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The COVID-19 pandemic has changed life in Europe and globally. The pandemic affects both individuals and the broader society across many domains, including physical and psychological health, the economy and general welfare. The measures taken to counteract the pandemic have significantly altered daily life and, along with the threat of contracting the coronavirus and uncertainties surrounding future developments, created a complex system of stressors with a negative impact on public mental health. This paper aims to outline the ESTSS strategy to address mental health issues related to COVID-19 and focuses on (1) trauma-informed policies, (2) capacity building, (3) collaborative research and (4) knowledge-exchange. To facilitate implementation of a trauma-informed approach and appropriate measures, ESTSS has developed a toolkit of recommendations on mental health and psychosocial assistance to be provided during the different phases of crisis and its aftermath. To promote capacity building, ESTSS offers a certification programme based on a curriculum in psychotraumatology and corresponding on-line training to the European community of mental health professionals. To assure evidence-based approaches and methods tailored to current circumstances, ESTSS has initiated a pan-European research project with international cooperation aimed at studying the mental health consequences of the pandemic, with a focus on psychological trauma and other stress-related reactions. To foster knowledge-exchange, the European Journal of Psychotraumatology (EJPT), the official journal of ESTSS, is publishing a special issue on COVID-19. [ABSTRACT FROM AUTHOR]

Vaccines against human papillomavirus (HPV) are available in Europe since 2006. They have been highly effective in preventing infection and disease caused by the vaccine types. Clinical efficacy data are available for cervical, vulvovaginal and anal precancer and invasive cervical cancer. Disease reduction is best with early vaccination and a coverage of more than 70%. Gender-neutral vaccination provides direct protection for all men and improves the coverage. A good coverage is followed by herd protection of the unvaccinated men and women. School-based programs appear to be most effective; under the age of 15 years, two doses with an interval of 6–12 months are sufficient. From the age of 15 years, the standard regimen with three doses is recommended. A broad catch-up program for young adult women and men improves the effectiveness. The vaccines are also effective in sexually active women and men with previous but cleared infections. Vaccination in addition to local treatment of HPV-related disease appears to reduce recurrent or subsequent HPV-related disease. Combination of HPV vaccination and screening with HPV testing is the most effective approach to prevention of cervical cancer. The screening intervals may increase in the vaccinated cohorts. The upper age limit for vaccination remains to be evaluated, is country specific and depends on cost-effectiveness. The European Society of Gynaecologic Oncology and the European Federation for Colposcopy strongly support gender-neutral vaccination programs for children and young adolescents, with a catch-up program for young adults. • Human papillomavirus (HPV) vaccination is highly effective in preventing cervical disease caused by the vaccine types. • It further reduces the burden of other HPV-related cancers, such as anal, oropharyngeal, vulvar and vaginal cancer. • School-based programs appear to be more cost-effective. • The vaccines have excellent safety profile. [ABSTRACT FROM AUTHOR]

During the past two decades, an increasing number of European countries have introduced language requirements for residency, citizenship, and sometimes even for entry to the country and family reunification. As a result, democratic rights as well as basic human rights have come to depend upon an individual's ability to obtain a certain score on a language test and the consequences of failing may be detrimental. In the field of language testing, this use of language tests is often referred to as "test misuse," yet the term lacks a precise definition in the literature. In this paper we propose a definition of test misuse in relation to language tests for migration purposes and focus particular attention on low-literate adult migrants for whom the requirements pose a considerable barrier. The main purpose of this paper is to address the question why language tests are being misused in migration policies, exploring linguistic, political as well as test theoretical explanations. We suggest that a more central role of test misuse in validity theory is essential in order to remedy its lack of research focus in our field.

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]

Purpose: Digitization is reshaping the functioning of educational institutions. Large attention has been paid to the innovative service models enabled by digitization. However, the implications of digitization on employees' well-being need further investigation. The purpose of this paper is to examine the effects of digitization on psycho-social risks at work in a large sample of European educational institutions. Design/methodology/approach: Secondary data were collected from the third wave of the European Survey of Enterprises on New and Emerging Risks (ESENER). A serial mediation model was designed to obtain evidence on the implications of digitization on the psycho-social risks at work in 3,540 educational institutions. Alongside the direct implications of digitization on psycho-social risks, its indirect effects mediated by occupational health interventions and healthy workplace initiatives were investigated. Findings: Digitization exacerbated psycho-social stressors at work. Increasing time pressures and intensifying work, digitization imperiled the employees' well-being. Occupational health partially mediated the implications of digitization on psycho-social risks. Although healthy workplace interventions seemed to prevent the side effects of digitization on psycho-social risk, its mediating role was not statistically significant. Practical implications: Digitization should be accompanied by interventions aimed at ensuring occupational health and at promoting a healthy workplace to minimize its drawbacks on psycho-social risks. Occupational health creates a greater awareness of the negative effects of digitization on work-related stressors. Healthy workplace initiatives contribute to enhancing the employees' psycho-physical well-being. Originality/value: This study reports the negative implications of digitization on psycho-social risks at work in educational institutions, envisioning some avenues for further development.

Peripartum cardiomyopathy is an idiopathic cardiomyopathy presenting with heart failure secondary to left ventricular systolic dysfunction towards the end of pregnancy or in the months following delivery, where no other cause for heart failure is identified. Outcome varies from full recovery to residual left ventricular systolic dysfunction and even death. Many women return to their physician to acquire information on their long-term prognosis, to seek medical advice regarding contraception, or when planning a subsequent pregnancy. This position paper summarizes current evidence for long-term outcome, risk stratification of further pregnancies and overall management. Based on the best available evidence, as well as the clinical experience of the European Society of Cardiology Study Group on Peripartum Cardiomyopathy members, a consensus on pre- and postpartum management algorithms for women undergoing a subsequent pregnancy is presented. [ABSTRACT FROM AUTHOR]

This article presents results from an extensive systematic and meta-analytical review of the effectiveness of school-based bullying prevention programs. Its main aim is to explore the results of this meta-analysis specifically in regard to variations in the effectiveness of school-bullying programs globally and the effectiveness of specific anti-bullying programs. Our meta-analysis included 100 independent evaluations, and found that, overall, programs were effective in reducing school-bullying perpetration and victimization. In the present paper, we focused on 12 countries (e.g., Italy, Norway, USA, UK), three regions (i.e., Europe, North America, and Scandinavia) and four anti-bullying programs (i.e., KiVa, NoTrap!, OBPP, and ViSC) with multiple evaluations. Our results showed that anti-bullying programs evaluated in Greece were the most effective in reducing bullying perpetration, followed by Spain and Norway. Anti-bullying programs evaluated in Italy were the most effective in reducing bullying victimization, followed by Spain and Norway. Evaluations conducted in North America were the most effective in reducing bullying perpetration, and evaluations conducted in Scandinavia were the most effective in reducing bullying victimization. Evaluations of the Olweus Bullying Prevention Program produced the largest effect sizes for bullying perpetration outcomes, but the NoTrap! Program was the most effective in reducing bullying victimization. We also systematically review the core components of the intervention programs and make recommendations for researchers, practitioners, and policy makers.

Paralleling the global epidemic of obesity figures in the general population, the incidence of maternal obesity (BMI>30kg/m(2) at the start of pregnancy) has been rising over the last world. While most European countries do not systematically report obesity figures in their pregnant population, the prevalence of maternal obesity varies from 7 to 25% and seems strongly related to social and educational inequalities. Obesity during pregnancy represents an important preventable risk factor for adverse pregnancy outcomes and is associated with negative long-term health outcomes for both mothers and offspring. These effects are often aggravated by the high incidence of abnormal glucose tolerance and excessive gestational weight gain found in this group. The main controversies around the management of the obese pregnant women are related to (1) the value of repeated weighing during pregnancy, (2) the optimal gestational weight gain to advise and the lifestyle messages to deliver in order to achieve this, (3) the optimal strategy and timing of screening for gestational diabetes (GDM) and (4) the optimal timing and mode of delivery. These controversies are reviewed in this review, with the exception of screening for gestational diabetes that is discussed extensively elsewhere in this issue (Benhalima et al.). An agenda for research is proposed with the hope that it will catch the attention of policy-makers and funders and ultimately lead to the development of European-wide evidence-based guidelines for clinicians. [ABSTRACT FROM AUTHOR]

During the last decade, scientists have given increasingly frequent warnings about global warming, linking it to mycotoxin-producing moulds in various geographical regions across the world. In the future, more pronounced climate change could alter host resilience and host–pathogen interaction and have a significant impact on the development of toxicogenic moulds and the production of their secondary metabolites, known as mycotoxins. The current climate attracts attention and calls for novel diagnostic tools and notions about the biological features of agricultural cultivars and toxicogenic moulds. Since European climate environments offer steadily rising opportunities for Aspergillus flavus growth, an increased risk of cereal contamination with highly toxic aflatoxins shall be witnessed in the future. On top of that, the profile (representation) of certain mycotoxigenic Fusarium species is changing ever more substantially, while the rise in frequency of Fusarium graminearum contamination, as a species which is able to produce several toxic mycotoxins, seen in northern and central Europe, is becoming a major concern. In the following paper, a high-quality approach to a preventative strategy is tailored to put a stop to the toxicogenic mould- and mycotoxin-induced contamination of foods and feeds in the foreseeable future. [ABSTRACT FROM AUTHOR]

Cybersecurity of production systems is a very topical issue in response to the dangers associated with the very high number of cyber-attacks in Europe. The current digital transformation of the industry associated with the digitalisation of manufacturing brings both the positives associated with increased flexibility and productivity of production, and the negatives associated with the risk of data loss, data alteration or blocking of control systems. Cybersecurity issues are also reflected in the revision of EU harmonisation legislation governing the requirements for placing products on the market or in service. It appears that the issue of cyber security needs to be addressed comprehensively across the entire infrastructure of a manufacturing plant. The present paper focuses on the relationship between machinery security and OT/IT security and presents the results of a study aimed at identifying potential sources of threats in an integrated manufacturing system. [ABSTRACT FROM AUTHOR]

The May 2022 proposal from the European commission for a 'European health data space' envisages advantages for health from exploiting the growing mass of health data in Europe. However, key stakeholders have identified aspects that demand clarification to ensure success. Data will need to be freed from traditional silos to flow more easily and to cross artificial borders. Wide engagement will be necessary among healthcare professionals, researchers, and the patients and citizens that stand to gain the most but whose trust must be won if they are to allow use or transfer of their data. This paper aims to alert the wider scientific community to the impact the ongoing discussions among lawmakers will have. Based on the literature and the consensus findings of an expert multistakeholder panel organised by the European Alliance for Personalised Medicine (EAPM) in June 2022, it highlights the key issues at the intersection of science and policy, and the potential implications for health research for years, perhaps decades, to come. [ABSTRACT FROM AUTHOR]

Compelling evidence supports the causative link between increased levels of low-density lipoprotein cholesterol (LDL-C) and atherosclerotic cardiovascular disease (CVD) development. For that reason, the principal aim of primary and secondary cardiovascular prevention is to reach and sustain recommended LDL-C goals. Although there is a considerable body of evidence that shows that lowering LDL-C levels is directly associated with CVD risk reduction, recent data shows that the majority of patients across Europe cannot achieve their LDL-C targets. In attempting to address this matter, a new overarching concept of a lipid-lowering approach, comprising of even more intensive, much earlier and longer intervention to reduce LDL-C level, was recently proposed for high-risk patients. Another important concern is the residual risk for recurrent cardiovascular events despite optimal LDL-C reduction, suggesting that novel lipid biomarkers should also be considered as potential therapeutic targets. Among them, small dense LDL particles (sdLDL) seem to have the most significant potential for therapeutic modulation. This paper discusses the potential of traditional and emerging lipid-lowering approaches for cardiovascular prevention by targeting sdLDL particles. [ABSTRACT FROM AUTHOR]

Copyright of Varstvoslovje: Journal of Criminal Justice & Security is the property of University of Maribor, Faculty of Criminal Justice & Security and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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]

Copyright of Internal Security is the property of Police Academy in Szczytno and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background As digitalization is progressively permeating all aspects of society, how can be it fruitfully employed to sustain the public health goals of quality, accessibility, efficiency and equity in health care and prevention? In this paper, we reflect on the potential of applying digital tools to public health and discuss some key challenges. Methods We first define 'digitalization' in its broader sense, as well as applied to public health. We then build a conceptual framework where key public health domains are associated to available digital technologies in a matrix that help to identify digital features that bolster public health action. We also provide illustrative data and evidence on the application of digital solutions on selected public health areas. In the second part, we identify the strategic pillars for a successful European strategy for public health digitalization and we outline how the approach being pursued by the European Public Health Association (EUPHA) applies to digital health. Results From a public health perspective, digitalization is being touted as providing several potential benefits and advantages, including support for the transition from cure to prevention, helping to put people and patients at the center of care delivery, supporting patient empowerment and making healthcare system more efficient, safer and cheaper. These benefits are enabled through the following features of digital technologies: (i) Personalization and precision; (ii) Automation; (iii) Prediction; (iv) Data analytics and (v) Interaction. Conclusion A successful European strategy for public health digitalization should integrate the following pillars: political commitment, normative frameworks, technical infrastructure, targeted economic investments, education, research, monitoring and evaluation. EUPHA acknowledges digitalization is an asset for public health and is working both to promote the culture of "public health digitalization", as well as to enable its planning, implementation and evaluation at the research, practice and policy level. [ABSTRACT FROM AUTHOR]

There is overwhelming consensus among policy makers, academics, and professionals about the need to support families in their childrearing tasks. Consequently, European countries have been encouraged to develop family support interventions aimed at guaranteeing children's rights, targeting particularly those children in situations of psychosocial risk. While a certain amount of evidence exists regarding how family support is generally delivered in certain European countries, with a particular focus on parenting initiatives, this paper aims to take existing evidence one step further by providing an updated review focusing on two core components of the Council of Europe's Recommendation on Positive Parenting: families at psychosocial risk as the target population, and family education and support initiatives as the delivery format. The scope of the study was therefore broad, in both geographical and conceptual terms. An online survey was conducted with experts from 19 European countries to gather information regarding how they perceive family education and support initiatives for families at psychosocial risk. Both quantitative and qualitative data were analysed by computing frequencies/percentages and by following a thematic synthesis method, respectively. The results revealed both similarities and disparities as regards provider profiles, intervention characteristics, and quality standards. Practical implications are discussed, such as the need to diversify initiatives for at‐risk families in accordance with the tenets of progressive universalism, the ongoing need for an evidence‐based, pluralistic approach to programmes, and the skills and qualifications required in the family support workforce. This study constitutes a first step towards building a common family support framework at a European level, which would encompass family support and parenting policies aimed at families at psychosocial risk. [ABSTRACT FROM AUTHOR]

Purpose Evidence on implementing effective adolescent mental health promotion and prevention interventions in the European context is underdeveloped. The purpose of this paper is to identify evidence-based mental health promotion and prevention interventions for adolescents that have been developed and/or implemented across the school, community and digital settings in Europe. This review also sought to identify the relevant implementation processes in relation to what works, for whom and under what circumstances.Design/methodology/approach A narrative synthesis of the evidence was conducted which included two stages: a systematic search of studies assessing adolescent mental health promotion and prevention interventions; and a selection of interventions with the most robust evidence base, using pre-defined criteria, that have been either developed and/or implemented in Europe.Findings A total of 16 interventions met the inclusion criteria. The majority of interventions were school-based programmes. The review findings support the delivery of interventions aimed at enhancing young people's social and emotional learning (SEL) and preventing behavioural problems. Results indicate that the effective delivery of SEL interventions on a school-wide basis could provide an important platform on which other universal interventions such as anxiety and bullying prevention, and targeted depression prevention could be developed in a multi-tiered fashion. There were a limited number of studies providing robust evidence on the effectiveness of suicide prevention, digital and community-based interventions.Originality/value This review identifies a number of robust evidence-based promotion and prevention interventions for promoting adolescent mental health. While the interventions have been implemented in Europe, the majority has not been evaluated rigorously and few included detailed information on the quality of programme implementation. Evidence of the effective cross-cultural transferability of these interventions needs to be strengthened, including more systematic research on their implementation across diverse country contexts. [ABSTRACT FROM AUTHOR]

The evidence underpinning public health policy is often of low quality, leading to inconsistencies in recommended interventions. One example is the divergence in national policies across Europe for managing contacts of invasive meningococcal disease. Aiming to develop consistent guidance at the European level, a group of experts reviewed the literature and formulated recommendations. The group defined eight priority research questions, searched the literature, and formulated recommendations using GRADE methodology. Five of the research questions are discussed in this paper. After taking into account quality of evidence, benefit, harm, value, preference, burden on patient of the intervention, and resource implications, we made four strong recommendations and five weak recommendations for intervention. Strong recommendations related not only to one question with very low quality of evidence as well as to two questions with moderate to high quality of evidence. The weak recommendations related to two questions with low and very low quality of evidence but also to one question with moderate quality of evidence. GRADE methodology ensures a transparent process and explicit recognition of additional factors that should be considered when making recommendations for policy. This approach can be usefully applied to many areas of public health policy where evidence quality is often low. [ABSTRACT FROM AUTHOR]

Across Europe there are growing concerns about Islamophobia and far-right and anti-democratic movements. Until Anders Behring Breivik’s July 2011 attacks in which 77 died, Norway’s vulnerability was not perceived as great as that of other jurisdictions. Breivik declared his abhorrence of multiculturalism but also drew the world’s attention to intolerance and xenophobia in Europe, increasingly directed towards Muslims. In response, Prime Minister Stoltenberg spoke widely of ‘the new Norwegian we’, cautioning against exclusionary discourses and underlining that minorities are an equal part of Norwegian society. This paper examines education policy in the context both of extreme right political activity and national and international debates about nationalism and cosmopolitanism, considering ways in which policy supports an inclusive notion of nationhood, and ways in which it promotes an exclusive model of national identity. Drawing on framing questions from the International Association for the Evaluation of Educational Achievement’s 1995 civic education study, relating to national identity and social cohesion, it examines how programmes address social cohesion, human rights, cultural diversity, and conceptualise minorities. It assesses the effectiveness of cross-curricular approaches to contribute to justice and equality and challenge racism in a multicultural society, proposing an inclusive model of education for cosmopolitan citizenship, which incorporates diversity. [ABSTRACT FROM PUBLISHER]

This paper investigates how to address non-traditional security (NTS) challenges where the principal concern is to safeguard individuals. Since unilateral action cannot effectively deal with piracy, terrorism, cross-border conflicts, etc, there is a need for multilateral responses. Yet, time and again, the insistence on non-interference in the domestic affairs of countries has proven a major obstacle. European Union members, conceptualizing sovereignty in terms of ‘constitutional independence’, have made some progress addressing these challenges. Although, recently, some progress has also been made in Asia Pacific, there sovereignty often is still being used as a semantic weapon. Since states not only have rights but obligations, I argue, there is a need for a careful recalibration of sovereignty-related norms that stand in the way of improved human rights. Focusing on a specific issue area within NTS challenges, the Responsibility to Protect, I illustrate how a recalibration of sovereignty-related norms might take place. [ABSTRACT FROM PUBLISHER]

Whether we wish to acknowledge it or not, trust issues permeate all security policy deliberations, including recent discussions at United Nations headquarters focused on building acceptance of the Responsibility to Protect (RtoP) norm and laying out plans for the full implementation of all three of its programmatic 'pillars.' This paper assesses resources for and commitments to trust building in three core areas - trust in the viability of the norm itself, trust in the persons most closely associated with the norm, and trust in the institutions (UN and Regional Bodies) projected to 'house' the norm and oversee all phases of its implementation. As this implementation process moves from consideration of state-focused, 'first pillar' preventive and early warning capacities to 'third pillar,' last-resort, direct responses to threats of atrocity crimes, the need for durable and dependable bonds of trust between RtoP advocates, diplomats and policymakers becomes more acute. [ABSTRACT FROM AUTHOR]

A literature review was conducted to facilitate allied health professionals' implementation of the recommendations made by the Prevention of Falls Network Europe (ProFaNE) (Yardley et al 2007a) on promoting older people's engagement in activities to prevent falls. The falls prevention literature was searched for relevant papers to aid allied health professionals' choice of strategies and to inspire ideas about how to implement ProFaNE's recommendations in everyday practice. Suggestions for each of the six ProFaNE recommendations are made, which may in turn promote older people's adherence to falls prevention interventions [ABSTRACT FROM AUTHOR]

Copyright of Globalizations is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Tens and hundreds of thousands of disturbances occur annually in modern power systems. The overwhelming majority of them are eliminated by relay protection devices and other automatic systems and by the actions of the dispatching personnel. A small fraction of the emergencies (tens of cases in such large power interconnections as those in the United States and Canada, Europe, and the United Power System (UPS) of Russia) result in significant system failures, sometimes of a cascading nature. They are consequences of unusual primary disturbances, failures of automatic emergency control systems, protection device malfunctions, and errors by personnel, but do not cause extreme consequences for the power system and the consumers. Of these, only some rare failures--blackouts--become catastrophes with severe long-term consequences for the national economies and population. Recent blackouts in North America, Europe, Russia, and other countries require specialists once again to pay closer attention to the blackout phenomenon. It is often believed that the philosophy of preventing blackouts should be based on dispatching personnel training, wide-area system visibility, and better computer models for the analysis of the stability and security of power systems. The authors of this paper also think that in emergency situations of a cascading nature, automatic emergency control systems should play a major role. A confirmation for this statement is the fact that from 1975 to 2005 there were no blackouts in the UPS of Russia (where automatic emergency control systems are widely used). At the same time, the Moscow blackout demonstrated that the growing problems in the Russia's UPS (such as aging equipment and load growth) made it also vulnerable to major blackouts. This stresses again that the electrical power industry faces common global problems and that a global effort, cooperation, and exchange of the best practices are needed to prevent blackouts. This paper describes the Russian principles and systems of dispatch and emergency control--a multilevel defense system protecting the Russian power grefid from developing cascade failures. [ABSTRACT FROM AUTHOR]

Suicides and trespassing accidents result in more than 3800 fatalities in Europe, representing 88% of all fatalities occurring within the EU railway system. This paper presents a problem-solving model, which consists of a multistep approach structuring the analysis of a suicide or trespass-related problem on the railways. First, we present the method used to design, evaluate and improve the problem-solving model. Then we describe the model in detail: it comprises six steps with several subsequent actions, and each action is approached through a checklist of prompting questions and possible answers. At the end, we discuss the added value of this model for decision makers and its usability in the selection of optimal prevention measures. [ABSTRACT FROM AUTHOR]

Purpose Of Review: The aim of this paper is to evaluate recent literature on valproic acid (VPA) in women and girls of childbearing age and to emphasize new findings.Recent Findings: Recent research confirms VPAs teratogenicity and risk of hormone disruption. VPA exposure in utero increases the risk for a variety of major congenital malformations (MCMs), reduced IQ and behavioral problems. In girls and women, VPA increases the risk of hormone abnormalities, obesity, and polycystic ovarian syndrome (PCOS). Despite guidelines recommending caution, VPA use continues to be prescribed to reproductive-aged women and girls. Despite significant and well-documented risk, adherence to guidelines in VPA use in reproductive-aged girls and women remains low. [ABSTRACT FROM AUTHOR]

In order to tackle the increasing problem of malnutrition ( i.e. protein-energy malnutrition) in the older population, the Joint Action Malnutrition in the Elderly ( MaNu EL) Knowledge Hub has been recently launched as part of the Strategic Research Agenda of the Joint Programming Initiative ( JPI) A Healthy Diet for a Healthy Life ( HDHL). This paper introduces this new European initiative and describes its objectives and design. The MaNu EL consortium consists of 22 research groups from seven countries (Austria, France, Germany, Ireland, Spain, The Netherlands and New Zealand). The Consortium aims to extend scientific knowledge; strengthen evidence-based practice in the management of malnutrition in older persons; build a sustainable, transnational, competent network of malnutrition experts; and harmonise research and clinical practice. MaNu EL is built on five interconnected work packages that focus on (i) defining treatable malnutrition; (ii) screening of malnutrition in different settings; (iii) determinants of malnutrition; (iv) prevention and treatment of malnutrition; and (v) policies and education regarding malnutrition screening and treatment in older persons across Europe. Systematic literature reviews will be performed to assess current research on malnutrition and identify potential knowledge gaps. Secondary data analyses of nutritional intervention trials and observational studies will also be conducted. Using Web-based questionnaires, MaNu EL will provide insight into current clinical practice, policies and health professionals' education on malnutrition and will make recommendations for improvement. MaNu EL is being advised by a stakeholder board of five experts in geriatric nutrition who represent relevant European professional societies. [ABSTRACT FROM AUTHOR]

This paper discusses the current tendency in the EU to promote a criminal justice model focusing on prevention. In doing so, I examine the EU's internal security agenda with regard to criminal law and assess the extent to which this strategy fits the picture of an European Area of Freedom, Security and Justice placing equal value on freedom, security and justice. I also consider the external dimension to the EU's security program by examining the extent to which the EU benefits from the dual layer of security action provided for in the Treaty on the Functioning of the European Union and the Treaty of the European Union, or whether such double action creates unnecessary complexity. I contrast the current aspirations for more security and prevention in EU criminal law with the Commission's recent communication on the effective implementation of EU policies through criminal law. This communication stresses the importance of ensuring coherence in EU criminal law, while also respecting national diversity and serving the citizens. In addition, I discuss the extent to which the EU's promotion of preventive criminal justice risks turning the EU into a disintegrator instead of an agent of European values (depending on what these values are intended to mean in practice). [ABSTRACT FROM PUBLISHER]

When states over- and under-react to perceived transboundary threats, their mistakes can have equally harmful consequences for the citizens they mean to protect. Yet, studies of intelligence and conventional foreign policy tend to concentrate on cases of under-reaction to threats from states, and few studies set out criteria for identifying cases of under- and over-reaction to other kinds of threats or investigate common causes. The paper develops a typology of over- and under-reaction in foreign policy revolving around threats assessment, response proportionality and timeliness. Drawing on pilot case studies, the contribution identifies combinations of factors and conditions that make both over- or under-reaction more likely. It is hypothesized that three factors play significant causal roles across the cases: (1) institutions have learned the wrong lessons from previous related incidents; (2) decision-making is organized within institutional silos focused on only one kind of threat; and (3) actors have strong pre-existing preferences for a particular outcome. [ABSTRACT FROM PUBLISHER]

The repositioning of risk and resilience within the social work and mental health agenda is examined in this paper through a consideration of the social exclusion of vulnerable children and adults living in Eastern Europe and Central Asia (EECA). There is a pressing need in this region for the development of better conceptions and cultural adaptations of risk and resilience models. An important task is spelling out the implications for effective prevention and intervention programs, and for practitioners and service users in terms of an inclusive, person-centred, and emancipatory practice. The societies of the EECA region may be understood as comprising a distinctive form of risk society, distinguished from Western counterparts by their adverse risk levels, and by their emancipatory potential. Strategies based on user inclusion and participatory action require to be fashioned, along with the development of the social work profession, to facilitate the empowerment of users in the EECA region. [ABSTRACT FROM AUTHOR]

In recent years, the fight against foreign bribery has become a critical concern for many European governments. However, empirical research on the way that internationally active firms respond to the increased requirements of their organizational environment regarding corruption prevention is quite rare. Based on the neo-institutional theory, this paper addresses this issue using a sample of 510 internationally active Swiss firms. The findings indicate that firms do not anticipate the risk of potentially being confronted with corruption when operating in foreign countries where the level of corruption is perceived to be high. On the contrary, it seems that firms tend to follow a reactive approach toward the management of corruption risks in foreign countries and only implement measures against corruption if they have actually been confronted with the issue. [ABSTRACT FROM AUTHOR]

Although both improved risk communication and the building of social capacities have been advocated as vital ways to increase societies' resilience towards natural hazards across the world, the literature has rarely examined the ways in which these two concepts may integrate in theory and practice. This paper is an attempt to address this gap in a European context. It begins with a conceptual discussion that unites the literature on risk communication with the literature on social capacity building. We then use the insights from this discussion as a basis to conduct a review of 60 risk communication practices from across Europe. This review indicates a gap between theory and practice because, whilst the literature highlights the importance of integrated and coordinated communication campaigns featuring both a one-way transfer and a two-way dialogue between the public, stakeholders and decision-makers, the majority of the communication practices reviewed here appear to be relatively disparate initiatives that rely on one-way forms of communication. On the basis of these findings, we conclude by making some recommendations for the way in which such practices could be improved in order to be more supportive of social capacities across Europe. [ABSTRACT FROM AUTHOR]

The purpose of this paper was to present the current knowledge on the prevention of group B streptococcus (GBS) neonatal infections and the status of prevention policies in European countries and to present the DEVANI pan-European program, launched in 2008. The aim of this program was to assess the GBS neonatal infection burden in Europe, to design a new vaccine to immunize neonates against GBS infections, to improve the laboratory performance for the diagnosis of GBS colonization and infection, and to improve the methods for the typing of GBS strains. The current guidelines for GBS prevention in different countries were ascertained and a picture of the burden before and after the instauration of prevention policies has been drawn. After the issue of the Centers for Disease Control and Prevention (CDC) guidelines, many European countries have adopted universal screening for the GBS colonization of pregnant women and intrapartum prophylaxis to colonized mothers. Nevertheless, some European countries continue advocating the risk factor approach to GBS prevention. Most European countries have implemented policies to prevent GBS neonatal infections and the burden of the disease has decreased during the last several years. Nevertheless, further steps are necessary in order to develop new strategies of prevention, to improve microbiological techniques to detect GBS colonization and infection, and to coordinate the prevention policies in the EU. [ABSTRACT FROM AUTHOR]

Background. In 2009, the European Randomized Study of Screening for Prostate Cancer (ERSPC) was one of two studies to report interim data on the effect of screening for prostate cancer (PC) on the disease specific mortality. Contradictory results caused considerable discussion and misunderstanding in secondary literature. Methods. This document is based on a non systematic review of recent evidence for and against screening for PC, specifically considering three recently published randomized screening trials [1--3]. Results. The ERSPC data are based on a core age group of 162 387 men, aged 55--69 years, who were identified through population registries in seven European countries. Men were randomized between a screening group that received screening at an average of once every four years and a control group. After a median follow-up of nine years, a reduction in the rate of death from PC by 20% was shown which increased to 31% after adjusting for non-compliance and contamination. Overdetection and subsequent overtreatment (with a number needed to treat (NNT) of 48) are considered to be the major down sides of screening. The recently published 14-year results have shown that these down sides strongly depend on the duration of follow-up. In response to the outcomes of the ERSPC, several points of discussion have been brought up by various authors concerning the usefulness of screening considering benefits, harms and costs, the methodology of the ERSPC and the interpretation of its outcomes. Important issues to address regarding PC screening are addressed. Conclusions. This paper sheds a light on the controversial points of the ERSPC as well as on the priority issues of PC screening. On July 2, 2010 the Swedish section of ERSPC (Gööteborg screening trial) published their results with a median follow-up of 14 years. With longer follow-up the data confirm the trend seen in improvement of PC mortality and suggest much more favorable future outcomes also with respect to the NNT to prevent one PC death. [ABSTRACT FROM AUTHOR]

Reducing alcohol-related harm in young people is a major priority across Europe. Much alcohol use and associated harm in young people occurs in public drinking environments. This review aims to identity environmental factors in drinking establishements that are associated with increased alcohol consumption and associated harm and to understand the extent of study in this area across Europe. A systematic literature search identified studies that had explored associations between physical, staffing and social factors in drinking environments and increased alcohol use or alcohol-related harm. Fifty-three papers were identified, covering 34 studies implemented in nine countries. Most studies had been implemented in non-European countries and many had collected data more than a decade prior to the review. The majority had used observational research techniques. Throughout the studies, a wide range of physical, staffing and social factors had been associated with higher levels of alcohol use and related harm in drinking environments. Factors that appeared particularly important in contributing to alcohol-related problems included a permissive environment, cheap alcohol availability, poor cleanliness, crowding, loud music, a focus on dancing and poor staff practice. However, findings were not always consistent across studies. Drinking establishments, their management and the behaviours of the young people who use them vary widely across Europe. While international research shows that environmental factors in drinking settings can have an important influence on alcohol-related harm, there is currently a scarcity of knowledge on the relevance and impacts of such factors in modern European settings. Developing this knowledge will support the implementation of strategies to create drinking environments in Europe that are less conducive to risky drinking and alcohol-related harm. [ABSTRACT FROM AUTHOR]

Abstract: Europe has been subject to tremendous changes in terms of flexibility of work and labour in response to macro trends like globalisation and the resulting fierce market competition. Such changes in the world of work can give rise to new safety risks. Although the effects of “changing work environment” are fairly documented for psychosocial and ergonomic risks, the subsequent effects on occupational safety are less investigated. This paper sets a general framework on changing work environment presenting prominent descriptions by various institutes. New trends in work environment including new work organisational forms, new contractual relationships, new technologies and changes in the workforce are briefly presented. This paper reviews existing evidence on the effects of changing work environment on safety and occupational accidents. It further suggests an underlying mechanism explaining these effects that is based on organizational factors. Finally it discusses safety prevention challenges to policy makers. In conclusion a sustainable work system is suggested as an alternative to intensive systems. [Copyright &y& Elsevier]

European animal disease policy seems to find its justification in a “harm to other” principle. Limiting the freedom of animal keepers—e.g., by culling their animals—is justified by the aim to prevent harm, i.e., the spreading of the disease. The picture, however, is more complicated. Both during the control of outbreaks and in the prevention of notifiable, animal diseases the government is confronted with conflicting claims of stakeholders who anticipate running a risk to be harmed by each other, and who ask for government intervention. In this paper, we first argue that in a policy that aims to prevent animal diseases, the focus shifts from limiting “harm” to weighing conflicting claims with respect to “risks of harm.” Therefore, we claim that the harm principle is no longer a sufficient justification for governmental intervention in animal disease prevention. A policy that has to deal with and distribute conflicting risks of harm needs additional value assumptions that guide this process of assessment and distribution. We show that currently, policies are based on assumptions that are mainly economic considerations. In order to show the limitations of these considerations, we use the interests and position of keepers of backyard animals as an example. Based on the problems they faced during and after the recent outbreaks, we defend the thesis that in order to develop a sustainable animal disease policy other than economic assumptions need to be taken into account. [ABSTRACT FROM AUTHOR]

Prevention in Norway and in Europe more generally, is a multidisciplinary collaboration between many professions, organized largely in municipalities, villages, and counties. This paper addresses three questions: • What relevant legislation on prevention currently exists? • What are the perspectives of ongoing activities and their intentions? • What are the strategic issues? Since 1984, Norway's primary health care system has been based on the Local Authority Health Care Act. In 1995, the Communicable Disease Control Act replaced the chapter on communicable diseases in the old Public Health Act of 1860. The new act emphasizes communicable disease control as more of a right rather than a duty for both the individual and the population. In Europe, future public health policy, practice, and research will need to focus not only causes of disease and injuries, but also on factors promoting health. [ABSTRACT FROM AUTHOR]

Background: Tuberculosis (TB) is a communicable disease that is a major cause of death and one of the leading causes of death worldwide. Currently, there is no analyzed data to examine the financial profile of TB by country, continent, and year; this article analyzed TB prevention, diagnosis, and treatment financial profile during the last two decades. Methods: Original research, reviews, and governmental databases are analyzed to present the financial profile of TB. Results: Analyzed data showed Europe (23137.133), Asia (20137.073), and Africa (15237.973) had the most allocated funds (US $ million), and Oceania (236.702), and America (4745.043) had the lowest allocated fund (US $ million) during 2006–2021. Additionally, the allocation of funds (domestic funds, global funds, and grants [excluding global funds]) in different countries and proper planning for TB eradication has caused that in the last two decades, the slope of the confirmed cases and deaths graph line is negative. Conclusion: The number of confirmed cases and deaths reported globally is decreasing. The trend lines showed that the assigned funds are increasing, indicating that the TB eradication plan can be apprehended soon. [ABSTRACT FROM AUTHOR]

Background: Early identification of AMD can lead to prompt and more effective treatment, better outcomes, and better final visual acuity; several risk scores have been devised to determine the individual level of risk for developing AMD. Herein, the Delphi method was used to provide recommendations for daily practice regarding preventive measures and follow-up required for subjects at low, moderate, and high risk of AMD evaluated with the Simplified Test AMD Risk-assessment Scale (STARS®) questionnaire. Methods: A steering committee of three experts drafted and refined 25 statements on the approach to be recommended in different clinical situations [general recommendations (n = 2), use of evaluation tools (n = 4), general lifestyle advice (n = 3), and AREDS-based nutritional supplementation (n = 5)] with the help of a group of international experts, all co-authors of this paper. Thirty retinal specialists from Europe and the US were chosen based on relevant publications, clinical expertise, and experience in AMD, who then provided their level of agreement with the statements. Statements for which consensus was not reached were modified and voted upon again. Results: In the first round of voting, consensus was reached for 24 statements. After modification, consensus was then reached for the remaining statement. Conclusion: An interprofessional guideline to support preventive measures in patients at risk of AMD based on STARS® scoring has been developed to aid clinicians in daily practice, which will help to optimize preventive care of patients at risk of AMD. [ABSTRACT FROM AUTHOR]

Background: Delayed, large-volume bacterial culture and amotosalen/ultraviolet-A light pathogen reduction are effective at reducing the risk of bacterial proliferation in platelet concentrates (PCs). Hemovigilance programs continue to receive reports of suspected septic transfusion reactions, most with low imputability. Here, we compile national hemovigilance data to determine the relative efficacy of these interventions.Study Design and Methods: Annual reports from the United Kingdom, France, Switzerland, and Belgium were reviewed between 2005 and 2016 to assess the risk of bacterial contamination and septic reactions.Results: Approximately 1.65 million delayed, large-volume bacterial culture-screened PCs in the United Kingdom and 2.3 million amotosalen/ultraviolet-A-treated PCs worldwide were issued with no reported septic fatalities. One definite, one possible, and 12 undetermined/indeterminate septic reactions and eight contaminated "near misses" were reported with delayed, large-volume bacterial cultures between 2011 and 2016, for a lower false-negative culture rate than that in the previous 5 years (5.4 vs. 16.3 per million: odds ratio, 3.0; 95% confidence interval, 1.4-6.5). Together, the Belgian, Swiss, and French hemovigilance programs documented zero probable or definite/certain septic reactions with 609,290 amotosalen/ultraviolet-A-treated PCs (<1.6 per million). The rates were significantly lower than those reported with concurrently transfused, nonpathogen-reduced PCs in Belgium (<4.4 vs. 35.6 per million: odds ratio, 8.1; 95% confidence interval,1.1-353.3) and with historic septic reaction rates in Switzerland (<6.0 vs. 82.9 per million: odds ratio, 13.9; 95% confidence interval, 2.1-589.2), and the rates tended to be lower than those from concurrently transfused, nonpathogen-reduced PCs in France (<4.7 vs. 19.0 per million: odds ratio, 4.1; 95% confidence interval, 0.7-164.3).Conclusion: Pathogen reduction and bacterial culture both reduced the incidence of septic reactions, although under-reporting and strict imputability criteria resulted in an underestimation of risk. [ABSTRACT FROM AUTHOR]

Although rabies in domestic and wild animals represents a significant threat to public health and can cause economic losses among livestock, there are very few studies that examine the economics of rabies in animals. The literature that does exist can be characterised as poorly documented estimates of costs, with insufficient information to allow replication of the analyses. Most papers have numerous 'violations' of the standard recommended procedures for assessing burden of disease and the cost and benefits of interventions. For example, most studies do not distinguish between financial charges and true economic costs. Further, despite the fact that controlling rabies in animal populations is often a multi-year task, only a few papers contain a multi-year framework, complete with discounting of future costs and benefits. Globally, dog-transmitted rabies represents the largest threat to human health. In order to prevent the transmission of rabies in a dog population, it is theoretically necessary to vaccinate a minimum of 60 to 70% of the dogs. Even countries with potentially sufficient resources, however, do not often meet and sustain these rates. One reason for such failure might be that individual dog owners might feel that it is too expensive to vaccinate their pets. Recent estimates in the US of the cost of vaccinating dogs range from $US16 to $US24 per dog. In developing countries, estimates range from $US0.52 in Thailand, to $US1.19 in the Philippines, to $US2.70 in Malawi. None of these estimates include indirect costs accured by the pet owners. Lethal methods of dog population control are even more expensive, and attempting to control rabies by reducing dog populations has not worked for any extended period. Rabies in livestock is often reported, but the impact in the US and most developed countries appears relatively small. Vampire bat-transmitted rabies in Latin America appears to be the most serious rabies problem in livestock. The largest cost due to wildlife rabies is the cost of vaccinating domestic animals, both large and small. In the US, domestic animals face multiple sources of wildlife rabies. Attributing the entire cost of vaccinating domestic animals to 1 species can result in the over estimation of the benefits of immunising a given wildlife population via vaccine-laden baits. For example, despite a definite decline in the number of rabid foxes, it has been difficult to obtain the promised benefits of using oral vaccines in Europe to control fox rabies. Other authors maintain that the use of oral vaccines to control fox rabies is cost beneficial, but there are no convincing data supporting that claim. Additionally, vaccinating raccoons with an oral vaccine requires approximately 4 times more vaccine-laden baits vaccinating foxes, which makes it highly questionable if it would be cost beneficial to use oral vaccine to attempt raccoon rabies elimination in areas where it is already enzootic. The economics of using oral vaccines to prevent raccoon rabies invading uninfected areas has yet to be examined. [ABSTRACT FROM AUTHOR]

The aim of this study was to analyse the relationship between physical activity and the incidence of dementia in a cohort of people aged 50 years or older without dementia from different countries in Europe between the years 2013 and 2015. Prospective longitudinal design study (2013-2015) with a sample of 46,141 people without dementia in 2013 who participated in the SHARE project in waves 5 and 6, where 15 European countries participated. We defined dementia as a self-report of Alzheimer's disease, organic brain syndrome, senility, or any other serious memory impairment during follow-up. The frequency of moderate, vigorous and moderate-to-vigorous physical activity in 2013 was obtained from a validated questionnaire. Incidences of dementia by year (between 2013 and 2015) were calculated for each category of physical activity. Poisson regression models with robust variance were fitted for the association between physical activity and dementia. The incidence of dementia was 7.4 [95%CI = 6.8-7.9] cases per 1000 persons per year. Very frequent moderate physical activity is a protective factor for dementia independently of the frequency of vigorous physical activity and inversely. The risk of dementia was 2.36 [95%CI = 1.77-3.14] higher in people who hardly ever, or never did moderate-to-vigorous physical activity comparing to people engaged in it more than once a week independently of the baseline cognitive level. Physical activity is associated with the incidence of dementia in people aged 50 and over in both men and women in Europe. [ABSTRACT FROM AUTHOR]

Objectives To assess the efficacy of comprehensive geriatric assessment ( CGA) in prevention of delirium after hip fracture. Design Systematic review and metaanalysis. Setting Ward based models on geriatrics wards and visiting team based models on orthopaedics wards were included. Participants Four trials (three European, one U.S.; 973 participants) were identified. Two assessed ward-based, and two assessed team-based interventions. Measurements MEDLINE, EMBASE, CINAHL and Psyc INFO databases; Clinicaltrials.gov; and the Central Register of Controlled Trials were searched. Reference lists from full-text articles were reviewed. Incidence of delirium was the primary outcome. Length of stay, delirium severity, institutionalization, long-term cognition and mortality were predefined secondary outcomes. Duration of delirium was included as a post hoc outcome. Results There was a significant reduction in delirium overall (relative risk ( RR) = 0.81, 95% confidence interval ( CI) = 0.69-0.94) in the intervention group. Post hoc subgroup analysis found this effect to be preserved in the team-based intervention group ( RR = 0.77, 95% CI = 0.61-0.98) but not the ward-based group. No significant effect was observed on any secondary outcome. Conclusion There was a reduction in the incidence of delirium after hip fracture with CGA. This is in keeping with results of non-randomized controlled trials and trials in other populations. Team-based interventions appeared superior in contrast to the Ellis CGA paper, but it is likely that heterogeneity in interventions and population studied affected this. [ABSTRACT FROM AUTHOR]

Background: Prior research has solely focused on the association between handgrip strength and risk of depression in single countries or general populations, but more knowledge is required from wider-spread cohorts and target populations.Aims: This study aimed to investigate the association between handgrip strength and risk of depression using repeated measures in adults aged 50 years and over.Method: Data on handgrip strength and risk of depression were retrieved from the Survey of Health, Ageing and Retirement in Europe (SHARE) waves 1, 2, 4, 5, 6 and 7, using a hand dynamometer (Smedley, S Dynamometer, TTM) and the EURO-D 12-item scale, respectively. Time-varying exposure and covariates were modelled using both Cox regression and restricted cubic splines.Results: A total of 115 601 participants (mean age 64.3 years (s.d. = 9.9), 54.3% women) were followed-up for a median of 7.3 years (interquartile range: 3.9-11.8) and 792 459 person-years. During this period, 30 208 (26.1%) participants experienced a risk of depression. When modelled as a continuous variable, we observed an inverse significant association for each kg increase of handgrip strength and depression up to 40 kg in men and up to 27 kg in women.Conclusions: Being physically strong may serve as a preventive factor for depression in older adults, but this is limited up to a maximum specific threshold for men and women. [ABSTRACT FROM AUTHOR]