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Background: The concept of stigma has been widely used to understand patterns of discrimination and negative ideas surrounding people with mental health problems, yet we know little of the specific nuances of how this might operate beyond the 'Global North'. Aim: This paper aims to explore the notion of stigma in an Indian context by considering the lived experience of patients, carers and community members. Methods: A sample of 204 participants, representing mental health patients, informal carers and community members was recruited from urban and rural areas in Kerala, India. Participants took part in interviews where they were encouraged to talk about their experiences of mental ill health, attitudes towards these problems, barriers encountered and sources of support. Results: Experiences akin to the experience of stigma in Europe and the United States were elicited but there were important local dimensions specific to the Indian context. The difficulties faced by people with diagnoses of mental disorders in finding marriage partners was seen as an important problem, leading to marriage proposals being refused in some cases, and secrecy on the part of those with mental health problems. Rather than the 'self-stigma' identified in the US, participants were more likely to see this as a collective problem in that it could reflect badly on the family group as a whole rather than just the sufferer. Conclusions: In the Indian context, the idioms of stigma emphasised impairments in marriage eligibility and the implications for the family group rather than just the self. [ABSTRACT FROM AUTHOR]

Background: Minimal research has been done to determine how well European nursing students understand the core principles of academic integrity and how often they deviate from good academic practice. Aim: The aim of this study was to find out what educational needs nursing students have in terms of academic integrity. Research design: A quantitative cross-sectional study in the form of a survey of nursing students was conducted via questionnaire in the fall of 2020. Participants: The sample was composed of 79 students in the BScN and MScN programs at Zürich University of Applied Sciences. Ethical considerations: An application for a non-competence clearance was approved by the Ethics Committee in Zurich (BASEC No. Req-2020-00868). The survey was anonymous, and informed consent was obtained prior to participation. Results: The participants had a high level of confidence in their own knowledge but were in many cases unable to correctly identify clear-cut examples of misconduct and to differentiate them from questionable practices. About 13% of the participants admitted that during their university education they had copied shorter passages from other sources into their own text without marking them as quotes. Conclusions: The study documents extensive knowledge gaps among nursing students regarding both academic misconduct and questionable practices and indicates a need for improved academic integrity training. [ABSTRACT FROM AUTHOR]

Objective: To identify barriers and facilitators to international implementation of a prospective system for standardized outcomes measurement in cleft care. Design: Cleft teams that have implemented the International Consortium for Health Outcomes Measurement Standard Set for cleft care were invited to participate in this 2-part qualitative study: (1) an exploratory survey among clinicians, health information technology professionals, and project coordinators, and (2) semistructured interviews of project leads. Thematic content analysis was performed, with organization of themes according to the dimensions of the reach, effectiveness, adoption, implementation and maintenance (RE-AIM) framework: reach, effectiveness, adoption, implementation, and maintenance. Results: Four cleft teams in Europe and North America participated in this study. Thirteen participants completed exploratory questionnaires and 5 interviewees participated in follow-up interviews. Survey responses and thematic content analysis revealed common facilitators and barriers to implementation at all sites. Teams reach patients either via email or during the clinic visit to capture patient-reported outcomes. Adopting routine data collection is enhanced by aligning priorities at the organizational and cleft team level. Streamlining workflows and developing an efficient data collection platform are necessary early on, followed by pilot testing or stepwise implementation. Regular meetings and financial resources are crucial for implementing, sustaining, analyzing collected data, and providing feedback to health care professionals and patients. Fostering patient-centered care was articulated as a positive outcome, whereas time presented challenges across all RE-AIM dimensions. Conclusions: Identified themes can inform ongoing implementation efforts. Intentionally investing time to lay a sound foundation early on will benefit every phase of implementation and help overcome barriers such as lack of support or motivation. [ABSTRACT FROM AUTHOR]

Studies examining the application of information technology to the delivery of health-care services often highlight the anticipated benefits. In consequence, the benefits of health-care information technology adoption, often referred to as 'e-health', are widely reported yet there is limited empirical evidence as to how such benefits can be realized. Design and implementation guidelines have been considered from a socio-technical perspective and there is support for the successful application of these principles. There are also some global surveys on the topic, but these often report only statistical data and lack richness of content. This study draws on existing literature to examine whether the principles of health-care information technology adoption are currently applied in practice. The paper presents a timely international analysis of the drivers, critical enablers and successful deployment strategies for e-health from the perspective of leading practitioners. The study considers the adoption of e-health in 15 countries. A qualitative research design was used and semistructured interviews were conducted with 38 thought leaders with expertise in health-care information systems and technology. The study presents a comparative analysis of the lessons learned from implementing, integrating and embedding e-health in practice, and presents a four-phase approach from the perspective of practitioners for the accelerated deployment of e-health systems: (i) develop a strategic approach, (ii) engage the workforce, (iii) capitalize on information technology and (iv) partner with the patient/citizen. [ABSTRACT FROM AUTHOR]

We identify and analyse practices and management regimes around burial and handling of ashes across eight case study towns within six Northern European countries. We analyse management of cemeteries and crematoria gardens, majority practices and provision for minority communities, including various burial types, cremated remains, the re-use of graves, and costs for interments. Comparative data is drawn from analysis of national and local regulations, interviews with stakeholders, and observations at cemeteries and crematoria gardens. The findings show significant variation in national and local regulations and practices for burial and cremation particularly around the re-use of graves, handling of ashes and costs for grave space and cremation. We identify the opportunities and constraints of these variations in terms of accessibility, diversity and equality; and argue for national directions to avoid unequal treatment within nations. Furthermore, we stress the importance of a liberal and inclusive management of European cemeteries and crematoria gardens. [ABSTRACT FROM AUTHOR]

Objectives: Examine trends in limitations among young (15–39), middle-aged (40–64) and older age-groups (>=65) and their socioeconomic differences. Methods: Population-based European Social Survey data (N = 396,853) were used, covering 30 mostly European countries and spanning the time-period 2002–2018. Limitations were measured using a global activity limitations indicator. Results: Age-differential trends in limitations were found. Activity limitations generally decreased in older adults, whereas trends varied among younger and middle-aged participants, with decreasing limitations in some countries but increasing limitations in others. These age-differential trends were replicated across limitation severity and socioeconomic groups; however, stronger limitation increases occurred regarding less-severe limitations. Discussion: Functional health has improved in older adults. Contrarily, the increasing limitations in younger and middle-aged individuals seem concerning, which were mostly observed in Western and Northern European countries. Given its public health importance, future studies should investigate the reasons for this declining functional health in the young and middle-aged. [ABSTRACT FROM AUTHOR]

Culture change is common in healthcare organisations worldwide today, and change agents are key persons in the process of change. It is therefore of vital importance to deepen the knowledge about change agents’ experiences. The aim of the study was to illuminate meanings of being a change agent to improve home care services. Ten change agents were interviewed individually using open-ended questions. The interviews were analysed with phenomenological hermeneutics. The design of the study followed the COREQ guidelines. Three themes were revealed in the analysis: ‘Being confirmed by the opportunity to make quality improvements’; ‘Pushing oneself to transfer the message’; and ‘Being strengthened by achievements but wishing for better conditions’. In order to prepare co-workers, change agents need training before their mission begins and during the change process. [ABSTRACT FROM AUTHOR]

Introduction: Post-stroke fatigue (PSF) is common and debilitating. However, while its effective management is a priority for clinicians and stroke survivors, there remains little evidence to provide guidance or underpin practice. Our aim, therefore, was to gain insights into the experiences of clinicians who routinely manage patients with fatigue. Method: Qualitative interview study. The target was to recruit a purposeful sample of approximately 20 participants with expertise in managing PSF and fatigue arising from other conditions. Maximum variation sampling was used to ensure a balance of participants across different settings. Data were analysed using a framework approach, iteratively developed and refined by including emergent themes. Results: We recruited 20 participants: nine occupational therapists (OTs), five physiotherapists, three nurses and three psychologists, which included three 'fatigue experts' from Europe and Australia. Analysis generated core themes around management and strategies used; these were similar regardless of professional background, clinical or geographical setting or condition treated. OTs felt a particular responsibility for fatigue management, although multidisciplinary teamwork was stressed by all. Conclusion: There are clear similarities in clinicians' experiences of managing PSF and fatigue across different conditions and also across professional groups. Clinicians rely predominantly on their own clinical knowledge for guidance. [ABSTRACT FROM AUTHOR]

Background: In the neonatal intensive care unit, immigrant parents may experience even greater anxiety than other parents, particularly if they and the nurses do not share a common language. Aim: To explore the complex issues of trust and the nurse–mother relationship in neonatal intensive care units when they do not share a common language. Design and methods: This study has a qualitative design. Individual semi-structured in-depth interviews and two focus group interviews were conducted with eight immigrant mothers and eight neonatal intensive care unit nurses, respectively. Data analysis was based on Braun and Clarke's thematic analytic method. Ethical considerations: Approval was obtained from the hospital's Scientific Committee and the Data Protection Officer. Interviewees were informed in their native language about confidentiality and they signed an informed consent form. Results: Trust was a focus for mothers and nurses alike. The mothers held that they were satisfied that their infants received the very best care. They seemed to find the nurses' care and compassion unexpected and said they felt empowered by learning how to care for their infant. The nurses discussed the mother's vulnerability, dependency on their actions, attitudes and behaviour. Discussion: Lack of a common language created a challenge. Both parties depended on non-verbal communication and eye contact. The nurses found that being compassionate, competent and knowledgeable were important trust-building factors. The mothers were relieved to find that they were welcome, could feel safe and their infants were well cared for. Conclusion: The parents of an infant admitted to the neonatal intensive care unit have no choice but to trust the treatment and care their infant receives. Maternal vulnerability challenges the nurse's awareness of the asymmetric distribution of power and ability to establish a trusting relationship with the mother. This is particularly important when mother and nurse do not share a verbal language. The nurses worked purposefully to gain trust. [ABSTRACT FROM AUTHOR]

The safeguards and measures to prevent child trafficking mentioned in the 1993 Hague Convention on Intercountry Adoption have proven insufficient in curbing the so-called irregular adoptions. An analysis of how Spanish central authorities and intermediary agencies managed the flow of adoption dossiers between 2003 and 2013 presents their inability to react swiftly to the imbalance between adoption demand and supply. The 2015 reforms in the Spanish law introduced measures to bring demand in line with real needs. However, imaginaries that portray adopters and children from the Global South as victims of meaningless bureaucracy continue to hold true even today. [ABSTRACT FROM AUTHOR]

Research shows how racism can negatively affect access to health care and treatment. However, limited theoretical research exists on conceptualizing racism in health care. In this article, we use structural violence as a theoretical tool to understand how racism as an institutionalized social structure is enacted in subtle ways and how the "violence" built into forms of social organization is rendered invisible through repetition and routinization. We draw on interviews with health care users from three European countries, namely, Sweden, Germany, and Portugal to demonstrate how two interrelated processes of unequal access to resources and inequalities in power can lead to the silencing of suffering and erosion of dignity, respectively. The strength of this article lies in illuminating the mechanisms of subtle racism that damages individuals and leads to loss of trust in health care. It is imperative to address these issues to ensure a responsive and equal health care for all users. [ABSTRACT FROM AUTHOR]

The economic, social, and health costs of mental distress are increasingly burdening individuals and societies in Europe. Yet, overmedicalization of mild symptoms is also well documented. This accumulates in more pressures and demands on health care systems. In this article, I explore how the process of help seeking in mental distress might be shaped by health system design and functioning in one of the South European societies—Spain. Employing Bourdieu's theoretical lens, in-depth interviews with health care providers and users of services are analyzed. I reveal how the logic of the mental health care field, which is reinforced by the market, the state, and the media, may result in medicalization of mild distress while severe mental illness remains undertreated. I also show how mental help-seeking practices could gradually influence the functioning of the treatment system. Nevertheless, points of resistance to medicalization can also be identified. [ABSTRACT FROM AUTHOR]

In this article, we apply narrative dialogism and new materialism to health research. We examine how material↔semiotic environments (MSEs) affect the rehabilitation process of Patrick, a man who exercised with the aim to recover from spinal cord injury. The MSEs are considered embedded subcases within the overall holistic case of Patrick. Three MSEs were identified: the hospital gym, the personal gym, and the adapted gym. These are examined using the analytical lens of assemblages. First, the mutually affecting components of each MSE are described. Second, a larger environmental assemblage is identified, which is termed exercise-is-restitution assemblage. This composite assemblage illuminates the associations between the three MSEs, and reveals how restitution resonated across time and space. The article contributes to the literature by reconceptualizing restitution. It highlights the importance of the materiality of health-related narratives, and it reveals the potential of MSE for transforming rehabilitation and improving exercise promotion and maintenance. [ABSTRACT FROM AUTHOR]

Longitudinal studies of caregiver burden when caring for persons with dementia living at home are sparse. The aim of the study was to identify factors associated with caregiver burden and predicting increased burden related to caregivers, persons with dementia and formal care. Data were collected through interviews with 1223 caregivers in eight European countries. Bivariate and multivariate regression analyses were performed. Factors associated with caregiver burden included extensive informal care provision, decreased well-being and reduced quality of life for the caregiver and reduced cognition, decreased quality of life, severe neuropsychiatric symptoms and depression in the person with dementia and caregivers' negative experience of quality of care. Factors predicting an increased burden were diminished caregiver well-being, severe neuropsychiatric symptoms of the person with dementia and caregivers' negative perception of quality of care. The knowledge gained in this study may be useful in developing more adequate service systems and interventions to improve dementia care. [ABSTRACT FROM AUTHOR]

New technology has made pornography increasingly accessible to young people, and a growing evidence base has identified a relationship between viewing pornography and violent or abusive behavior in young men. This article reports findings from a large survey of 4,564 young people aged 14 to 17 in five European countries which illuminate the relationship between regular viewing of online pornography, sexual coercion and abuse and the sending and receiving of sexual images and messages, known as “sexting.” In addition to the survey, which was completed in schools, 91 interviews were undertaken with young people who had direct experience of interpersonal violence and abuse in their own relationships. Rates for regularly viewing online pornography were very much higher among boys and most had chosen to watch pornography. Boys’ perpetration of sexual coercion and abuse was significantly associated with regular viewing of online pornography. Viewing online pornography was also associated with a significantly increased probability of having sent sexual images/messages for boys in nearly all countries. In addition, boys who regularly watched online pornography were significantly more likely to hold negative gender attitudes. The qualitative interviews illustrated that, although sexting is normalized and perceived positively by most young people, it has the potential to reproduce sexist features of pornography such as control and humiliation. Sex and relationships education should aim to promote a critical understanding of pornography among young people that recognizes its abusive and gendered values. [ABSTRACT FROM AUTHOR]

Background: Integrated palliative care aims at improving coordination of palliative care services around patients' anticipated needs. However, international comparisons of how integrated palliative care is implemented across four key domains of integrated care (content of care, patient flow, information logistics and availability of (human) resources and material) are lacking. Aim: To examine how integrated palliative care takes shape in practice across abovementioned key domains within several integrated palliative care initiatives in Europe. Design: Qualitative group interview design. Setting/participants: A total of 19 group interviews were conducted (2 in Belgium, 4 in the Netherlands, 4 in the United Kingdom, 4 in Germany and 5 in Hungary) with 142 healthcare professionals from several integrated palliative care initiatives in five European countries. The majority were nurses (n = 66; 46%) and physicians (n = 50; 35%). Results: The dominant strategy for fostering integrated palliative care is building core teams of palliative care specialists and extended professional networks based on personal relationships, shared norms, values and mutual trust, rather than developing standardised information exchange and referral pathways. Providing integrated palliative care with healthcare professionals in the wider professional community appears difficult, as a shared proactive multidisciplinary palliative care approach is lacking, and healthcare professionals often do not know palliative care professionals or services. Conclusion: Achieving better palliative care integration into regular healthcare and convincing the wider professional community is a difficult task that will take time and effort. Enhancing standardisation of palliative care into education, referral pathways and guidelines and standardised information exchange may be necessary. External authority (policy makers, insurance companies and professional bodies) may be needed to support integrated palliative care practices across settings. [ABSTRACT FROM AUTHOR]

Background: Patients with advanced diseases often experience deficient continuity of care. Although integrated palliative care promotes continuity of care, it is not clear how it can be optimized to improve continuity of care experiences. Aim: To examine how relational, informational and management continuity of care are experienced by patients with advanced diseases and their family caregivers receiving care from several integrated palliative care initiatives in five European countries. Design: We adopted a longitudinal qualitative study design including two interviews (interval 3 months) with patients and family caregivers focusing on how health care professionals responded to their needs. Interviews were audio-recorded and transcribed verbatim. Analysis involved a two-step qualitative content approach. Setting/participants: A total of 22 integrated palliative care initiatives (established local palliative care collaborations) were selected in Belgium, Germany, Hungary, the Netherlands and the United Kingdom. We recruited 152 patients (63% cancer, 24% chronic obstructive pulmonary disease, 13% heart failure; life expectancy <1 year; mean age 68 years, 56% female) and 92 family caregivers (mean age 61 years, 66% female). Results: Trusted relationships with a small number of key health care professionals to receive tailored care and easily access help were essential. Relational continuity was often deficient, especially with general practitioners. Although informational and management continuity was often lacking in care provision, collaborative integrated palliative care initiatives were related to consistent and coherent care. Conclusion: Patients and family caregivers most likely experience continuity of care by having a small number of trusted health care professionals who are available, provide multidisciplinary care and regularly transfer information to all health care professionals involved. Optimizing continuity of care requires further integration of integrated palliative care initiatives with other health care professionals involved in the patients’ care networks. [ABSTRACT FROM AUTHOR]

Assurance of transcript accuracy and quality in interview-based qualitative research is foundational for data accuracy and study validity. Based on our experience in a cross-cultural ethnographic study of women’s pelvic organ prolapse, we provide practical guidance to set up step-by-step interview transcription and translation protocols for team-based research on sensitive topics. Beginning with team decisions about level of detail in transcription, completeness, and accuracy, we operationalize the process of securing vendors to deliver the required quality of transcription and translation. We also share rubrics for assessing transcript quality and the team protocol for managing transcripts (assuring consistency of format, insertion of metadata, anonymization, and file labeling conventions) and procuring an acceptable initial translation of Spanish-language interviews. Accurate, complete, and systematically constructed transcripts in both source and target languages respond to the call for more transparency and reproducibility of scientific methods. [ABSTRACT FROM AUTHOR]

Background: The 2008 financial crisis in Europe came abruptly and surprisingly. Many countries also suffered a second recession during the period 2010–2012. We examined the impact of the crisis on life satisfaction (LS) by country and individual socioeconomic level. Method: We used a representative sample from the European Social Survey (2002–2014) with data from 26 countries (N = 294,407). LS was measured with a single question with 11 response alternatives. Time from start of crisis (either 2008 or 2010-2012) was determined separately for each interview. Data were analyzed by multilevel analysis Results: There was a sharp decrease in LS in the beginning of the crisis in 2008, and another, but not so severe, decline in 2011, each of them of short duration. However, there was also a slight and progressive yearly decrease in LS that continued one to at least 3 years after either financial crisis that was independent of the effect of being unemployed. Associations varied considerably between countries. A negative decline after the financial crisis was especially evident among those in the most educated groups, and in those in the higher occupational levels. Conclusions: The 2008 financial crisis had a double effect on LS: (1) a sharp short-term decrease consistent with the Easterlin paradox; (2) a slighter long-term progressive decrease that was over and above the strong negative relationship with unemployment that lasted several years. The long-term decline in LS after the start of the financial crisis tended to occur especially in the higher socioeconomic groups. [ABSTRACT FROM AUTHOR]

The purpose of this research study was to examine the experiences of prosecutors in Athens, Greece, as they implement a restorative justice (RJ; mediation) model in cases of intimate partner violence (IPV). Greece recently enacted a new legislation related to domestic violence, part of the requirement is mediation. This study used semi-structured interviews with 15 public prosecutors at the courts of first instance and three interviews with facilitators of mediation process. The findings indicate widespread role confusion. Prosecutors’ experiences, professional positions, and views of RJ in adult cases of gendered violence were shaped by their legal training. That is, their perceptions reflected their work in an adversarial system. Their views were complex yet ultimately unreceptive and their practices failed the victims of IPV. The study report concluded with recommendations for the legislators and for better preparation of court actors. [ABSTRACT FROM AUTHOR]

How do public opinion signals affect political representatives' opinion formation? To date, we have only limited knowledge about this essential representative process. In this article, we theorize and examine the signaling strength of one type of societal signal: protest. We do so by means of an innovative experiment conducted among Belgian national and regional politicians. Elected officials were exposed to manipulated television news items covering a protest demonstration. Following Tilly's previously untested WUNC claim, four features of the event were manipulated: the demonstrators' worthiness, unity, numerical strength, and commitment. We argue that these protest features present elected officials with useful cues about what (a segment of) the public wants. We find that these cues affect elected officials' beliefs. The salience they attach to the protest issue, the position they take, and their intended actions all change as a consequence of exposure. The size of a protest event (numbers) and whether the protesters agree among themselves (unity) are the most persuasive protest factors. The effects of the protest signals come on top of strong receiver effects. We find no evidence that elected officials' predispositions moderate the effects of the protest features. [ABSTRACT FROM AUTHOR]

Background: Stakeholders are people with an interest in a topic. Internationally, stakeholder involvement in palliative care research and health technology assessment requires development. Stakeholder involvement adds value throughout research (from prioritising topics to disseminating findings). Philosophies and understandings about the best ways to involve stakeholders in research differ internationally. Stakeholder involvement took place in seven countries (England, Germany, Italy, Lithuania, the Netherlands, Norway and Poland). Findings informed a project that developed concepts and methods for health technology assessment and applied these to evaluate models of palliative care service delivery. Aims: To report on stakeholder involvement in the INTEGRATE-HTA project and how issues identified informed project development. Design: Using stakeholder consultation or a qualitative research design, as appropriate locally, stakeholders in seven countries acted as 'advisors' to aid researchers' decision making. Thematic analysis was used to identify key issues across countries. Setting/participants: A total of 132 stakeholders (82 professionals and 50 'lay' people) aged ≥18 participated in individual face-to-face or telephone interviews, consultation meetings or focus groups. Results: Different stakeholder involvement methods were used successfully to identify key issues in palliative care. A total of 23 issues common to three or more countries informed decisions about the intervention and comparator of interest, sub questions and specific assessments within the health technology assessment. Conclusion: Stakeholders, including patients and families undergoing palliative care, can inform project decision making using various involvement methods according to the local context. Researchers should consider local understandings about stakeholder involvement as views of appropriate and feasible methods vary. Methods for stakeholder involvement, especially consultation, need further development. [ABSTRACT FROM AUTHOR]

Background: Research on the costs of healthcare provision has so far focused on insurer costs rather than out-of-pocket costs. Out-of-pocket costs may be important to patients making medical decisions. Aim: To investigate the self-reported out-of-pocket costs associated with healthcare in the last year of life of older adults in Europe. Design: A post-death survey, part of the Survey of Health, Ageing, and Retirement in Europe, completed by proxy respondents in four waves from 2005 to 2012. Setting/participants: Proxy respondents for 2501 deceased adults of 55 years or over. Data from 13 European countries and four waves from 2005 to 2012 were used. Results: The proportion of people with out-of-pocket costs ranged from 21% to 96% in different European Union countries. Out-of-pocket costs ranged from 2% to 25% of median household income. Secondary and institutional care was most often the largest contributor to out-of-pocket costs, with care received in a care home being the most expensive type of care in 11 of 13 countries. Multilevel analyses showed that limitations in more than two activities of daily living (coefficient = 6.47, 95% confidence interval = 1.81–11.14) and a total hospitalization time of 3–6 months (coefficient = 14.66; 95% confidence interval = 0.97–28.35) or more than 6 months (coefficient = 31.01; 95% confidence interval = 11.98–50.15) were associated with higher out-of-pocket costs. In total, 24% of the variance on a country level remained unexplained. Conclusion: Variation in out-of-pocket costs for healthcare in the last year of life between European countries indicates that countries face different challenges in making healthcare in the last year of life affordable for all. [ABSTRACT FROM AUTHOR]

This study examines the connection of love styles with relationship satisfaction on the basis of cross-cultural research, including Bosnia, Germany, Romania, Russia, and German immigrants from Russia and Turkey. Love styles include romantic love, friendship love, game-playing love, possessive love, altruistic love, and pragmatic love. The validation of the measurement model across cultural groups was successful because partial measurement invariance was secured, which allows for the application of correlation, regression, and path analysis. Results indicate that the effects of love styles on relationship satisfaction were consistent across cultures with the exception of game-playing love that negatively predicted relationship satisfaction for Germans, Romanians, and Turkish migrants but not for Bosnians, Russians, and Russian migrants. In addition, cultural variation occurred with respect to the strength of the associations. The implications of these findings are discussed in relation to universality and cultural relativity. In general, the effect of love styles on well-being turned out to be manifold. [ABSTRACT FROM AUTHOR]

How do national institutional contexts mediate the global? This article aims to answer this question by analyzing screen translation—the translation of audiovisual materials like movies and television programs—in four European countries: France, Italy, the Netherlands, and Poland. A cross-national, multi-method research project combining interviews, ethnography, and a small survey found considerable cross-national differences in translation norms and practices, sometimes leading to very different translated versions of the same product. The analysis shows how differences between national translation fields are produced and perpetuated by the interplay of institutional factors on four interdependent levels: technology, and the organizational, national, and transnational fields. On each level, various institutions are influential in shaping nationally specific translation norms and practices by producing institutional constraints or imposing specific meanings. I propose a model that explains the persistence of national translation systems—not only from the logics of specific institutions, fields, or levels—but by the feedback loops and interdependencies between institutions on various levels. This analysis has implications for the sociological understanding of globalization, the production of culture and media, cross-national comparative research, as well as institutional theory and the role of translation in sociological practice. [ABSTRACT FROM AUTHOR]

The article focuses on a study which presents an economic assessment of aseptic compounding rooms in hospital pharmacies in five European countries. Topics discussed include the topics covered by the survey form used in the study, which include infrastructure cost, equipment cost and staff cost, and the characteristics of hospitals and workstations. Also mentioned are the total costs of environmental microbiological and preparation microbiological controls.

Immigration as a solution to staff and skill shortages in the health system is increasingly on the agenda in the European Union. This article highlights the related social and policy dilemmas by comparing a new destination country with an old destination country: Spain and the United Kingdom. After describing the challenges met by the United Kingdom, we ask how well-prepared Spain is to face the same issues. In particular, attention is paid to the occupational mobility of health workers after entry and to how immigration as a staffing solution poses new political and social challenges. Through a review of background information regarding the immigration of health workers in the two countries and the preliminary analysis of 15 exploratory interviews, we aim to identify the primary trends and key concerns for future analysis. Although our interviews only allow us to draw tentative conclusions, they do highlight emerging issues to be explored in the near future. Our conclusions show that many of the problems traditionally encountered in the United Kingdom are now emerging in Spain, suggesting scope for further collaboration among government, employers, and other stakeholders across the European Union. [ABSTRACT FROM AUTHOR]

An effective response to the rising burden of chronic disease requires a health system environment that is conducive to implementing structured, integrated approaches to chronic disease prevention and management. This study presents some of the reported factors hindering the successful implementation of chronic care approaches in six European healthcare systems and focuses on processes to address these. We conducted 42 semi-structured interviews with key informants in Austria, Denmark, France, Germany, The Netherlands and Spain, representing the decision-maker, payer, provider and/or patient perspective. Despite differences among the healthcare systems studied, a shared set of barriers emerged. These included: (i) a continued focus on complications management and a failure to integrate risk minimisation and disease prevention along the spectrum of care; (ii) care fragmentation acting as a barrier to better coordination; (iii) a mismatch between intent, at national level, to enhance coordination and integration, and ability at regional or local level to translate these ambitions into practice; and (iv) a lack of structures suitable to promote proactive engagement with patients in the management of their own condition. Findings suggest successful implementation of chronic care across Europe will require cross-disciplinary collaboration, raising the profile of general practitioners and nurses, designing care explicitly around the needs of the patient, and the political will to carry forward these chronic care measures. [ABSTRACT FROM AUTHOR]

Background: European city councils are increasingly developing interventions against health inequalities. There is little knowledge about how they are perceived. This study describes and analyses good practices and challenges for local interventions on inequalities in health through the narratives of European city managers. Methods: A qualitative study was conducted. Each participating city (Amsterdam, Barcelona, Cluj-Napoca, Helsinki, Lisbon, London, Madrid, Rotterdam) selected interventions following these criteria: at least 6 months of implementation; an evaluation performed or foreseen; the reduction of health inequalities among their objectives, and only one of the interventions selected could be based on health care. Managers of these local interventions were interviewed following an outline. Eleven individual in-depth interviews describing nine local interventions were obtained. A thematic content analysis was performed. Results: One or more local interventions against health inequalities were identified in each city. Most relied on quantitative data and were linked to national strategies. Few interventions addressed socio-economic determinants. Health care, employment and education were the main determinants addressed. With variable depth, evidence-base, participation and intersectorality were regular components of the interventions. Half of them targeted the city and half some deprived neighbourhoods. Few interventions had been evaluated. Scarcity of funding and sustainability of the projects were the main perceived barriers by the managers. Conclusions: City intervention managers were familiar with health inequalities and concepts as intersectorality, participation and evidence-based action, but others such as socioeconomic aims, gradient approach, evaluation and sustainability were not so widely applied. Managers’ capacities and political leadership in governance for health should be reinforced. [ABSTRACT FROM PUBLISHER]

The article discusses a study to evaluate the cross-cultural development of a stand-alone European Organization for Research and Treatment of Cancer (EORTC) measure of spiritual well being for palliative care patients with cancer. The study found that a provisional 36-item measure ready for Phase IV field-testing, the EORTC QLQ-SWB36 has been developed, with the items are comprehensible across languages and cultures. The need for Phase IV testing is highlighted.

This article reports the results of the European ‘DAFFODIL’’ (Dynamic Assessment of Functioning and Oriented at Development and Inclusive Learning) Project on the question of how functional and learning assessment systems facilitate or inhibit participation of children with developmental difficulties in inclusive education. Questionnaires were sent to medical, psychological, educational professionals, and parents in Sweden, Portugal, Hungary, Belgium, Romania, Norway, and the Virgin Islands. Interviews and focus groups were organized. Results (95%) showed that static standardized psychometric tests of intellectual, behavioural, and language functioning were mainly used, with the WISC-III being the most frequent test applied. Less than 5% of the 166 professionals in our sample used formative assessment and contextual observation to reveal learning or developmental potential in a process-oriented way. Experts were generally not satisfied with current assessment practices. Reported weaknesses included lack of time, human resources, materials, cooperation, and follow-up. Assessment practice was mainly used to determine whether a child should be placed in a special needs programme, a special school, or an institutional setting, depending on whether a country has inclusive education practice or not. Parents were satisfied with static functional assessment when its purpose was to obtain disability benefits (financial, special education resources, recognition), but were unhappy with the negative outlook of reports. The main complaint of teachers and parents was about the poverty of recommendations on how to work with the child. Our conclusion is that the current practice of standardized psychometric testing seems to contribute to barriers to learning if it is used in a deterministic or predictive way. In this regard, dynamic and functional assessment methods that are qualitatively oriented seem promising in addressing the issues of learning and development in a different way. The methods also contribute to an understanding of the child’s needs in learning and development. However, interpretation and communication of assessment results in a way that emphasizes a more adequate and challenging educational intervention for the child seems to be central. [ABSTRACT FROM PUBLISHER]

The authors analyze interviewer-related nonresponse differences in face-to-face surveys, distinguishing three types of interviewers: those who have previous experience with the same high standard cross-sectional survey (‘‘experienced’’), those who were chosen by the survey agency to complete refusal conversions (‘‘seniors’’), and usual interviewers. The nonresponse components are obtaining household contact, target person contact, and target person cooperation. In addition, the authors consider whether interviewer homogeneity with respect to these components is different across the three interviewer groups. Data come from the European Social Survey (ESS) contact forms from four countries that participated in the rounds of 2002, 2004, and 2006 and used the same survey agency that, in turn, used the same interviewers to some extent. To analyze interviewer effects, the authors use discrete two-level models. The authors find some evidence of better performance by both senior and experienced interviewers and indications of greater homogeneity for nonresponse components, especially for those with room for improvement. Surprisingly, the senior interviewers do not outperform the experienced ones. The authors conclude that survey agencies should make more efforts to decrease the comparatively high interviewer turnover. [ABSTRACT FROM AUTHOR]

Compares compulsory labor market programmes in several European countries. Problems of compulsory social policies; Findings from qualitative interviews with policy makers, administrators and clients that were carried out in each of the countries; Effects of the use of compulsion.