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A child's disability, long-term illness, or mental ill-health is known to affect siblings' health, social life, school engagement, and quality of life. This article addresses a research gap by its focus on young sibling carers and the impact of providing care to a sibling. A cross-national survey study was conducted in 2018–2019 (Italy, the Netherlands, Slovenia, Sweden, Switzerland, the UK) to examine the incidence of adolescent sibling carers, the extent of care they provide, and their self-reported health, well-being, and school situation. The survey was completed by 7146 adolescents, aged 15–17, and 1444 of them provided care to family members with health-related conditions. Out of these, 286 were identified as Sibling Carers and 668 as Parent Carers, while 181 had both sibling(s) and parent(s) with health-related conditions, and thus were identified as Sibling–Parent Carers. Sibling Carers and Sibling–Parent Carers carried out higher levels of caring activities compared to Parent Carers. They reported both positive aspects of caring, such as increased maturity, and negative aspects, such as mental ill-health, impact on schooling and a lack of support. To reduce the negative aspects of a sibling carer role, it is important to recognise them and to implement early preventive measures and formal support. [ABSTRACT FROM AUTHOR]

The European natural gas market is characterized by declining indigenous resources, particularly in the UK and the Netherlands, and a growing dependence on a small number of large exporters who, as a consequence, see their market power increasing. In this paper we analyze long-run scenarios for the European natural gas markets in a model, NATGAS, that explicitly includes both factors, resource constraints and producers' market power. Finite resources lead to interdependencies of current production decisions and future opportunities. These decisions in turn depend on the potential for large producers to set market prices above marginal costs. We analyze the impact of conditions on the global LNG market on market shares of pipeline gas suppliers, as well as on the speed of depletion of indigenous European resources. We focus on how shadow prices of resource constraints affect substitution patterns in the various scenarios. [ABSTRACT FROM AUTHOR]

The article presents information about the book "Institutions and Regional Labour Markets in Europe." The book contains twelve papers that take an institutional perspective in comparing the performance of European labor markets in different regional socioeconomic settings. The papers discuss the spatial-institutional perspective on the labor market in Europe; general changes in the European labor market; regional and institutional changes in European labor markets; regional labor markets and institutions in Great Britain; institutions and regional labor markets in the Netherlands; institutions and regional return to education in Sweden; institutions and regional labor markets in Spain.

Background In Europe, more than 15 million people live with heart failure (HF). It imposes an enormous social, organizational and economic burden. As a reaction to impending impact on healthcare provision, different country-specific structures for HF-care have been established. The aim of this report is to provide an overview and compare the HF-care approaches of Germany, Ireland, the Netherlands and the UK, and to open the possibility of learning from each other's experience. Methods A mixed methods approach was implemented that included a literature analysis, interviews and questionnaires with HF-patients and caregivers, and expert interviews with representatives from healthcare, health service research and medical informatics. Results The models of HF-care in all countries analyzed are based on the European Society of Cardiology guidelines for diagnosis and treatment of HF. Even though the HF-models differed in design and implementation in practice, key challenges were similar: (i) unequal distribution of care between urban and rural areas, (ii) long waiting times, (iii) unequal access to and provision of healthcare services, (iv) information and communication gaps and (v) inadequate implementation and financing of digital applications. Conclusion Although promising approaches exist to structure and improve HF-care, across the four countries, implementation was reluctant to embrace novel methods. A lack of financial resources and insufficient digitalization making it difficult to adopt new concepts. Integration of HF-nurses seems to be an effective way of improving current models of HF-care. Digital solutions offer further opportunities to overcome communication and coordination gaps and to strengthen self-management skills. [ABSTRACT FROM AUTHOR]

Widespread use of the Internet in 21st century society is not risk-free. This paper studies the comorbidity of some problematic uses of Internet with depression in order to assess their correlation. With that aim, a meta-analysis of 19 samples obtained from 13 different studies (n=33,458) was carried out. The subjects of these studies are adolescents between the ages of 12 and 18 years ([mu]=15.68) from different cultures and continents (Europe, Euro-Asia, America and Asia). The effect size obtained from the use of a random-effects model (r=0.3, p<0.000) is significant, moderate and positive, thus confirming the relation between pathologic uses of the Internet and depression. Moreover, meta-regression test results showed that 9% of the variance (R2=0.09) is associated with the male gender, while age and culture are not significant variables. The variability rate of the studies is high (I2=87.085%), as a consequence of heterogeneity rather than publication bias, as Egger's regression test shows (1-tailed p-value=0.25; 2-tailed p-value=0.50, and [sigma]=1.57). Therefore, the need for specific interventions in secondary education dealing with this issue is evident to ensure that it does not extend into adult life.

Student learning outcomes assessment examines whether programs cover the material stated in their learning goals, whether students are learning the material, and the impact on student retention, graduation, post-graduation outcomes, and institutional accreditation, with the aim of providing faculty with data that can be used to help programs evolve or improve. While there is a plethora of research regarding effective methods of assessment used in the United States, little has been written regarding cross-national comparisons of assessment methodologies. This paper examines the current state of assessment in several nations and regions, and draws parallels in practices across countries. A literature search using the term "outcomes assessment" yielded 228 articles, of which, only 35 described practices outside the United States. Generally, searches on the terms "outcomes assessment" and "global" tend to return studies of outcomes assessment of teaching about global issues as it is practiced in the United States, rather than results about outcomes assessment practices used in other countries.

Objectives To measure changes in prevalence and predictors of home smoking bans (HSBs) among smokers in four European countries after the implementation of national smoke-free legislation. Design Two waves of the International Tobacco Control Policy Evaluation Project Europe Surveys, which is a prospective panel study. Pre- and post-legislation data were used from Ireland, France, Germany and the Netherlands. Two pre-legislation waves from the UK were used as control. Participants 4634 respondents from the intervention countries and 1080 from the control country completed both baseline and follow-up and were included in the present analyses. Methods Multiple logistic regression models to identify predictors of having or of adopting a total HSB, and Generalised Estimating Equation models to compare patterns of change after implementation of smoke-free legislation to a control country without such legislation. Results Most smokers had at least partial smoking restrictions in their home, but the proportions varied significantly between countries. After implementation of national smoke-free legislation, the proportion of smokers with a total HSB increased significantly in all four countries. Among continuing smokers, the number of cigarettes smoked per day either remained stable or decreased significantly. Multiple logistic regression models indicated that having a young child in the household and supporting smoking bans in bars were important correlates of having a pre-legislation HSB. Prospective predictors of imposing a HSB between survey waves were planning to quit smoking, supporting a total smoking ban in bars and the birth of a child. Generalised Estimating Equation models indicated that the change in total HSB in the intervention countries was greater than that in the control country. Conclusions The findings suggest that smoke-free legislation does not lead to more smoking in smokers' homes. On the contrary, our findings demonstrate that smoke-free legislation may stimulate smokers to establish total smoking bans in their homes. [ABSTRACT FROM AUTHOR]

This literature review aims to examine the approach given to open science policy in the different studies. The main findings are that the approach given to open science has different aspects: policy framing and its geopolitical aspects are described as an asymmetries replication and epistemic governance tool. The main geopolitical aspects of open science policies described in the literature are the relations between international, regional, and national policies. There are also different components of open science covered in the literature: open data seems much discussed in the works in the English language, while open access is the main component discussed in the Portuguese and Spanish speaking papers. Finally, the relationship between open science policies and the science policy is framed by highlighting the innovation and transparency that open science can bring into it.

The article presents a study on the impact of multimorbidity on the frequency of participation of older people in Europe in social leisure activities. Topics include the use of data from the European Project on Osteoarthritis (EPOSA), the concept of multimorbidity, and the individual and environmental factors that predict social leisure activity participation among the elderly. It also discusses the continuity theory of Robert Atchley.

Background: Strong primary care systems are believed to have an important role in dealing with healthcare challenges. Strengthening primary care systems is therefore a common policy goal for many countries. This study aims to investigate whether the Netherlands, the UK and Germany have strengthened their primary care systems in 2006-2012. Method: For this cross-sectional study, data from the International Health Policy surveys of the Commonwealth Fund in 2006, 2009 and 2012 were used. The surveys represent the experiences and perspectives of primary care physicians with their primary care system. The changes over time were researched in three areas: organization of primary care processes, use of IT in primary care and use of benchmarking and financial incentives for performance improvement. Results: Regarding organization of primary care processes, in all countries the use of supporting personnel in general practice increased, but at the same time practice accessibility decreased. IT services were most advanced in the UK. The UK and the Netherlands showed increased use of performance feedback information. German GPs were least satisfied with how their system works across the 2006-2012 timeframe. Conclusion: All three countries show trends towards stronger primary care systems, although in different areas. Coordination and comprehensive care through the assignment of assisting personnel and use of disease management programs improved in all countries. In the Netherlands and the UK, informational continuity is in part ensured through better IT services. All countries showed increasing difficulties upholding primary care accessibility. [ABSTRACT FROM AUTHOR]

Background: The evidence that inspires and fosters communication skills, teaching programmes and clinical recommendations are often based on national studies which assume, implicitly, that patients' preferences towards doctors' communication style are not significantly affected by their cultural background. The cross-cultural validity of national results has been recognized as a potential limitation on how generally applicable they are in a wider context. Using 35 country-specific focus group discussions from four European countries, the aim of the present study is to test whether or not national cultures influence lay people's preferences towards doctors' style of communication.Methods: Lay people preferences on doctor's communication style have been collected in Belgium, the Netherlands, the United Kingdom and Italy. Each centre organized between eight and nine focus groups, where participants (n = 259) were asked to comment on a video of a simulated medical interview. The discussions were audiotaped, transcribed and coded using a common framework (Guliver Coding System) that allowed for the identification of different themes.Results: The frequency distribution of the topics discussed highlights lay people's generally positive views towards most part of doctors interventions. The regression model applied to the Guliver categories highlighted slight national differences and the existence of a cross-cultural appreciation, in particular, of five types of intervention: Doctors attitudes (both Task-Oriented and Affective/Emotional), Summarizing, Structuring and Providing solution.Conclusion: Lay panels valued doctors' communication style in a similar manner in the countries selected. This highlights the existence of a common background, which in the process of internationalization of heath care, might foster the implementation of cross-national teaching programmes and clinical guidelines. [ABSTRACT FROM AUTHOR]

Achterberg and colleagues conclude there is in train a significant change toward deprivatization in Europe. In the late 1990s Christians were more pro public religion in countries where they were least numerous and in the Netherlands in particular there had been an increasing difference in attitudes between believers and nonbelievers over 25 years. Examining more recent survey data on British attitudes (1998 and 2008), we find a firm consensus among the nonreligious against religion having a high public profile, while Christians are more likely to object to antireligion sentiment and people belonging to non-Christian religions are more likely to support public religion. Nonreligious people appear to be no more hostile now than in the late 1990s, and where there has been a decrease in sympathy for public religion it is among religious groups. [ABSTRACT FROM AUTHOR]

Ever since the increase at the beginning of the 1980s unemployment in the European Union has remained high. Now, at the end of the 1990s, it is slowly declining but still averages about 10% of the working population. This poor performance is not shared by every European country, however. In particular, much has been made of the relatively good performance of the Netherlands and Great Britain. It is asked whether the Netherlands and Great Britain really have had such an outstanding labour market performance and if so, why is this the case and what lessons can be drawn for other countries. The strategy is to use recent international comparisons to identify the potential determinants of labour market performance and to investigate in detail to what extent these determinants play a role in the specific labour markets of the Netherlands and Great Britain. In the early 1980s standardized unemployment rates in the Netherlands and Great Britain were well above the European Union (EU) average. By the late 1980s unemployment in both countries had fallen to the EU average and was well below.

Background: Psychosocial factors shape the health of older adults through complex inter-relating pathways. Besides socioeconomic factors, time use activities may explain gender inequality in self-reported health. This study investigated the role of work-related and social time use activities as determinants of health in old age. Specifically, we analysed whether the impact of stress in terms of time pressure on health mediated the relationship between work-related time use activities (i.e. housework and paid work) on self-reported health. Methods: We applied structural equation models and a maximum-likelihood function to estimate the direct and indirect effects of psychosocial factors on health using pooled data from the Multinational Time Use Study on 11,168 men and 14,295 women aged 65+ from Italy, Spain, UK, France and the Netherlands. Results: The fit indices for the conceptual model indicated an acceptable fit for both men and women. The results showed that socioeconomic status (SES), demographic factors, stress and work-related time use activities after retirement had a significant direct influence on self-reported health among the elderly, but the magnitude of the effects varied by gender. Social activities had a positive impact on self-reported health but had no significant impact on stress among older men and women. The indirect standardized effects of work-related activities on self-reported health was statistically significant for housework (β = − 0.006; P < 0.001 among men and β = − 0.008; P < 0.001 among women) and paid work (β = 0.012; P < 0.01 among men and β = 0.000; P > 0.05 among women), which implied that the paths from paid work and housework on self-reported health via stress (mediator) was very weak because their indirect effects were close to zero. Conclusions: Our findings suggest that although stress in terms of time pressure has a direct negative effect on health, it does not indirectly influence the positive effects of work-related time use activities on self-reported health among elderly men and women. The results support the time availability hypothesis that the elderly may not have the same time pressure as younger adults after retirement. [ABSTRACT FROM AUTHOR]

An increasing number of findings from epidemiological studies support associations between exposure to air pollution and the onset of several diseases, including pulmonary, cardiovascular and neurodegenerative diseases, and malignancies. However, intermediate, and potentially mediating, biological mechanisms associated with exposure to air pollutants are largely unknown. Previous studies on the human exposome have shown that the expression of certain circulating microRNAs (miRNAs), regulators of gene expression, are altered upon exposure to traffic-related air pollutants. In the present study, we investigated the relationship between particulate matter (PM) smaller than 2.5 μm (PM 2.5 ), PM 2.5 absorbance (as a proxy of black carbon and soot), and ultrafine-particles (UFP, smaller than 0.1 μm), measured in healthy volunteers by 24 h personal monitoring (PEM) sessions and global expression levels of peripheral blood miRNAs. The PEM sessions were conducted in four European countries, namely Switzerland (Basel), United Kingdom (Norwich), Italy (Turin), and The Netherlands (Utrecht). miRNAs expression levels were analysed using microarray technology on blood samples from 143 participants. Seven miRNAs, hsa-miR-24-3p, hsa-miR-4454, hsa-miR-4763-3p, hsa-miR-425-5p, hsa-let-7d-5p, hsa-miR-502-5p, and hsa-miR-505-3p were significantly (FDR corrected) expressed in association with PM 2.5 personal exposure, while no significant association was found between miRNA expression and the other pollutants. The results obtained from this investigation suggest that personal exposure to PM 2.5 is associated with miRNA expression levels, showing the potential for these circulating miRNAs as novel biomarkers for air pollution health risk assessment., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier Ltd. All rights reserved.)