapy Strategies Based on European Union Standards' (BestCARE) project was a strategic partnership within Erasmus plus for vocational education and training. The BestCARE project was coordinated by the Akdeniz University Nursing Faculty and was carried out with six partners from Turkey and Europe. Results: Fifteen nurses from Turkey and Italy were trained in complementary therapies in England. In addition, training courses and seminars were held in Turkey and Italy for women's health and oncology nurses. The BestCARE programme consisted of 14 work packages. The BestCARE programme was implemented via websites, an e‐learning training programme, training videos, reference and handbook, a curriculum proposal on complementary therapies and a simulation laboratory. Conclusion and implications for nursing and/or health policy: The BestCARE project allowed nurses to gain knowledge, experience and skills about complementary therapies and created a cultural awareness and sensitivity towards patients, caregivers and health professionals. [ABSTRACT FROM AUTHOR]

Background: In Europe, although the prevalence of childhood obesity seems to be plateauing in some countries, progress on tackling this important public health issue remains slow and inconsistent. Breastfeeding has been described as a protective factor, and the more exclusively and the longer children are breastfed, the greater their protection from obesity. Birth weight has been shown to have a positive association with later risk for obesity. Objectives: It was the aim of this paper to investigate the association of early-life factors, namely breastfeeding, exclusive breastfeeding and birth weight, with obesity among children. Method: Data from 22 participating countries in the WHO European COSI study (round 4: 2015/2017) were collected using cross-sectional, nationally representative samples of 6- to 9-year-olds (n = 100,583). The children's standardized weight and height measurements followed a common WHO protocol. Information on the children's birth weight and breastfeeding practice and duration was collected through a family record form. A multivariate multilevel logistic regression analysis regarding breastfeeding practice (both general and exclusive) and characteristics at birth was performed. Results: The highest prevalence rates of obesity were observed in Spain (17.7%), Malta (17.2%) and Italy (16.8%). A wide between-country disparity in breastfeeding prevalence was found. Tajikistan had the highest percentage of children that were breastfed for ≥6 months (94.4%) and exclusively breastfed for ≥6 months (73.3%). In France, Ireland and Malta, only around 1 in 4 children was breastfed for ≥6 months. Italy and Malta showed the highest prevalence of obesity among children who have never been breastfed (21.2%), followed by Spain (21.0%). The pooled analysis showed that, compared to children who were breastfed for at least 6 months, the odds of being obese were higher among children never breastfed or breastfed for a shorter period, both in case of general (adjusted odds ratio [adjOR] [95% CI] 1.22 [1.16–1.28] and 1.12 [1.07–1.16], respectively) and exclusive breastfeeding (adjOR [95% CI] 1.25 [1.17–1.36] and 1.05 [0.99–1.12], respectively). Higher birth weight was associated with a higher risk of being overweight, which was reported in 11 out of the 22 countries. Bulgaria, Croatia, France, Italy, Poland and Romania showed that children who were preterm at birth had higher odds of being obese, compared to children who were full-term babies. Conclusion: The present work confirms the beneficial effect of breastfeeding against obesity, which was highly increased if children had never been breastfed or had been breastfed for a shorter period. Nevertheless, adoption of exclusive breastfeeding is below global recommendations and far from the target endorsed by the WHO Member States at the World Health Assembly Global Targets for Nutrition of increasing the prevalence of exclusive breastfeeding in the first 6 months up to at least 50% by 2025. [ABSTRACT FROM AUTHOR]

Over the past decades, the number of effective and safe child vaccines available has increased. Yet, more and more parents have become concerned about vaccine safety. The authors address the following question: are vaccinations, especially in children, to be considered as mandatory treatment or should parents be entitled to choose whether to have their children vaccinated or not? In Europe, eleven countries have instituted mandates, whereas others have opted for mere recommendations and rely on information campaigns. Italy is one of those which have recently enacted legislation designed to broaden the scope of mandatory vaccinations. The paper's authors argue that it is certainly hard to draw the line between individual and collective rights, yet it is incumbent upon state authorities to foster the common interest and the public good, which gives governments a right and an obligation to promote immunisation, at least until the safety threshold is reached. [ABSTRACT FROM AUTHOR]

Objectives: There is a growing consensus worldwide that palliative care needs to be both more inclusive of conditions other than cancer and to improve. This paper explores some common challenges currently faced by professionals providing palliative care for patients with either cancer or dementia across five countries. Method: One focus group (n = 7) and 67 interviews were conducted in 2012 across five countries: England, Germany, Italy, the Netherlands and Norway, with professionals from dementia, cancer and palliative care settings. Results: The interviews revealed five common challenges faced across the five countries: communication difficulties (between services; and between professionals, and patients and their families); the variable extent of structural/functional integration of services; the difficulties in funding of palliative care services; problematic processes of care (boundaries, definitions, knowledge, skills and inclusiveness) and, finally, time constraints. Conclusion: These are not problems distinct to palliative care, but they may have different origins and explanations compared to other areas of health care. This paper explored deeper themes hidden behind a discourse about barriers and facilitators to improving care. [ABSTRACT FROM AUTHOR]

The Eco-Management and Audit Scheme (EMAS) is a voluntary Regulation that defines the European Environmental Management System (EMS). Today the EMAS is undergoing a revision process, in order to fit the scheme to organizations and stakeholders’ requirements and increase its diffusion. Italy accounts for roughly 1,000 of the 4,000 certified European organizations and, especially during the last five years, a growing number of organizations have not renewed the certification. Thus, the aim of the survey is to investigate why many Italian organizations have dropped out of EMAS, and to identify which enabling measures would be more effective in order to encourage organizations to move back to the certification. The target of the questionnaire were the 339 Italian organizations that did not renew their EMAS registration between 2010 and 2015, and respondents were 99. In the first part of the paper, we present the general findings, while in the second one, certified Public Administrations and private-owned organizations are compared in order to delineate significant differences between the two groups. Concerning motivations for not renewing EMAS, implementation costs were the key reasons for both groups. Conversely, considering the possible enabling measures, while private-owned organizations demand long term tax benefits, Public Administrations prefer a greater consideration of EMAS in public funding. This paper systematically addresses this phenomenon through a survey, contributing to reduce the existing gap in literature and providing a useful input to decision-makers who are overseeing the EMAS revision process. [ABSTRACT FROM AUTHOR]

BACKGROUND Family reunification of migrants in their destination country is often the result of a process that includes one or more steps and combines family and migration events. However, the lack of relevant data often limits the possibility of studying all these stages. OBJECTIVE The paper aims to identify family migration models by means of the entire family migration trajectory, highlighting the relationship of these models with the migration project and with the family, cultural, and gender norms of the country of origin. METHODS We used sequence analysis on a large sample of resident families with at least one foreign-born member in Italy, using data collected by the Italian Institute of Statistics in 2011-2012. We focused exclusively on migrants from less developed countries and the countries of Central and Eastern Europe. RESULTS Our results indicate that family characteristics and stability in the host country are not always relevant for family reunification. Family, cultural, and gender norms of the home country and the nature of the migration project itself determine the family migration model. When the migration project becomes orientated, or converges over time to settlement, family reunification is pursued regardless of the possible difficulties and conditions during emigration. Conversely, during the time that migrants are maintaining a temporary project, family reunification is not even considered. CONTRIBUTION Adopting a longitudinal approach, we generalised and extended previous results, considering migrants from additional countries and studying the reunification of all family members. We compared family migration models and their association with gender, cultural, and family norms of the country of origin and the family migration project. [ABSTRACT FROM AUTHOR]