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Individuals who reside in a country without regular authorisation generally find it difficult to access public medical services beyond emergency treatment. Even in countries with universal healthcare, there is often a gap between rights on paper and their implementation. Civil society organisations (CSOs) fill this gap by providing medical services to vulnerable populations, including irregular migrants. What, if any, are the ethical dilemmas that arise for CSO staff when delivering such services in countries with universal healthcare? Under what conditions do these dilemmas arise? And what strategies do CSO staff use to mitigate them? We answer these questions using 40 semi-structured interviews with CSO staff working in two European countries with high levels of irregularity, universal healthcare provisions on paper, and significant differences in approaches and availability of public services for irregular migrants: Italy and Spain. We show that CSO staff providing medical services to irregular migrants in places with universal healthcare coverage face a fundamental dilemma between humanitarianism and equity. CSO staff respond to the humanitarian belief in the value of taking all possible steps to prevent or alleviate human suffering, thus promoting a decent quality of life that includes access to both emergency and non-emergency care. In doing so, however, they run the risk of substituting rather than complementing public provisions, thereby preventing governments from assuming responsibility for these services in the long term. Individuals who acknowledge the existence of this dilemma generally oppose the creation of parallel structures; that is, services specifically developed for irregular migrants outside the public system; while those who ignore it essentially subscribe to a tiered system, giving up on considerations of equity. We argue that CSOs involved in the provision of healthcare to irregular migrants do not simply provide services; they also play an inherently political role. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to investigate how institutional and organisational factors affect case management of patients with mental disorders by GPs in Italy and Spain. The paper highlights the importance of improving the effectiveness of primary care to ensure easy access to mental health services, which is crucial in responding to the increasing incidence of mental disorders and preventing negative outcomes. Design/methodology/approach: This article details a qualitative research study that examines the management of patients with mental disorders by general practitioners (GPs) in Italy and Spain, using cross-national comparison and in-depth interviews with GPs as research methods. Findings: The study revealed that Italian self-employed GPs have more scheduling autonomy than Spanish Health Centre GPs. Both face high work pressure and resource scarcity, highlighting the need for targeted training. The COVID-19 pandemic led to a rise in phone consultations. Originality/value: This study provides novel insights into mental health management by examining the case management of patients with mental disorders by GPs in Italy and Spain, with a focus on the impact of institutional and organisational factors. The cross-national comparison and in-depth interviews enhance the originality of the study, offering a nuanced understanding of the constraints faced by GPs in their work context. Furthermore, the comparison of the similar primary care frameworks of Italy and Spain may offer insight into their evolution. [ABSTRACT FROM AUTHOR]

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

Purpose: The Comprehensive assessment of Acceptance and Commitment Therapy (CompACT) is a 23-item questionnaire measuring psychological flexibility, a quality of life protective factor. An 18-item version was recently produced. We assessed validity and reliability of CompACT, and equivalence of paper and electronic (eCompACT) versions in people with multiple sclerosis (PwMS) in Italy, Germany and Spain., Methods: We used confirmatory factor analysis and assessed CompACT-23 and CompACT-18 measurement invariance between the three language versions. We assessed construct validity (Spearman's correlations) and internal consistency (Cronbach's alpha). Test-retest reliability (intraclass correlation coefficient, ICC) and equivalence of paper and eCompACT (ICC and linear regression model for repeated measures) were assessed in subsamples of PwMS., Results: A total of 725 PwMS completed the study. The three-factor structure of the CompACT-23 showed poor fit (RMSEA 0.07; CFI 0.82; SRMR 0.08), while the fit of the CompACT-18 was good (RMSEA 0.05; CFI 0.93; SRMR 0.05). Configural and partial metric invariance were confirmed, as well as partial scalar invariance (reached when five items were allowed to vary freely). The CompACT-18 showed good internal consistency (all alpha ≥ 0.78); and test-retest reliability (all ICCs ≥ 0.86). Equivalence between paper and eCompACT was excellent (all ICCs ≥ 0.86), with no mode, order, or interaction effects., Conclusion: Results support using the refined CompACT-18 as a three-factor measure of psychological flexibility in PwMS. Paper and eCompACT-18 versions are equivalent. CompACT-18 can be used cross-culturally, but sub-optimal scalar invariance suggests that direct comparison between the three language versions should be interpreted with caution., (© 2024. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

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

Background: The development of cities and transport infrastructure produces a large volume of mineral waste (e.g. excavated earth material). At the same time, cities are increasingly trying to develop green infrastructures, given the ecosystem services they provide to people, but this comes with considerable economic and environmental costs associated with the transfer of fertile soil from rural areas to cities. In a circular economy approach, the reuse of mineral waste to build fertile soil is a substantial opportunity to reduce the economic and environmental costs of both mineral waste management and green infrastructure development. Soils constructed from these materials (constructed Technosols) must be able to support vegetation growth and become a suitable living environment for soil organisms. This requires ecological engineering to maximise the potential of constructed soils for biodiversity, both from a taxonomic and functional perspective. In this context, we systematically mapped the evidence related to the ability of soils constructed from mineral wastes to support biodiversity. Methods: We gathered published and grey literature through searches in two publications databases (Scopus and Web of Science Core Collection), one search engine (Google Scholar), nine organisational websites and through a call for literature. Titles, abstracts, and full-texts were successively screened using eligibility criteria. All included studies were described with coded variables and a database was produced. The extent of evidence was assessed and knowledge clusters and gaps were identified. Review findings: The searches yielded 9265 articles, and 153 articles were retained after the screening process. More than half of these articles were from European countries, with France leading the field with 40 articles, followed by Spain (15 articles) and Italy (10 articles). Most of the articles (75%) were produced after 2015. The main reasons for constructing soils from mineral waste were for mine rehabilitation (35%), waste recycling (16%) and experimental purpose (15%). The 153 articles were divided into 1962 studies, a study being a combination of a taxon, an intervention (i.e. soil construction) and a measured outcome. Among these studies, the most studied biological group is plants (69% of studies) and especially herbaceous species (32%), followed by microorganisms (17%) and invertebrates (14%). The most used type of mineral waste is mine waste (31% of studies) followed by excavated soil (16%) and demolition waste (14%). Finally, the most frequently measured outcome is plant growth (42% of studies), followed by organism abundance (16%) and diversity (10%). Conclusions: Three main knowledge clusters were identified which could be addressed in the future for full synthesis of the results: (1) How well do plants grow in soils constructed from mineral wastes? (2) What is the potential of soils constructed from mineral wastes to support biodiversity? and (3) How do microbial communities develop in soils constructed from mineral wastes? There is a lack of studies investigating several biological groups at the same time: only 6 articles out of 153 investigated the response of both plants, invertebrates and microorganisms to soil construction. More research is therefore needed on the ability to support a diversity of organisms. [ABSTRACT FROM AUTHOR]

In countries that are big producers of olive oil such as Spain, Italy, or Greece, large amounts of olive husk remain as waste from processing olives and pose a serious environmental issue. One of the solutions could be to use this waste to partially replace sand in cement mortar to preserve the environment, decrease the consumption of cement, and improve economic benefits. This work presents our initial results which show the viability of using olive waste as an aggregate in cementitious mortars, indicating that the organic materials studied can be promising for this purpose. [ABSTRACT FROM AUTHOR]

Although concepts such as research without borders have become more commonplace in recent decades, few studies have investigated the capabilities that global researchers require to cross both cultural and disciplinary borders. This paper explores global capabilities along with strategies and spaces that may facilitate academic researchers' acquisition and development of global research competence. The study's dataset comprises responses of 26 participants across 15 countries -- all of whom are members of a specific comparative education society -- who contributed their views via e-questionnaire. Findings indicate that research capacity building is a dynamic process and global competence calls for complex skills and conscious attitudes. Commitment to expand scientific curiosity beyond one's own culture and academic discipline appears to be a main criterion in achieving global competence. Results of this study are not meant to be prescriptive but rather exploratory and informative for a broad group of academic stakeholders.

Objective: This review summarizes evidence pertaining to the impact of the COVID-19 pandemic on the psychological health of children and adolescents with autism spectrum disorder (ASD). Materials and Methods: An electronic search was conducted using four major databases--PubMed, ScienceDirect, Web of Science, and Google Scholar. Using an umbrella methodology, the reference lists of relevant papers were reviewed, and citation searches were conducted. The study included articles written in English between January 2020 and March 2021 that focused on the psychological health of autistic children and adolescents. Results: All eight studies included in the final review were cross-sectional. Three of the eight studies were conducted in Italy, two in Turkey, and one study each in Portugal, Spain, and the United Kingdom, with a total of 1,407 participants. All studies used a mixture of standardized and non-standardized questionnaires to collect data. The total number of patients were 1407 at a mean age of 9.53 (SD = 2.96) years. Seven studies report gender; male 74.7% (657/880) and female 25.3% (223/880). The finding showed that behavioral issues in children and adolescents with ASD have significantly increased; 521 (51.9 percent) of the 1004 individuals with ASD presented with behavioral changes, including conduct problems, emotional problems, aggression, and hyperactivity. Some studies also found increased anxiety and difficulties managing emotions. Only one study reported clinical stabilization in children with ASD during COVID-19. Finally, 82.7% of families and caregivers of children with ASD (544 out of 658) faced challenges during COVID-19. Conclusion: Although the studies in this review suggest a general worsening of ASD children's clinical status, it remains difficult to draw definitive conclusions at this moment, with newer COVID-19 variants on the rise worldwide. During this difficult pandemic period, caregivers, families, and healthcare professionals are recommended to pay more attention to the ASD patients' health and care needs.

Introduction: The high recombinogenic potential of HIV-1 has resulted in the generation of countless unique recombinant forms (URFs) and around 120 reported circulating recombinant forms (CRFs). Here we identify through analyses of near full-length genomes (NFLG) a new HIV-1 CRF derived from subtypes B and F1. Methods: HIV-1 protease-reverse transcriptase (Pr-RT) sequences were obtained by RT-PCR amplification from plasma RNA. Near full-length genome sequences were obtained after amplification by RT-PCR in 5 overlapping fragments. Phylogenetic sequence analyses were performed via maximum likelihood. Mosaic structures were analyzed by boot-scanning and phylogenetic analyses of genome segments. Temporal and geographical estimations of clade emergence were performed with a Bayesian coalescent method. Results: Through phylogenetic analyses of HIV-1 Pr-RT sequences obtained by us from samples collected in Spain and downloaded from databases, we identified a BF1 recombinant cluster segregating from previously reported CRFs comprising 52 viruses, most from Brazil (n =  26), Spain (n =  11), and Italy (n =  9). The analyses of NFLG genomes of 4 viruses of the cluster, 2 from Spain and 2 from Italy, allowed to identify a new CRF, designated CRF75_BF1, which exhibits a complex mosaic structure with 20 breakpoints. All 4 patients harboring CRF75_BF1 viruses studied by us had CD4+ T-cell lymphocyte counts below 220/mm³ less than one year after diagnosis, a proportion significantly higher (p =  0.0074) than the 29% found in other patients studied in Spain by us during the same period. The origin of the clade comprising CRF75_BF1 and related viruses was estimated around 1984 in Brazil, with subsequent introduction of CRF75_BF1 in Italy around 1992, and migration from Italy to Spain around 1999. Conclusion: A new HIV-1 CRF, designated CRF75_BF1, has been identified. CRF75_BF1 is the 6th CRF of South American origin initially identified in Western Europe, reflecting the increasing relationship of South American and European HIV-1 epidemics. The finding of low CD4+ T-cell lymphocyte counts early after diagnosis in patients harboring CRF75_BF1 viruses warrants further investigation on the virulence of this variant. [ABSTRACT FROM AUTHOR]

Introduction: Educators require focused training to foster the development of intercultural competence in nurses. Training programs for educators need to be based on a comprehensive profile with a focus on intercultural learning. This study aims to define and validate a profile of the Intercultural Nursing Educator (INE). Method: The Delphi method was used with an iterative, multi-stage process to transform opinions into group consensus. A total of 46 European, African, and American experts from the nursing and intercultural field participated. Inclusion criteria required English at a level of B2, expertise in the field of intercultural competence, experience in teaching intercultural competence in the nursing context, and publications focused on intercultural topics. Results: The INE profile was developed and all 126 competencies were validated. Discussion and conclusion: The profile is freely available on the project website and provides the basis for curricula, training programs and assessment of the required competences. [ABSTRACT FROM AUTHOR]

Introduction: Randomized controlled trials (RCTs) are the gold standard when comparing treatment effectiveness, and Health Technology Assessment (HTA) agencies state a clear preference for such direct comparisons. When these are not available, an indirect treatment comparison (ITC) is an alternative option. The objective of this study was to assess the acceptance of ITC methods by HTA agencies across England, France, Germany, Italy, and Spain, using oncology cases for a homogeneous sample of HTA evaluations. Methods: The study was conducted on the PrismAccess database in May 2021 to retrieve HTA evaluation reports for oncology treatments for solid tumors, in which an ITC was presented. The analysis was restricted to HTA evaluation reports published between April 2018 and April 2021 in England, France, Germany, Italy, and Spain. Identified HTA evaluation reports were screened and reviewed by two independent reviewers. For each ITC presented, the methodology and its acceptance by the HTA agency were analyzed. Results: Five hundred and forty-three HTA evaluation reports were identified, of which 120 (22%) presented an ITC. This proportion was the highest in England (51%) and lowest in France (6%). The overall acceptance rate of ITC methods was 30%, with the highest in England (47%) and lowest in France (0%). Network meta-analysis (NMA; 23%) was the most commonly used ITC technique, with a 39% acceptance rate overall, followed by Bucher ITC (19%; 43% acceptance rate) and matching-adjusted indirect comparison (13%; 33% acceptance rate). The most common criticisms of the ITC methods from HTA agencies related to data limitations (heterogeneity and lack of data; 48% and 43%, respectively) and the statistical methods used (41%). Conclusions: The generally low acceptance rate of ITC methods by HTA agencies in oncology suggests that, whilst in the absence of a direct comparison ITCs may provide relevant evidence, this evidence is not widely considered sufficient for the purpose of HTA evaluations. The perception of ITC methods for the purpose of HTA evaluations varies substantially between countries. There is a need for further clarity on the properties of ITC techniques and the assessment of their results as ITC methods continue to evolve quickly and further techniques may become available in the future. [ABSTRACT FROM AUTHOR]

This article provides a comprehensive study of ecosystem rehabilitation methods widely used in the 21st century, focusing on Europe. The review covers the evolution and trends in scientific article publication, identification of European countries demonstrating high publication outputs, collaboration patterns, leading journals, and thematic areas. Additionally, it examines primary stressors in European aquatic ecosystems, and different methods and treatments commonly employed for remediation purposes. The analysis of selected articles revealed a significant increase in studies over time, driven by public awareness and financial incentives from national, European and global organizations. Italy, Portugal and Spain were the leading countries in degraded ecosystem rehabilitation studies, mainly focusing on remediating contaminated areas where metals were identified as the primary stressor (chemical pollution). Chemical remediation method emerged as the most used, closely followed by biological remediation method, which have gained prominence in recent years due to their ecological, economic, and social combined benefits. Furthermore, recent studies demonstrate a growing trend towards the combined use of more than one treatment/method to rehabilitate ecosystems, particularly with biological treatments. This combined approach has the potential for synergistic effects in achieving more effective rehabilitation and their sustainability in the long term, thus, a focus for future research., 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 © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Over the years, different solutions were developed and tested to reduce the emissions of ammonia and particulate matter from the livestock facilities. The environmental performances of these solutions were not always evaluated in detail. This study examines the environmental footprint of pig production at farm gate, with a focus on emissions from housing. Using Life Cycle Assessment, the environmental impact of pig production in a transition farm in Spain and in two finishing farms in Italy was evaluated considering three scenarios (one baseline and two of them involving an air treatment technology: wet scrubber or dry scrubber). The study goal was to quantify the environmental footprint of pig production in different scenarios, identify key environmental hotspots, and to assess impact reduction efficiency due to the two assessed technologies, analyze the environmental trade-offs that come with the use of these technologies, and identify potential for improvements. Both wet and dry scrubbers showed potential for reducing emissions in pig housing, affecting environmental impact categories related to air pollutants such as particulate matter, acidification and eutrophication. However, there were trade-offs between emissions reduction and categories related to energy and resource use. The infrastructure and consumables required to operate the scrubber added to the impacts compared to the baseline. The dry scrubber showed a more favorable balance between emission reduction and trade-offs. In this regard, results were similar for the Spanish and Italian farms, although there were slight variations. Scrubbers had a greater effect in the Italian farms due to their use along longer periods of the pig fattening (closed cycle farms) compared to the Spanish farm (transition farm). Scrubbers are environmentally promising, especially where acidification, eutrophication and particulate matter are local problems. However, they alone cannot fully address the complex environmental impacts of pig production, which require comprehensive interventions across the supply chain., 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 © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Considerable resources are spent globally on actions to improve the separate collection of municipal waste aiming to minimise the environmental and economic impacts of municipal waste management. One of such actions are know-as-you-throw (KAYT) schemes, which aim to change the behaviour of waste generators through tailored communication of information. KAYT schemes offer a relatively uncontroversial and simple tool, yet their environmental and economic performance remains unknown due to their limited implementation. To fill this gap, the LIFE-funded REthinkWASTE project applied a novel KAYT scheme in four pilot areas in Italy and Spain. The results of such pilots were evaluated in terms of carbon footprint and life-cycle costs of municipal waste management. The carbon footprint was notably reduced in all pilot areas, ranging from a 46% to 19% reduction, mainly due to notable reductions in unsorted waste (between 10 and 17% reduction) and subsequent lower treatment impacts. Life-cycle costs slightly increased overall, ranging from 4.6% to a -0.4% change. In addition to various sources of uncertainty, self-selection and recency biases are highlighted as major sources for potentially overestimating the benefits of KAYT in the context of large-scale and long-term KAYT implementation. The results however consistently show that the additional carbon footprint from KAYT actions can be offset with less than a 5% reduction in unsorted waste, well below the observed values. The results robustly reveal the potential of KAYT to notably reduce the carbon footprint of waste management systems with limited investment of economic resources., 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 © 2024 Elsevier Ltd. All rights reserved.)

This study addressed the scarcity of NH 3 measurements in urban Europe and the diverse monitoring protocols, hindering direct data comparison. Sixty-nine datasets from Finland, France, Italy, Spain, and the UK across various site types, including industrial (IND, 8), traffic (TR, 12), urban (UB, 22), suburban (SUB, 12), and regional background (RB, 15), are analyzed to this study. Among these, 26 sites provided 5, or more, years of data for time series analysis. Despite varied protocols, necessitating future harmonization, the average NH 3 concentration across sites reached 8.0 ± 8.9 μg/m 3 . Excluding farming/agricultural hotspots (FAHs), IND and TR sites had the highest concentrations (4.7 ± 3.2 and 4.5 ± 1.0 μg/m 3 ), followed by UB, SUB, and RB sites (3.3 ± 1.5, 2.7 ± 1.3, and 1.0 ± 0.3 μg/m 3 , respectively) indicating that industrial, traffic, and other urban sources were primary contributors to NH 3 outside FAH regions. When referring exclusively to the FAHs, concentrations ranged from 10.0 ± 2.3 to 15.6 ± 17.2 μg/m 3 , with the highest concentrations being reached in RB sites close to the farming and agricultural sources, and that, on average for FAHs there is a decreasing NH 3 concentration gradient towards the city. Time trends showed that over half of the sites (18/26) observed statistically significant trends. Approximately 50 % of UB and TR sites showed a decreasing trend, while 30 % an increasing one. Meta-analysis revealed a small insignificant decreasing trend for non-FAH RB sites. In FAHs, there was a significant upward trend at a rate of 3.51[0.45,6.57]%/yr. Seasonal patterns of NH 3 concentrations varied, with urban areas experiencing fluctuations influenced by surrounding emissions, particularly in FAHs. Diel variation showed differing patterns at urban monitoring sites, all with higher daytime concentrations, but with variations in peak times depending on major emission sources and meteorological patterns. These results offer valuable insights into the spatio-temporal patterns of gas-phase NH 3 concentrations in urban Europe, contributing to future efforts in benchmarking NH 3 pollution control in urban areas., 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 © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)