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Changes in urban residential density represent an important issue in terms of land consumption, the conservation of ecosystems, air quality and related human health problems, as well as the consequential challenges for urban and regional planning. It is the decline of residential densities, in particular, that has often been used as the very definition of sprawl, describing a phenomenon that has been extensively studied in the United States and in Western Europe. Whilst these studies provide valuable insights into urbanization processes, only a handful of them have reflected the uneven dynamics of simultaneous urban growth and shrinkage, using residential density changes as a key indicator to uncover the underlying dynamics. This paper introduces a contrasting analysis of recent developments in both de- and re-concentration, defined as decreasing or increasing residential densities, respectively. Using a large sample of European cities, it detects differences in density changes between successional population growth/decline. The paper shows that dedensification, found in some large cities globally, is not a universal phenomenon in growing urban areas; neither the increasing disproportion between a declining demand for and an increasing supply of residential areas nor actual concentration processes in cities were found. Thus, the paper provides a new, very detailed perspective on (de)densification in both shrinking and growing cities and how they specifically contribute to current land take in Europe. [ABSTRACT FROM AUTHOR]

Many countries have some kind of energy-system transformation either planned or ongoing for various reasons, such as to curb carbon emissions or to compensate for the phasing out of nuclear energy. One important component of these transformations is the overall reduction in energy demand. It is generally acknowledged that the domestic sector represents a large share of total energy consumption in many countries. Increased energy efficiency is one factor that reduces energy demand, but behavioral approaches (known as “sufficiency”) and their respective interventions also play important roles. In this paper, we address citizens’ heterogeneity regarding both their current behaviors and their willingness to realize their sufficiency potentials—that is, to reduce their energy consumption through behavioral change. We collaborated with three Swiss cities for this study. A survey conducted in the three cities yielded thematic sets of energy-consumption behavior that various groups of participants rated differently. Using this data, we identified four groups of participants with different patterns of both current behaviors and sufficiency potentials. The paper discusses intervention types and addresses citizens’ heterogeneity and behaviors from a city-based perspective. [ABSTRACT FROM AUTHOR]

This paper explores which demographic characteristics substantially bias self-reported physical and cognitive health status of older Europeans. The analysis utilises micro-data for 19 European countries from the Survey of Health, Ageing and Retirement in Europe to compare performance-tested outcomes of mobility and memory with their self-reported equivalents. Relative importance analysis based on multinomial logistic regressions shows that the bias in self-reported health is mostly due to reporting heterogeneities between countries and age groups, whereas gender contributes little to the discrepancy. Concordance of mobility and cognition measures is highly related; however, differences in reporting behaviour due to education and cultural background have a larger impact on self-assessed memory than on self-assessed mobility. Southern as well as Central and Eastern Europeans are much more likely to misreport their physical and cognitive abilities than Northern and Western Europeans. Overall, our results suggest that comparisons of self-reported health between countries and age groups are prone to significant biases, whereas comparisons between genders are credible for most European countries. These findings are crucial given that self-assessed data are often the only information available to researchers and policymakers when asking health-related questions. [ABSTRACT FROM AUTHOR]

This paper describes the process of adapting the Stanford Coreference resolution module to the Basque language, taking into account the characteristics of the language. The module has been integrated in a linguistic analysis pipeline obtaining an end-to-end coreference resolution system for the Basque language. The adaptation process explained can benefit and facilitate other languages with similar characteristics in the implementation of their coreference resolution systems. During the experimentation phase, we have demonstrated that language-specific features have a noteworthy effect on coreference resolution, obtaining a gain in CoNLL score of 7.07 with respect to the baseline system. We have also analysed the effect that preprocessing has in coreference resolution, comparing the results obtained with automatic mentions versus gold mentions. When gold mentions are provided, the results increase 11.5 points in CoNLL score in comparison with results obtained when automatic mentions are used. The contribution of each sieve is analysed concluding that morphology is essential for agglutinative languages to obtain good performance in coreference resolution. Finally, an error analysis of the coreference resolution system is presented which have revealed our system’s weak points and help to determine the improvements of the system. As a result of the error analysis, we have enriched the Basque coreference resolution adding new two sieves, obtaining an improvement of 0.24 points in CoNLL F1 when automatic mentions are used and of 0.39 points when the gold mentions are provided. [ABSTRACT FROM AUTHOR]

The outcomes of bargaining over losses, the subject of this paper, have rarely been studied. But experimental studies of related situations, such as those involving bankruptcies or bequests in which the sum of the legal claims that can be made against a bank or firm or estate are greater than their values, have produced strong support for the proportionality principle. To test whether this principle would find support in other situations involving losses we designed an experimental game in which four players start out with differing initial endowments of real money. They are then informed that a certain amount of this resource has to be given back to the experimenter. How should the loss be shared among the agents? This game was run at different locations and under different treatments over a period of almost three years. We found that the proportionality principle was rarely proposed and even less frequently accepted as a solution to this problem. One of the main reasons for this result was that the two players with the smallest endowments opposed most of the proposals which asked them to contribute at least some positive amount of their own initial resource. [ABSTRACT FROM AUTHOR]

This paper investigates how former hunter-gatherers living along the southern North Sea coast in NW Europe adapted to long-term and short-term climatic and environmental changes at the beginning of the Holocene. It is argued that contemporaneous hunter-gatherers repeatedly changed their hunting equipment in response to changing climate and environment, not just for functional reasons but mainly driven by socio-territorial considerations. Based on a Bayesian analysis of 122 critically selected radiocarbon dates a broad chronological correlation is demonstrated between rapid changes in the design and technology of stone projectiles and short but abrupt cooling events, occurring at 10.3, 9.3 and 8.2 ka cal BP. Combined with the rapid sea level rises and increased wildfires these climatic events probably impacted the lifeways of hunter-gatherers in such a way that they increasingly faced resource stress and competition, forcing them to invest in the symbolic defense of their social territories. [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]

Background: Patient and public involvement (PPI) is a requirement for UK health and social care research funding. Evidence for how best to implement PPI in research programmes, such as National Institute for Health Research (NIHR) Collaborations for Applied Health Research and Care (CLAHRCs), remains limited. This paper reports findings from an action research (AR) project called IMPRESS, which aims to strengthen PPI within CLAHRC East of England (EoE). IMPRESS combines AR with Normalisation Process Theory (NPT) to explore PPI within diverse case study projects, identifying actions to implement, test and refine to further embed PPI. Methods: We purposively selected CLAHRC EoE case study projects for in-depth analysis of PPI using NPT. Data were generated from project PPI documentation, semi-structured qualitative interviews with researchers and PPI contributors and focus groups. Transcripts and documents were subjected to abductive thematic analysis and triangulation within case. Systematic across case comparison of themes was undertaken with findings and implications refined through stakeholder consultation. Results: We interviewed 24 researchers and 13 PPI contributors and analysed 28 documents from 10 case studies. Three focus groups were held: two with researchers (n = 4 and n = 6) and one with PPI contributors (n = 5). Findings detail to what extent projects made sense of PPI, bought in to PPI, operationalised PPI and appraised it, thus identifying barriers and enablers to fully embedded PPI. Conclusion: Combining NPT with AR allows us to assess the embeddedness of PPI within projects and programme, to inform specific local action and report broader conceptual lessons for PPI knowledge and practice informing the development of an action framework for embedding PPI in research programmes. To embed PPI within similar programmes teams, professionals, disciplines and institutions should be recognised as variably networked into existing PPI support. Further focus and research is needed on sharing PPI learning and supporting innovation in PPI. [ABSTRACT FROM AUTHOR]

Cities are major drivers of environmental change at all scales and are especially at risk from the ensuing effects, which include poor air quality, flooding and heat waves. Typically, these issues are studied on a city-by-city basis owing to the spatial complexity of built landscapes, local topography and emission patterns. However, to ensure knowledge sharing and to integrate local-scale processes with regional and global scale modelling initiatives, there is a pressing need for a world-wide database on cities that is suited for environmental studies. In this paper we present a European database that has a particular focus on characterising urbanised landscapes. It has been derived using tools and techniques developed as part of the World Urban Database and Access Portal Tools (WUDAPT) project, which has the goal of acquiring and disseminating climate-relevant information on cities worldwide. The European map is the first major step toward creating a global database on cities that can be integrated with existing topographic and natural land-cover databases to support modelling initiatives. [ABSTRACT FROM AUTHOR]

Background: Due to changes in Polish society resulting from a significant inflow of immigrants to Poland, the need to develop the cultural competences of various professional groups who have contact with immigrants in their work has increased. These groups should include healthcare professionals, especially because of the significant increase in the number of culturally diverse patients. Therefore, medical education in Poland has had to rapidly adapt to this novel situation. For instance, the teaching process should be now more focused on the development and evaluation of the cultural competences of prospective health care workers. However, there is still a lack of standardized, valid and reliable instruments to assess cross-cultural competences among healthcare professionals. The purpose of the present paper was to describe, for the first time, the translation, adaptation, and psychometric evaluation of the Polish version of the Cross-Cultural Competence Inventory. Methods: Across two studies, we examined psychometric properties of the Cross-Cultural Competence Inventory (CCCI) such as reliability (i.e. internal consistency, test-retest reliability, factor structure) and validity (i.e. theoretical, criteria, convergent). In the first study, 408 participants (75% were healthcare professionals) completed the Polish version of the CCCI and the Positive/Negative Attitude Towards Culturally Divergent People Questionnaire. In the second study, 317 participants (97% were healthcare professionals) completed the CCCI twice, with an interval of at least 22 days. In addition, across two study sessions, participants completed questionnaires constructed to measure (a) cultural intelligence, (b) need for cognitive closure, (c) emphatic sensitiveness, (d) emotional intelligence, (e) self-esteem, (f) social desirability, and (g) personality. Finally, to additionally examine the theoretical validity, 36 professional cross-cultural competence trainers completed the CCCI during a one-session study. Results: Our findings confirm the reliability and validity of the CCCI. More precisely, in study 1 we proved the theoretical validity and reliability (i.e. internal consistency) of the CCCI. While the assumed structure did not fit the data well, all items were significantly related to the general factor, thus providing strong support for the usage of the total score of the CCCI. In study 2, we additionally estimated the test-retest reliability and theoretical, criterion and convergent validity. Across two studies we were able to successfully confirm these psychometric properties. The reliability was satisfactory and ranged from .83 to .86. We also observed a high and significant positive correlation between CCCI and the Cultural Intelligence Scale, which measures a concept similar to the one measured by CCCI. In addition, a significant relationship between intercultural competences (CCCI) and other variables such as personality, empathic sensitivity, emotional intelligence, self-esteem (positive correlations) and the need for cognitive closure (mainly negative correlation) were demonstrated. Conclusions: The obtained results support the usage of the CCCI questionnaire in scientific research, such as, for example, among healthcare professionals (nurses, doctors) and students of medical fields (nursing, medicine). [ABSTRACT FROM AUTHOR]

Urban agriculture has become a common form of urban land use in European cities linked to multiple environmental, social and economic benefits, as well as to diversified forms (from self-production allotments to high-tech companies). Social acceptance will determine the development of urban agriculture and specific knowledge on citizens’ perception is required in order to set the basis for policy-making and planning. The ecosystem services provided by urban agriculture can be determinant in this process. The goal of this paper is to evaluate the social acceptance and the perceived ecosystem services of urban agriculture in the city of Bologna (Italy), as an example of a Southern European city. In particular, we evaluated the preferences for urban land uses, for different typologies of urban agriculture and for the resulting products, the perceived provision of ecosystem services and the willingness to engage in new initiatives. A survey that investigated these topics (including open questions, closed questions and Likert-scale evaluation) was performed on the citizens of Bologna (n = 380) between October and November 2016. Results showed that urban agriculture is widely accepted by the inhabitants of Bologna, particularly regarding vegetable production. Although intensive farming systems were the least preferred forms to be implemented in Bologna, citizens highly accepted a large variety of urban agriculture goods, with preference for those obtained from plants as compared to animal products. The willingness-to-pay for urban food products was mostly the same as for conventional ones, although the participants recognised the social values, proximity and quality of the former. Socio-cultural ecosystem services were perceived as more valuable than environmental ones. Policy-making recommendations can be extracted from the results to facilitate the development of urban agriculture plans and policies. [ABSTRACT FROM AUTHOR]

European farmlands are vital arenas for socio-ecological sustainability because of their significant land coverage and potential for integrating food production with biodiversity conservation. The knowledge produced by scientific research is a critical ingredient in developing and implementing socio-economically and ecologically sustainable management strategies for farming landscapes. The grasslands of Europe have been managed for millennia. They have exceptional socio-cultural and economic value and are among the most biodiverse ecosystems in the world. The quality of scientific knowledge on them and its potential to address grasslands as complex socio-ecological systems is strongly dependent not only on the creativity and scientific ambition of the researcher, but also on the network around the researcher (including both academic and non-academic sectors). The goal of this study is to map the research network around Romania’s grasslands using bibliometrics analysis, a well-developed scientific domain that utilizes network theory to analyze relationships between affiliations networks, co-authorship networks, and co-word analysis. The number of studies targeting grasslands in Romania is increasing, owing mostly to international involvement. However, management of the grasslands is still deficient and the contribution of science to the process is virtually absent. The current research is mainly related to the biological and ecological characteristics of grasslands, with topics related to their management notably absent from internationally visible research, especially in the context of EU Common Agricultural Policies. To increase scientific inquiry and better inform the EU and local policies on grasslands management, Romanian researchers should capitalize on international collaborations and local academic leaders. Our findings can be used to identify research gaps and to improve collaboration and knowledge exchange between practitioners, researchers, policy makers, and stakeholders. [ABSTRACT FROM AUTHOR]

Roe deer (Capreolus capreolus) is the most abundant cervid in Europe and, as such, has a considerable impact over several human activities. Accurate roe deer population size estimates are useful to ensure their proper management. We tested 3 methods for estimating roe deer abundance (drive counts, pellet-group counts, and camera trapping) during two consecutive years (2012 and 2013) in the Apennines (Italy) in order to assess their precision and applicability. During the study period, population density estimates were: drive counts 21.89±12.74 roe deer/km2 and pellet-group counts 18.74±2.31 roe deer/km2 in 2012; drive counts 19.32±11.12 roe deer/km2 and camera trapping 29.05±7.48 roe deer/km2 in 2013. Precision of the density estimates differed widely among the 3 methods, with coefficients of variation ranging from 12% (pellet-group counts) to 58% (drive counts). Drive counts represented the most demanding method on account of the higher number of operators involved. Pellet-group counts yielded the most precise results and required a smaller number of operators, though the sampling effort was considerable. When compared to the other two methods, camera trapping resulted in an intermediate level of precision and required the lowest sampling effort. We also discussed field protocols of each method, considering that volunteers, rather than technicians, will more likely be appointed for these tasks in the near future. For this reason, we strongly suggest that for each method managers of population density monitoring projects take into account ease of use as well as the quality of the results obtained and the resources required. [ABSTRACT FROM AUTHOR]

Introduction: The Accelerated Development of VAccine beNefit-risk Collaboration in Europe (ADVANCE) is a public private collaboration aiming to develop and test a system for rapid benefit-risk (B/R) monitoring of vaccines, using existing electronic healthcare record (eHR) databases in Europe. Part of the data in such sources is missing due to incomplete follow-up hampering the accurate estimation of vaccination coverage. We compared different methods for coverage estimation from eHR databases; naïve period prevalence, complete case period prevalence, period prevalence adjusted for follow-up time, Kaplan-Meier (KM) analysis and (adjusted) inverse probability weighing (IPW). Methods: We created simulation scenarios with different proportions of completeness of follow-up. Both completeness independent and dependent from vaccination date and status were considered. The root mean squared error (RMSE) and relative difference between the estimated and true coverage were used to assess the performance of the different methods for each of the scenarios. We included data examples on the vaccination coverage of human papilloma virus and pertussis component containing vaccines from the Spanish BIFAP database. Results: Under completeness independent from vaccination date or status, several methods provided estimates with bias close to zero. However, when dependence between completeness of follow-up and vaccination date or status was present, all methods generated biased estimates. The IPW/CDF methods were generally the least biased. Preference for a specific method should be based on the type of censoring and type of dependence between completeness of follow-up and vaccination. Additional insights into these aspects, might be gained by applying several methods. [ABSTRACT FROM AUTHOR]

Key message: One QTL for resistance against Leptosphaeria maculans growth in leaves of young plants in controlled environments overlapped with one QTL detected in adult plants in field experiments. The fungal pathogen Leptosphaeria maculans initially infects leaves of oilseed rape (Brassica napus) in autumn in Europe and then grows systemically from leaf lesions along the leaf petiole to the stem, where it causes damaging phoma stem canker (blackleg) in summer before harvest. Due to the difficulties of investigating resistance to L. maculans growth in leaves and petioles under field conditions, identification of quantitative resistance typically relies on end of season stem canker assessment on adult plants. To investigate whether quantitative resistance can be detected in young plants, we first selected nine representative DH (doubled haploid) lines from an oilseed rape DY (‘Darmor-bzh’ × ‘Yudal’) mapping population segregating for quantitative resistance against L. maculans for controlled environment experiment (CE). We observed a significant correlation between distance grown by L. maculans along the leaf petiole towards the stem (r = 0.91) in CE experiments and the severity of phoma stem canker in field experiments. To further investigate quantitative trait loci (QTL) related to resistance against growth of L. maculans in leaves of young plants in CE experiments, we selected 190 DH lines and compared the QTL detected in CE experiments with QTL related to stem canker severity in stems of adult plants in field experiments. Five QTL for resistance to L. maculans growth along the leaf petiole were detected; collectively they explained 35% of the variance. Two of these were also detected in leaf lesion area assessments and each explained 10–12% of the variance. One QTL on A02 co-localized with a QTL detected in stems of adult plants in field experiments. This suggests that resistance to the growth of L. maculans from leaves along the petioles towards the stems contributes to the quantitative resistance assessed in stems of adult plants in field experiments at the end of the growing season. [ABSTRACT FROM AUTHOR]

Background: A general recommendation for adult pneumococcal vaccination with 23-valent polysaccharide vaccine (PPV23) for adults 60 and older has been in place in Germany since 1998, but uptake has been low. Just over a decade after the implementation of an infant pneumococcal conjugate vaccine recommendation, we examined indirect protection effects on adult invasive pneumococcal disease (IPD) in Germany. Methods and findings: Reported IPD cases decreased in children under two years of age from 11.09 per 100,000 in 2003–2006 to 5.94 per 100,000 in 2017/18, while in adult age groups, reported IPD cases rose across the board, most dramatically in adults 60 years of age and over, from 1.64 to 10.08 cases per 100,000. PCV13-type IPD represents 31% of all cases in this age group, the lion’s share of which is due to the rapid increase of serotype 3 IPD, which, by itself, has reached 2.11 reported cases per 100,000 and makes up 21% of all IPD cases in this age group. The two vaccine formulations currently in development (PCV15 and PCV20) would increase current (PCV13) coverage by 8.5% points and 28.0% points in children, while in adults coverage would increase by 10.4% points and 21.9% points, respectively. Conclusions: While original models predicted that indirect effects of childhood vaccination would suffice for adults, it seems that the herd protection effect has reached its limit, with vaccine serotypes 4, 19F, and 19A IPD persisting in adults after initial reductions, and serotype 3 IPD not showing any herd protection effect at all. [ABSTRACT FROM AUTHOR]

Commercially motivated junk news–i.e. money-driven, highly shareable clickbait with low journalistic production standards–constitutes a vast and largely unexplored news media ecosystem. Using publicly available Facebook data, we compared the reach of junk news on Facebook pages in the Netherlands to the reach of Dutch mainstream news on Facebook. During the period 2013–2017 the total number of user interactions with junk news significantly exceeded that with mainstream news. Over 5 Million of the 10 Million Dutch Facebook users have interacted with a junk news post at least once. Junk news Facebook pages also had a significantly stronger increase in the number of user interactions over time than mainstream news. Since the beginning of 2016 the average number of user interactions per junk news post has consistently exceeded the average number of user interactions per mainstream news post. [ABSTRACT FROM AUTHOR]

Background: Nabiximols (THC/CBD Oromucosal Spray, Sativex) is used as an add-on therapy to treat moderate to severe spasticity of Multiple Sclerosis (MS). Objectives: To examine the impact of physiotherapy (PT) programs on effectiveness and persistence of nabiximols treatment in people with MS-related spasticity. Methods: This is an observational multicenter study with a follow-up period of 12 weeks, conducted in routine care settings in Italy. Patients with moderate to severe MS-related spasticity who started nabiximols were included. Spasticity was evaluated by the patient-rated 0–10 numerical rating scale (NRS). Clinical data were collected at baseline (T0), 4 weeks (T1) and 12 weeks (T2) months after enrollment. Results: A total of 297 MS patients were selected, 290 completed the 3 months follow-up period. Mean NRS scores were 7.6 ± 1.1 at T0, 5.8 ± 1.4 at T1 and 5.5 ± 1.5 at T2. At T1, 77% of patients reached ≥20% improvement (initial response, IR); 22% reached ≥30% improvement (clinically relevant response, CRR). At T1, patients undergoing PT had a higher probability to reach CRR (Odds Ratio = 2.6 95% CI 1.3–5.6, p = 0.01). Nabiximols was discontinued in 30/290 (10.3%) patients at T1 (early discontinuers) and in 71/290 (24.5%) patients at T2 (late discontinuers). The probability of being late discontinuers was reduced in patients undergoing PT (Hazard Ratio = 0.41; 95% CI 0.23–0.69, p = 0.001). Conclusions: Our real-life study confirms nabiximols’ effectiveness in MS-related spasticity and suggests that the association of a PT program may improve overall response and persistence to nabiximols treatment. [ABSTRACT FROM AUTHOR]

Background: Apolipoprotein E is a glycoprotein best known as a mediator and regulator of lipid transport and uptake. The APOE-ε4 allele has long been associated with increased risks of Alzheimer's disease and mortality, but the effect of the less prevalent APOE-ε2 allele on diseases in the elderly and survival remains elusive. Methods: We aggregated data of 38,537 individuals of European ancestry (mean age 65.5 years; 55.6% women) from six population-based cohort studies (Rotterdam Study, AGES-Reykjavik Study, Cardiovascular Health Study, Health-ABC Study, and the family-based Framingham Heart Study and Long Life Family Study) to determine the association of APOE, and in particular APOE-ε2, with survival in the population. Results: During a mean follow-up of 11.7 years, 17,021 individuals died. Compared with homozygous APOE-ε3 carriers, APOE-ε2 carriers were at lower risk of death (hazard ratio,95% confidence interval: 0.94,0.90–0.99; P = 1.1*10−2), whereas APOE-ε4 carriers were at increased risk of death (HR 1.17,1.12–1.21; P = 2.8*10−16). APOE was associated with mortality risk in a dose-dependent manner, with risk estimates lowest for homozygous APOE-ε2 (HR 0.89,0.74–1.08), and highest for homozygous APOE-ε4 (HR 1.52,1.37–1.70). After censoring for dementia, effect estimates remained similar for APOE-ε2 (HR 0.95,0.90–1.01), but attenuated for APOE-ε4 (HR 1.07,1.01–1.12). Results were broadly similar across cohorts, and did not differ by age or sex. APOE genotype was associated with baseline lipid fractions (e.g. mean difference(95%CI) in LDL(mg/dL) for ε2 versus ε33: -17.1(-18.1–16.0), and ε4 versus ε33: +5.7(4.8;6.5)), but the association between APOE and mortality was unaltered after adjustment for baseline LDL or cardiovascular disease. Given the European ancestry of the study population, results may not apply to other ethnicities. Conclusion: Compared with APOE-ε3, APOE-ε2 is associated with prolonged survival, whereas mortality risk is increased for APOE-ε4 carriers. Further collaborative efforts are needed to unravel the role of APOE and in particular APOE-ε2 in health and disease. [ABSTRACT FROM AUTHOR]

We present a lab-in-the-field experiment and surveys of marginalised Roma children in Slovakia to examine whether reminding Roma of their ethnicity reduces their performance in a cognitive task. Research on social identity and stereotypes has documented that when individuals feel that their social group is negatively stereotyped in a domain, their performance declines, which can reinforce discrimination. In an effort to break the cycle of negative stereotypes, we remind Roma subjects of either Roma or non-Roma role models. We find that the activation of a Roma’s ethnicity reduces cognitive performance. In contrast, Roma exposed to Roma role models outperform those reminded of their ethnicity and of non-Roma role models. We then attempt to understand the channels through which social identity and role models affect performance. We show that priming the identity of a Roma has a direct effect on confidence, decreasing performance. [ABSTRACT FROM AUTHOR]

The participation of diverse demographics in higher education has risen over the last half-century; meanwhile, different political and social tiers have been assigning a more active role to institutions in terms of equality and social justice. This change in circumstances has led to the roll out of processes to institutionalise diversity outreach. This study was conducted for the clear purpose of assessing the current institutionalisation status of diversity outreach in 127 key universities from the Academic Ranking of World Universities based on the opinions of diversity outreach managers and the information published on institutional websites, in turn measuring compliance with various indicators. A qualitative analysis of the institutional statements, the goals sought through strategic plans and the definitions of diversity itself was also conducted. The evidence reveals the early stage of the institutionalisation process in universities on account of the low percentage obtained for the proposed indicators. Furthermore, the study failed to exhibit significant differences in this process in terms of the institutional ownership or position held in the ranking; however, more prominent progress was noted in the North-American region when geographical differences were taken into account, likely as a result of the historical background in the advocacy for equal opportunities. Lastly, a change of approach to the conceptualisation of diversity is suggested in favour of equality and social justice. [ABSTRACT FROM AUTHOR]

Austrian beekeepers frequently suffered severe colony losses during the last decade similar to trends all over Europe. This first surveillance study aimed to describe the health status of Austrian bee colonies and to analyze the reasons for losses for both the summer and winter season in Austria. In this study 189 apiaries all over Austria were selected using a stratified random sampling approach and inspected three times between July 2015 and spring 2016 by trained bee inspectors. The inspectors made interviews with the beekeepers about their beekeeping practice and the history of the involved colonies. They inspected a total of 1596 colonies for symptoms of nine bee pests and diseases (four of them notifiable diseases) and took bee samples for varroa mite infestation analysis. The most frequently detected diseases were three brood diseases: Varroosis, Chalkbrood and Sacbrood. The notifiable bee pests Aethina tumida and Tropilaelaps spp. were not detected. During the study period 10.8% of the 1596 observed colonies died. Winter proved to be the most critical season, in which 75% of the reported colony losses happened. Risks for suffering summer losses increased significantly, when colonies were weak in July, had queen problems or a high varroa mite infestation level on bees in July. Risks for suffering winter losses increased significantly, when the colonies had a high varroa mite infestation level on bees in September, were weak in September, had a queen older than one year or the beekeeper had few years of beekeeping experience. However, the effect of a high varroa mite infestation level in September had by far the greatest potential to raise the winter losses compared to the other significant factors. [ABSTRACT FROM AUTHOR]

Background: Despite improvements in treatment for rheumatoid arthritis (RA), psoriatic arthritis (PsA) and spondyloarthritis (axSpA), several key unmet needs remain, such as fatigue. The objective of this study was to describe the severity of fatigue, disease characteristics and socioeconomic factors in people with RA, PsA and axSpA. Methods: The study was designed as a cross-sectional survey collecting patient characteristics such as disease characteristics, socioeconomic factors and fatigue in people with RA, PsA and axSpA in Denmark. Respondents were consecutively recruited for the study over a six-month period in 2018 via routine visits to outpatient rheumatology clinics. Study nurses collected information on diagnosis, current disease-related treatment and disease activity from medical journals. People were invited to complete a questionnaire related to socioeconomic factors and containing the FACIT-Fatigue subscale. Descriptive statistics were analyzed using SAS. Results: We invited 633 people to participate, and 488 (77%) completed the questionnaire. Women constituted 62% of respondents, and the mean age was 53.5 years. Respondents had on average been diagnosed between 11 and 15 years ago. Overall, 79% had no changes to their disease-related treatment during the past year, and the average disease activity as indicated by DAS28 for RA and PsA was 2.48 and 2.36, respectively, and BASDAI for axSpA was 28.40. Fatigue was present in all three diagnoses (mean: 34.31). The mean fatigue score varied from respondents answering that they suffered from no or little fatigue (mean: 45.48) to extreme fatigue (mean: 10.11). Analyses demonstrated that the respondents were not considerably different from nonrespondents, and the study population is considered representative compared with Danish RA and axSpA patients in the Danish National Rheumatology Registry, the DANBIO database. Conclusion: We found that the majority of the study population were fatigued (61%). They had low disease activity and few disease-related treatment changes. [ABSTRACT FROM AUTHOR]

Objectives: In August 2016, new prescription guidelines were introduced in Hungary to reduce the co-payments for antibiotics among children aged 0-4. This study aims at analysing the implementation of this policy and its effect on the use of antibiotics. Methods: The analysis is based on administrative prescription records between January 2010—February 2018, covering the entire population of Hungary aged 0-7. Spatial autocorrelation indices are calculated and settlement level regression models are estimated to analyse the spatial variation in the application of the new guidelines. The effect of reduced co-payments on antibiotic use is estimated with a difference-in-differences type model: the treatment and control groups are children aged 0-4 and 5-7, respectively; the treatment and control periods are August 2016—February 2018 and January 2010—July 2016, respectively. Results: The new prescription guidelines are more widely applied in settlements with higher per capita income and lower unemployment rate. Adherence to the new guidelines is spatially clustered. A 10–15% decrease in the out-of-pocket costs of antibiotics is estimated to increase the consumption of antibiotics by about 5% (95% CI: 2.63%–7.55%). Conclusions: In the absence of clear enforcement mechanisms, the adoption of the new prescription guidelines is selective, contradicting the aims of the policy of making antibiotics affordable for the poor children. The results point to the possible role of physicians’ information networks in the application of prescription guidelines. The use of antibiotics among children aged 0-4 is responsive to the price subsidy of antibiotics. [ABSTRACT FROM AUTHOR]

Sustainable development goals are used as a guidance for strategies development on local, regional and national levels. The importance of including young people in this complex process is recognized in all relevant documents (i.e. Agenda 21), however it is not an easy task to elicit opinions and preferences from the youth. Furthermore, the assessment of the sustainable development goals itself presents a challenge for the noisy data and nonlinear relationships in data. Popular approach is fuzzy set models where expert knowledge is presented with comprehensible rules; however expert knowledge elicitation takes a long time too. Several studies proposed an adaptive neuro-fuzzy inference system approach that combines the fuzzy set theory to model expert knowledge with neural networks for inferring rules and membership functions from data to assess the sustainable development performance. We base our assumptions that ANFIS can be used to predict the importance of sustainable development pillars from the demographic data of young people. For this purpose, we have conducted an online survey on sustainable development goals opinions and importance of young people in Serbia. The sample of 386 respondents has been split into a training sample of 300 instances (to generate membership functions and fuzzy rules) and a testing sample of 86 instances to predict the importance of the three pillars. We have conducted a trace-driven simulation test to validate the results of the proposed ANFIS model. Results of the study provided insights into how the young people in Serbia assess the importance of sustainable development goals. Secondly, the results suggest that ANFIS can be applied to predict values of importance of the three sustainable development pillars with the relative error of Rel Err < 5%. It must be noted that the considered model could be further improved by using training samples with more data. [ABSTRACT FROM AUTHOR]

Background: The concept of ‘patient experience’ has become central to how to improve healthcare. Remote communication with patients is today a frequent practice in healthcare services, showing similar outcomes to standard outpatient care while enabling cost reduction in both formal and informal care. The purpose of this study was to analyse the experiences of people with telemonitoring pacemakers. Methods: Patients were randomly allocated to either the telemonitoring or hospital monitoring follow-ups. Using the ‘Generic Short Patient Experiences Questionnaire’ (GS-PEQ), as well as an ad-hoc survey from the ‘telehealth patient satisfaction survey’ and ‘costs survey’, patients’ experiences were measured six months after the pacemaker implant in a cohort of 50 consecutive patients. The mean age was 74.8 (± 11.75) years and 26 (52%) patients were male of which 1 was lost in follow-up. Finally, 24 patients were followed up with standard hospital monitoring, while 25 used the telemonitoring system. Differences in baseline characteristics between groups were not found. Results: Findings showed overall positive and similar experiences in patients living with telemonitoring and hospital monitoring pacemakers. Significant differences were found in GS-PEQ concerning how telemonitoring patients received less information about their diagnosis/afflictions (p = 0.046). We did not find significant differences in other items such as ‘confidence in the clinicians’ professional skills’, ‘treatment perception adapted to their situation’, ‘involvement in decisions regarding the treatment’, ‘perception of hospital organisation’, ‘waiting before admission’, ‘satisfaction of help and treatment received’, ‘benefit received’, and ‘incorrect treatment’. Conclusions: The remote communication of pacemakers was met with positive levels of patients’ experiences similarly to patients in the hospital monitoring follow-up. However, telemonitoring patients received less information. Thus, improving the quality and timing of information is required in telemonitoring patients in the planning and organisation of future remote communication healthcare services for people living with a pacemaker implant. [ABSTRACT FROM AUTHOR]

Human populations in Western Europe during the Last Glacial Maximum were geographically constrained to glacial refugia by the severity of the climate and ecological risk factors. In this research we use an agent-based model of human mobility and interaction, based on ethnographic and archaeological data, to explore the impact of ecological risk on human population structure via a reconstructed landscape of habitat suitability. The agent-based model allows us to evaluate the size and location of glacial refugia, the size of the populations occupying them and the degree of genetic relatedness between people occupying these areas. To do this, we model the probability of an agent foraging groups’ survival as a function of habitat suitability. The model’s simulated “genomes” (composed of regionally specific genetic markers) allow us to track long-term trends of inter-regional interaction and mobility. The results agree with previous archaeological studies situating a large glacial refugium spanning southern France and northeastern Spain, but we expand on those studies by demonstrating that higher rates of population growth in this central refugium led to continuous out-migration and therefore genetic homogeneity across Western Europe, with the possible exception of the Italian peninsula. These results concur with material culture data from known archaeological sites dating to the Last Glacial Maximum and make predictions for future ancient DNA studies. [ABSTRACT FROM AUTHOR]

To assess the current hepatitis A virus (HAV) endemicity in the Autonomous Province of Vojvodina, Serbia, we examined the seroprevalence and susceptibility profiles of the general population. A serum bank of 3466 residual samples, collected in 2015–16 as per the specifications of the European Sero-Epidemiology Network 2 project (ESEN2), was tested for anti-HAV antibodies with an enzyme immunoassay. Relationships between anti-HAV positivity and demographic features of respondents were examined by univariable and multivariable analyses. Present-day HAV seroprevalence was compared with that obtained in 1978–79. Surveillance data for hepatitis A recorded between 2008 and 2017 were also analyzed. Age was the only demographic variable found to be independently associated with a HAV seropositive status. Seropositivity (17% overall vs. 79% in 1978–79) increased with age to a maximum of 90% in the elderly ≥60 years. Only 5% of subjects <30 years were seropositive, unlike the 44% of seropositives ≥30 years. The estimated age at midpoint of population immunity (AMPI) increased markedly from 14 years in the late 70s to 55 years in 2015–16. Meanwhile, disease incidence decreased noticeably in recent years (from 11 in 2008 to 2 per 100,000 population in 2017). In the ongoing pre-vaccine era, natural infection provides immunity for merely a third (31%) and two thirds (57%) of people in their 40s and 50s, respectively. Hence, the majority of people ≤40 years (94%) and middle-aged adults 40–49 years (69%) are susceptible to HAV. Older susceptible individuals, particularly those ≥50 years (24%), are prone to severe symptoms. Taken together, these changes reflect the epidemiological transition of Vojvodina and Serbia from high to very low HAV endemicity, thereby supporting the current national policy of immunization of only high-risk groups. [ABSTRACT FROM AUTHOR]

The topology of animal transport networks contributes substantially to how fast and to what extent a disease can transmit between animal holdings. Therefore, public authorities in many countries mandate livestock holdings to report all movements of animals. However, the reported data often does not contain information about the exact sequence of transports, making it impossible to assess the effect of truck sharing and truck contamination on disease transmission. The aim of this study was to analyze the topology of the Swiss pig transport network by means of social network analysis and to assess the implications for disease transmission between animal holdings. In particular, we studied how additional information about transport sequences changes the topology of the contact network. The study is based on the official animal movement database in Switzerland and a sample of transport data from one transport company. The results show that the Swiss pig transport network is highly fragmented, which mitigates the risk of a large-scale disease outbreak. By considering the time sequence of transports, we found that even in the worst case, only 0.34% of all farm-pairs were connected within one month. However, both network connectivity and individual connectedness of farms increased if truck sharing and especially truck contamination were considered. Therefore, the extent to which a disease may be transmitted between animal holdings may be underestimated if we only consider data from the official animal movement database. Our results highlight the need for a comprehensive analysis of contacts between farms that includes indirect contacts due to truck sharing and contamination. As the nature of animal transport networks is inherently temporal, we strongly suggest the use of temporal network measures in order to evaluate individual and overall risk of disease transmission through animal transportation. [ABSTRACT FROM AUTHOR]

The causes of disappearance of the Neanderthals, the only human population living in Europe before the arrival of Homo sapiens, have been debated for decades by the scientific community. Different hypotheses have been advanced to explain this demise, such as cognitive, adaptive and cultural inferiority of Neanderthals. Here, we investigate the disappearance of Neanderthals by examining the extent of demographic changes needed over a period of 10,000 years (yrs) to lead to their extinction. In regard to such fossil populations, we inferred demographic parameters from present day and past hunter-gatherer populations, and from bio-anthropological rules. We used demographic modeling and simulations to identify the set of plausible demographic parameters of the Neanderthal population compatible with the observed dynamics, and to explore the circumstances under which they might have led to the disappearance of Neanderthals. A slight (<4%) but continuous decrease in the fertility rate of younger Neanderthal women could have had a significant impact on these dynamics, and could have precipitated their demise. Our results open the way to non-catastrophic events as plausible explanations for Neanderthal extinction. [ABSTRACT FROM AUTHOR]

Patient satisfaction with the general practitioner (GP) is lower in older persons with a higher level of complexity of health problems. This study investigates whether, in these older persons, changes in satisfaction with their GP, on receiving improved integrated care, is related to their perceived health state.Using the Integrated Systematic Care for Older People (ISCOPE) trial (aimed at improving person- centered integrated care) this study compared changes in satisfaction with the GP in older persons (aged ≥75 years) with a high level of complex health problems on receiving integrated care, stratified for perceived health state at baseline. Satisfaction with the GP was registered on a 5-point Likert scale. Perceived health state was estimated with the Older Persons and Informal Caregivers Survey-Composite End Point (TOPICS-CEP) at baseline, stratified into 33% percentiles. Differences in satisfaction change between the intervention and usual care/control groups (overall and stratified for perceived health state) are presented by percentages of ‘very satisfied’ participants and improving or deteriorating 1 or more points on the Likert scale. At baseline, the intervention (n = 151) and control group (n = 603) were mainly female (75%) and living alone (62%); mean age was 83 years. Medical status, perceived health state and characteristics of participants were similar. Overall, at baseline 44.4% of respondents in the intervention group were ‘very satisfied’ compared with 37.1% at follow-up, (difference -7.3%). In the control group, ‘very satisfied’ at baseline was 32% and at follow up 29.2% (difference -2.8%). The p-value for this difference in change is 0.56. After stratification for TOPICS-CEP the results were the same. In older persons with a high level of complexity of health problems, implementation of person- centered integrated healthcare did not influence their satisfaction with the GP, also not among those with the highest or lowest perceived health state. [ABSTRACT FROM AUTHOR]

The aim of this article is to provide a detailed description of the SWEDE-I cohort, a prospective study designed to investigate work-related risk factors for transmission of viral infections. A total of 2,237 subjects aged 25–64, working and residing in Eskilstuna (central Sweden), enrolled in the study in August 2011. They filled in five detailed questionnaires including information on demography, personal characteristics, work tasks, work place, contact patterns, family structure, health status, physical activity and diet. During a 9-month follow-up period, the participants self-reported—via internet or telephone—any onset of fever, upper respiratory tract infection, or gastroenteritis immediately as they occurred. For each disease episode, the participants were asked to submit a self-sampled nasal swab for viral diagnosis. In total, 1,733 disease reports were recorded and 1,843 nasal swabs were received, of which 48% tested positive for one or more of 14 analyzed viruses. The cohort has been used to date to study diet, sleep and physical activity as determinants for upper respiratory tract infections. Analyses of contact patterns and occupational circumstances as risk factors for the transmission of infections are ongoing. The SWEDE-I study should be seen as a first pioneering effort to provide new insight in the epidemiology and prevention of viral infections. Potential joint collaborations can be discussed with the principal investigators. [ABSTRACT FROM AUTHOR]

Objective: To compare the differences in the use of healthcare services: visits to the doctor and hospitalisation, performance of routine tests, and preventive influenza vaccination, between users and non-users of homeopathic products. Methods: We used the microdata for adults over 15 years old from three waves of the Spanish National Health Survey, corresponding to the years 2011, 2014 and 2017. We proposed a comparative design of a quasi-experimental type, considering as the treatment group the respondents who said that they had used homeopathic products in the past two weeks; and another group, for control, comprising respondents who said that they had not used this type of products, but only conventional medicines, with observable characteristics similar to those of the treatment group. We used a model for rare events logistics regression (relogit) to estimate the probability of using homeopathy. From the propensity score and a vector of control variables, we used techniques of genetic matching to match individuals from the treatment group with similar individuals belonging to the control group. Results: There are no statistically significant differences between users and non-users of homeopathy in visits to the general practitioner (P>|z| 0.387), to the specialist (P>|z| 0.52), in hospitalisations (P>|z| 0.592) or in the use of emergency services (P>|z| 0.109). Nor were there any statistically significant differences in the performance of routine tests, except for the faecal occult blood test, which is more prevalent in users of homeopathic products. 20.9% of users of homeopathy had done this test compared with 15.3% of non-users (P>|z| 0.022). There are also significant differences in vaccination against influenza with 12.6% of homeopathy users stating that they had been vaccinated in the last influenza campaign, against 21.0% of non-users (P>|z| <0.001). The health conditions which homeopathy users reported were constipation (OR: 1.65 CI: 1.16–2.36), malignant tumour (OR: 1.60 CI: 1.09–2.36) osteoporosis (OR: 1.49 CI: 1.05–2.10), varicose veins (OR: 1.35 CI: 1.05–1.74) and allergy (OR: 1.35 CI: 1.06–1.72). Conclusions: Differences in the use of healthcare resources between users and non-users of homeopathic products have not been found to be statistically significant in Spain. It has been shown that most homeopathic products are used as a complement to treatment with conventional medicine. Nevertheless, our results highlight some warning signs which should raise the attention of healthcare authorities. The use of these therapies in patients with malignant tumours and the rejection of vaccines are warning signs of a possible health hazard in the long term. [ABSTRACT FROM AUTHOR]

Introduction: The reported prevalence rate of violence varies considerably between studies, even when conducted in similar populations. The reasons for this are largely unknown. This article considers the effects of nonresponse bias on the reported prevalence rate of interpersonal violence. We also single out violence perpetrated in intimate relationships and compare our results to previous Swedish studies. The aim was to explore the reasons for the large discrepancies in the prevalence rates found between studies. Material and method: This is a cross sectional study of a random population sample. The NorVold Abuse Questionnaire (NorAQ), covering emotional, physical, and sexual violence, was answered by 754 men (response rate 35%) and 749 women (response rate 38%). Nonresponse bias was investigated in six ways, e.g., findings were replicated in two samples and we explored non-responders’ reasons for declining participation. Also, the prevalence rate of intimate partner violence was compared to four previous studies conducted in Sweden, considering the methodological differences. Results and discussion: The only evidence of nonresponse bias found was for differences between the sample and the background population concerning the sociodemographic characteristics. However, the magnitude of that effect is bleak in comparison with the large discrepancies found in the prevalence rates between studies concerning intimate partner violence, e.g., emotional violence women: 11–41% and men: 4–37%; sexual and/or physical violence women: 12–27% and men: 2–21%. Some of the reasons behind these differences were obvious and pertained to differences in the definition and operationalization of violence. However, a considerable proportion of the difference could not easily be accounted for. Conclusion: It is not reasonable that so little is known about the large discrepancies in the prevalence rate for what is supposedly the same concept, i.e., intimate partner violence. This study is a call for more empirical research on methods to investigate violence. [ABSTRACT FROM AUTHOR]

Out-of-pocket payments might threaten the vertical equity of financing and generate unmet medical needs. The main objective was to assess the vertical equity of outpatient out-of-pocket payments for lymphedema patients in France. Twenty-seven centres, among which 11 secondary care hospitals and 16 primary care practices participated in this prospective national multicenter study. We measured the lymphedema-specific outpatient out-of-pocket payments over 6 months. The vertical equity of out-of-pocket payments was examined using concentration curves, the Gini coefficient for income, the Kakwani index, and the Reynolds-Smolensky index. We included 231 lymphedema patients aged 7 years or more, living in metropolitan France, and being able to use Internet and email. After voluntary health insurance reimbursement, the mean out-of-pocket payment was equal to 101.4 Euros per month, mainly due to transport (32%) and medical devices (26%). Concentration curves indicated regressivity of out-of-pocket payments. Total out-of-pocket payments represented 10.1% of the income by consumption unit for the poorest quintile and 3.5% for the wealthiest (p<0.05). The Kakwani index for out-of-pocket payments was equal to -0.18. Regarding outpatient health care, French lymphedema patients face significant and regressive out-of-pocket payments, associated with an increased risk of unmet medical needs. Such results shed light on significant socioeconomic inequalities and bring into question the current financing arrangements of outpatient health care in France. Trial registration: ClinicalTrials.gov ID: [ABSTRACT FROM AUTHOR]

Can participation in job-related training contribute to the formation and maintenance of adults’ literacy skills? Although evidence suggests that participation in training is related to higher literacy skills, it remains unclear whether this association reflects a causal effect of training participation on literacy (training effects), results from the self-selection of more high-skilled individuals into training (selection effects), or is due to other sources of endogeneity (e.g., omitted variable bias). To unravel these possibilities, we used data from the Programme for the International Assessment of Adult Competencies (PIAAC) and its German follow-up, PIAAC-Longitudinal (PIAAC-L). As these unique data offer repeated measures of literacy skills, spaced three years apart, in a large and representative sample, they allowed us to disentangle training effects from selection effects and to account for potential endogeneity. Analyses revealed that, even after taking account of formal education and a host of job characteristics, individuals with higher literacy skills were more likely to participate in training. By contrast, no evidence for effects of training on literacy skills emerged in any of our models, which comprised lagged-dependent, fixed effects, and instrumental-variable models. These findings suggest that, rather than job-related training contributing to literacy development, individuals with higher literacy skills are more likely to participate in training. [ABSTRACT FROM AUTHOR]

Given the high prevalence of common mental disorders (CMDs) and individuals living alone in the United Kingdom, the goal of this study using English nationally representative data was to examine the association between living alone and CMDs, and to identify potential mediating factors of this association. The data were drawn from the 1993, 2000 and 2007 National Psychiatric Morbidity Surveys. CMDs were assessed using the Clinical Interview Schedule-Revised (CIS-R), a questionnaire focusing on past week neurotic symptoms. The presence of CMDs was defined as a CIS-R total score of 12 and above. Multivariable logistic regression and mediation analyses were conducted to analyze the association between living alone and CMDs, and to identify mediators in this association. The prevalence of CMDs was higher in individuals living alone than in those not living alone in all survey years. Multivariable analysis showed a positive association between living alone and CMDs in all survey years (1993: odds ratio [OR] = 1.69; 2000: OR = 1.63; and 2007: OR = 1.88). Overall, loneliness explained 84% of the living alone-CMD association. Living alone was positively associated with CMDs. Interventions addressing loneliness among individuals living alone may be particularly important for the mental wellbeing of this vulnerable population. [ABSTRACT FROM AUTHOR]

Effective global collaboration is crucial to achieving the UN Sustainable Development Goals (SDGs). It requires an understanding of the needs of individual countries and their expectations related to bioeconomy. With the aim to explore the prospective developments in the global bioeconomy over the next 20 years, the German Bioeconomy Council, an independent advisory body to the German Federal Government, commissioned BIOCOM-AG to invite experts from around the globe to share their insights in a global expert survey. The survey was conducted online in autumn 2017. 345 experts from 46 countries completed the questionnaire about future developments and strategies in the global bioeconomy. As claimed by the experts, the upcoming bioeconomy must primarily meet humanity’s needs in the energy, agriculture, and food sectors. Moreover, innovative products based on renewable resources are anticipated to be of great importance. Even though all UN SDGs will be affected by future bioeconomy success stories, five SDGs stood out within the sample: SDG 12: ‘responsible consumption and production’; SDG 9: ‘industry, innovation and infrastructure’; SDG 13: ‘climate action’; SDG 7: ‘affordable and clean energy’; and SDG 11: ‘sustainable cities and communities’. About three quarters of the experts emphasized the need to specifically address three conflicting goals in any future bioeconomy strategy: non-food uses of arable land, use of crop land to produce feedstock for meat, milk and egg production and, finally, the conversion of virgin forests into agricultural land. Most experts stated that reducing food loss and waste is crucial to eradicating the world hunger problem. The proposed solutions relied greatly on innovation and technological development. Bioeconomy expertise and know-how should be shared in close cooperation between developed and developing economies to reach UN SDGs. A supportive political framework would be the ultimate goal towards furthering the progress of a future bioeconomy all over the world. [ABSTRACT FROM AUTHOR]

Most of the Paleolithic art and ornaments discovered in Romania come from the site of Poiana Cireșului. Four Paleolithic layers have been studied at this site—the oldest one belongs to the Early Gravettian period between 30 ka and 31 ka BP. The ornaments discovered in this layer include perforated shells from three species of mollusks: freshwater Lithoglyphus naticoide and Lithoglyphus apertus as well as Homalopoma sanguineum (an exclusively Mediterranean species). Poiana Cireșului is one of the very few Gravettian sites where perforated Homalopoma sanguineum shells were found, and the importance of this discovery is stressed even more by the very long distance between the site and the nearest source located over 900 km away. This find suggests the connection of communities here with the Mediterranean area as well as a possible movement of populations from the south of the continent to the east of the Carpathians with significant implications in understanding human group mobility and the origin of the Early Gravettian in this area. Furthermore, Poiana Cireșului is the only Gravettian settlement where Lithoglyphus naticoides shells were used. The unique association of perforated shells—not found in any other Gravettian settlement—contributes to the identity of the Paleolithic community of Poiana Cireșului through their ornaments. [ABSTRACT FROM AUTHOR]

Little is known about the types of social organization characterizing the pre-Roman Celtic populations of Italy. Here, we explore the funerary variability characterizing the late Iron Age site of Seminario Vescovile (SV: Verona, Italy, 3rd-1st c. BC), and test its possible correlation to diet and relative exposure to developmental stressors. Patterns on funerary treatment (N = 125), δ13C and δ15N (N = 90), and linear enamel hypoplasia (N = 47) from SV are compared, and their possible association with sex and age-at-death further discussed. Results point to the presence at SV of variable funerary customs while at the same time demonstrating a rather homogenous diet and exposure to developmental stressors: funerary treatment is mainly correlated to age-at-death but do not appear to be associated to either isotopic patterns or hypoplasia frequencies. Accordingly, even if some weak social differentiation may have characterized the individuals buried at SV, this was not reflected in markedly differing living conditions. Our study is the first to attempt an exploration of the links between age, sex, funerary variability, and diet in a pre-Roman Celtic community from Italy. While highlighting the potential of a multifaceted approach in bioarcheology, it also points to a series of analytical and theoretical issues relevant when trying to disentangle the cultural and biological dimensions of social differentiation in the past. [ABSTRACT FROM AUTHOR]

The concept of multi-use of the sea has gained popularity in recent years as a result of ocean space (coastal areas and regions with relatively small sea space in particular) becoming increasingly crowded due to the development of the maritime economy. Competing claims for space can be a source of conflict, however this may also lead to mutual benefits for different users when sustainable combinations are sought. Despite increasing European-wide efforts, on-the-ground knowledge and practice of multi-use are still limited. Therefore, with the aim of investigating opportunities for multi-use development in the European seas, 10 case studies were selected, involving different site-specific contexts. This study analyses the characteristics and development potential for ocean multi-use, integrating results from desk analysis and stakeholder perceptions from different sectors in each of the case study locations. Similarities and differences between various combinations of sea uses are also identified. The results show a high heterogeneity of multi-use opportunities between case studies, with a range of combinations identified. The investigated combinations of maritime uses share an overall balance between factors promoting (drivers) and hindering (barriers) multi-use development. Based on stakeholder opinions, expected benefits (added values) of multi-use implementation outweigh potential negative impacts. Management actions are also proposed to further exploit multi-use potential at a local, regional (sub-national) and national levels. [ABSTRACT FROM AUTHOR]

Both close inbreeding and distant outbreeding may reduce fitness below the level of individuals with intermediate parental relatedness. In the haplodiploid plant-inhabiting predatory mite Phytoseiulus persimilis, which is patchily distributed within and among host plants, fitness is indeed reduced in the short term, i.e. by a single generation of inbreeding. However, in the medium to long term (multiple generations), distant out-breeding should provide for favorable demographic founder effects in isolated populations. We tested this prediction in isolated experimental lineages founded by females mated to a sibling (close inbreeding), a male from the same population (intermediate relatedness) or a male from another population (distant outbreeding) and monitored lineage growth and persistence over four generations. Cross-generationally, lineages founded by distantly outbred females performed the best, i.e. produced the most descendants. However, this was solely due to superior performance from the F2 generation onwards, whereas in the F1 generation, lineages founded by females mated to males from their own population (intermediate relatedness) performed the best, as predicted from short-term in- and out-breeding depression effects. At the genetic level, this result was most likely due to distantly outbred founders introducing higher allelic variability and lower homozygosity levels, counterbalancing inbreeding depression, which inevitably occurs in isolated lineages, from the F2 generation onwards. [ABSTRACT FROM AUTHOR]

Objective: To explore pregnant women’s preferences for birth setting in England. Design: Labelled discrete choice experiment (DCE). Setting: Online survey. Sample: Pregnant women recruited through social media and an online panel. Methods: We developed a DCE to assess women’s preferences for four hypothetical birth settings based on seven attributes: reputation, continuity of care, distance from home, time to see a doctor, partner able to stay overnight, chance of straightforward birth and safety for baby. We used a mixed logit model, with setting modelled as an alternative-specific constant, and conducted a scenario analysis to evaluate the impact of changes in attribute levels on uptake of birth settings. Main outcome measures: Women’s preferences for birth setting. Results: 257 pregnant women completed the DCE. All birth setting attributes, except ‘time to see doctor’, were significant in women’s choice (p<0.05). There was significant heterogeneity in preferences for some attributes. Changes to levels for ‘safety for the baby’ and ‘partner able to stay overnight’ were associated with larger changes from baseline uptake of birth setting. If the preferences identified were translated into the real-world context up to a third of those who reported planning birth in an obstetric unit might choose a midwifery unit assuming universal access to all settings, and knowledge of the differences between settings. Conclusions: We found that ‘safety for the baby’, ‘chance of a straightforward birth’ and ‘can the woman’s partner stay overnight following birth’ were particularly important in women’s preferences for hypothetical birth setting. If all birth settings were available to women and they were aware of the differences between them, it is likely that more low risk women who currently plan birth in OUs might choose a midwifery unit. [ABSTRACT FROM AUTHOR]

The tetraploid wheat species Triticum turgidum and Triticum timopheevii are morphologically similar, and misidentification of material collected from the wild is possible. We compared published sequences for the Ppd-A1, Ppd-B1 and Ppd-G1 genes from multiple accessions of T. turgidum and T. timopheevii and devised a set of four polymerase chain reactions (PCRs), two specific for Ppd-B1 and two for Ppd-G1. We used these PCRs with 51 accessions of T. timopheevii and 20 of T. turgidum. Sixty of these accessions gave PCR products consistent with their taxon identifications, but the other eleven accessions gave anomalous results: ten accessions that were classified as T. turgidum were identified as T. timopheevii by the PCRs, and one T. timopheevii accession was typed as T. turgidum. We believe that these anomalies are not due to errors in the PCR tests because the results agree with a more comprehensive analysis of genome-wide single nucleotide polymorphisms, which similarly suggest that these eleven accessions have been misclassified. Our results therefore show that the accepted morphological tests for discrimination between T. turgidum and T. timopheevii might not be entirely robust, but that species identification can be made cheaply and quickly by PCRs directed at the Ppd-1 gene. [ABSTRACT FROM AUTHOR]

England’s national Improving Access to Psychological Therapies (IAPT) programme advocates stepped care as its organizational delivery of psychological therapies to common mental health problems. There is limited evidence regarding the efficacy of stepped care as a service delivery model, heterogeneity of definition and differences in model implementation in both research and routine practice, hence outcome comparison in terms of effectiveness of model is difficult. Despite sound evidence of the efficacy of low intensity interventions there appears to be a perpetuation of the notion that severity and complexity should only be treated by a high intensity intervention through the continuation of a stratified care model. Yet no psychotherapy treatment is found to be more superior to another, and not enough is known about what works for whom to aid the matching of treatment decision. In the absence of understanding precise treatment factors optimal for recovery, it may be useful to better understand the impact of a service delivery model, and whether different models achieve different outcomes. This study aims to contribute to the discussion regarding the stepped care definition and delivery, and explores the impact on clinical outcomes where different types of stepped care have been implemented within the same service. An observational cohort study analysed retrospective data (n = 16,723) over a 4 year period, in a single IAPT service, where delivery changed from one type of stepped care model to another. We compared the outcomes of treatment completers with a stratified care model and a progression care model. We also explored the assumption that patients who score severe on psychological measures, and therefore are potentially complex, would achieve better outcomes in a stratified model. Outcomes in each model type were compared, alongside baseline factor variables. A significant association was observed between a recovery outcome and model type, with patients 1.5 times more likely to recover in the progression delivery model. The potential implications are that with a progression stepped care model of service delivery, more patients can be treated with a lower intensity intervention, even with initial severe presentations, ensuring that only those that need high intensity CBT or equivalent are stepped up. This could provide services with an effective clinical model that is efficient and potentially more cost effective. [ABSTRACT FROM AUTHOR]

Tick-borne encephalitis virus (TBEV) is the most important tick-transmitted pathogen. It belongs to the Flaviviridae family and causes severe human neuroinfections. In this study, protective efficacy of the chimeric antibody chFVN145 was examined in mice infected with strains belonging to the Far-Eastern, European, and Siberian subtypes of TBEV, and the antibody showed clear therapeutic efficacy when it was administered once one, two, or three days after infection. The efficacy was independent of the TBEV strain used to infect the mice; however, the survival rate of the mice was dependent on the dose of TBEV and of the antibody. No enhancement of TBEV infection was observed when the mice were treated with non-protective doses of chFVN145. Using a panel of recombinant fragments of the TBEV glycoprotein E, the neutralizing epitope for chFVN145 was localized in domain III of the TBEV glycoprotein E, in a region between amino acid residues 301 and 359. In addition, three potential sites responsible for binding with chFVN145 were determined using peptide phage display libraries, and 3D modeling demonstrated that the sites do not contact the fusion loop and, hence, their binding with chFVN145 does not result in increased attachment of TBEV to target cells. [ABSTRACT FROM AUTHOR]

Many disciplines of scholarship are interested in the Relative Age Effect (RAE), whereby age-banding confers advantages on older members of the cohort over younger ones. Most research does not test this relationship in a manner consistent with theory (which requires a decline in frequency across the cohort year), instead resorting to non-parametric, non-directional approaches. In this article, the authors address this disconnect, provide an overview of the benefits associated with Poisson regression modelling, and two managerially useful measures for quantifying RAE bias, namely the Indices of Discrimination and Wastage. In a tutorial-like exposition, applications and extensions of this approach are illustrated using data on professional soccer players competing in the top two tiers of the “Big Five” European football leagues in the search to identify paragon clubs, leagues, and countries from which others may learn to mitigate this form of age-discrimination in the talent identification process. As with OLS regression, Poisson regression may include more than one independent variable. In this way we test competing explanations of RAE; control for unwanted sources of covariation; model interaction effects (that different clubs and countries may not all be subject to RAE to the same degree); and test for non-monotonic versions of RAE suggested in the literature. [ABSTRACT FROM AUTHOR]

African migrants in Europe and continental Africans are disproportionately affected by type 2 diabetes (T2D). Both groups develop T2D at a younger age, and have higher morbidity and mortality from T2D and complications, compared to European populations. To reduce risk, and avoidable disability and premature deaths, culturally congruent and context specific interventions are required. This study aimed to: (a) assess perceptions and knowledge of T2D among Ghanaian migrants in Europe and their compatriots in Ghana and (b) identify specific perceptions and knowledge gaps that might predispose migrants to higher risk of diabetes. Data was gathered through 26 focus groups with 180 individuals, aged 21 to 70, from Amsterdam, Berlin and London and rural and urban Ashanti Region, Ghana. Thematic analysis of the data was informed by Social Representations Theory, which focuses on the sources, content and functions of social knowledge. Three key insights emerged from analysis. First, there was general awareness, across migrant and non-migrant groups, of T2D as a serious chronic condition with life threatening complications, and some knowledge of biomedical strategies to prevent diabetes (e.g healthy eating) and diabetes complications (e.g medication adherence). However, knowledge of T2D prevention and reduction of diabetes complications was not comprehensive. Secondly, knowledge of biomedical diabetes theories and interventions co-existed with theories about psychosocial and supernatural causes of diabetes and the efficacy of herbal and faith-based treatment of diabetes. Finally, migrants’ knowledge was informed by both Ghanaian and European systems of T2D knowledge suggesting enculturation dynamics. We discuss the development of culturally congruent and context-specific T2D interventions for the research communities. [ABSTRACT FROM AUTHOR]

Purpose: 1) To systematically review the available scientific literature regarding specific instruments developed and/or tested in a Spanish population, to assess these PROMs in hip arthroplasty; 2) to carry out a standardized assessment of their measurement properties; and 3) to identify the best tools for use in Spain in an arthroplasty registry context. Methods: A systematic review of PubMed/MEDLINE and EMBASE and CINHAL was done. Furthermore, a standardized assessment of the questionnaires identified using the Evaluating the Measurement of Patient-Reported Outcomes (EMPRO) tool was performed. All developments, validation and studies aiming to assess the measurement properties of PROMs in hip arthroplasty in the Spanish population were included. Data from the questionnaires on metric properties was taken into account to identify the best candidates for inclusion in a register. Results: A total of 853 documents were found. After screening title and abstract, 13 full text documents were reviewed and 8 questionnaires adapted and validated to assess some of the aspects of hip arthroplasty in the Spanish population were identified. After the EMPRO assessment, 4 questionnaires showed suitable properties (WOMAC, OAKHQOL, mini-OAKHQOL and PFH). Conclusions: In Spain, there are a few suitable hip-specific questionnaires currently available to assess PROMs in hip arthroplasty surgery. Some of the more widely used questionnaires, like the OHS and HOOS, have not been validated in the Spanish population until now. Identified tools are suitable for use in a clinical context, however their use in an arthroplasty register is more questionable due to the lack of validation studies of the widely used tools in other registers. [ABSTRACT FROM AUTHOR]

Access to reliable and timely information ensures that decision-makers can operate effectively. The motivations and challenges of parliamentarians and policy-makers in accessing evidence have been well documented in the policy literature. However, there has been little focus on research-providers. Understanding both the demand- and the supply-side of research engagement is imperative to enhancing impactful interactions. Here, we examine the broader experiences, motivations and challenges of UK-based research professionals engaging with research-users relevant to policy-making and scrutiny in the UK using a nationwide online questionnaire. The context of the survey partly involved contributing to the UK Evidence Information Service (EIS), a proposed rapid match-making service to facilitate interaction between parliamentary arenas that use evidence and research-providers. Our findings reveal, at least for this sub-sample who responded, that there are gender-related differences in policy-related experience, motivations, incentives and challenges for research professionals to contribute to evidence-informed decision-making through initiatives such as the EIS. Male and female participants were equally likely to have policy experience; however, males reported both significantly broader engagement with the research-users included in the survey and significantly higher levels of engagement with each research-user. Reported incentives for engagement included understanding what the evidence will be used for, guidance on style and content of contribution, and acknowledgement of contributions by the policymaker or elected official. Female participants were significantly more likely to select the guidance-related options. The main reported barrier was workload. We discuss how academia-policy engagement initiatives can best address these issues in ways that enhance the integration of research evidence with policy and practice across the UK. [ABSTRACT FROM AUTHOR]