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The European Association of Cardiovascular Imaging (EACVI) is committed to maintaining the highest standards of professional excellence in all aspects of cardiovascular imaging. The mission of the EACVI is to promote excellence in clinical diagnosis, research, technical development, and education in cardiovascular imaging with a particular focus on education, training, scientific initiatives, and research. The EACVI established the Scientific Initiatives Committee (SIC) in December 2018. This committee has responsibility for surveys among imagers, patients' surveys and surveys including data from clinical practice. The current document describes the aims of the EACVI SIC and the creation of the international EACVI survey network. This document summarizes the EACVI's standards for the survey questions and standards for writing the papers with the results of the surveys. These are in accordance with previous recommendations and were approved by the EACVI SIC and the EACVI Board in 2019. [ABSTRACT FROM AUTHOR]

Objectives Research among older adults reveals that the loss of core network members is a risk factor for loneliness. Still, it is not clear whether all such losses induce similar levels of loneliness, particularly as network members are distributed at varied geographic distances. Neither is it clear whether tie addition—the other ubiquitous aspect of network turnover in later life—offsets the loneliness that arises from different network loss scenarios. Methods This paper scrutinized core network losses across multiple relationship–distance scenarios. We used the fourth and sixth waves of data from the Survey of Health, Ageing, and Retirement in Europe and estimated fixed-effect models. Results The loss of a child from a core network increases feelings of loneliness across variant distances, especially when not complemented by additional connections. Losing relatives or nonkin core connections in proximity (within 1 km and 5 km radius, respectively) is also associated with increased loneliness, yet such effects are also largely mitigated by the addition of new core network members. Discussion The relationship between core network member losses and loneliness can significantly differ based on the nature of the lost connection and its geographic distance. Active rebalancing of one's core network following losses and proactive network expansion can serve as pivotal strategies to prevent loneliness for the aging population. [ABSTRACT FROM AUTHOR]

Background: Within the European Union (EU), substantial efforts are being made to achieve economic and social cohesion, and the reduction of health inequalities between EU regions is integral to this process. This paper is the first to examine how self-reported conditions and non-communicable diseases (NCDs) vary spatially between and within countries. Methods: Using 2014 European Social Survey (ESS) data from 20 countries, this paper examines how regional inequalities in self-reported conditions and NCDs vary for men and women in 174 regions (levels 1 and 2 Nomenclature of Statistical Territorial Units, 'NUTS'). We document absolute and relative inequalities across Europe in the prevalence of eight conditions: general health, overweight/obesity, mental health, heart or circulation problems, high blood pressure, back, neck, muscular or joint pain, diabetes and cancer. Results: There is considerable inequality in self-reported conditions and NCDs between the regions of Europe, with rates highest in the regions of continental Europe, some Scandinavian regions and parts of the UK and lowest around regions bordering the Alps, in Ireland and France. However, for mental health and cancer, rates are highest in regions of Eastern European and lowest in some Nordic regions, Ireland and isolated regions in continental Europe. There are also widespread and consistent absolute and relative regional inequalities in all conditions within countries. These are largest in France, Germany and the UK, and smallest in Denmark, Sweden and Norway. There were higher inequalities amongst women. Conclusion: Using newly available harmonized morbidity data from across Europe, this paper shows that there are considerable regional inequalities within and between European countries in the distribution of self-reported conditions and NCDs. [ABSTRACT FROM AUTHOR]

Background: It has been suggested that cross-national variation in educational inequalities in health outcomes (e.g. NCDs) is due to cross-national variation in risky health behaviour. In this paper we aim to use highly recent data (2014) to examine educational inequalities in risky health behaviour in 21 European countries from all regions of the continent to map cross-national variation in the extent to which educational level is associated with risky health behaviour. We focus on four dimensions of risky health behaviour: smoking, alcohol use, lack of physical activity and lack of fruit and vegetable consumption. Methods: We make use of recent data from the 7th wave of the European Social Survey (2014), which contains a special rotating module on the social determinants of health. We performed logistic regression analyses to examine the associations between educational level and the risky health behaviour indicators. Educational level was measured through a three-category version of the harmonized International Standard Classification of Education (ISCED). Results: Our findings show substantial and mostly significant inequalities in risky health behaviour between educational groups in most of the 21 European countries examined in this paper. The risk of being a daily smoker is higher as respondents' level of education is lower (Low education (L): OR = 4.24 (95% CI: 3.83^.68); Middle education (M): OR = 2.91 (95% CI: 2.65-3.19)). Respondents have a lower risk of consuming alcohol frequently if they have a low level of education (L: OR = 0.59 (95% CI: 0.54-0.64); M: OR = 0.70 (95% CI: 0.65-0.76)), but a higher risk of binge drinking frequently (L: OR = 1.29 (95% CI: 1.16-1.44); M: OR = 1.15 (95% CI: 1.04-1.27)). People are more likely to be physically active at least 3 days in the past week when they have a higher level of education (M: OR = 1.42 (95% CI: 1.34-1.50); H: OR = 1.67 (95% CI: 1.55-1.80)). Finally, people are more likely to consume fruit and vegetables at least daily if they have a higher level of education (fruit: M: OR = 1.09 (95% CI: 1.03-1.16); H: OR = 1.77 (95% CI: 1.63-1.92); vegetables: M: OR = 1.34 (95% CI: 1.26-1.42); H: OR = 2.35 (95% CI: 2.16-2.55)). However, we also found considerable cross-national variation in the associations between education and risky health behaviour. Conclusions: Our results yield a complex picture: the lowest educational groups are more likely to smoke and less likely to engage in physical activity and to eat fruit and vegetables, but the highest educational groups are at greater risk of frequent alcohol consumption. Additionally, inequalities in risky health behaviour do not appear to be systematically weakest in the South or strongest in the North and West of Europe. [ABSTRACT FROM AUTHOR]

Objectives This paper explores how to measure successful aging in a manner consistent with the preferences of older persons about what matters in their lives. Method To overcome the fact that existing objective and subjective measures of successful aging may not reflect the preferences of older persons about what matters in their lives, a new preference-based measure of successful aging is proposed. To implement the measure, the preferences of older persons are estimated using a statistical life satisfaction model, which is estimated with data from 11 European countries from the Survey of Health, Ageing and Retirement in Europe (SHARE). Results The proposed measure is found to yield different results compared to objective and subjective measures in terms of how successful aging has evolved between 2007 and 2013 and how countries are ranked for successful aging. Successful aging measured by a subjective measure is highest in 2011 compared to 2007 and 2013, for instance, whereas the ranking is reversed for the objective- and preference-based measures. Discussion The findings highlight the relevance of the degree of importance we attribute to the preferences of older persons in the measurement of successful aging, methodologically as well as empirically. [ABSTRACT FROM AUTHOR]

This paper reports on a study undertaken to determine what progress has been made in the uptake and impact of the CompHP Core Competencies on Health Promotion practice, education and training in Europe since their publication in 2011. The study used a purposive sample comprising health promoters who had contributed to the development of the CompHP Competencies was augmented by snowball sampling across European Health Promotion practitioners. An online survey tool was employed to elicit information on respondents' attitudes to the Competencies, levels of current and intended use, and opinions on their impact. A total of 81 responses were received from 25 European countries. Findings on factors considered likely to influence the use of the Competencies were generally positive, as were respondents' attitudes to them. However, only 53% of respondents reported that the CompHP Competencies were used in their country and 54% that they used them in their practice. The Competencies were most frequently used in Health Promotion education, where their impact was also most apparent. A lack of support and recognition of the Competencies by key organizations and stakeholders at country level emerges as a potentially critical factor influencing their uptake and use. The survey findings provide an insight into the uptake and impact of the CompHP Core Competencies to date and begin to address the gap in empirical evidence on the use and impact of Health Promotion competencies. However, further research is required to explore the factors influencing implementation of the CompHP Core Competencies at a country level. [ABSTRACT FROM AUTHOR]

Objectives IgA vasculitis (IgAV, formerly known as Henoch–Schönlein purpura) is the most common cause of systemic vasculitis in childhood. To date, there are no internationally agreed, evidence-based guidelines concerning the appropriate diagnosis and treatment of IgAV in children. Accordingly, treatment regimens differ widely. The European initiative SHARE (Single Hub and Access point for paediatric Rheumatology in Europe) aims to optimize care for children with rheumatic diseases. The aim therefore was to provide internationally agreed consensus recommendations for diagnosis and treatment for children with IgAV. Methods Recommendations were developed by a consensus process in accordance with the EULAR standard operating procedures. An extensive systematic literature review was performed, and evidence-based recommendations were extrapolated from the included papers. These were evaluated by a panel of 16 international experts via online surveys and subsequent consensus meeting, using nominal group technique. Recommendations were accepted when ⩾80% of experts agreed. Results In total, 7 recommendations for diagnosis and 19 for treatment of paediatric IgAV were accepted. Diagnostic recommendations included: appropriate use of skin and renal biopsy, renal work-up and imaging. Treatment recommendations included: the importance of appropriate analgesia and angiotensin-converting enzyme inhibitor use and non-renal indications for CS use, as well as a structured approach to treating IgAV nephritis, including appropriate use of CS and second-line agents in mild, moderate and severe disease along with use of angiotensin-converting enzyme inhibitors and maintenance therapy. Conclusion The SHARE initiative provides international, evidence-based recommendations for the diagnosis and treatment of IgAV that will facilitate improvement and uniformity of care. [ABSTRACT FROM AUTHOR]

Background Family policies have been shown to affect men's and women's health throughout the European Union, though particularly in the case of women. This paper seeks to analyze this effect by creating two Synthetic Health Indicators (SHIs) differentiated by gender applying the P 2 distance method. We also aim to compare the results obtained by means of our SHI and the Self-rated health (SRH) indicator, as it is the most common indicator used to approach individuals' health. Methods The 2012 European Quality of Life Survey was used to construct the SHI. Dimensions such as physical health, mental health, psychosocial resources, the capacity of health services and community health status were included in our SHI. All proved to be relevant when measuring individuals' health. Results Gender health inequalities differed depending on the indicator used in each European country. When considering family policy, we found significant gender health gaps that favoured men in traditional countries, regardless of the indicator used (SHI or SRH). Moreover, with our SHI we found significant gender health inequalities in market-oriented and dual-earner countries that were not revealed by the SRH indicator, highlighting the fact that current equality policies are necessary but insufficient to overcome the gender health gap. Conclusions The SHI was more sensitive to gender differences and evidenced certain advantages compared to the SRH. The SHI includes a wide range of variables that incorporated large amounts of fresh information, allowing men and women to have a personalized design of their own health. [ABSTRACT FROM AUTHOR]

Objectives The European Single Hub and Access point for paediatric Rheumatology in Europe initiative aimed to optimize care for children with rheumatic diseases. Kawasaki disease (KD) is the most common cause of acquired heart disease in children and an important cause of long-term cardiac disease into adulthood. Prompt diagnosis and treatment of KD is difficult due to the heterogeneity of the disease but is crucial for improving outcome. To date, there are no European internationally agreed, evidence-based guidelines concerning the diagnosis and treatment of KD in children. Accordingly, treatment regimens differ widely. The aim of this study is to provide consensus-based, European-wide evidence-informed recommendations for diagnosis and treatment of children with KD. Methods Recommendations were developed using the EULAR's standard operating procedures. An extensive systematic literature search was performed, and evidence-based recommendations were extrapolated from the included papers. These were evaluated by a panel of international experts via online surveys and subsequently discussed in three consensus meetings, using nominal group technique. Recommendations were accepted when ⩾80% agreed. Results In total, 17 recommendations for diagnosis and 14 for treatment of KD in children were accepted. Diagnostic recommendations included laboratory and imaging workup for complete as well as incomplete KD. Treatment recommendations included the importance of early treatment in both complete and incomplete KD, use of intravenous immunoglobulin, aspirin, corticosteroids for high-risk cases, and other treatment options for those with resistant disease. Conclusion The Single Hub and Access point for paediatric Rheumatology in Europe initiative provides international evidence-based recommendations for diagnosing and treating KD in children, facilitating improvement and uniformity of care. [ABSTRACT FROM AUTHOR]

Background There is substantial evidence on the importance of voluntary activities for the health of middle-aged and older adults. Evidence on the effects of health and well-being on volunteering is more limited. This study examines reciprocal longitudinal associations between voluntary and/or charity activities and 21 indicators related to physical health, well-being, cognitive impairment and daily life functioning among middle-aged and older adults. Methods Longitudinal data were collected between 2011 and 2020 from a sample of 19 821 middle-aged and older adults from 15 countries participating in the Survey of Health, Ageing and Retirement in Europe. An outcome-wide analysis and an exposure-wide analysis were applied and generalized estimating equations were used. Robustness analyses were conducted. Results Voluntary and/or charity activities almost every week or more often were prospectively associated with greater emotional well-being, reduced risks of limitations in activities of daily living and of being diagnosed with Alzheimer's disease at a 6-year follow-up. Positive reverse associations were found from emotional well-being to volunteering. Limitations in daily life activities, increased loneliness, high blood cholesterol, hypertension and chronic lung disease were found to impede participation in voluntary and/or charity activities over time. Feedback loops between voluntary and/or charity activities and well-being and limitations in daily activities may exist. Conclusion Understanding the reciprocal nature of the relationship between volunteering and health and well-being can help identify strategies to encourage volunteering among middle-aged and older adults with specific health conditions and to target health promotion efforts towards volunteers. [ABSTRACT FROM AUTHOR]

Introduction: EURO-URHIS 2 aimed to collect comparable health indicators across a large number of urban areas (UAs) across Europe and Vietnam using four data collection tools. This paper outlines the process for the selection of indicators to be collected from routinely available sources, and the piloting of the data collection tool. Methods: A long-list of indicators potentially collectable from routinely available sources was generated by the EURO-URHIS 2 consortium. Key contacts from each UA completed an e-mail survey reporting for each indicator whether it could be collected using the given definition, an alternative definition or not at all. Additionally participants listed the 20 leading causes of death for their UAs from the Eurostat 65. Results were compiled to inform indicator selection for the main data collection phase. Results: Responses were received for 25 of 28 eligible UAs. Of the 29 proposed indicators, 55.1% (n = 16) were accepted without change, 24.1% (n = 7) were re-allocated to other data collection tools and 17.2% (n = 5) were accepted after a modification of the EURO-URHIS 2 definition. Discussion: This scoping exercise and piloting phase for the 'existing data tool' for the project was useful and informative. It provided detailed information on what could be collected, and an opportunity to modify indicator definitions to maximize response rates. These results are only applicable to those UAs returning results and cannot be generalized. Detailed interrogation of definitions is essential to this sort of data collection, and the process described was designed with cross-national comparability in mind. [ABSTRACT FROM AUTHOR]

Background: Financial difficulties in childhood may be associated with immediate and long-term consequences for mental health. The aim of the current paper is to investigate the association between childhood financial difficulties and adult depression, and assess the relative contribution of financial difficulties in childhood to symptoms of adult depression across different age groups. Methods: Using three age cohorts (25-40, 41-59, 60-75) from 19 countries in the European Social Survey Round 7 (N=18 401), multi-level and country-wise OLS regression analyses were used to investigate the association between financial difficulties in childhood and adult depression, while adjusting for age, education, gender, highest education in family, level of family conflict, number of social meetings and marital status. Results: Financial difficulties in childhood was found to be influential predictors of depression scores for 25-40 year olds in 10 out of 19 countries in fully adjusted models. In older participants, depression scores were mostly influenced by frequency of social meetings and marital status. There was great variation in the pattern of influential risk factors across countries, and the predicted effect childhood financial difficulties had on adult depression scores. Conclusion: Childhood financial difficulties as predictors of depression appear to, by themselves, exert the strongest influence in younger adults. There was, however, large variation between countries in the magnitude of associated risk, and in the pattern of risk factors contributing to adult depression, which underscores the need to account for country-level factors when aiming to gain knowledge about mental health. [ABSTRACT FROM AUTHOR]

Background: A range of non-communicable diseases (NCDs) has been found to follow a social pattern whereby socioeconomic status predicts either a higher or lower risk of disease. Comprehensive evidence on the socioeconomic distribution of NCDs across Europe, however, has been limited. Methods: Using cross-sectional 2014 European Social Survey data from 20 countries, this paper examines socioeconomic inequalities in 14 self-reported NCDs separately for women and men: heart/circulatory problems, high blood pressure, back pain, arm/ hand pain, foot/leg pain, allergies, breathing problems, stomach/digestion problems, skin conditions, diabetes, severe headaches, cancer, obesity and depression. Using education to measure socioeconomic status, age-controlled adjusted risk ratios were calculated and separately compared a lower and medium education group with a high education group. Results: At the pooled European level, a social gradient in health was observed for 10 NCDs: depression, diabetes, obesity, heart/circulation problems, hand/arm pain, high blood pressure, breathing problems, severe headaches, foot/leg pain and cancer. An inverse social gradient was observed for allergies. Social gradients were observed among both genders, but a greater number of inequalities were observed among women. Country-specific analyses show that inequalities in NCDs are present everywhere across Europe and that inequalities exist to different extents for each of the conditions. Conclusion: This study provides the most up-to-date overview of socioeconomic inequalities for a large number of NCDs across 20 European countries for both women and men. Future investigations should further consider the diseases, and their associated determinants, for which socioeconomic differences are the greatest. [ABSTRACT FROM AUTHOR]

Background: Health inequalities persist between and within European countries. Such inequalities are usually explained by health behaviours and according to the conditions in which people work and live. However, little is known about the relative contribution of these factors to health inequalities in European countries. This paper aims to investigate the independent and joint contribution of a comprehensive set of behavioural, occupational and living conditions factors in explaining social inequalities in self-rated health (SRH). Method: Data from 21 countries was obtained from the 2014 European Social Survey and examined for respondents aged 25-75. Adjusted rate differences (ARD) and adjusted rate risks (ARR), generated from binary logistic regression models, were used to measure health inequalities in SRH and the contribution of behavioural, occupational and living conditions factors. Result: Absolute and relative inequalities in SRH were found in all countries and the magnitude of socio-economic inequalities varied considerably between countries. While factors were found to differentially contribute to the explanation of educational inequalities in different European countries, occupational and living conditions factors emerged as the leading causes of inequalities across most of the countries, contributing both independently and jointly with behavioural factors. Conclusion: The observed shared effects of different factors to health inequalities points to the interdependent nature of occupational, behavioural and living conditions factors. Tackling health inequalities should be a concentred effort that goes beyond interventions focused on single factors. [ABSTRACT FROM AUTHOR]

Background A pre-existing, well-established European influenza surveillance network known as I-MOVE enabled the rapid implementation of a European multi-country COVID-19 hospital surveillance network for surveillance of hospitalized COVID-19 cases in early 2020. This network included 257 hospitals in 11 surveillance sites across nine countries. We aimed to identify whether the surveillance objectives were relevant to public health actions, whether the surveillance system met its objectives, where and how shortcomings could be improved, and whether the system was sustainable. Methods We identified six key attributes (meeting objectives, usefulness, timeliness, data quality, simplicity and sustainability) to assess, using Centers for Disease Control and Prevention's evaluation framework. We analyzed pooled datasets, held interviews and group discussions with 10 participating and coordinating sites and gathered feedback through web surveys. Results There was overall agreement that the surveillance objectives had been met and being involved in a network of European partners had additional important benefits for stakeholders. While the publication of the outputs was not always sufficiently timely, data submission processes were considered straightforward and the key surveillance variables (age, sex, hospital admission and mortality data) were complete. The main challenges were identified as the collection of the large number of variables, limited available human resources and information governance and data protection laws. Conclusions I-MOVE-COVID-19 delivered relevant and accurate data supporting the development and implementation of COVID-19 surveillance. Recommendations presented here identify learning opportunities to support preparedness and surveillance response for future pandemics. The applied evaluation framework in this study can be adapted for other European surveillance system evaluations. [ABSTRACT FROM AUTHOR]

Who do citizens blame for the recent European economic crisis? In this paper, we test theories about blame attribution with respect to the economic crisis. We argue that blame for the crisis is partially conditioned by partisan bias and framings of the crisis as being related to globalization. We test the argument with new survey data and a survey experiment from Spain. In the experiment, respondents receive different framings of the economic crisis which are endorsed by different political parties and non-partisan organizations. We obtain the following findings: (i) blame for who is responsible for the economic crisis is greatly affected by partisanship; (ii) making globalization as a cause of the crisis salient exonerates the government of blame, but only for co-partisans of the government; and (iii) citizens are willing to blame other globalization-related factors for the crisis, in particular, European governments and blame the domestic government less. The results expand our understanding of public opinion dynamics during major economic recessions and also suggest conditions under which 'scapegoating' globalization can occur. [ABSTRACT FROM AUTHOR]

The article discusses anchoring vignettes as a solution to differential item functioning (DIF). It explains the non-parametric method and parametric solution known as the hierarchical ordered probit (HOPIT) model of anchoring vignettes. Particular focus is offered for the application of the models to the data on the Survey of Health, Ageing and Retirement in Europe (SHARE) to highlight how the anchoring vignettes can correct DIF.

The design of a national dose protocol for interventional radiology has been one of the tasks during the European SENTINEL Coordination Action. The present paper describes the pilot experience carried out in cooperation with the Spanish Society on Vascular and Interventional Radiology (SERVEI). A prospective sample of procedures was initially agreed. A common quality control of the X-ray systems was carried out, including calibration of the air kerma area product (KAP) meters. Occupational doses of the radiologists involved in the survey were also included in the survey. A total of 10 Spanish hospitals with interventional X-ray units were involved. Six hundred and sixty-four patient dose data were collected from 397 diagnostic and 267 therapeutic procedures. Occupational doses were evaluated in a sample of 635 values. The obtained KAP median/mean values (Gy·cm²) for the gathered procedures were: biliary drainage (30.6/68.9), fistulography (4.5/9.8), lower limb arteriography (52.2/60.7), hepatic chemoembolisation (175.8/218.3), iliac stent (45.9/73.2) and renal arteriography (39.1/59.8). Occupational doses (mean monthly values, in mSv) were 1.9 (over apron); 0.3 (under apron) and 4.5 (on hands). With this National experience, a protocol was agreed among the SENTINEL partners to conduct future similar surveys in other European countries. [ABSTRACT FROM AUTHOR]

Background Accurate comparable prevalence proportions are required to better understand the epidemiology of frailty. Estimates in many countries are missing or incomparable. The Global Burden of Disease Frailty Index (GBD-FI) applies the deficit accumulation model to generate frailty scores from items available in the Global Burden of Disease study. Objective To externally validate the GBD-FI. Methods Data were obtained from the Survey of Health Ageing and Retirement in Europe (SHARE). A 20-item modified GBD-FI was compared with established frailty measures: a 70-item frailty index (FI-70), the Clinical Frailty Scale (CFS), Frailty Phenotype (FP) and SHARE-FI. Area under receiver operating characteristic curves (AUC) were fitted to examine diagnostic accuracy for frailty and predictive validity for 2-year mortality. Results In total, 31,624 participants aged ≥50 years from 15 countries were included. Frailty prevalence was 22% using the GBD-FI (ranging from 8% in Switzerland to 41% in Poland). The GBD-FI had good to excellent diagnostic accuracy for frailty, irrespective of approach; the AUC ranged from 0.86 (95% confidence interval: 0.85–0.87) measuring frailty using the CFS to 0.94 (0.93–0.94) with the FI-70. The GBD-FI had similar accuracy for 2-year mortality (AUC 0.71, 0.69–0.74) compared with the CFS (0.73; P  = 0.186), FP (0.73; P  = 0.392) and SHARE-FI (0.70; P  = 0.255) but lower than the FI-70 (0.76; P  < 0.001). Conclusion The GBD-FI demonstrated concurrent and predictive validity, suggesting it is a valid measure of frailty. It has the potential to be an efficient, replicable and consistent approach to comparing frailty between countries and regions across time using GBD data. [ABSTRACT FROM AUTHOR]

Urban–rural disparities in resources, services and facilities not only impact daily living conditions but also contribute to inequalities in physical activity, which may be associated with variations in basic public resources between urban and rural areas. This study aims to examine the evolution of perceived opportunities for physical activity in European urban and rural environments from 2002 to 2017 and their association with an active lifestyle. Data from four waves (2002, 2005, 2013 and 2017) of cross-sectional Eurobarometer surveys were collected (n = 101 373), and multilevel binomial logistic regressions were conducted. Firstly, the time trend of perceived opportunities for physical activity between urban and rural environments was explored, and secondly, the effect of urban–rural perceived opportunities on achieving an active lifestyle over the years was estimated. The findings revealed that individuals residing in rural settings encountered less opportunities to be physically active. Conversely, urban settings experienced an increase in perceived opportunities. The significance of health promotion through perceived physical activity opportunities lies in the increased likelihood of being physically active, regardless of place of residence or individual socioeconomic factors [in the area: odds ratio (OR) = 1.40, 95% confidence interval (CI) = 1.34–1.47; provided by local sport clubs: OR = 1.29, 95% CI = 1.23–1.35]. Modifying environmental aspects, such as enhancing the quantity, quality and accessibility of physical activity opportunities in both rural and urban areas, may lead to improved physical activity and health promotion, particularly among individuals who are more physically inactive. [ABSTRACT FROM AUTHOR]

The author looks at the development of the European Social Survey by the late National Centre for Social Research (Natcen) co-founder Sir Roger Jowell. Topics discussed include the importance of scientifically chosen population samples in information gathering for evidence-based policies, the influence of British Social Attitudes Surveys towards the European Social Survey, and his early work with the European Social Survey since retiring from Natcen in 2001.

Background The increasing availability of Direct-to-Consumer Genetic Tests (DTC-GTs) has great implications for public health (PH) and requires literate healthcare professionals to address the challenges they pose. We designed and conducted a survey to assess the state of knowledge, attitudes and behaviours of PH professionals members of the European Public Health Association (EUPHA) towards DTC-GTs. Methods EUPHA members were invited to participate and fill in the survey. We performed multivariable logistic regression to evaluate associations between selected covariates and knowledge, attitudes and behaviours of healthcare professionals towards DTC-GT. Results Three hundred and two professionals completed the survey, 66.9% of whom were not involved in genetics or genomics within their professional activities. Although 74.5% of respondents were aware that DTC-GTs could be purchased on the web, most of them reported a low level of awareness towards DTC-GTs applications and regulatory aspects. The majority did not approve the provision of DTC-GTs without consultation of a healthcare professional (91.4%), were doubtful about the test utility and validity (61%) and did not feel prepared to address citizens' questions (65.6%). Predictors of knowledge on DTC-GT were the involvement in genetics/genomics and receiving training during the studies (P  < 0.0001 and P  = 0.043). Predictors of attitudes were medical degree and knowledge about DTC-GTs (P  = 0.006 and P  = 0.027). Conclusions Our results revealed a high level of awareness of DTC-GT web purchasing and a moderate to low level of awareness towards their applications. Despite the overall positive attitudes, PH professionals reported a high need for strengthening regulatory aspects of DTC-GTs provision process. [ABSTRACT FROM AUTHOR]

Background Sugar-sweetened beverage (SSB) taxes have emerged as an effective and increasingly popular tool to reduce added sugar intake, an important contributor to obesity and non-communicable diseases. A common barrier to the implementation of well-designed SSB taxes is the opposition of commercial actors. Focusing on the WHO European Region, this study seeks to map if and how key stakeholders have experienced industry efforts to influence SSB taxes. Methods We identified 11 countries in the WHO European Region which have implemented SSB taxes or attempted to do so. Using an online survey informed by the global literature on industry interference with SSB taxation, we approached 70 in-country policymakers, advocates and academics. The data were analysed using an existing framework of corporate political activity. Results Twenty-three experts from nine countries responded to the survey. Transnational SSB producers and their business associations were identified as the most active opponents of SSB taxation. Industry claims that the policy would have negative economic effects were identified as the most common and powerful arguments. Direct lobbying was reported in all study countries. Shifts in political activity were recognisable across stages of the policy process, moving from outright opposition to attempts to delay or weaken the policy after its announcement. Conclusion Those seeking to introduce effective SSB taxation can use our findings to pre-empt and counter industry opposition. We identify several measures for preventing and mitigating industry interference with SSB tax policy. [ABSTRACT FROM AUTHOR]

Background Employees have witnessed rising trend in work stress over the last few decades. However, we know a little about country differences in those trends. Our article fills this gap in the literature by examining heterogeneities in trends in working conditions by country groups defined by their amount of investment into labor market policy (LMP) programs. Additionally, we provide findings on differences in occupational inequalities between country groups. Methods We use comparative longitudinal data of the European Working Conditions Surveys including cross-sectional information on employees from 15 countries surveyed in Waves 1995, 2000, 2005, 2010 and 2015. Estimation results are provided by three-way multilevel models with employees nested within country-years nested within countries. Our work stress measure is the proxy version of job strain based on the demand-control model. Results Our regression results indicate that for employees in countries with the least LMP spending job strain increased by 10% from 1995 to 2015 compared to a smaller and insignificant change in middle- and high-LMP countries. In low-LMP countries, inequalities in job strain also widened during the studied period: the gap in job strain between the highest- and lowest-skilled increased by 60% from 1995 to 2015. This contrasts a stable gap in middle- and high-LMP countries. Conclusions Our results direct the attention to the vulnerable position of the least skilled and highlight that LMP investments may buffer some of the adverse impacts of globalization and technological changes and effectively improve the labor market situation of the least skilled. [ABSTRACT FROM AUTHOR]

ABSTRACT The European Southern Observatory's (ESO) Visible and Infrared Survey Telescope for Astronomy (VISTA) is a 4-m class survey telescope for wide-field near-infrared imaging. VISTA is currently running a suite of six public surveys, which will shortly deliver their first Europe wide public data releases to ESO. The VISTA Kilo-degree Infrared Galaxy survey (VIKING) forms a natural intermediate between current wide shallow and deeper more concentrated surveys, by targeting two patches totalling 1500 deg2 in the Northern and Southern hemispheres with measured 5 σ limiting depths of Z≃ 22.4, Y≃ 21.4, J≃ 20.9, H≃ 19.9 and Ks≃ 19.3 (Vega). This architecture forms an ideal working parameter space for the discovery of a significant sample of 6.5 ≤ z ≤ 7.5 quasars. In the first data release, priority has been placed on small areas encompassing a number of fields well sampled at many wavelengths, thereby optimizing science gains and synergy whilst ensuring a timely release of the first products. For rare object searches, e.g. high- z quasars, this policy is not ideal since photometric selection strategies generally evolve considerably with the acquisition of data. Without a reasonably representative data set sampling many directions on the sky, it is not clear how a rare object search can be conducted in a highly complete and efficient manner. In this paper, we alleviate this problem by supplementing initial data with a realistic model of the spatial, luminosity and colour distributions of sources known to heavily contaminate photometric quasar selection spaces, namely dwarf stars of spectral types M, L and T. We use this model along with a subset of available data to investigate contamination of quasar selection space by cool stars and galaxies and lay down a set of benchmark selection constraints that limit contamination to reasonable levels whilst maintaining high completeness as a function of both magnitude and redshift. We review recent follow-up imaging of the first VIKING high- z quasar candidates and find that the results lend considerable support for the choice of selection constraints. The methods outlined here are also applicable to rare object searches in a number of other ongoing and forthcoming projects. [ABSTRACT FROM AUTHOR]

The article presents a statistical study on the role of response consistency in reporting work disability in Europe. It discusses details of the anchoring vignette approach and conventional panel data techniques to determine the stability of styles of reporting work disability over time using the data from the 2004 and 2006 Surveys of Health, Ageing and Retirement in Europe (SHARE). It explores the significance of the research in application to social security systems.

The article presents a study on the validity of the parametric model for the anchoring vignette method. It explores the sensitivity of the method called the compound hierarchical ordered probit (CHOPIT) model on the choice of the vignette and the domains. It discusses details of the application of the model on data from the 2004 and 2007 Surveys of Health, Ageing and Retirement in Europe (SHARE).

The article presents a statistical study to account for sample selection due to non-response in the anchoring vignette approach. It discusses the parametric solution of the standard compound hierarchical ordinal probit (CHOPIT) model and an extended CHOPIT model (ss_chopit model) used in the study. Particular focus is offered in the Survey of Health, Ageing and Retirement in Europe (SHARE) that used data on the life situations of people aged 50 and over to highlight the use of the models.

Non-response weighting is a commonly used method to adjust for bias due to unit non-response in surveys. Theory and simulations show that, to reduce bias effectively without increasing variance, a covariate that is used for non-response weighting adjustment needs to be highly associated with both the response indicator and the survey outcome variable. In practice, these requirements pose a challenge that is often overlooked, because those covariates are often not observed or may not exist. Surveys have recently begun to collect supplementary data, such as interviewer observations and other proxy measures of key survey outcome variables. To the extent that these auxiliary variables are highly correlated with the actual outcomes, these variables are promising candidates for non-response adjustment. In the present study, we examine traditional covariates and new auxiliary variables for the National Survey of Family Growth, the Medical Expenditure Panel Survey, the American National Election Survey, the European Social Surveys and the University of Michigan Transportation Research Institute survey. We provide empirical estimates of the association between proxy measures and response to the survey request as well as the actual survey outcome variables. We also compare unweighted and weighted estimates under various non-response models. Our results from multiple surveys with multiple recruitment protocols from multiple organizations on multiple topics show the difficulty of finding suitable covariates for non-response adjustment and the need to improve the quality of auxiliary data. [ABSTRACT FROM AUTHOR]

Background As populations age, the possible consequences of increased frailty are a major concern for the health sector. Here, we investigate how life expectancy with and without frailty has changed during a 10–11-year-period across Europe. Methods The Sullivan method was used to investigate changes in life expectancy with and without frailty in 10 European countries. Frailty status (non-frail, pre-frail and frail) was determined by use of the Survey of Health, Ageing and Retirement in Europe Frailty Instrument (SHARE-FI). Data on frailty prevalence was obtained from 21 698 individuals in wave 1 (2004–05) and 38 859 individuals in wave 6 (2015) of the SHARE. Information on mortality was obtained from the Eurostat Database. Results In 2015, women aged 70 spent 25.0% (95% CI: 24.0–26.1) of their remaining life expectancy in a frail state, and the number for men was 11.5% (95% CI: 10.7–12.3). Southern Europeans spent 24.2% (95% CI: 22.9–25.4) of their remaining life expectancy in a frail state and the numbers for Central Europeans and Northern Europeans were 17.0% (95% CI: 16.0–17.9) and 12.2% (95% CI: 10.9–13.5), respectively. From 2004–05 to 2015, life expectancy increased by 1.1 years (from 15.3 to 16.4 years) for 70-year-old Europeans. Similarly, non-frail life expectancy increased by 1.1 years (95% CI: 0.8–1.4), whereas no significant changes in life expectancy in frail states were observed. Conclusions This study suggests that Europeans today spend more years in a non-frail state than Europeans did 10–11 years ago. Our findings reflect a considerable inequality by gender and region. [ABSTRACT FROM AUTHOR]

Background The quality of life (QoL) of older adults is a key aspect of healthy ageing, and older adults' socioeconomic status (SES), the neighbourhood they live in and their social networks (SN) are known to impact QoL. However, little is known about the interaction between these concepts. The aim was to examine how SN, SES and neighbourhood type are associated with QoL in older adults. Methods : Wave 4 (year 2011) and wave 6 (year 2015) data from the longitudinal Survey of Health, Ageing and Retirement in Europe were used for the analysis. Multilevel regression models estimated the associations including 34 792 participants from wave 4 and 67 334 participants from wave 6 from 16 countries (mean age = 66.45 years). The outcome variable was QoL, independent variables were SES (education and making end meet) and neighbourhood type (housing type and housing area), and SN variables (satisfaction and size) were the moderators. Results : SES and SN variables were positively associated with QoL. Living in a house or duplex was positively associated with QoL compared with living in a farmhouse. SN moderated the association between education and QoL. The effect of area type on QoL was moderated by SN size. SN satisfaction was an independent correlate of QoL. Conclusion : Older adults' satisfaction with their SN may be more important than having a large SN. Low SES older adults may be more prone to having weak SN. Maintaining and creating supportive SN may attenuate the negative effects of low SES or less favourable neighbourhood characteristics. [ABSTRACT FROM AUTHOR]

Objectives The Gateway to Global Aging Data (Gateway; g2aging.org) is a data and information platform developed to facilitate cross-country analyses on aging, especially those using the international family of Health and Retirement studies. We provide a brief introduction to the Gateway to Global Aging Data, discussing its potential for cross-national comparisons of family, social environment, and healthy aging. Methods We summarize the survey metadata, study characteristics, and harmonized data available from the Gateway, describing the population represented in each study. We portray cohort characteristics and key measures of health and social environment from 37 countries in North America, Europe, and Asia using harmonized data. Results Significant cross-country heterogeneity was observed in many measures of family, social environment, and healthy aging indicators. For example, there was a threefold difference in coresidence with children, ranging from 14% in Sweden to over 46% in Spain and Korea in 2014. From 2002 to 2014, the difference between informal care receipt in individuals of low and high wealth decreased by 6% in the United States and remained unchanged in England. The percentage of individuals aged 50–59 living alone in 2012 varied 15-fold, from a low of 2% in China to a high of 30% in Mexico. Discussion By partnering with nationally representative studies around the globe, the Gateway to Global Aging Data facilitates comparative research on aging through the provision of easy-to-use harmonized data files and other valuable tools. [ABSTRACT FROM AUTHOR]

The statistical power of prospective studies on diet in relation to chronic disease risk can be improved by maximizing the variation in true intake levels actually distinguished--or 'predicted'--by dietary questionnaire assessments collected at baseline. This can be achieved by 1) developing a questionnaire method that provides measurements with the smallest possible random errors, thus maximizing the correlation of measured with true habitual intake levels; and 2) increasing the between-person variation in true dietary intake levels when combining multiple cohorts in populations with diverse consumption patterns. The first approach implies that, during the development or selection of the questionnaire method, correlations between measurements and true intake levels can be monitored; the second approach requires adjustment for between-centre differences in over--or underestimation of dietary questionnaire measurements. Besides optimizing the statistical power, it is important that the magnitude of the predicted variation in true intake level is estimated accurately, so as to allow unbiased estimations of relative risks. To meet these various objectives, substudies must be conducted for the 'validation' or 'calibration' of dietary questionnaire assessments, by comparison with additional measurements that have independent sources of error. This paper reviews the methodological considerations underlying the design and implementation of such substudies in the EPIC project, a collaborative multicentre study in nine Western European countries. [ABSTRACT FROM AUTHOR]

Early and late cardiovascular (CV) toxicities related to many cancer treatments may complicate the clinical course of patients, offsetting therapeutic benefits, and altering prognosis. The early detection, monitoring, and treatment of cardiotoxicity have therefore become essential parts of cancer patient care. CV imaging is a cornerstone of every cardio-oncology unit, but its use may vary across Europe because of the non-uniform availability of advanced imaging techniques and differences in the organization and logistics of cardio-oncology services. The purpose of this EACVI survey in cardio-oncology is to obtain real-world data on the current usage of cardiac imaging in cancer patients. Data from 104 centres and 35 different countries confirmed that cardiac imaging plays a pivotal role in the detection and monitoring of cardiac toxicity in oncology patients in Europe and beyond. However, it also revealed gaps between guidelines recommendations and everyday clinical practice, highlighting some of the challenges that need to be overcome in this rapidly advancing field. [ABSTRACT FROM AUTHOR]

Background Studies comparing adolescent e-cigarette use in different countries are scarce. We study students' e-cigarette and conventional cigarette ever-use, their social correlates and e-liquid use in seven EU countries. Methods SILNE-R data (N =12 167, response rate 79.4%) of 14–17-year-olds from Amersfoort (NL), Coimbra (PT), Dublin (IR), Hanover (GE), Latina (IT), Namur (BE) and Tampere (FI) were used. E-cigarette and conventional cigarette ever-use, dual-use, type of e-liquid and social correlates were measured with a school survey and analyzed with cross-tabulations and multinomial logistic regression. Results About 34% had tried e-cigarettes, but the variation was large between the cities (Latina 50%; Hanover 23%). Of e-cigarette ever-users, 37% had used nicotine e-liquid, 43% exclusively non-nicotine liquid and 20% did not know the content. Nicotine e-liquid was more prevalent among monthly e-cigarette users and weekly smoking e-cigarette users. The social correlates were mainly the same for exclusive e-cigarette ever-use, exclusive conventional cigarette ever-use and dual-use. Boys had greater odds for exclusive e-cigarette and dual-use compared to girls. Of social correlates, low academic achievement and parental smoking were positively associated with all categories of use, but parental education and immigrant background were not. The strongest association was found between peer smoking (most/all best friends smoke) and dual-use (OR 34.29). Conclusions Students' e-cigarette ever-use varies greatly between EU countries. E-cigarettes seem not to be a substitute for conventional cigarettes but more a complementary product. Tobacco control policies might also prevent e-cigarette use but specific regulations on e-cigarettes are needed to prevent nicotine addiction originating from them. [ABSTRACT FROM AUTHOR]

Aims  The European Association of Cardiovascular Imaging (EACVI) Scientific Initiatives Committee performed a global survey to evaluate the current practice for the assessment and management of patients with suspected patent foramen ovale (PFO) and cryptogenic stroke. Methods and results  In total, 79 imaging centres from 34 countries across the world responded to the survey, which comprised 17 questions. Most non-invasive investigations for PFO were widely available in the responding centres, with the exception of transcranial colour Doppler which was only available in 70% of sites, and most commonly performed by neurologists. Standard transthoracic echocardiography, with or without bubbles, was considered the first-level test for suspected PFO in the majority of the centres, whereas transoesophageal echocardiography was an excellent second-level modality. Most centres would rule out atrial fibrillation (AF) as a source of embolism in all patients with cryptogenic stroke (63%), with the remainder reserving investigation for patients with multiple AF risk factors (33%). Cardiac magnetic resonance was the preferred tool for identifying other unusual aetiologies, like cardiac masses or thrombi. After PFO closure, there was variation in the use of antiplatelet therapy: a quarter recommended treatment for life, while only 12% recommended 5 years as stipulated in the guidelines (12%). Antibiotic prophylaxis prior to dental or endoscopic procedures was not recommended in 41% of centres, contrary to what the guidelines recommended. Conclusion  Our survey revealed a variable adherence to the current recommendations for the diagnosis and management of patients with cryptogenic stroke and PFO. Efforts should focus on optimizing and standardizing diagnostic tests and treatment of this condition. [ABSTRACT FROM AUTHOR]

Background The extreme social circumstances caused by declared COVID-19 pandemic deeply intervene people's everyday life and should not be neglected but seen through the view of social reality pinpointing the 'ordinary' people. In this article, authors explored basic segments of everyday and their subjective perception to what extent sleeping habits, physical inactivity, physical activity, nutritional habits and smoking have changed. Methods The online survey was conducted in nine European countries (Bosnia and Herzegovina, Croatia, Greece, Kosovo*, Italy, Serbia, Slovakia, Slovenia and Spain) in 4108 participants, aged 15–82 years. The survey took place 30–40 days after World Health Organization declared COVID-19 pandemic state, from 15 April to 3 May 2020. Results The results have shown 30 min longer sleeping time, 50% longer physical inactivity time, 65% longer screen time, 43% shorter walking time, 24% shorter sport time and 37% longer physical work time. Additionally, body mass gains (0.3 kg) could be explained in 20.6% with meals sizes, unhealthy food consumption, screen time and sport time. Further, respondents reported more regular meals (44%) and healthier meals with less alcohol consumption and less smoking, which have been positive outcomes of home confinement. Conclusion The findings draw attention to negative changes in everyday praxis (inactivity, body mass gain) after such a short period. Because of possible risk to population's health (especially of countries such as Italy and Spain with serious threat and more stringent measures), findings enable development of recommendations for maintaining healthy lifestyle habits with minimal negative health consequences in similar pandemic circumstances. [ABSTRACT FROM AUTHOR]

Long-term exposures to the stress and stimulation of different work, parenting, and partnership combinations might influence later life cognition. We investigated the relationship between women's work-family life histories and cognitive functioning in later life. Analyses were based on data from women born between 1930 and 1957 in 14 European countries, from the Survey of Health, Ageing and Retirement in Europe (2004–2009) (n  = 11,908). Multichannel sequence analysis identified 5 distinct work-family typologies based on women's work, partnership, and childrearing statuses between ages 12 and 50 years. Multilevel regressions were used to test the association between work-family histories and later-life cognition. Partnered mothers who mainly worked part-time had the best cognitive function in later life, scoring approximately 0.63 (95% confidence interval (CI): 0.18, 1.07) points higher than mothers who worked full-time on a 19-point scale. Partnered mothers who were mainly unpaid caregivers or who did other unpaid activities had cognitive scores that were 1.19 (95% CI: 0.49, 1.89) and 0.93 (95% CI: 0.20, 1.66) points lower than full-time working mothers. The findings are robust to adjustment for childhood advantage and educational credentials. This study provides new evidence that long-term exposures to certain social role combinations after childhood and schooling are linked to later-life cognition. [ABSTRACT FROM AUTHOR]

Background The study assessed awareness and use of heated tobacco products (HTPs) and factors that influenced these issues among cigarette smokers from six European countries in 2016 (Wave 1) and 2018 (Wave 2). Methods A survey was conducted among a nationally representative sample of cigarette smokers aged 18 years or older from Germany, Greece, Hungary, Poland, Romania and Spain in 2016 (N  = 6011) and 2018 (N  = 6027; 53% of smokers from the previous wave were retained, regardless of smoking status and dropouts were replaced by a replenishment sample of smokers). Data were collected through face-to-face interviews. Estimates were produced using weighted data. The study presents the cross-sectional results. Results Awareness of HTPs increased from 8% to 17% between the two waves. At Wave 1, 1.1% of the smokers declared having used HTPs at least once during their lifetime; and at Wave 2, this increased to 1.9% (around 1% or less in four countries, except for Greece and Romania where it was around 4%). Factors associated with HTPs use among those who had ever heard about these products at Wave 1 were country of residence, being a daily cigarette smoker and ever use of electronic cigarettes. At Wave 2, ever use of HTPs was significantly higher among those who had tried to quit smoking combustible cigarettes in the last 12 months, had tried electronic cigarettes during lifetime and perceived HTPs as less dangerous than combustible cigarettes; the country of residence was also associated with HTPs use. Conclusion This study offers insights into the behaviours and perceptions of European adult smokers regarding HTPs, an important emerging issue in the field of tobacco control. [ABSTRACT FROM AUTHOR]

Background The 2016 European Tobacco Products Directive (TPD) required Member States (MS) to implement new regulations for electronic cigarettes (ECs). We conducted a longitudinal study to assess changes over 2 years in smokers' support for EC policies and identify predictors of support in seven European countries after TPD implementation. Methods Prospective cohort surveys were conducted among adult smokers in Germany, Greece, Hungary, Poland, Romania, Spain and England in 2016 (n  = 9547; just after TPD) and 2018 (n  = 10 287; 2 years after TPD). Multivariable logistic regression models employing generalized estimating equations assessed changes in support for four EC policies, and tested for country differences and strength of key predictors of support. Results Banning EC use in smoke-free places was supported by 53.1% in 2016 and 54.6% in 2018 with a significant increase in Greece (51.7–66.0%) and a decrease in Spain (60.1–48.6%). Restricting EC/e-liquid nicotine content was supported by 52.2 and 47.4% in 2016 and 2018, respectively, with a significant decrease in England (54.2–46.5%) and Romania (52.5–41.0%). An EC promotion ban was supported by 41.1 and 40.2%. A flavour ban was supported by 33.3% and 32.3% with a significant increase in Hungary (34.3–43.3%). Support was generally higher in Poland, Hungary and Greece vs. England. Support was lower among dual and EC-only users, and low-income smokers. Conclusions Smokers in all countries strongly supported banning EC use in smoke-free places and restricting nicotine content after TPD implementation, with no clear trends for changes in policy support. [ABSTRACT FROM AUTHOR]

Background We examined quit attempts, use of cessation assistance, quitting beliefs and intentions among smokers who participated in the 2018 International Tobacco Control (ITC) Europe Surveys in eight European Union Member States (England, Germany, Greece, Hungary, the Netherlands, Poland, Romania and Spain). Methods Cross-sectional data from 11 543 smokers were collected from Wave 2 of the ITC Six European Country (6E) Survey (Germany, Greece, Hungary, Poland, Romania and Spain—2018), the ITC Netherlands Survey (the Netherlands—late 2017) and the Four Countries Smoking and Vaping (4CV1) Survey (England—2018). Logistic regression was used to examine associations between smokers' characteristics and recent quit attempts. Results Quit attempts in the past 12 months were more frequently reported by respondents in the Netherlands (33.0%) and England (29.3%) and least frequently in Hungary (11.5%), Greece (14.7%), Poland (16.7%) and Germany (16.7%). With the exception of England (35.9%), the majority (56–84%) of recent quit attempts was unaided. Making a quit attempt was associated with younger age, higher education and income, having a smoking-related illness and living in England. In all countries, the majority of continuing smokers did not intend to quit in the next 6 months, had moderate to high levels of nicotine dependence and perceived quitting to be difficult. Conclusions Apart from England and the Netherlands, smokers made few quit attempts in the past year and had low intentions to quit in the near future. The use of cessation assistance was sub-optimal. There is a need to examine approaches to supporting quitting among the significant proportion of tobacco users in Europe and increase the use of cessation support as part of quit attempts [ABSTRACT FROM AUTHOR]

With the rise of digital technologies, electronic learning and communication tools are becoming a firm part of academia to promote knowledge of health sciences. This study sought to analyse the attitude of students regarding social media and digital learning for study purposes in sport and exercise science. A survey was carried out with a questionnaire (20 main items) in six sport science faculties, equally spread across Germany (G), Italy (I) and the United Kingdom (UK) between February and October 2017. The focus areas were students' usage of social media (Facebook, Google+, Instagram, LinkedIn, Skype, Twitter, WhatsApp, YouTube) for academic purposes and their use of e-learning. Data were analysed by quantitative and qualitative methods. 229 students participated in the study (G: 68, I: 121, UK: 40). While YouTube was mostly used for receiving knowledge, WhatsApp and Facebook showed additional preferences for peer contacts for learning purposes and knowledge discussions. Preferred online data sources were PubMed (77%), free access journals (67%), YouTube (66%) and Wikipedia (63%). Often used digital learning materials were own universities' PowerPoints (77%), scripts (59%) and scientific articles (53%). However, some preferences showed national differences. The evaluated participants showed an overall high use of social media and e-learning tools for their studies. Students would like more digital learning sources made available to them by their institutions. However, some differences in preferences of digital learning or communication tools may exist and this should be considered for international approaches to promote health knowledge among students. [ABSTRACT FROM AUTHOR]

Aortic stenosis (AS) is the most prevalent valvular disease in developed countries, with a prevalence that is set to expand further with an ageing population. The most recent guidelines on valvular heart disease published by the European Society of Cardiology and the European Association for Cardio-Thoracic Surgery, aim to standardize the diagnosis and management of valvular heart diseases. The imaging criteria of the current guidelines are mostly based on EACVI Recommendations, with an appropriate diagnostic workflow being of major importance, to ensure streamlined and efficient patient assessment and accurate diagnoses and decisions regarding the timing of surgery. The EACVI Scientific Initiatives Committee, therefore, created a survey on the imaging assessment of patient with AS to investigate the diagnostic patient pathways used in different centres across Europe. In particular, we conducted this survey to better understand the use and access of advanced imaging techniques in AS including 3D transthoracic echocardiography and 3D transoesophageal echocardiography, cardiac computed tomography, and cardiovascular magnetic resonance. [ABSTRACT FROM AUTHOR]

Background The purpose of this article is to report on a comparative analysis of the official food-based dietary guidelines (FBDG) that were applicable in 2015 in 25 EU Member States. We assess FBDG in relation to the main guidelines established by the FAO/WHO, the EURODIET project and the EFSA, with a particular focus on identifying strengths and limitations of current FBDG in Europe towards addressing diet-related health inequalities. Methods This is a review research, in which a mixed-methods sequenced procedure was utilized. In each EU country key informants, including sociologists, economists, dietitians and nutritionists were asked to provide data regarding: (i) current dietary guidelines and national health priorities, (ii) model of health promotion currently available, (iii) results of the latest food consumption survey. All documents were reviewed by the coordinating team. Full data were analysed by two nutritionists, using a tabulated sheet to organize and compare the results. Results While all countries have national FBDG, the level of detail and quality varies substantially with regard to: time of last update; availability of recommendations for specific target groups; specification of frequency and portion size; the graphical representation; recommended amounts and limits of foods consumed; and recommendations regarding physical activity. Conclusions European countries have great opportunities to improve FBDG to better serve Public Health policy through a more consistent foundation of how these guidelines are developed, the inclusion of different population subgroups as a target for recommendations and the implementation of monitoring systems. [ABSTRACT FROM AUTHOR]

Introduction: Secondary prevention of cardiovascular disease is a significant clinical challenge and despite European Society of Cardiology (ESC) Guidelines, evidence confirms sub-optimal patient care. Aim: The aim of this study was to evaluate ESC members' opinions on the current provision of cardiovascular prevention and rehabilitation services across Europe and explore barriers to guideline implementation. Method: Electronic surveys using a secure web link were sent to members of the ESC in eight purposively selected ESC affiliated countries. Results: A total of 479 professionals completed the survey, of whom 67% were cardiologists, 8.6% general physicians, 8.2% nurses and 16.2% other healthcare professionals. Respondents were predominantly (91%) practising clinicians, generally highly motivated regarding cardiovascular disease prevention, but most reported that secondary prevention in their country was sub-optimal. The main barriers to prevention were lack of available cardiac rehabilitation programmes and long-term follow-up, patients' disease perception and professional attitudes towards prevention. While knowledge of the prevention guidelines was generally good, practices such as motivational counselling and better educational tools were called for to promote exercise, smoking cessation and for nutritional aspects. Conclusions: The provision of services focusing on the secondary prevention of cardiovascular disease varies greatly across Europe. Furthermore, despite ESC Guidelines and a strong evidence base supporting the efficacy of secondary prevention, the infrastructure and co-ordination of such care is lacking. In addition patient motivation is considered poor and some professionals remain unconvinced about the merits of prevention. The disappointing results outlined in this survey emphasise that improved tools are urgently required to educate both patients and professionals and confirm the priority of cardiovascular prevention internationally. [ABSTRACT FROM AUTHOR]

Objectives To identify diverse pathways to linguistic isolation (LI) and explain the differences in LI for older immigrants from different countries. Method A demographic decomposition of LI was applied to 18 largest origin subgroups of foreign-born, ages 65 and older, in the 2010–2014 American Community Survey data. Results LI varied from 12% for older Indians to 68% for older Ukrainians. Decomposition analysis identified 3 components: (a) Limited English proficiency (LEP); (b) Solitary living; and (c) Limited English of co-resident others. The relative contribution of components differed by country of origin, pointing to different pathways to LI. Older Mexicans have the highest LEP, but moderate LI due to infrequent solitary living and the English proficiency of co-resident others. Many Chinese and Vietnamese older adults are LI because they live with other LEP adults. Older Europeans' common pathway to LI is solitary living. Discussion Components of LI in ethnic communities can inform communication strategies for older LEP lacking access to critical information. [ABSTRACT FROM AUTHOR]

One of the missions of the European Association of Cardiovascular Imaging (EACVI) is 'to promote excellence in clinical diagnosis, research, technical development, and education in cardiovascular imaging'. The future of imaging involves multimodality so each imager should have the incentive and the possibility to improve its knowledge in other cardiovascular techniques. This article presents the results of a 20 questions survey carried out in cardiovascular imaging (CVI) centres across Europe. The aim of the survey was to assess the situation of experience and training of CVI in Europe, the availability and organization of modalities in each centre and to ask for vision about potential improvements in CVI at national and European level. [ABSTRACT FROM AUTHOR]

Background To compare patterns of alcohol consumption and alcohol-related harm from a survey of university students sampled from universities in Denmark, England, Germany, Italy, Portugal and Switzerland. Methods A total of 2191 university students (70% female, 90% white ethnic group, age range 18–25) completed the survey. Participants completed measures of demographic variables (age, age of onset, ethnic group and sex) and the Alcohol Use Disorders Identification Test (AUDIT), which was the primary outcome. Results Sixty-three percent of the sample scored negative for harmful drinking on the AUDIT (<8), with 30% categorized as hazardous drinkers, 4% harmful drinkers and 3% with probable dependence. Analysis of variance, including demographic factors as covariates, identified a main effect of country on AUDIT scores F (5, 2086) = 70.97, P < 0.001, partial eta square = 0.15. AUDIT scores were highest in England (M = 9.99; SD = 6.17) and Denmark (M = 9.52; SD = 4.86) and lowest in Portugal (M = 4.90; ° = 4.60). Post hoc tests indicated large effect size differences between scores in Denmark and England and scores in all other countries (0.79 < d < 0.94; all P 's < 0.001). Conclusions European university students in our sample mainly reported low risk patterns of alcohol consumption and alcohol-related harm. However, students from Northern European countries had significantly higher AUDIT scores compared with students from Central and Southern European countries. Research is needed to replicate the present study using nationally representative samples to estimate the prevalence of alcohol use disorders among university students in different European countries. [ABSTRACT FROM AUTHOR]

Objectives Increasing numbers of older adults cross-nationally are without children or partners in later life and therefore likely have greater reliance on nonkin (e.g. friends). This pattern may be particularly pronounced in country contexts that emphasize friendship. This article hypothesizes that those who lack kin (e.g. children, partners) and/or who live in countries with a stronger emphasis on friendship have more friends in their networks. Although these hypothesized patterns are consistent with interdisciplinary literatures, they have not been tested empirically and therefore remain overlooked in current "aging alone" narratives. Method This study combines individual-level data from the Survey of Health, Ageing, and Retirement in Europe (Wave 6) with nation-level data from the European Values Survey to estimate multilevel negative binomial models exploring number of friends among those aged more than 50 years who lack kin across 17 countries. Results Older adults who lack kin or whose kin are unavailable report more friends in their networks, particularly in countries with a higher percentage of people who believe that friends are "very important" in life. Discussion This article challenges dominating assumptions about "aging alone" that rely heavily on lack of family as an indicator of "alone." Future studies of "kinlessness" should consider the extent to which friendship is correlated with lack of kin, particularly in more socioeconomically developed countries. Previous research on "aging alone" may have overestimated risk in more privileged countries that already emphasize friendship, but underestimated risk in family-centered countries where "kinlessness" and alternative sources of support are less common. [ABSTRACT FROM AUTHOR]

Objectives We examined bidirectional, time-ordered associations between age-related changes in depressive symptoms and memory. Method Data came from 107,599 community-dwelling adults, aged 49–90 years, who participated in the Survey of Health, Ageing, and Retirement in Europe (SHARE). Depressive symptoms were measured with the EURO-D inventory, and memory was evaluated as delayed recall of a 10-word list. Participants were assessed up to five times at 2-year intervals. Dynamic structural equation models were used to estimate longitudinal and time-ordered (lead-lag) relations between depressive symptoms and memory performance. Results Depressive symptoms increased and memory scores decreased across the observed age range, with worsening mostly evident after age 62 years. These long-term changes were moderately negatively correlated (r = −.53, p <.001). A time-ordered effect emerged such that age-specific memory deficits preceded shorter-term increases in depression symptoms. This effect can be translated such that each 1-point decrement on a 10-point memory scale at a given age predicted a 14.5% increased risk for depression two years later. Statistical adjustment for covariates (sex, education, re-test, smoking, and body mass index) had little influence on these associations. Conclusion In later adulthood, lower memory performance at a given age predicts subsequent 2-year increases in depressive symptoms. [ABSTRACT FROM AUTHOR]