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The development of adolescent health and medicine as a medical discipline lags behind in Europe compared with other regions of the world. This study aims to evaluate the structure and content of adolescent medicine and health training curricula for medical students, paediatricians, and other primary care physicians in the European region. A questionnaire survey was sent by e-mail to experts in the field from 36 European countries, addressing the content of adolescent health issues. Data was obtained from all 36 countries. At the undergraduate level, seven countries reported some mandatory stand-alone teaching (sessions dealing specifically with adolescents), while seven countries reported optional stand-alone teaching. In only 7 out of 36 countries were issues critical to adolescents covered as stand-alone sessions. At the postgraduate level, 15 countries delivered stand-alone mandatory training sessions to primary, secondary, or tertiary care paediatricians, covering most of the five critical areas listed in the questionnaire. In another 13 countries, such sessions were not mandatory and were inexistent in eight of them. The coverage among school physicians was similar but was much lower among general practitioners.Conclusion: Paediatric associations and academic institutions should advocate for a better coverage of adolescent health and medicine in the training curricula of health care providers. What is known: • In most European countries, adolescent medicine is still poorly represented as a discipline. • Experts have recently published recommendations regarding what form the structure and content of a training curriculum in this field should take. What is new: • This paper gives information on the extent and content of training in adolescent medicine and health as currently offered within under- and postgraduate European training curricula, in terms of stand-alone mandatory (versus optional) sessions. • In many European countries, both medical students and residents are poorly exposed to the basic knowledge and skills pertaining to adolescent health care. [ABSTRACT FROM AUTHOR]

Eurasian perch (Perca fluviatilis) and pikeperch (Sander lucioperca) have been identified as candidates for production in aquaculture with the potential to deliver products of high quality and value and associated market acceptance. Current aquaculture production of these species predominately targets niche, premium markets, and its up-scaling is still limited due to several bottlenecks. This paper summarizes the most important and recent technological aspects and innovations regarding broodstock management, controlled reproduction, larval and early juvenile stages, nursery, and grow-out culture including methods for the improvement of growth and production in percid fishes. This review study also attempts to identify and outline further prospects and challenges for the future development of the percid aquaculture sector in Europe. [ABSTRACT FROM AUTHOR]

For a long time, the Eneolithic attribution of the Rudki-type double spiral ornaments was contested by a wide academic audience, and therefore, this new and extraordinary category of the copper metalwork seemed to have fallen into scientific oblivion. In this paper, we contribute to the debate about cultural attribution of the Rudki-type double spiral ornaments considering their chemical and isotope characteristics (using ED XRF and MC-ICP-MS) and the manufacturing technology (OM, X-ray, CT). Noticeably, this study represents the first documented implementation of the lead isotope analysis (LIA) for the Eneolithic metalwork from Poland. The new scientific analyses give ground to the hypothesis that the Rudki-type double spiral ornaments were produced by the Baden culture metalworker(s) who practiced somewhere in the Carpathian Basin and who have used copper ore mined in the Slovak Ore Mountains (Špania Dolina–Banská Bystrica–Kremnica mine complex). These ornaments were redistributed towards the northern ecumene of the Baden culture complex. The new owners, the Funnel Beaker (TRB) culture communities from the region of modern Poland, deposited the ornaments in hoards (Kałdus, Przeuszyn and Rudki) during the mid-4th millennium BC. The results, furthermore, indicate that the so-called Baden spiral metalwork package must be now complemented by the Rudki-type double spiral ornaments. Remarkably, this package also found an echo in pottery decoration, as documented by a narrative scene incised on an amphora from Kałdus, which could be also interpreted as one of the earliest known proofs for the wagon transport in Europe, alongside the famous ones reported from Bronocice or Flintbek. [ABSTRACT FROM AUTHOR]

Foresters from many countries are seeking for tree species or provenances able to cope with expected climate change. While it becomes clear that some temperate tree species will increasingly suffer from climate warming, the fate of the ecologically and economically important silver fir (Abies alba Mill.) remains uncertain and debated because the ecological requirements of this species, as well as its resilience to drought, are still unclear. On the one hand, paleoecological studies reveal that this species was widely distributed under much warmer climate, suggesting a high potential to cope with ongoing and future climate warming. On the other hand, species distribution models generally predict a strong decline of its climatic suitability in the future. This paper aims to clarify the potential of this species to thrive in central and western Europe under predicted climate warming by reviewing the knowledge gained from different fields. Based on insight from different fields, we argue that silver fir has a great potential to thrive under warmer conditions in western and central Europe provided sufficient rainfall, as forecasted by climate models for most regions by 2100. For instance, dendroecological studies demonstrate that silver fir is more resistant and resilient to drought compared to co-occurring species such as Norway spruce, European beech and larch. The most prominent obstacle for increasing the proportion of fir in mixed forests nowadays is ungulate browsing that often prevents its upgrowth. [ABSTRACT FROM AUTHOR]

The majority of houses in the Groningen gas field region, the largest in Europe, consist of unreinforced masonry material. Because of their particular characteristics (cavity walls of different material, large openings, limited bearing walls in one direction, etc.) these houses are exceptionally vulnerable to shallow induced earthquakes, frequently occurring in the region during the last decade. Raised by the damage incurred in the Groningen buildings due to induced earthquakes, the question whether the small and sometimes invisible plastic deformations prior to a major earthquake affect the overall final response becomes of high importance as its answer is associated with legal liability and consequences due to the damage-claim procedures employed in the region. This paper presents, for the first time, evidence of cumulative damage from available experimental and numerical data reported in the literature. Furthermore, the available modelling tools are scrutinized in terms of their pros and cons in modelling cumulative damage in masonry. Results of full-scale shake-table tests, cyclic wall tests, complex 3D nonlinear time-history analyses, single degree of freedom (SDOF) analyses and finally wall element analyses under periodic dynamic loading have been used for better explaining the phenomenon. It was concluded that a user intervention is needed for most of the SDOF modelling tools if cumulative damage is to be modelled. Furthermore, the results of the cumulative damage in SDOF models are sensitive to the degradation parameters, which require calibration against experimental data. The overall results of numerical models, such as SDOF residual displacement or floor lateral displacements, may be misleading in understanding the damage accumulation. On the other hand, detailed discrete-element modelling is found to be computationally expensive but more consistent in terms of providing insights in real damage accumulation. [ABSTRACT FROM AUTHOR]

This paper presents the results of the analysis of the Western Sudetes' snow cover temporal and spatial changes, as well as it demonstrates the research on the long-term trends in the changes of snow cover durability. In order to conduct the study, the coefficient of snow cover durability (V) was used, which was defined as the quotient of the actual and the potential time of snow cover duration and expressed in percentage (1–100%). Moreover, the frequency of total disappearance of snow cover was established for the optimal winter season (December–March). Measurement data were obtained from 17 stations in the 1961–2015 period. The snow cover on the Western Sudetes' slopes with southern (S) macro-exposure lasts longer (has greater durability) than on the slopes in analogous altitude zones with northern (N) macro-exposure. At the altitudinal level of 600–700 m a.s.l., where the differences are the biggest, the average V values range from 60% at stations N to 75% in stations S. In the analysed area, excluding the upper ranges, slight negative trends in V changes have been noted. Snow cover persists for a shorter and shorter time. For the substantial majority of the stations, the trends in these changes are not statistically significant at the 0.05 level of statistical significance. They refer to the tendencies in other mountainous regions in Poland and Europe. Analogously, the stations with S macro-exposure, located at similar altitudes as stations with N macro-exposure, are characterised by two to three times lesser frequency of total disappearance of snow cover. Coefficient V is negatively correlated with the total disappearance of snow cover. At the stations with S macro-exposure in the Western Sudetes, these correlations are usually strong or very strong, whereas at the stations with N macro-exposure, at similar altitudes, they are usually moderate or very weak. [ABSTRACT FROM AUTHOR]

Spatiotemporal predictions of ecological phenomena are highly useful and significant in scientific and socio-economic applications. However, the inadequate availability of ecological time-series data often impedes the development of statistical predictions. On the other hand, considerable amounts of temporally discrete biological records (commonly known as 'species occurrence records') are being stored in public databases, and often include the location and date of the observation. In this paper, we describe an approach to develop spatiotemporal predictions based on the dates and locations found in species occurrence records. The approach is based on 'time-series classification', a field of machine learning, and consists of applying a machine-learning algorithm to classify between time series representing the environmental variation that precedes the occurrence records and time series representing the full range of environmental variation that is available in the location of the records. We exemplify the application of the approach for predicting the timing of emergence of fruiting bodies of two mushroom species (Boletus edulis and Macrolepiota procera) in Europe, from 2009 to 2015. Predictions made from this approach were superior to those provided by a 'null' model representing the average seasonality of the species. Given the increased availability and information contained in species occurrence records, particularly those supplemented with photographs, the range of environmental events that could be possible to predict using this approach is vast. [ABSTRACT FROM AUTHOR]

Recycling Phosphorus (P) from urban wastewater can secure part of domestic agricultural P supply and contribute to a circular P supply chain. In this paper, we use literature review, stakeholder interviews and analysis, and systems dynamics for the capital cities of Stockholm and Budapest as case studies. We find that political support is a prerequisite for developing the P recycling sector, and policy makers are the most influential stakeholders. P criticality is the main driver for political support. P externalities from mining to sludge disposal should be considered when evaluating P criticality and recycling profitability. We conclude with policy recommendations for the development of the P recycling sector, arguing for legally binding P recycling targets and prioritization of the safest technological solutions available. Our analysis identifies three policy action indicators and five policy interventions in the recycling system. [ABSTRACT FROM AUTHOR]

The seismic design of structures according to current codes is generally carried out using a uniform-hazard spectrum for a fixed return period, and by employing a deterministic approach that disregards many uncertainties, such as the contribution of earthquake ground motions with return periods other than that assumed for the design. This results in uncontrolled values of the failure probability, which vary with the structure and the location. Risk targeting has recently emerged as a tool for overcoming these limitations, allowing achievement of consistent performance levels for structures with different properties through the definition of uniform-risk design maps. Different countries are implementing the concepts of risk targeting in different ways, and new methods have recently emerged. In the first part of this article, the most well-known approaches for risk targeting are reviewed, with particular focus on the one implemented in recent American design codes, the one based on the use of risk-targeted behaviour factors (RTBF), and an approach based on direct estimation of hazard curves for inelastic response of single-degree-of-freedom systems. The effect of the linearization of the hazard curve is investigated first. A validation of the RTBF approach is then provided, based on comparison with the results of uniform-risk design spectral accelerations for single-degree-of-freedom systems with elastic-perfectly plastic behaviour for two different sites. The effectiveness of the current risk-targeting framework applied in the United States is also investigated. In the last part of the paper, uniform-risk design maps for Europe are developed using the RTBF approach, showing how the seismic design levels may change when moving from a uniform-hazard to a uniform-risk concept. [ABSTRACT FROM AUTHOR]

The impacts of climate change are of primary importance for economic sectors whose proper operation greatly depends on climatic conditions; this is particularly true for beach tourism. Knowledge on climate preferences of tourists is essential for estimating the effects of changes in future climate to the climatic comfort of tourists, and consequently on their willingness to travel to specific destinations. In Southern Europe, changes of future temperature and precipitation are expected to be prominent but empirical studies on tourists' climate preferences are still limited. The paper presents the results of a recent survey carried out on 13 Greek islands among beach tourists during high season (summer), conducted through questionnaires completed mainly at the beach but also at airports and hotels. Findings reveal that precipitation is a crucial climatic parameter for beach tourism, while climate preferences of tourists differ to some extent according to demographic and other characteristics. Based on the statistical analysis of responses, a utility function was built for ambient temperature, rain, cloudiness, and wind, and the weights of these parameters were estimated. Finally, a Beach Utility Index (BUI) incorporating the estimated climatic utility functions is proposed. [ABSTRACT FROM AUTHOR]

This paper reviews the main tools for communicating benefit-risk medicines information to patients that are used, or could be used, by pharmaceutical regulators. One highly successful tool from the food safety sector (front-of-package traffic-light labelling) and the mental models approach (which provides a framework for developing new tools) are also reviewed as they show great promise for being usefully adapted to the pharmaceutical context. The evolution of benefit-risk medicines communication is first contextualised within the broader risk communication literature. Three distinct goals are then made explicit before critically examining the evidence for and against tools developed in the US (e.g. at the Food and Drug Administration [FDA]) and Europe (e.g. at the European Medicines Agency [EMA]). These goals are (i) sharing information (e.g. publishing clinical trial and adverse event data online); (ii) changing patients' beliefs by conveying factual knowledge (e.g. patient information leaflets and the drugs facts box); and (iii) changing behaviour (e.g. patient alert cards and warning labels). The mental models approach and traffic-light labelling, developed outside the pharmaceutical context, are then examined. Ultimately, the paper provides a helicopter view of the variety of benefit-risk communication tools that are used, or could be used, by pharmaceutical regulators in the US and Europe. [ABSTRACT FROM AUTHOR]

Across the world, an increased uptake of the so-called market-based instruments (MBIs) for energy efficiency, such as energy efficiency obligations and auctions, can be witnessed. So far, a global assessment of those instruments is absent. In this paper, we analyse the most recent data across the world for all MBIs for energy efficiency. Whilst most of the 52 instruments identified can be found in the USA and in Europe, they are now operational on all continents. We estimate that globally around $26 billion of investment in energy efficiency is delivered through these instruments—this equates to more than 10% of the global annual investment in energy efficiency. There is considerable variation in costs among programmes. The available data show that expenditure by obligated parties and payments to auctions winners (programme costs) average around 0.013 USD/kW and are below the typical costs of producing a kWh in most sectors and locations. [ABSTRACT FROM AUTHOR]

There is a need to measure and improve the quality of paediatric primary care in Europe where major differences in the delivery and outcomes of child health care exist. A collaborative panel of paediatric senior experts developed a Core Set of Indicators for Paediatric Primary Care in Europe by compiling 42 quality indicators in a modified consensus process following the RAND/UCLA appropriateness method. The aim of this study was to explore the feasibility of the quality indicator set in European paediatric primary care practices. Seventy-nine practices from eight countries participated in a detailed online interview. The practices rated the applicability, relevance, reliability and acceptance of the 42 quality indicator as well as the availability, technical feasibility and effort to retrieve the needed data from their medical records. Most quality indicators were considered applicable, available, reliable, acceptable and relevant for monitoring quality of care in paediatric primary care. Respondents rated feasibility and effort to retrieve the data lowest because of difficulties collecting the data from the medical records.Conclusion: European paediatric primary care practices generally agree with the proposed quality indicator set. They document most of the parameters. However, the collection of specific needed values from available routine patient-data is considered technically difficult and time-consuming. What is Known? • Paediatric primary care systems in Europe show striking differences in their performance. Pre-existing sets of quality indicators are predominantly limited to national populations, specific diseases and hospital care. • A Core Set of 42 quality indicators for paediatric primary care in Europe was developed by European paediatricians using a systematic literature review and a consensus process following a modified RAND/UCLA appropriateness method. What is New? • Paediatric primary care providers in Europe agree with the idea to use COSI-PPC-EU to monitor and improve the quality of care. The set was considered applicable, available, reliable, acceptable, and relevant for quality improvement. • The score for feasibility and effort to retrieve the data was low, because of technical reasons; the electronical or paper-based medical documentation in most cases does not allow convenient access to all necessary data. [ABSTRACT FROM AUTHOR]

Despite recent advances in technologies and equipment for automated progress monitoring, most construction companies worldwide do not utilize them for their projects. This can be due to many reasons, such as the high cost of technologies and equipment, need for skilled staff, and lack of sufficient information about the impact of automated progress monitoring on project performance control. The aim of the present research is to investigate the impact of automated progress monitoring on key project performance indicators: time, cost, and quality. This study prepared based on a survey of contracting and engineering consulting firms in North America, Europe, and the Middle East. In the first part of this study, structural equation modeling is used to identify the relations of different factors of project progress monitoring (both conventional and automated) with project performance control. In the second part of the study, a benefit analysis is evaluated based on the sixteen (16) journal and international conference papers and also twenty-four (24) international construction projects for which automated progress monitoring was employed. The research findings validate the positive impact of real-time, accurate, and cost-effective automated progress monitoring environments and reveal how automated progress monitoring affects construction project success. [ABSTRACT FROM AUTHOR]

Qualitative methods, and specifically narrative interviews, have received increasing attention in recent years in the United States and the English-speaking world in general. In this paper, the authors aim to illustrate the value of the role of biographical sociology and, more specifically, of the narrative interview developed by Fritz Schütze that is commonly used in German-speaking Europe for social work and pastoral care. They focus on interviewees' biographical trajectories for a better understanding of the ways people afflicted by homelessness respond to living in a local, evangelical-based homeless shelter and the initial steps they take to improve their lives. In order to understand the role of biographical trajectory and how participants address it, the authors provide two case studies of individuals living in homeless shelters at the time of the interview. They then contend that this form of narrative interview has the capacity to help in understanding a person's life history and biographical trajectory in-depth and could be used as a form of assessment that would contribute to social work and pastoral care in the United States. [ABSTRACT FROM AUTHOR]

The aim of this paper is to conduct an analysis of the application of the specific rules of nanotechnology incorporated in Regulation No. 1223/2009 of the European Parliament and of the Council of 30 November 2009 on cosmetic products. It has been ten years since the European Commission had issued its proposal to start the co-decision procedure to create Regulation 1223 of 2009. Although it has been praised for noting the regulatory difference of nanomaterials over the rest of the chemicals, what has been the efficacy of the standard? It is concluded that despite what it meant, the regulation has encountered technical obstacles, thus rendering the objectives relating to nanotechnology that were proposed from the European Commission unfulfilled. This finding is inferred through legal dogmatic methodologies and the identification of nanomaterials that have not been expressly approved. Nevertheless, products incorporating nanomaterials still circulate in the European market. The precepts about nanotechnology in the regulation should be reviewed because technical inconsistencies should be avoided in future regulations or applicable regulations in contexts other than Europe. Such inconsistencies exist with respect to the high level of protection of human health that should be ensured and the provisions intended to protect consumer safety. For instance, the catalog of nanomaterials in circulation does not indicate the materials that have been approved or their toxicological profiles. To date, no comparison studies have been presented between the expectations and legislative objectives set as embodied in the regulation and debated in the European Parliament involving the actual efficacy of this regulation. [ABSTRACT FROM AUTHOR]

Over the last 30 years, Thelazia callipaeda (Spirurida: Thelaziidae) has increasingly been reported as an agent of ocular infections in animals and humans throughout Europe. Following the cases of canine ocular thelaziosis recently recorded in Austria for the first time, in the present paper, we describe the first case of T. callipaeda infection in an Austrian cat with no history of traveling abroad. This finding further supports the occurrence of the parasite's autochthonous transmission cycle in the country. The cat showed serous ocular discharge, conjunctival hyperemia, and mild conjunctival edema in the right eye. Mechanical removal of the parasite from the cat's eye, in combination with milbemycin oxime/praziquantel oral treatment and topical use of tobramycin/dexamethasone eye drops led to complete resolution of the clinical signs within 2 weeks. Results presented in the current study are of great importance for the local veterinarians who seemed largely unaware of this zoonotic parasite. Therefore, increased awareness of medical and veterinary communities is imperative for preventing further infections in both animals and humans. [ABSTRACT FROM AUTHOR]

The International Forum, established by the European Society of Radiology (ESR), aims to discuss important topics in the field of radiology with radiological partner societies from outside Europe. Value-based healthcare is currently a hot topic around the world and has been addressed in many papers. The ESR chose the topic "value-based radiology" for the ESR International Forum at ECR 2018 to discuss the trend within radiology to move from volume-based to value-based practice. The value-based healthcare (VBH) concept defined "value" as health outcomes achieved for patients relative to the costs of achieving them (European Society of Radiology (ESR) 2017, Insights Imaging 8: 566). Value should increase the health outcome and decrease the cost of delivering the outcomes. Radiology is simply counted as a cost and therefore, it is important that the radiologists themselves have an active role in the transition to be recognised as clinicians taking care of the patients. [ABSTRACT FROM AUTHOR]

The article presents a presidential address delivered at the 18th European Society for Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA) Congress in Glasgow, Armadillo Auditorium on May 10th, 2018. Topics included scientific papers, demonstrations of surgical techniques, discussions and debates and workshops.

Bats use a variety of tree-related microhabitats, however, only a few species inhabiting temperate regions use trees as roosts during winter. Our paper presents the first evidences of the use of cavities created by the longhorn beetles Cerambyx cerdo as hibernation sites in Central Europe. During research conducted in 2017–2018 in SW Poland bats hibernating in Cerambyx cavities were noted in 52.6% of the monitored trees (n = 19). All bats belonged to the genus Pipistrellus, and individuals identified to the species level were Pipistrellus nathusii. Bats were found at a distance of 5-15 cm from the edge of the entrance holes at the height of 150–305 cm above the ground, significantly more often in south and west-oriented cavities. There were no significant differences in tree diameter and health condition between inhabited and uninhabited trees. However, bats seemed to show preferences for oaks with high abundance of C. cerdo cavities. Our results indicate that bats frequently use these specific roots, which emphasises the importance of this beetle species as an ecosystem engineer. The protection of C. cerdo can therefore be an important component of the conservation of tree-dwelling bats. [ABSTRACT FROM AUTHOR]

During the last years, a demand for regionally produced biogas feedstocks was created by government subsidies to biogas production in Germany—contrary to the trend of specialization of agricultural production towards global commodity markets. The question arose whether this trend could contribute to an increased cultivation of uncommon crops and diversification of cropping patterns, owing to comparably different and less restricted feedstock requirements. In the cooperative research project "EVA," a multi-site experimental crop rotation field trial was conducted over 8 years at eight sites, representing the variety of soil-climatic conditions in Germany. The aim of the trial was to assess a variety of established and novel crops for anaerobic digestion. This paper presents the key findings of the trial. Special emphasis is given to biomass productivity and profitability. The chances for the approach "diversification of cropping patterns via energy cropping" are discussed. Results show that maize (average 4-year dry matter yield varied site-specific between 14.22 and 25.12 t ha−1) is clearly the most efficient crop for biogas production in Central Europe. Some cropping options for biogas feedstock production, such as winter triticale (whole crop, average yield of 6.71 to 15.17 t ha−1) or perennial fodder mixtures (average yield of 7.51 to 19.44 t ha−1) are feasible choices for farmers in some regions, which could contribute to diverse cropping systems. [ABSTRACT FROM AUTHOR]

This is an introductory paper to the special section "Multilingual learning and social inclusion of children: The development of educational programmes to connect school and family". [ABSTRACT FROM AUTHOR]

This paper updates the results obtained earlier with the climate model developed at the A.M. Obukhov Institute of Atmospheric Physics of the Russian Academy of Sciences (IAP RAS CM) and describing the impact of atmospheric sulfur dioxide on the terrestrial carbon cycle. Since no global data are available for the near-surface SO2 concentration, a statistical model was used to reconstruct its concentration from appropriate data on surface sulfate concentrations; the coefficients of this model were tuned by using the output of the RAMS-CMAQ atmospheric chemistry and transport model. The results obtained in this study are generally consistent with data reported earlier. Specifically, the most significant SO2 impact on the terrestrial carbon cycle was found to be for southeastern North America and for Europe. However, this impact for southeastern Asia obtained in this study is considerably weaker than the value obtained earlier, which can be explained by the excessive moisture content in the atmosphere used in the IAP RAS CM for this region. [ABSTRACT FROM AUTHOR]

The ECTS, European Credit Transfer System, is now widely used throughout higher education institutions as it facilitates student mobility within Europe and the comparison of study programs and courses. Most European institutions provide students with the number of ECTS each course and module is worth. A full-time student needs to complete 60 ECTS per academic year, which represents about 1500 to 1800 h of study. However, there is a lack of research showing that ECTS metrics have been properly implemented in different degrees and universities. The aim of this paper is to assess the relevance of the ECTS metric as a valid indicator of students’ and courses’ workloads. Detailed workload measurements have been taken in two Spanish universities, with 250,000 work hours monitored from 1400 students. This is the first study published with such a large dataset that includes a range of simultaneous courses and throughout a whole semester. Empirical distribution functions of workload indicators have been obtained. Evidence is provided indicating that nominal ECTS credit hours may be overestimated, that the variability of student workload could be too large for ECTS to sensibly characterize course workload, and that workload statistics of courses with same nominal ECTS are generally not comparable. Although the ECTS metric conception seems to be a valid metric to facilitate mobility between different institutions and higher education systems, in practice, according to this study, it requires revision, at least in the two institutions that have been included in this study. Further studies like the present one are required to test if this is a broader problem that has implications for the comparability of degrees across Europe. [ABSTRACT FROM AUTHOR]

Population aging in developed countries has created new challenges to improve the well-being of individuals at different age cohorts. This issue is especially significant for Southern European countries, were aging societies have worse health and less socio-economic resources. The aim of this study is to contribute to this body of literature and to estimate the effect of aging on quality of life of oldest people. This paper uses the latest available data (6th wave) from the Survey on Health, Ageing and Retirement in Europe (SHARE). Specifically, robust ordinary least squares and multilevel regressions are employed to analyse the effects of socioeconomic, health, and community factors on quality of life among the oldest population for Southern European countries. Our findings confirm the significance of several factors on life satisfaction among the oldest population in this group of countries. Moreover, we show that the determinants which are correlated with quality of life include predisposing, health, geographic area and social isolation factors. [ABSTRACT FROM AUTHOR]

Objectives: To update the 2012 European Society of Musculoskeletal Radiology (ESSR) clinical consensus guidelines for musculoskeletal ultrasound referral in Europe.Methods: Twenty-one musculoskeletal imaging experts from the ESSR participated in a consensus study based on a Delphic process. Two independent (non-voting) authors facilitated the procedure and resolved doubtful issues. Updated musculoskeletal ultrasound literature up to July 2017 was scored for shoulder, elbow, wrist/hand, hip, knee, and ankle/foot. Scoring of ultrasound elastography was included. The strength of the recommendation and level of evidence was scored by consensus greater than 67% or considered uncertain when the consensus was consensus less than 67%.Results: A total of 123 new papers were reviewed. No evidence change was found regarding the shoulder. There were no new relevant articles for the shoulder, 10 new articles for the elbow, 28 for the hand/wrist, 3 for the hip, 7 for the knee, and 4 for the ankle/foot. Four new evidence levels of A were determined, one for the hip (gluteal tendons tears), one for the knee (meniscal cysts), one for the ankle (ankle joint instability), and one for the foot (plantar plate tear). There was no level A evidence for elastography, although for Achilles tendinopathy and lateral epicondylitis evidence level was B with grade 3 indication.Conclusions: Four new areas of level A evidence were included in the guidelines. Elastography did not reach level A evidence. Whilst ultrasound is of increasing importance in musculoskeletal medical practice, the evidence for elastography remains moderate.Key Points: • Evidence and expert consensus shows an increase of musculoskeletal ultrasound indications. • Four new A evidence levels were found for the hip, knee, ankle, and foot. • There was no level A evidence for elastography. [ABSTRACT FROM AUTHOR]

The Mediterranean basin is the richest biodiversity region in Europe and a global hotspot of biological diversity. In spite of that, anthropogenic climate change is one of the most serious concerns for nature conservation in this region. One of the climatic threats is represented by shifts of the Mediterranean climate and expansion of the arid climate. In this paper, we present an assessment of changes in the spatial range of the Mediterranean climate in Europe and the conversion into arid climate under different greenhouse gas forcings, namely RCP4.5 and RCP8.5. We used 11 simulations in two future 30-year periods of state-of-the-art regional climate models from EURO-CORDEX. Our results indicate that by the end of the century under RCP8.5 the present Mediterranean climate zone is projected to contract by 16%, i.e. an area (~ 157,000 km2) equivalent to half the size of Italy. This compares with the less severe scenario RCP4.5 that projected only a 3% reduction. In addition, the Mediterranean climate zone is projected to expand to other zones by an area equivalent to 24 and 50% of its present extent under RCP4.5 and RCP8.5, respectively. Our study indicates that expansion of the arid zone is almost always the cause for contraction of the Mediterranean zone. Under RCP8.5 the arid zone is projected to increase by more than twice its present extent, equivalent to three times the size of Greece. Results of this study are useful for identifying (1) priority zones for biodiversity conservation, i.e. stable Mediterranean climate zones, (2) zones requiring assisted adaptation, such as establishment of new protected areas, implementation of buffer zones around protected areas and creating ecological corridors connecting stable Mediterranean zones. [ABSTRACT FROM AUTHOR]

Wireless vehicular communications are gaining momentum, mainly to improve road safety through the use of cooperative systems. Such visionary cooperative applications are based on recently established families of standards, notably the IEEE Wireless Access for Vehicular Environment (WAVE) and the ETSI ITS G5. Despite some relevant differences, both family of standards share the same physical and MAC layers, described in the IEEE 802.11:2012 - amendment 6, also know as IEEE 802.11p. Due to the characteristics of the wireless communications in vehicular environment, e.g., high-speed mobility causing unpredictable time-varying changes in connectivity, IP protocols are not suitable for safety communications as they require channel scanning, authentication and association under strict time limits. Safety vehicular communications rely, instead on non-IP protocols, either the WAVE Short Message Protocol (WSMP) or the FAST Network and Transport Protocol (FNTP). In this paper, we explore some of the challenges of implementing such protocols, and designed an architecture for a stack capable of handling both standards. The proposed architecture, including the communication and transport layers of the stack, was implemented in a custom ETSI ITS G5 compliant platform (IT2S), and its performance was assessed using a prototype. [ABSTRACT FROM AUTHOR]

The Neolithic transition began the spread of early agriculture throughout Europe through interactions between farmers and hunter-gatherers about 10,000 years ago. Archeological evidence produced by radiocarbon dating indicates that the expanding velocity of farming is roughly constant all over Europe. Theoretical understanding of such evidence has been performed from mathematical modeling viewpoint. However, the expanding velocity determined by existing modeling approaches is faster than the observed velocity. For understanding this difference, we propose a three-component reaction-diffusion system which consists of two different types of farmers (sedentary and migratory) and hunter-gatherers from the viewpoint of the influence of farming technology. Our purpose is to study the relation between the expanding velocity of farmers and the farming technology parameter (say, γ). In this paper, we mainly focus on the one-dimensional traveling wave solution with minimal velocity and show that the minimal velocity decreases, as γ increases. This can be compatible with the observed velocity when farming technology is developed. Our results suggest that the reason for the slowdown of the Neolithic transition might be related to the increase in the development of farming technology. [ABSTRACT FROM AUTHOR]

The aftermath of the Global Financial and Economic Crisis of 2007/2008 turned out as a veritable “stress test” for European welfare states. Aiming to stabilize citizens’ living conditions and mitigate socio-economic hardship, European governments have engaged in active crisis management. Yet, the protective capacities of European welfare states vary, as does individuals’ exposure to crisis-induced social risks. Hence, the crisis has impacted countries and the members of different social classes unequally. Against this backdrop, this paper asks how Europeans’ perceptions of the personal impact of the crisis are associated with their welfare attitudes, focusing on variations between social classes and across nations. Using cross-sectional Eurobarometer survey data from 2010 for 27 European countries, I find that perceived crisis impact is associated with greater support for welfare state responsibility and redistribution. However, this association is not homogeneous but moderated by an individual’s class position as well as national economic conditions and social spending levels. More specifically, on the individual level, perceived crisis impact is associated with more favourable welfare attitudes not only among its traditional supporters—such as the working class or the unemployed—but also among its traditional opponents, notably the self-employed. Furthermore, where social spending is higher, welfare state support is less strongly related to perceived crisis impact, suggesting that more encompassing welfare states mitigate the subjective impacts of the crisis. However, redistribution appears to be slightly more contested between those affected and those not affected by the crisis under better economic conditions. Given the challenges facing welfare states across Europe, it remains to be seen how stable a basis of popular support can be formed on these grounds. [ABSTRACT FROM AUTHOR]

In this paper we characterize the seasonal and inter-annual variabilities of cloud fraction profiles in both observations and simulation since they are critical to better assess the impact of clouds on climate variability. The spaceborne lidar onboard CALIPSO, providing cloud vertical profiles since 2006, is used together with a 23-year WRF simulation at 20 km resolution. A lidar simulator helps to compare consistently model with observations. The bias in observations due to the satellite under-sampling is first estimated. Then we examine the vertical variability of both occurrence and properties of clouds. It results that observations indicate a similar occurrence of low and high clouds over continent, and more high than low clouds over the sea except in summer. The simulation shows an overestimate (underestimate) of high (low) clouds comparing to observations, especially in summer. However the seasonal variability of cloud vertical profiles is well captured by WRF. Concerning inter-annual variability, observations show that in winter, those of high clouds is twice the low clouds one, an order of magnitude that is is well simulated. In summer, the observed inter-annual variability is vertically more homogeneous while the model still simulates more variability for high clouds than for low clouds. The good behavior of the simulation in winter allows us to use the 23 years of simulation and 8 years of observations to estimate the time period required to characterize the natural variability of the cloud fraction profile in winter, i.e. the time period required to detect significant anomalies and trends. [ABSTRACT FROM AUTHOR]

During the market transition in Eastern Europe, social support mechanisms shifted from employment-based measures to means-tested ones. This restructuring, along with an overall decrease in social support and economic productivity and an increase in unemployment, meant that these payments were often inadequate to address the large rise in poverty during this period of time. Little research, however, considers whether individual-level payments were effective in reducing poverty. This paper considers the efficacy of these individual-level payments in Bulgaria, Hungary, and Romania, using two-wave panel data. It shows that state transfers to individuals reduced their poverty in all these countries. Thus, while the level of payments may have been inadequate to eliminate the adverse effects of the market transition, the payments themselves were beneficial to individuals and reduced their poverty. [ABSTRACT FROM AUTHOR]

Road authorities, freight, and logistic industries face a multitude of challenges in a world changing at an ever growing pace. While globalization, changes in technology, demography, and traffic, for instance, have received much attention over the bygone decades, climate change has not been treated with equal care until recently. However, since it has been recognized that climate change jeopardizes many business areas in transport, freight, and logistics, research programs investigating future threats have been initiated. One of these programs is the Conference of European Directors of Roads’ (CEDR) Transnational Research Programme (TRP), which emerged about a decade ago from a cooperation between European National Road Authorities and the EU. This paper presents findings of a CEDR project called CliPDaR, which has been designed to answer questions from road authorities concerning climate-driven future threats to transport infrastructure. Pertaining results are based on two potential future socio-economic pathways of mankind (one strongly economically oriented “A2” and one more balanced scenario “A1B”), which are used to drive global climate models (GCMs) producing global and continental scale climate change projections. In order to achieve climate change projections, which are valid on regional scales, GCM projections are downscaled by regional climate models. Results shown here originate from research questions raised by European Road Authorities. They refer to future occurrence frequencies of severely cold winter seasons in Fennoscandia, to particularly hot summer seasons in the Iberian Peninsula and to changes in extreme weather phenomena triggering landslides and rutting in Central Europe. Future occurrence frequencies of extreme winter and summer conditions are investigated by empirical orthogonal function analyses of GCM projections driven with by A2 and A1B pathways. The analysis of future weather phenomena triggering landslides and rutting events requires downscaled climate change projections. Hence, corresponding results are based on an ensemble of RCM projections, which was available for the A1B scenario. All analyzed risks to transport infrastructure are found to increase over the decades ahead with accelerating pace towards the end of this century. Mean Fennoscandian winter temperatures by the end of this century may match conditions of rather warm winter season experienced in the past and particularly warm future winter temperatures have not been observed so far. This applies in an even more pronounced manner to summer seasons in the Iberian Peninsula. Occurrence frequencies of extreme climate phenomena triggering landslides and rutting events in Central Europe are also projected to rise. Results show spatially differentiated patterns and indicate accelerated rates of increases. [ABSTRACT FROM AUTHOR]

This paper presents the annual time series and the average annual growth rate of the European Gender Equality Index, which was proposed by Bericat (Soc Indic Res 108:1-28, ), for the EU and its 27 member countries for the period 2000-2011. The paper also reports the time series and average annual growth rate for each of the three subdimensions of gender equality-education, work, and power-and the underlying indicators for each subdimension for EU as a whole. The calculated index shows that in the period 2000-2011, overall gender equality, equality in education, work, and power in the EU has been improving at a rate of 1.7, 0.92, 0.65, and 3.48 % per year, respectively. By 2011, overall gender equality, and equality in education, work, and power has reached 58.3, 77.4, 60.9, and 42.7, respectively. In short, this paper offers the scientific community, as well as those that design and implement public policies, a robust, valid and precise synthetic description of the current situation and evolution, from 2000 to 2011, of structural gender equality in European countries. [ABSTRACT FROM AUTHOR]

This introductory paper presents 20 river restoration cases throughout Europe that were investigated in the EU-funded research project REFORM. In the following, this special issue provides seven specific papers that highlight and discuss the effects of restoration on the investigated river-floodplain systems. Additionally, restoration success was estimated from a socio-economic perspective. The first part of this paper presents the overall study concept and the general sampling design of the field investigations. Each study site was examined with the same array of methods, covering habitat composition in the river and its floodplain, three aquatic and two floodplain-related organism groups, as well as food web composition and 'aquatic terrestrial' interactions as reflected by stable isotopes. An overview of the rivers and the study sites summarizes main attributes of all investigated sites, with emphasis on the large-scale restoration projects. Some of the projects represent the 'state of the art' restoration approaches for two major European river types: gravel-bed mountain rivers and sand-bed lowland rivers. Concluding, restoration efforts had positive effects even in the small restoration projects investigated but did not increase with project size. No 'single best' measure could be identified, but river widening generally had a larger effect compared to other restoration measures. [ABSTRACT FROM AUTHOR]

This paper is a reflection that critically examines the dynamics of education and the struggle by African people for freedom, control of the mind, self-definition and the right to determine their own destiny from the start of colonial rule to the present. The primary methodological approach is historical structuralism, which stipulates that social reality and facts are determined and created by social agents within structural and historical contingencies. It addresses some of the most powerful challenges and contradictions that explain the ineffectiveness of numerous post-independence reforms, and presents the arguments for relevance and use of African languages, for instance, that have been made since the 1960s. The first section of the paper deals with the colonial imperatives for setting new education systems in the colonised societies of Africa and the initial attitudes of the Africans towards colonial education. The second section critically examines the evolving meanings of Western education in Europeanising African societies, the articulation of their rationale and the mechanism for resistance. It analyses the turning point when Africans began to embrace European education and demand it in the colonial and post-independence era. The third section addresses the roots of the inadequacies of received post-colonial education and the imperative of deconstruction and re-appropriation of African education using an ubuntu framework for an African renewal. [ABSTRACT FROM AUTHOR]

The recent financial crisis has triggered considerable concerns about the activities of credit rating agencies (CRAs), which has led to a shift away from self-regulation based on voluntary compliance with the IOSCO Code to the implementation of a regulatory framework at EU level under the supervision of the European Securities and Markets Authority. Against the background of the role CRAs play in the financial market system and how they have failed to fulfil their intermediary function, this paper examines the main weaknesses attributed to the operation of CRAs before and during the financial crisis and assesses the EU's regulatory response to these weaknesses. As the paper will elucidate, many of the major concerns identified have been addressed following consecutive regulatory amendments, albeit to differing degrees and levels of satisfaction, which in the future will require redress and further improvements to be implemented, including, but not limited to, the issuer-pays model, over-reliance on ratings, ratings shopping and private enforcement. [ABSTRACT FROM AUTHOR]

In the summer of 2014, the European Court of Human Rights ruled that the French 2010 law banning face-covering clothing in public spaces, the so-called burqa ban, did not violate the right to freedom of religion. Due to the 'wide margin of appreciation', the Court deemed the ban proportionate to the French state's legitimate aim with the ban of preserving the conditions of 'living together'. The paper analyses and provides an internal criticism of the Court's justification for this judgement focusing on the aim of living together and the right to freedom of religion. The Court's justification presupposes that (a) there is a justification for the ban in terms of the aim of living together, (b) this is a legitimate aim and (c) the ban is a proportional means of pursuing this aim. The paper analyses the Court's justification and argues that it fails to substantiate all three conditions. [ABSTRACT FROM AUTHOR]

This paper assesses how various types of financial risk such as credit risk, market risk, and liquidity risk affect banking stability in emerging Europe. It also examines how the quality of supervisory standards may have mitigated the vulnerabilities arising from these risk factors. Using panel data, the paper finds that (1) credit quality is of general concern especially in circumstances where credit growth is accelerating; (2) although higher provisioning could adversely affect profits and returns volatility, good supervisory policies on provisioning mitigate such adverse effects; and (3) highly liquid banks are not necessarily more stable because they might be pursuing activities with more volatile returns, but a well-functioning payments system helps to lower the adverse impact on stability. The paper also corroborates earlier evidence of the positive (negative) effect of financial depth (foreign ownership) on stability. [ABSTRACT FROM AUTHOR]

An amendment to this paper has been published and can be accessed via a link at the top of the paper. [ABSTRACT FROM AUTHOR]

Higher education research frequently refers to the complex external conditions that give our old-fashioned universities a good reason to change. The underlying theoretical assumption of such framing is that organizations are open systems. This paper presents an alternative view, derived from the theory of social systems autopoiesis. It proposes that organizations, being open systems, are yet operationally closed, as all their activities and interactions with the environment are aspects of just one process: the recursive production of themselves, according to a pattern of their own identity. It is their identity that captures exactly what can and what cannot be sustained in their continuous self-production. Examining the organizational identity of universities within the theoretical framework of autopoiesis may hence shed new light on their resistance to change, explaining it as a systemic and social phenomenon, rather than an individual and psychological one. Since all processes of an autopoietic system are processes of its self-production, this paper argues that in the case of traditional European universities, the identity consists in the intertwinement of only two processes: (1) introducing continuous change in the scope of scientific knowledge and (2) educating new generations of scholars, who will carry on this activity. This surprisingly leaves at the wayside seemingly the most obvious 'use of the university': the adequate education of students for the job market. [ABSTRACT FROM AUTHOR]

This paper describes how the earthquake parameters of historical earthquakes have been determined in Europe from macroseismic data by means of the so-called 'Boxer' method, in the frame of the European Commission 2009-2012 Project SHARE (Seismic Hazard Harmonization in Europe). The problems related to the assessment of magnitude are described with more detail; the methodological issues are developed with special reference to the 'stable continental region'. The paper first describes how the coefficients of the Boxer method are determined in five tectonic regions of the European area from the relevant calibration data sets, and discusses the problems dealt with while performing this task. Then it describes how the results have been checked against data different from those used in the previous phase. Finally, the application of the new coefficients to nearly a thousand of European earthquakes before 1900 is described. Stressing that, for the first time in Europe, homogeneous results have been obtained at such a large scale, the final part of the paper is devoted to analyse such results, with special reference to the general trends and to some case-histories. [ABSTRACT FROM AUTHOR]

The paper deals with poverty orderings when multidimensional attributes exhibit some degree of comparability. The paper focuses on an important special case of this, that is, comparisons of poverty that make use of incomes at different time periods. The ordering criteria extend the power of earlier multidimensional dominance tests by making (reasonable) assumptions on the relative marginal contributions of each time dimension to poverty. Inter alia, this involves drawing on natural symmetry and asymmetry assumptions as well as on the mean/variability framework commonly used in the risk literature. The resulting procedures make it possible to check for the robustness of poverty comparisons to choices of intertemporal aggregation procedures and to areas of intertemporal poverty frontiers. The results are illustrated using a rich sample of 23 European countries over 2006-2009. [ABSTRACT FROM AUTHOR]

Over the last few decades, globalization and ever-increasing demands of the knowledge-based economy have caused higher education in most countries around the world to undergo significant transformation. Notwithstanding the dramatic changes in higher education, it is clearly noticed that the influence of the European higher education models is still present despite the fact that the American model has then become dominant on higher education in Europe or even worldwide. The changes have been seen in the evolutionary roles of universities, which share the common trend from traditional missions of teaching and research to the third mission for economic development. Despite various viewpoints about the third mission, the common one concerns the entrepreneurial role of university for socio-economic development, underlying the concept of entrepreneurial university in which the collaboration between university and external stakeholders is emphasized. This paper is aimed to present a review of the taxonomy of the three European higher education models, namely the Humboldtian, Napoleonic, and Anglo-Saxon model, which is followed by a discussion on the emergence of the Anglo-American model of higher education. The paper then presents the third mission in relation to the roles of a university in developed countries, which is followed by the elaboration on the transformation from mode 1 to mode 2 in knowledge production, and a pathway toward entrepreneurial universities. [ABSTRACT FROM AUTHOR]

Biobanks have been recognized as a key research infrastructure and how to approach ethical questions has been a topic of discussion for at least a decade by now. This article explores the characteristics of donors' participation in European biobanks as reflected in the consent documents of a selection of different biobanks from various European countries. The primary aim of this study is to understand how donors are informed about their participation in biobanking. Also the paper discusses what the most important thematic issues of information are to be given to the biobank participants and how this information should be presented in the consent documents. For these purposes, we analyse consent documents from 14 biobanks in 11 countries for six ethically relevant issues: (1) model of consent, (2) scope of future research, (3) access to medical data, (4) feedback to the participants, (5) consent withdrawal, and (6) role of research ethics committee. In order to compare different trends of informing donors of human biological material and medical data, we interpret the six analysed issues in the context of respect to donor's autonomy paradigm. Although the results of the paper reflect the heterogeneity of biobank consent document policies applied in different European countries, we uncovered some trends and suggested several examples of good practices to balance the interests of the donors with those of the researchers and future patients. [ABSTRACT FROM AUTHOR]

Climate change impacts are already happening through the world, and it is now clear that there is the need for an adaptive response from global institutions down to the local level. Reducing vulnerability to cope with climate variability might be more challenging in tropical countries than in North America or Europe. The ten papers of this special issue were presented during the Adaptclim conference that was held by the Sinergia Project, the CLARIS LPB project, and the GeoData Institute in Asunción, Paraguay, in 2010. All papers, except one regarding the Brahmaputra Basin in South Asia, present studies from South America. These studies are first contextualized geographically and then are related one to another by a simplified vulnerability concept linking climate stress to sensitivity and adaptive capacity of natural and human systems. One half of the papers focus on actual or future climate change and the present-day causes of the vulnerability of natural and agrosystems. Droughts are and will be the main source of stress for agriculture in South America. Increasing fragmentation of forest of the center of this continent is aggravating their vulnerability to dry spells. Another half of the studies of this special issue deal with the adaptive capacity human populations to system perturbations produced or enhanced by climate change. The studies point out inclusion of traditional knowledge and involvement of local actors in their own vulnerability assessment to increase adaptive capacity. These elements of climate justice, giving voice to those less responsible for carbon emissions but bearing their most severe consequences, allow the particular needs of a community to be considered and can direct adaptation policy toward preserving or rebuilding their specific capabilities under threat from climate change. The special issue also made clear that a basin analysis of the climate change problem could provide information, results, and methods more readily of use for the local population and decision makers. [ABSTRACT FROM AUTHOR]

This paper proposes a new perspective for higher education policy research. It introduces the concept of policy object to designate the discrete preoccupation(s) of a policy text (e.g. a new governance regime, a quality system, or new degrees) and suggests that actor conceptualisations of the policy object intersect with other elements in the policy process to shape enactment and outcomes. First, the policy object concept is described. It is argued that the policy object does not have an objective existence and two concepts are proposed to explain it: ontology and enacted ontology. The former refers to what actors believe the policy object is, a socially-construed context-determined conceptualisation, whereas enacted ontology refers to what the policy object becomes further to enactment under the influence of ontology. Second, the paper presents the findings of a comparative study of master degrees further to the Bologna process in different national and institutional settings to illustrate the policy object approach. This research puts forward arguments to suggest that the policy object could be an important variable to consider in policy research. This somewhat different lens, inviting fine-grained attention to a specific policy object (its ontologies and enacted ontologies), could bring additional insight into policy outcomes. [ABSTRACT FROM AUTHOR]

As it stands there is no viable health care option for undocumented immigrants of low socioeconomic status. Even more worrisome is that Affordable Care Act simply does not address this issue with any direct plan. The US is in a very influential time period in terms of undocumented immigration and its relationship with health care. The purpose of this paper is to examine international examples of undocumented immigrant health care and their implications for the United States' undocumented immigrant health care. This study found that physicians in the US must work to prevent the initiation of policies which exclude undocumented immigrants from accessing health care. Exclusionary policies implemented in European nations have had disastrous effects on physicians and patients. This paper examines the implications which similar policies would have if implemented in the US. [ABSTRACT FROM AUTHOR]

Research on immigrants’ assimilation is widespread both in the U.S. and Europe. While it has been extensively studied how immigrants fare compared to natives on socio-economic indicators, few studies have focussed on immigrants’ perception of their position. In this paper we focus on comparing life satisfaction of immigrants and natives across Europe and on the role of social embeddedness. Using data from the first six rounds (2002-2012) of the European Social Survey, a repeated cross-sectional survey, we find that life satisfaction among immigrants is lower than among natives even though differences diminish over generations. For first generation immigrants part of the life satisfaction gap is explained by the lower level of social embeddedness they have compared to natives. We also find that social embeddedness is a key explanatory factor for life satisfaction for both immigrants and natives. For two out of the three indicators of social embeddedness that we consider we however find different patterns of association with life satisfaction for immigrants compared to natives. [ABSTRACT FROM AUTHOR]

The proposed diagnosis of Internet gaming disorder (IGD) in DSM-5 has been criticized for “borrowing” criteria related to substance addiction, as this might result in misclassifying highly involved gamers as having a disorder. In this paper, we took a person-centered statistical approach to group adolescent gamers by levels of addiction-related symptoms and gaming-related problems, compared these groups to traditional scale scores for IGD, and checked how groups were related to psychosocial well-being using a preregistered analysis plan. We performed latent class analysis and regression with items from IGD and psychosocial well-being scales in a representative sample of 7865 adolescent European gamers. Symptoms and problems matched in only two groups: an IGD class (2.2%) having a high level of symptoms and problems and a Normative class (63.5%) having low levels of symptoms and problems. We also identified two classes comprising 30.9% of our sample that would be misclassified based on their report of gaming-related problems: an Engaged class (7.3%) that seemed to correspond to the engaged gamers described in previous literature, and a Concerned class (23.6%) reporting few symptoms but moderate to high levels of problems. Our findings suggest that a reformulation of IGD is needed. Treating Engaged gamers as having IGD when their poor well-being might not be gaming related may delay appropriate treatment, while Concerned gamers may need help to reduce gaming but would not be identified as such. Additional work to describe the phenomenology of these two groups would help refine diagnosis, prevention and treatment for IGD. [ABSTRACT FROM AUTHOR]