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This study analyses the distribution of papers published by authors from the European Union (EU) in 47 international infectious diseases journals from 2002 to 2007. The Web of Science of the Institute for Scientific Information was used to collect medical articles. From 46,149 papers recovered, 24,064 (52.1%) were from the EU. The EU15 countries published 23,239 papers (96.7%). The ten countries that joined the EU in 2004 published only 767 (3.2%) and the two countries that last joined the EU in 2007 contributed only 0.1% of the papers. The United States contributed 41.2% of the documents. The leading EU27 countries in number of publications were the United Kingdom, France, and Germany. After taking the population into account, Denmark, Sweden, and The Netherlands headed the list, and after correcting for gross domestic product the greatest producers were Malta, Estonia, and Sweden. In conclusion, the production of scientific papers on infectious diseases during the last six years was greater in the EU than in the United States. The contribution to the infectious diseases research of the 12 countries that joined the EU in the last few years has yet been limited. [ABSTRACT FROM AUTHOR]

Aim: The goal of this paper is to analyze the COVID-19 policies of 10 European countries, including Sweden, Finland, Norway, Italy, France, Germany, Poland, Belgium, the Netherlands, and Hungary, with a time-series policy analysis tool. Subject and methods: The results of the COVID-19 policy analysis are based on a single time-series indicator, or daily population mortality rate: the number of COVID-19 daily cumulative deaths divided by the population in millions. The lower the score, the better the policy. Although many experts believe that the COVID-19 policy outcome analysis is premature, time series analysis is an excellent analysis that can provide information on the progress and transition of policy outcomes. In other words, the proposed time series analysis tool allows policymakers to identify and quantify when mistakes were made during the on-going COVID-19 pandemic. Results: The COVID-19 policy analysis discovered many useful facts. Sweden failed due to the herd immunity approach. Hungary made a fundamental mistake in COVID-19 tactics. Countries such as Sweden, Hungary, Belgium, and Poland showed time-series changes that differed from the others. Conclusion: Public health interventions can play a key role in mitigating the COVID-19 pandemic. The proposed policy analysis tool, hiscovid demonstrated the effectiveness of the time-series score behavior for discovering when policymakers made mistakes. [ABSTRACT FROM AUTHOR]

In Northwestern Europe, Germany, France, the Netherlands, the UK and Belgium constitute the biggest five potato producers, with total potato crop production around 60% of EU-28 production before Brexit. Soil and climate conditions are highly favourable for potato growth in this region. Production is under driving forces of (i) the potato processing industry, particularly in Belgium; (ii) the innovation for fresh potato in the UK, France and Germany; (iii) the leadership of Germany and the Netherlands for starch potato; and (iv) the dominance of the Netherlands for seed production. Based on an industrial agri-food production system, the region has the highest potato yield levels worldwide and developed relevant trade networks for export of seed, fresh and processed potato products in and outside Europe. Conventional and intensive potato production is widespread over the region, whilst organic production started to develop in Germany and France. Whether the coming decades will be as successful as the last ones for sustainable potato production will depend on how the sector and stakeholders of the whole potato value-chain will overcome new issues and challenges. These are mainly soil quality and health conservation, consequences of climate change, increasing bans on the use of plant protection products, tightening environmental standards, food waste reduction and increasing trade tensions hampering the flow of potatoes around the world. After a detailed description of the potato production in the region, this paper contains a SWOT analysis aiming to identify potential solutions to overcome environmental, technical, economic, political and societal issues in the region for sustainable potato production in the coming years and decades. [ABSTRACT FROM AUTHOR]

This paper compares and discusses the results of the research on mental maps of entrepreneurs conducted in three countries: Italy, Germany and the Netherlands. The stated locational preferences of Italian, German and Dutch entrepreneurs and their underlying explanatory factors are analysed and compared, using both qualitative and quantitative methods. The analysis points out that the three countries have some common characteristics regarding the patterns and the explanatory factors of the mental maps of their entrepreneurs. Examples are the centre–periphery dichotomy and the relevance of accessibility. One of the differences between the countries is the preference for large agglomerations that appears in the map image for Germany, a pattern that is less clear in the map image for Italy and the Netherlands. In some important respects, the results for Italy are different from those for the other two countries, as the North–South divide and organised crime apparently play an important role in the mental maps of entrepreneurs in this country. [ABSTRACT FROM AUTHOR]

The GIPS countries, the southern European crisis countries, have seen depressed output dynamics and high unemployment rates during the great recession following the 2007–2008 financial crisis. This paper considers the effects of measures that seek to improve competitiveness by reducing real unit labour costs. The results are derived in structural vector autoregressive models for each of the GIPS counties as well as two reference countries, Germany and the Netherlands. The responses of output and unemployment to innovations in real unit labour costs are economically and statistically significant for Germany and the Netherlands, whereas the responses are typically muted and imprecise estimated for the GIPS countries. The small and uncertain effects raise doubts regarding the efficacy of measures that seek to lower real unit labour costs in the GIPS countries. [ABSTRACT FROM AUTHOR]

Egg freezing has led to heated debates in healthcare policy and bioethics. A crucial issue in this context concerns the distinction between "medical" and "social" egg freezing (MEF and SEF)—contrasting objections to bio-medicalization with claims for oversimplification. Yet such categorization remains a criterion for regulation. This paper aims to explore the "regulatory boundary-work" around the "medical"–"social" distinction in different egg freezing regulations. Based on systematic documents' analysis we present a cross-national comparison of the way the "medical"–"social" differentiation finds expression in regulatory frameworks in Austria, Germany, Israel, and the Netherlands. Findings are organized along two emerging themes: (1) the definition of MEF and its distinctiveness—highlighting regulatory differences in the clarity of the definition and in the medical indications used for creating it (less clear in Austria and Germany, detailed in Israel and the Netherlands); and (2) hierarchy of medical over social motivations reflected in usage and funding regulations. Blurred demarcation lines between "medical" and "social" are further discussed as representing a paradoxical inclusion of SEF while offering new insights into the complexity and normativity of this distinction. Finally, we draw conclusions for policymaking and the bioethical debate, also concerning the related cryopolitical aspects. [ABSTRACT FROM AUTHOR]

Most countries that apply risk-equalization in their health insurance market(s) perform risk-equalization on medical claims but do not include other components of the insurance premium, such as administrative costs. Using fixed effects panel regressions from individual insurers in Australia, Germany, the Netherlands, Switzerland, and the US, we find evidence that health insurers with a high morbidity population on average have higher administrative costs. We argue that administrative costs should also be included in risk-equalization and we show that such equalization results in additional equalization payments nontrivial in size. Using examples from Germany and the US, we show how in practice policymakers can include administrative costs in risk-equalization. We are skeptical about applying risk-equalization to other components of the insurance premium, such as profits or costs related to solvency requirements of insurers. [ABSTRACT FROM AUTHOR]

Flood risk in urban areas around the world is increasing due to socio-economic development and climate change. Urban climate adaptation measures are beneficial over the longer term, particularly in coastal areas, yet the upfront costs of such measures are significant. Moreover, public actors responsible for adaptation to flood risk face constrained budgets. A promising strategy for overcoming these constraints and enabling greater adaptation investment is land reclamation that includes adaptation, i.e. flood risk reduction. Land reclamation in high-value urban areas can generate substantial revenues through the sale or lease of new land, or taxes on increased economic activities, thus offsetting public adaptation investments. This paper explores the potential of land reclamation for leveraging public adaptation investments and associated distributional issues, by analysing 3 urban land reclamation and adaptation projects in Germany, the Netherlands and the Maldives. We find that all projects have leveraging potential, and leveraging in projects primarily aimed at land creation is particularly high. Further, due to low adaptation costs needed to protect revenue streams in such projects, these investments appear to be 'low-regret'. Regarding distributional aspects, high project costs and limited public budgets for adaptation constrain public actors' ability to ensure equitable outcomes through planning instruments, for example, social housing. Further, in implementation, competition for project benefits can lead to further inequalities. We conclude that urban land reclamation presents a significant opportunity to leverage public adaptation investments under certain conditions. We further outline future research needs including to extend land-based financing theory from related urban infrastructure sectors to inform the design of equitable governance arrangements and to better understand the role of such urban land reclamation projects in regional or national development pathways. [ABSTRACT FROM AUTHOR]

In this paper, we present international comparisons of potential output growth among several economies—Canada, the euro area, France, Germany, Italy, Japan, the Netherlands, the United Kingdom, and the United States—for the period 1991–2004, for which we construct consistent and homogenous capital stock series. The main estimates rely on a structural approach where output of the whole economy is described by a Cobb–Douglas function and Total Factor Productivity (TFP) is estimated allowing for possible breaks in the deterministic trend. The results confirm that over the considered period the potential gross domestic product growth has been faster in the United States than in other studied countries, reflecting a combination of higher labour contribution and faster TFP growth. Overall, this paper might help to shed some light on cross-country differences in economic performance over the recent period. [ABSTRACT FROM AUTHOR]

The purpose of the paper is to assess the theory that the downside risk insurance provided by more generous welfare states generates long run efficiency gains, which counterbalance the short run efficiency losses caused by work disincentives in these states (Feldstein 1974, 1976; Sinn 1995, 1996). Testing downside risk theory requires long term data, so the paper makes use of the three longest running national socio-economic panel surveys. These are the American Panel Study of Income Dynamics (PSID, 1968-), the German Socio-Economic Panel (1984-) and the Dutch Socio-Economic Panel (SEP, 1984-). The paper focusses on prime age households (heads 25–59) and assesses their participation in and returns to adult education and job training. Our results indicate some support for the theory in so far as Dutch and German prime age adults, living in more generous welfare states, were much more likely than Americans to take the risk of foregoing current earnings and investing in additional education. In all three countries returns on investment were substantial. [ABSTRACT FROM AUTHOR]

This paper discusses the limitations of harmonised sampling designs for survey research on immigrants in Germany and the Netherlands. Although the concepts for immigrants are largely similar in both countries, there are severe constraints when it comes to comparable sampling designs. While in the Netherlands a sample can be drawn from a national population register by Statistics Netherlands, this is impossible in Germany due to the decentralised setup of the population register and legal restrictions on merging existing databases. Harmonisation of immigrant statistics is thus less a problem at the concept level than in the implementation. Achieving a harmonised data collection on immigrants for Germany and the Netherlands will be a major challenge. [ABSTRACT FROM AUTHOR]

Recently, several checklists systematically assessed factors that affect the transferability of cost-effectiveness (CE) studies between jurisdictions. The role of the threshold value for a QALY has been given little consideration in these checklists, even though the importance of a factor as a cause of between country differences in CE depends on this threshold. In this paper, we study the impact of the willingness-to-pay (WTP) per QALY on the importance of transferability factors in the case of smoking cessation support (SCS). We investigated, for several values of the WTP, how differences between six countries affect the incremental net monetary benefit (INMB) of SCS. The investigated factors were demography, smoking prevalence, mortality, epidemiology and costs of smoking-related diseases, resource use and unit costs of SCS, utility weights and discount rates. We found that when the WTP decreased, factors that mainly affect health outcomes became less important and factors that mainly effect costs became more important. With a WTP below €1,000, the factors most responsible for between country differences in INMB were resource use and unit costs of SCS and the costs of smoking-related diseases. Utility values had little impact. At a threshold above €10,000, between country differences were primarily due to different discount rates, utility weights and epidemiology of smoking-related diseases. Costs of smoking-related diseases had little impact. At all thresholds, demography had little impact. We concluded that, when judging the transferability of a CE study, we should consider the between country differences in WTP threshold values. [ABSTRACT FROM AUTHOR]

The author explores the conclusions of four research papers published within the issue on educational measurement, curricular innovation and school assessment. Topics include informal learning, non-formal education, and the success of the student/ teacher evaluations by examination and testing. Findings on the educational systems of Germany, Sweden, the Netherlands and Wyoming are presented.

The paper uses household economic panel data from five countries—Australia, Britain, Germany, Hungary and The Netherlands—to provide a reassessment of the impact of economic well-being on happiness. The main conclusion is that happiness is considerably more affected by economic circumstances than previously believed. In all five countries wealth affects life satisfaction more than income. In the countries for which consumption data are available (Britain and Hungary), non-durable consumption expenditures also prove at least as important to happiness as income. [ABSTRACT FROM AUTHOR]

Abstract  In the summer of 2006, a bluetongue epidemic started in the border area of Belgium, The Netherlands, and Germany, spread within 2 years over large areas of Western and Central Europe, and caused substantial losses in farm ruminants. Especially sheep and cattle were severely affected, leading to a case–fatality ratio of nearly 40% in sheep (Conraths et al., Emerg Inf Dis 15(3):433–435, 2009). The German federal ministry of food, agriculture, and consumer protection (BMELV) established a countrywide monitoring on the occurrence of the vectors of this virus, i.e., midges (family Ceratopogonidae) of the genus Culicoides. The monitoring was done on 91 sites, most of which were localized in the 150-km restriction zone that existed in December 2006. A grid consisting of 45 × 45 km2 cells was formed that covered the monitoring area. As a rule, one trap was placed into each grid cell. The monitoring program started at the end of March 2007 and lasted until May 2008. It included the catching of midges by ultraviolet light traps—done each month from days 1 until 8, the selection of midges of the Culicoides obsoletus, Culicoides pulicaris group, and other Culicoides spp., the testing of midges for bluetongue virus (BTV) by polymerase chain reaction (PCR), and the daily registration of weather data at each trap site for the whole monitoring period. The following main results were obtained: (1) Members of the C. obsoletus group were most commonly found in the traps, reaching often 3/4 of the catches. The African and South European vector of BTV—the species Culicoides imicola—was never found. (2) Members of the C. obsoletus group were most frequently found infected with BTV besides a few cases in the C. pulicaris group and other species. (3) Members of the C. obsoletus group were also found in winter. Their numbers were reduced, however, and they were caught mostly close to stables. Therefore, a true midge-free period does not exist during the year in Germany. (4) The amounts of midges caught daily depended on the weather conditions. If it was cold and/or windy, the traps contained only a few specimens. Since the months from January to May 2008 were considerably colder (at all farms) than their correspondents in 2007, the growing of the population of midges started 2–3 months later in 2008 than in 2007. (5) The highest populations of midges occurred in both years (2007 and 2008) during the months September and October. This corresponded significantly to the finding of highest numbers of infected midges and to the number of diseased cattle and sheep during these 2 months. (6) It is noteworthy that in general, the first virus-positive midges of the species C. obsoletus were found about 1 1/2 months later than the first clinical cases had occurred or later than the first PCR-proven virus-positive sentinel animals had been documented. In 2007, the first BTV-positive cattle were detected in May in North Rhine-Westphalia, while the first positive Culicoides specimens were only found in August on the same farm. Evaluating these main results of the entomological monitoring and the fact that many wild ruminants have also been infected with BTV, it becomes evident that bluetongue disease has become endemic in Central Europe, and that only constant effort including vaccination and perhaps also insecticidal protection of cattle and sheep will keep the economical losses at a reasonable level. The following papers (1–10) in this journal will contribute more details obtained from this worldwide unique entomological monitoring: Bartsch et al. 2009; Bauer et al. 2009; Stephan et al. 2009; Clausen et al. 2009; Hörbrand and Geier 2009; Kiehl et al. 2009; Mehlhorn et al. 2009; Kiel et al. 2009; Vorsprach et al. 2009; Balczun et al. 2009. [ABSTRACT FROM AUTHOR]

The paper studies the relation between different national cost-sharing models and how students from different socio-economic backgrounds finance their higher education in six different European countries: the Czech Republic, England, Germany, the Netherlands, Norway, and Spain. The findings reveal considerable differences both between the countries and also between different socio-economic groups of students within each country. Even though there are only small social differences in the students' level of income, there are considerable social differences in the students' sources of income. The findings are discussed related to the country's specific policy and higher education funding structures. [ABSTRACT FROM AUTHOR]

This work deals with the analysis of simulations carried out with a primitive equation numerical model for the region of the East Frisian Wadden Sea. The model, with 200-m resolution, is forced by wind, air–sea heat, and water fluxes and river runoff and is nested in a German Bight 1-km-resolution numerical model, the latter providing tidal forcing for the fine resolution model. The analysis of numerical simulations is focused both on responses due to moderate conditions, as well as to extreme events, such as the storm surge Britta, for which the model demonstrates very good skills. The question addressed in this paper is how well the model output can be compressed with the help of empirical orthogonal function analysis. It is demonstrated that, for the short-time periods of the order of a spring–neap cycle, only a few modes are necessary to almost fully represent the circulation. This is just an illustration that the circulation in this region is subject to the dominating tidal forcing, creating clear and relatively simple response patterns. However, for longer periods of about several months, wind forcing is also very important, and correspondingly, the circulation patterns become much more complex. Possible applications of the results in hindcasting and forecasting of hydrodynamics and sediment dynamics in the coastal zone are considered. [ABSTRACT FROM AUTHOR]

In this paper, we examine the effects of the introduction of free choice and price competition in social health insurance in Germany and the Netherlands. Using panel data at the sickness fund level we estimate the price elasticity of sickness fund choice in both countries. We find that the price elasticity in Germany is high and rapidly increasing. Consistent with findings of other studies on health plan choice, the price elasticity is much lower for elderly than for non-elderly. In the Netherlands, by contrast, the price elasticity of fund choice is negligible. Only when people were forced to choose a sickness fund, they were quite sensitive to premium differences. Key factors in explaining the observed differences in switching behavior between both countries are the degree of financial risk for sickness funds, the features of the risk-adjustment mechanism and the role of employers. [ABSTRACT FROM AUTHOR]

In colorectal cancer (CRC), artificial intelligence (AI) can alleviate the laborious task of characterization and reporting on resected biopsies, including polyps, the numbers of which are increasing as a result of CRC population screening programs ongoing in many countries all around the globe. Here, we present an approach to address two major challenges in the automated assessment of CRC histopathology whole-slide images. We present an AI-based method to segment multiple ( n = 14 ) tissue compartments in the H &E-stained whole-slide image, which provides a different, more perceptible picture of tissue morphology and composition. We test and compare a panel of state-of-the-art loss functions available for segmentation models, and provide indications about their use in histopathology image segmentation, based on the analysis of (a) a multi-centric cohort of CRC cases from five medical centers in the Netherlands and Germany, and (b) two publicly available datasets on segmentation in CRC. We used the best performing AI model as the basis for a computer-aided diagnosis system that classifies colon biopsies into four main categories that are relevant pathologically. We report the performance of this system on an independent cohort of more than 1000 patients. The results show that with a good segmentation network as a base, a tool can be developed which can support pathologists in the risk stratification of colorectal cancer patients, among other possible uses. We have made the segmentation model available for research use on https://grand-challenge.org/algorithms/colon-tissue-segmentation/. [ABSTRACT FROM AUTHOR]

The study assesses the relationship between technology innovation and renewable energy in the G10 countries. According to the findings, technology innovation has a significant impact on renewable energy in various countries, including Germany, the Netherlands, Sweden, the UK, and the USA. It argues that technological innovation is one of the most important elements in renewable energy in these countries because of their strong innovative base and huge spending on research and development. However, the results for the remaining countries show no causation from technology innovation to renewable energy, implying that variables other than technology innovation drive renewable energy development. On the other hand, renewable energy does Granger cause technology innovation in Germany, the Netherlands, and the USA. These countries need to invest in implementation instead of spending on the existing infrastructure. Furthermore, the increased dependence on fossil fuels and nuclear energy may leave renewables undeveloped, with less emphasis on renewable-technology diffusion. [ABSTRACT FROM AUTHOR]

This paper extends previous work on the information content of the term structure of interest rates using a newly constructed dataset for the United States, Japan, Germany, Switzerland, France, Belgium and the Netherlands (1982-1991). Results significantly differ from Jorion and Mishkin (1991). Apparently, the relation between the term structure of interest rates and future inflation is highly period- and country-dependent. We provide new evidence that these results may be due to the inability of financial markets to accurately predict a term structure of inflation in combination with the conduct of monetary policy. This probably accounts for large variation in ex post real interest rate levels and the term structure of real interest rates. Consequently, it is unlikely that the term structure of nominal interest rates wilt serve as a good indicator of future inflationary developments. [ABSTRACT FROM AUTHOR]

Backgroung/Objectives:Compares the nutritional quality of pre-packaged foods carrying health-related claims with foods that do not carry health-related claims.Subject/methods: Cross-sectional survey of pre-packaged foods available in Germany, The Netherlands, Spain, Slovenia and the United Kingdom in 2013. A total of 2034 foods were randomly sampled from three food store types (a supermarket, a neighbourhood store and a discounter). Nutritional information was taken from nutrient declarations present on food labels and assessed through a comparison of mean levels, regression analyses and the application of a nutrient profile model currently used to regulate health claims in Australia and New Zealand (Food Standards Australia New Zealand's Nutrient Profiling Scoring Criterion, FSANZ NPSC).Results: Foods carrying health claims had, on average, lower levels, per 100 g, of the following nutrients, energy-29.3 kcal (P<0.05), protein-1.2 g (P<0.01), total sugars-3.1 g (P<0.05), saturated fat-2.4 g (P<0.001), and sodium-842 mg (P<0.001), and higher levels of fibre-0.8 g (P<0.001). A similar pattern was observed for foods carrying nutrition claims. Forty-three percent (confidence interval (CI) 41%, 45%) of foods passed the FSANZ NPSC, with foods carrying health claims more likely to pass (70%, CI 64%, 76%) than foods carrying nutrition claims (61%, CI 57%, 66%) or foods that did not carry either type of claim (36%, CI 34%, 38%).Conclusions: Foods carrying health-related claims have marginally better nutrition profiles than those that do not carry claims; these differences would be increased if the FSANZ NPSC was used to regulate health-related claims. It is unclear whether these relatively small differences have significant impacts on health. [ABSTRACT FROM AUTHOR]

Background: Direct oral anticoagulants are available for patients with atrial fibrillation. Objective: This study compared adherence and persistence of once-daily (QD) vs twice-daily (BID) direct oral anticoagulants in patients with atrial fibrillation. Methods: A cohort study was conducted in three databases in the Netherlands, Italy and Germany. Patients with AF starting direct oral anticoagulants after drug approval date were included. The index date was the date of first dispensing. Study patients were restricted to those aged ≥ 18 years, ≥ 1 year database history and ≥ 1 year follow-up. Adherence to treatment was defined as the proportion of days covered ≥ 80% between the index date and the date of last dispensing of the index regimen (i.e. exposure period). The proportion of days covered was also determined during the 12-month follow-up. Persistence was defined as continuous use from index to treatment discontinuation. Results: In the Netherlands, Italy and Germany, respectively, 6068, 32,260 and 167,445 patients were included. The mean age of the patients was 70, 77 and 74 years, and 31%, 40% and 61% were QD users, all respectively. Among QD/BID users, 93/90%, 88/86% and 77/58%, respectively were adherent during the exposure period. Persistence rates at 1 year in QD/BID users were 60/59%, 13/14% and 46/31%, respectively. Conclusions: Adherence to treatment was high. In Germany, adherence was markedly higher in QD users compared with BID users. In Italy and the Netherlands, these differences were marginal. Persistence was low in all countries, but discontinuation was temporary. Only in Germany, persistence was markedly lower in BID users vs QD users. [ABSTRACT FROM AUTHOR]

The aim of the present study was to examine parental experiences of homeschooling during the COVID-19 pandemic in families with or without a child with a mental health condition across Europe. The study included 6720 parents recruited through schools, patient organizations and social media platforms (2002 parents with a child with a mental health condition and 4718 without) from seven European countries: the UK (n = 508), Sweden (n = 1436), Spain (n = 1491), Belgium (n = 508), the Netherlands (n = 324), Germany (n = 1662) and Italy (n = 794). Many parents reported negative effects of homeschooling for themselves and their child, and many found homeschooling to be of poor quality, with insufficient support from schools. In most countries, contact with teachers was limited, leaving parents with primary responsibility for managing homeschooling. Parents also reported increased levels of stress, worry, social isolation, and domestic conflict. A small number of parents reported increased parental alcohol/drug use. Some differences were found between countries and some negative experiences were more common in families with a child with a mental health condition. However, differences between countries and between families with and without a mental health condition were generally small, indicating that many parents across countries reported negative experiences. Some parents also reported positive experiences of homeschooling. The adverse effects of homeschooling will likely have a long-term impact and contribute to increased inequalities. Given that school closures may be less effective than other interventions, policymakers need to carefully consider the negative consequences of homeschooling during additional waves of the COVID-19 pandemic and future pandemics. [ABSTRACT FROM AUTHOR]

This paper describes and compares trends of religious homogamy and heterogamy in Germany (1901-1986) and the Netherlands (1914-1986), using four (and sometimes six) categories of religious denomination. Attention is paid mainly to the relative frequencies of religious assortive marriage, using loglinear models to control for the impact of demographic factors. Moreover, attention is drawn to the patterns of acceptance and rejection between members of different denominations on the marriage market. Special attention has been given to Jewish marriage behavior in Germany in the period 1927-1936 and in the Netherlands in the period 1935-1943, in order to reveal the effects of the rise of National-Socialism. With the exception of certain well-defined groups, crossing denominational borders on the marriage market has become a normal pattern in both countries. This is taken as an indication of growing social integration and societal openness. General theories such as modernization or industrialization can account for the trends only to a very limited degree. National history and denominational characteristics seem to provide more adequate interpretations. [ABSTRACT FROM AUTHOR]

Purpose: Psychosocial stress is associated with obesity in some populations, but it is unclear whether the association is related to migration. This study explored associations between psychosocial stress and obesity among Ghanaian migrants in Europe and non-migrant Ghanaians in Ghana.Methods: Cross-sectional data from the RODAM study were used, including 5898 Ghanaians residing in Germany, the UK, the Netherlands, rural Ghana, and urban Ghana. Perceived discrimination, negative life events and stress at work or at home were examined in relation to body mass index (BMI) and waist circumference (WC). Linear regression analyses were performed separately for migrants and non-migrants stratified by sex.Results: Perceived discrimination was not associated with BMI and WC in both migrants and non-migrants. However, negative life events were positively associated with BMI (β = 0.78, 95% CI 0.34-1.22) and WC (β = 1.96, 95% CI 0.79-3.12) among male Ghanaian migrants. Similarly, stress at work or at home was positively associated with BMI (β = 0.28, 95% CI 0.00-0.56) and WC (β = 0.84, 95% CI 0.05-1.63) among male Ghanaian migrants. Among non-migrant Ghanaians, in contrast, stress at work or at home was inversely associated with BMI and WC in both males (β = - 0.66, 95% CI - 1.03 to - 0.28; β = - 1.71 95% CI - 2.69 to - 0.73, respectively) and females (β = - 0.81, 95% CI - 1.20 to - 0.42; β = - 1.46, 95% CI - 2.30 to - 0.61, respectively).Conclusions: Negative life events and stress at work or at home are associated with increased body weight among male Ghanaians in European settings, whereas stress at work or at home is associated with reduced body weight among Ghanaians in Ghana. More work is needed to understand the underlying factors driving these differential associations to assist prevention efforts. [ABSTRACT FROM AUTHOR]

Context: The governance of international natural World Heritage sites is extremely challenging. In the search for effective multilevel governance there is a need to identify the community of people which have place attachment to the areas, i.e. 'the community of fans' at local to international levels. Objectives: Focusing on the landscape of the international Wadden Sea coastal area in the Netherlands, Germany and Denmark as a case study, we address three key questions: What is the spatial distribution of the community of fans? How does the size of this community relate to the overlapping communities of locals and actual visitors to the Wadden Sea coastal area? Which parts of the Wadden Sea coastal area are most appreciated by the community of fans, and how does this relate to its formal protection status? Methods: We analysed 7650 respondents' answers to a tri-lateral web survey (the standardized Greenmapper survey) conducted in Denmark, Germany and the Netherlands. Results: We estimated that 14 million German, Dutch and Danish citizens can be regarded as the potential—national level—community of fans. The correlation between place or landscape attachment and distance was varied among the three countries. Furthermore, only 37% of the markers placed by fans of the Wadden Sea coastal area are within the protected UNESCO World Heritage limits, suggesting that a broader demarcation could be possible. Conclusions: We discuss how the identification of fans can potentially contribute to more effective public involvement in the governance of valuable landscapes. [ABSTRACT FROM AUTHOR]

The 2018 ADTA International Panel presented the work of dance/movement therapists from around the world who are experts in implementing restorative methods and techniques that address the myriad psychological, emotional, and physical symptoms of those suffering from trauma. Panelists were asked to respond to the following questions: What is your specialty in the field of trauma? What is your country's cultural, political, and social response to trauma issues? What are the specific DMT interventions that you implement as a restorative treatment for trauma? And finally, what tools do you utilize as a DMT clinician to recuperate from working with clients of trauma? Countries represented were Holland, Australia, Canada, United States, Israel, and Germany. [ABSTRACT FROM AUTHOR]

Water tables are strictly controlled throughout much of the Netherlands. Higher water tables could permit the restoration of wetland ecosystems. Deriving benefits from this requires the spatial matching of physical planning, eco-hydrological processes, and economic activities. This paper reports on a study combining spatial analysis and disciplinary integration to assess management strategies for the Vecht river basin in the Netherlands. The paper addresses two research questions. How can the information generated by spatial models be condensed into performance indicators for the evaluation of strategies? How can spatial information be retained in the evaluation, and does this lead to different rankings and/or insights? Procedures for the construction of performance indicators for three criteria ? net present value, environmental quality and spatial equity ? are presented. The evaluation concludes that recreation and higher water tables provide a means for restoration, recouping of costs, and stimulating regional incomes. Maintenance of spatial detail led to different insights, and in particular indicated uncertainty about this conclusion. [ABSTRACT FROM AUTHOR]

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Purpose: After regulatory restrictions for terfenadine and astemizole in '90s, only scarce evidence on proarrhythmic potential of antihistamines has been published. We evaluate the risk of ventricular tachyarrhythmia (VA) related to the use of individual antihistamines. Methods: A matched case-control study nested in a cohort of new users of antihistamines was conducted within the EU-funded ARITMO project. Data on 1997-2010 were retrieved from seven healthcare databases: AARHUS (Denmark), GEPARD (Germany), HSD and ERD (Italy), PHARMO and IPCI (Netherlands) and THIN (UK). Cases of VA were selected and up to 100 controls were matched to each case. The odds ratio (OR) of current use for individual antihistamines (AHs) was estimated using conditional logistic regression. Results: For agents largely used to prevent allergic symptoms, such as cetirizine, levocetirizine, loratadine, desloratadine and fexofenadine, we found no VA risk. A statistically significant, increased risk of VA was found only for current use of cyclizine in the pooled analysis (ORadj, 5.3; 3.6-7.6) and in THIN (ORadj, 5.3; 95% CI, 3.7-7.6), for dimetindene in GEPARD (ORadj, 3.9; 1.1-14.7) and for ebastine in GEPARD (ORadj, 3.3; 1.1-10.8) and PHARMO (ORadj, 4.6; 1.3-16.2). Conclusions: The risk of VA associated with a few specific antihistamines could be ascribable to heterogeneity in pattern of use or in receptor binding profile. [ABSTRACT FROM AUTHOR]

Introduction: The objective of this study was to investigate the nature, management, and outcome of major injuries related to equestrian sports and to define the at-risk groups for serious and life-threatening injuries.Methods: We analyzed demographic, pre-hospital, clinical, and outcome data from an international population-based prospective trauma database (TraumaRegister DGU®). Patients with major injuries (Injury Severity Score [ISS] ≥9 points) related to equestrian sports activities were included (January 1, 1993, to December 31, 2012). Clinical and outcome parameters were stratified for four different types of injury mechanisms: fall from horse (FFH), horse-kick (HK), horse crush (HC), and carriage-related accidents (CRA). Participating countries included Germany, Austria, Switzerland, Finland, Slovenia, Belgium, Luxembourg, and The Netherlands. Statistical analyses were performed with SPSS (Version 22, IBM Inc., Armonk, NY).Results: The Database identified 122,000 documented patients, of whom 679 were equestrian incidents. Among these, the four major injury mechanisms were: FFH (n = 427), HK (n = 188), HC (n = 34), and the CRA (n = 30). Females were more likely to sustain FFH (75.5%, p < 0.001), leading to head injuries (n = 204, 47.8%) and spinal fractures (n = 109, 25.5%). HK injuries often resulted in facial fractures (29.3%, p < 0.001). Individuals sustaining HC injuries had a high risk for pelvic (32.4%, p < 0.001) and abdominal injuries (35.2%, p < 0.001). In contrast to the FFH cohort, the CRA cohort involved older males (57 ± 13 years), with chest (63.3% p = 0.001), and extremity injuries, resulting in significant injury severity (ISS 20.7 ± 10.6). In the CRA cohort, 16% were in haemorrhagic shock on scene, and also the highest in-hospital mortality (14.8%, p = 0.006) was observed.Conclusions: Young female riders are at risk from falling, horse-kicks, and crush-injuries. Older males in carriage-related accidents sustained the highest injury severity and mortality rate, and must specifically be targeted by future prevention initiatives. Level of evidence Descriptive Epidemiologic Study, Level II. [ABSTRACT FROM AUTHOR]

Purpose: Although survival after very preterm birth (VP)/very low birth weight (VLBW) has improved, a significant number of VP/VLBW individuals develop physical and cognitive problems during their life course that may affect their health-related quality of life (HRQoL). We compared HRQoL in VP/VLBW cohorts from two countries: The Netherlands (n = 314) versus Germany (n = 260) and examined whether different neonatal treatment and rates of disability affect HRQoL in adulthood.Method: To analyse whether cohorts differed in adult HRQoL, linear regression analyses were performed for three HRQoL outcomes assessed with the Health Utilities Index 3 (HUI3), the London Handicap Scale (LHS), and the WHO Quality of Life instrument (WHOQOL-BREF). Stepwise hierarchical linear regression was used to test whether neonatal physical health and treatment, social environment, and intelligence (IQ) were related to VP/VLBW adults' HRQoL and cohort differences.Results: Dutch VP/VLBW adults reported a significantly higher HRQoL on all three general HRQoL measures than German VP/VLBW adults (HUI3: .86 vs .83, p = .036; LHS: .93 vs. .90, p = .018; WHOQOL-BREF: 82.8 vs. 78.3, p < .001). Main predictor of cohort differences in all three HRQoL measures was adult IQ (p < .001).Conclusions: Lower HRQoL in German versus Dutch adults was related to more cognitive impairment in German adults. Due to different policies, German VP/VLBW infants received more intensive treatment that may have affected their cognitive development. Our findings stress the importance of examining effects of different neonatal treatment policies for VP/VLBW adults' life. [ABSTRACT FROM AUTHOR]

Maternal depression can be accounted for one of the most common complications during pregnancy and the postpartum period affecting women all over the world. So far, no detailed map of the worldwide maternal depression research architecture has been constructed, which encompasses aspects of research activity, quality, and also socioeconomic features. Using the NewQIS platform, density-equalizing mapping projections, scientometric techniques, and economic benchmarking procedures were applied to evaluate global maternal depression research for the period between 1900 and 2012. In total, 7330 related publications and 3335 international collaborations were identified. The USA was the most active country concerning collaborations and total research activity. In the socioeconomic analysis of research activity in high-income countries, Australia was ranked first with an average of 412.05 maternal depression-related publications per 1000 billion US$ GDP (Q), followed by the UK (Q = 373.51) and Canada (Q = 306.32). The group of upper-middle-income countries was led by South Africa (Q = 145.67), followed by Turkey (Q = 91.8). China authored 11.95 maternal depression-related publications per 1000 billion US$ GDP. The USA had the highest activity of maternal depression research per GDP in billion US$ per capita (Q = 60.86). When research activity was related to population size (Q = publications per Mio. inhabitants), Australia (Q = 26.44) was leading the field, followed by Norway (Q = 18.48). Gender analysis revealed a relatively high degree of female scientists involved in this field of research with pronounced differences between single subject areas. In summary, we here present the first picture of the global scientific development in maternal depression research over a period of more than 100 years. The research landscape is clearly dominated by North American and Western European countries, with only minor contribution of Asian or South American countries. [ABSTRACT FROM AUTHOR]

Background: Information on costs of managing adverse events (AEs) associated with current treatments in metastatic melanoma is limited. This study estimates costs of AEs in eight countries: Australia (AU), Canada (CA), France (FR), Germany (GE), Italy (IT), the Netherlands (NL), Spain (ES), and the UK.Methods: A literature search was conducted to identify grade 3/4 AEs from product label, published trials, conference abstracts, and treatment guidelines. Resource utilization for the management of each type of AE was determined via interviews with 5 melanoma clinicians in each country. Outpatient and inpatient costs were estimated for each type of AE using country-specific tariffs or government/published sources.Results: In outpatient settings, the most costly AEs per incident included cutaneous squamous cell carcinoma (CSCC) (€1063, £720; NL/UK), anemia (€1443, €1329, €1285; ES/IT/FR), peripheral neuropathy (€1289; ES), and immune-related diarrhea (AUS$1,121; AU). In inpatient settings, the most costly AEs per hospitalization included hypophysitis (€10,265; €5316; CAN$9735; AUS$7231: ES/FR/CA/AU), dyspnea (€9077; GE), elevated liver enzymes (€6913, CAN$8030, AUS$6594; FR/CA/AU), CSCC (CAN$8934; CA), peripheral neuropathy (€6977, €4144, CAN$9472; NL/ES/CA), and diarrhea (£4284, €4113; UK/ES).Conclusions: Costs of managing AEs can be significant, and thus effective treatments with lower rates of severe AEs would be valuable. [ABSTRACT FROM AUTHOR]

Background: Previous studies comparing restraint data from different countries had to rely on randomly published data and showed wide variance in the prevalence of restraint between countries.Aim: To systematically compare datasets from four similar European countries with regard to restraint prevalence.Methods: We analysed whole country or area datasets on restraint from Wales, Ireland, Germany and the Netherlands systematically, thus excluding selection, patient and setting bias. Learning disability (LD) and forensic settings were analysed separately. Differences in proportions between countries were tested by means of Chi square, with number of admissions, admission days and catchment area as denominator and counts of restraint as numerators.Results: Full datasets were obtained allowing calculations of total admissions, total restraint numbers, numbers of patients involved and total occupied bed days. Data for Ireland is from 2012 and from 2013 for the other three countries. The percentage of patients exposed to restraint varies between 4.5 and 9.4 %. The average number of restraints per patient is stable at around 3 in all countries. Patient numbers affected by restraint per 100 occupied bed days per month vary between 0.095 and 0.200. The Netherlands have the highest use of seclusion (79 %), the longest restraint times and low use of enforced medication. Wales the lowest use of seclusion (2 %), followed by Ireland (29 %) and Germany (49 %). Events per 100 admissions per month vary between 17 and 21. Patients affected by restraint per 100 admissions per month vary between 5.4 and 7.5. LD services account for a disproportionately high number of restraint events.Conclusion: Patient related restraint data are remarkably similar between countries. Type and length of restraint still vary significantly. [ABSTRACT FROM AUTHOR]

Background: Worldwide, approximately one in eight children or adolescents suffer from a mental disorder. The present study was designed to determine the cross-national prevalence of mental health problems in children aged 6-11 across seven European countries including Italy, Germany, the Netherlands, Lithuania, Bulgaria, Romania, and Turkey.Methods: Data were collected on 7682 children for whom either parent- or teacher SDQ were completed.Results: The present study provides country-specific normative banding for both parent- and teacher SDQ scores. Overall, 12.8 % of children have any probable disorder, with rates ranging from 15.5 % in Lithuania to 7.8 % in Italy, 3.8 % of children have a probable emotional disorder, 8.4 % probable conduct disorder, and 2.0 % probable hyperactivity/inattention. However, when adjusting for key sociodemographic variables and parental psychological distress, country of residence did not predict the odds of having any disorder. For specific disorders, however, country of residence does have an effect on the odds of presenting with mental health problems.Conclusions: As normative data are key in the comparison of mental health status on an international level, the present data considerably advance the possibilities of future research. Furthermore, the findings underline the importance of controlling for a number of sociodemographic and parental variables when conducting international comparisons of child mental health. In addition, the findings suggest that efforts are needed locally to assist in the detection and prevention of parental psychological distress. [ABSTRACT FROM AUTHOR]

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

Purpose: Osteoarthritis (OA) has been shown to be associated with decreased physical function, which may impact upon a person's self-rated health (SRH). Only a few studies have examined the association between OA and SRH in the general population, but to date none have used a clinical definition of OA. The objectives are: (1) To examine the cross-sectional association between clinical OA and fair-to-poor SRH in the general population; (2) To examine whether this association differs between countries; (3) To examine whether physical function is a mediator in the association between clinical OA and SRH.Methods: Baseline data of the European Project on OSteoArthritis (EPOSA) were used, which includes pre-harmonized data from six European cohort studies (n = 2709). Clinical OA was defined according to the American College of Rheumatology criteria. SRH was assessed using one question: How is your health in general? Physical function was assessed using the Western Ontario and McMaster Universities OA Index and Australian/Canadian OA Hand Index.Results: The prevalence of fair-to-poor SRH ranged from 19.8 % in the United Kingdom to 63.5 % in Italy. Although country differences in the strength of the associations were observed, clinical OA of the hip, knee and hand were significantly associated with fair-to-poor SRH in five out of six European countries. In most countries and at most sites, the association between clinical OA and fair-to-poor SRH was partly or fully mediated by physical function.Conclusions: Clinical OA at different sites was related to fair-to-poor SRH in the general population. Most associations were (partly) mediated by physical functioning, indicating that deteriorating physical function in patients with OA should be a point of attention in patient care. [ABSTRACT FROM AUTHOR]

The question whether ethnic diversity is associated with declining social cohesion has produced much controversy. We maintain that more attention must be paid to cognitive mechanisms to move the debate ahead. Using survey data from 938 localities in Germany, France, and the Netherlands, we explore a crucial individual-level mechanism: perceptions of diversity. We not only consider perceptions of the amount, but also of the qualitative nature of diversity. By asking about various qualitative aspects of diversity, we test the cognitive salience of three explanations that have been proposed in the literature for negative diversity effects: out-group biases, asymmetric preferences and coordination problems. We show that all three mechanisms matter. Perceptions both mediate statistical diversity effects, and have important explanatory power of their own. Moreover, we are able to address the question to what extend the relationship of perceived diversity and neighborhood social cohesion varies across policy contexts. Based on assumptions in the literature about positive impacts of inclusive and culturally pluralist immigrant integration policy approaches, we hypothesize that ethno-cultural diversity is less negatively related to neighborhood social cohesion in more inclusive policy contexts. Our results provide partial support for this hypothesis as perceived diversity has a significantly stronger negative impact on neighborhood cohesion in Germany. [ABSTRACT FROM AUTHOR]

This article focuses on the perceptions of Muslim immigrants regarding what might constitute 'successful integration' into two Western European countries: Germany and the Netherlands. I conducted qualitative interviews with representatives from Muslim umbrella organisations and reviewed their publications to analyse their definitions of 'integration'. The results support the assumption that differences in political opportunity structures derived from specific integration policies, as well as national regimes of religious governance, affect the views of Muslim organisations acting in these contexts. In the Netherlands, the Muslim representatives still support a policy of multicultural integration and, first and foremost, the right to preserve their original identities. In contrast, their counterparts in Germany occasionally consider moderate forms of acculturation, including the creation of 'hybrid' identities, within the country that receives them. Understanding areas of concordance between immigrant and state representatives within the same national context could pave the way for more constructive and less polarised dialogue between the two groups and might serve as a model for facilitating other types of integration. [ABSTRACT FROM AUTHOR]

Aim: Against the backdrop of controversial bioethical and public health debates on the role of age in decisions on healthcare allocation, we examine the perspectives of European lay persons on ethical implications of age and aging for medicine and health care. Subject and methods: The study uses a qualitative approach based on the content analysis of 29 focus group discussions (235 participants) held in 4 European countries (Austria, Germany, the Netherlands, and Sweden) between 2005 and 2012. Results: While lay persons unanimously reject chronological age as a criterion for resource allocation, they acknowledge that age can be an important factor in ethical decision-making processes in many different ways. In the discussions, they articulate biographical concepts and viewpoints (such as age roles, ideas of the course and prime of life, responsibilities between generations), framing questions of resource allocation with regard to a teleological perspective of a good life. Conclusion: Participants introduce a biographical outlook on medical decision making while at the same time articulating different conceptions of aging and the life course. Public health ethics needs to find ways to incorporate this plurality of temporal perspectives on the good life. [ABSTRACT FROM AUTHOR]

Background: Evidence-based guidelines for pediatric renal transplantation (Tx) are lacking. This may lead to unwanted treatment variations. We aimed to quantify the variation in treatment policies and its consequences in daily practice in 11 centers that provide renal Tx for children in three European countries. Methods: We surveyed Tx policies in all ten centers in the Netherlands and Belgium and one center in Germany. We compared Tx policies with the therapies actually provided and with recommendations from available published guidelines and existing literature. Information on treatment policies was obtained by a questionnaire; information on care actually provided was registered prospectively from 2007 to 2011. The clinical guidelines were identified by searches of MEDLINE and websites of pediatric nephrology organizations. Results: Between centers, we found discrepancies in policies on: the minimum accepted recipient weight (8-12 kg), the maximum living and deceased donor age (50-75 and 45-60 years, respectively). HLA-match policies varied between acceptation of all mismatches to at least 1A1B1DR match donor transplantations amounting to 49 % in the Netherlands versus 26 % in Belgium ( p = 0.006). Conclusions: Management policies for renal Tx in children vary considerably between centers and nations. This has a direct impact on the delivered care, and by extrapolation, on health outcome. [ABSTRACT FROM AUTHOR]

Purpose: We performed a meta-analysis of three sub-studies of the randomized Tamoxifen Exemestane Adjuvant Multinational (TEAM) trial to determine the effects of exemestane and tamoxifen on bone health. Methods: Patients received exemestane or tamoxifen as adjuvant therapy for hormone receptor-positive breast cancer. Bone mineral density (BMD) was assessed at baseline and after 12 and 24 months of treatment. Bone turnover markers were also measured. Results: Patients receiving tamoxifen showed a mean increase from baseline in lumbar spine BMD of 1.2% at month 12 and 0.2% at month 24. Patients receiving exemestane showed a mean decrease from baseline of 2.6% after 12 months and 3.5% after 24 months. There were significant differences in the changes in lumbar spine BMD between treatment groups ( P < 0.0001 at both time points). Changes in BMD from baseline at the total hip were also significantly different between exemestane and tamoxifen ( P < 0.05 at both time points). Bone turnover markers decreased from baseline with tamoxifen and increased with exemestane. Conclusions: Exemestane resulted in decreases in BMD and increases in bone turnover markers. BMD increased and bone turnover markers decreased with tamoxifen. [ABSTRACT FROM AUTHOR]

This contribution seeks to measure preferences for health insurance of individuals with and without chronic conditions in two countries, Germany and the Netherlands. The objective is to test the presumption that preferences between these two subpopulations differ and to see whether having a chronic condition has a different influence on preferences depending on the country. The evidence comes from two Discrete Choice Experiments performed in 2005 (Germany) and 2006 (the Netherlands, right after a major health reform). Results point to an even more marked resistance against restrictions of physician choice among individuals with chronic conditions in both countries. Thus, the alleged beneficiaries of Disease Management Programs would have to be highly compensated for accepting the restrictions that go with them. [ABSTRACT FROM AUTHOR]

Phenological studies have demonstrated changes in the timing of seasonal events across multiple taxonomic groups as the climate warms. Some northern European migrant bird populations, however, show little or no significant change in breeding phenology, resulting in synchrony with key food sources becoming mismatched. This phenological inertia has often been ascribed to migration constraints (i.e. arrival date at breeding grounds preventing earlier laying). This has been based primarily on research in The Netherlands and Germany where time between arrival and breeding is short (often as few as 9 days). Here, we test the arrival constraint hypothesis over a 15-year period for a U.K. pied flycatcher ( Ficedula hypoleuca) population where laying date is not constrained by arrival as the period between arrival and breeding is substantial and consistent (average 27 ± 4.57 days SD). Despite increasing spring temperatures and quantifiably stronger selection for early laying on the basis of number of offspring to fledge, we found no significant change in breeding phenology, in contrast with co-occurring resident blue tits ( Cyanistes caeruleus). We discuss possible non-migratory constraints on phenological adjustment, including limitations on plasticity, genetic constraints and competition, as well as the possibility of counter-selection pressures relating to adult survival, longevity or future reproductive success. We propose that such factors need to be considered in conjunction with the arrival constraint hypothesis. [ABSTRACT FROM AUTHOR]

Previous studies have reported that congenitally blind children without any additional impairment reveal a developmental delay of at least 4 years in perspective taking based on testing first-order false-belief tasks. These authors interpret this delay as a sign of autism-like behavior. However, the delay may be caused by testing blind children with false-belief tasks that require visual experience. Therefore, the present study gave alternative false-belief tasks based on tactile or auditory experience to 45 congenitally blind 4-10-year-olds and 37 sighted 3-6-year-olds. Results showed criterion performance at 80 months (6; 8 years) in blind children compared with 61 months (5; 1 years) in sighted controls. It is concluded that this 19-month (1; 7 year) difference, which is comparable with delays in other developmental areas, is a developmental delay caused by the fact of congenital blindness rather than a sign of a psychopathological disorder of autism-like behavior. [ABSTRACT FROM AUTHOR]

Natura 2000 sites are expected to assure the long-term survival of Europe’s most valuable and threatened species and habitats. It follows that successful management of the sites is of great importance. Next to goal attainment, cost-effectiveness is increasingly recognised as a key requirement for gaining social and political acceptance for costly conservation measures. We identify and qualitatively examine issues of cost-effectiveness related to the design and implementation of management measures in Natura 2000 sites in Finland, Germany, the Netherlands and Poland. Given the wide variety of management design and implementation options within the four countries, our study is purely of an exploratory nature. We derive recommendations for improving the cost-effectiveness of management in Natura 2000 sites and for future research. Examples of policy recommendations include guaranteeing the availability of funds for longer periods, and ensuring the appropriate allocation of funds between the different tasks of designing and implementing management plans. Further research should examine the cost-effectiveness of controversial suggestions such as, for example, more tailored payment schemes for conservation measures that result in higher ecological outputs but are costly to administer. Moreover, more research is needed to better understand how rules for administrations, as well as rules and governance structures for tasks within administrations, should be designed. [ABSTRACT FROM AUTHOR]

Loneliness concerns the subjective evaluation of the situation individuals are involved in, characterized either by a number of relationships with friends and colleagues which is smaller than is considered desirable (social loneliness), as well as situations where the intimacy in confidant relationships one wishes for has not been realized (emotional loneliness). To identify people who are lonely direct questions are not sufficient; loneliness scales are preferred. In this article, the quality of the three-item scale for emotional loneliness and the three-item scale for social loneliness has been investigated for use in the following countries participating in the United Nations “Generations and Gender Surveys”: France, Germany, the Netherlands, Russia, Bulgaria, Georgia, and Japan. Sample sizes for the 7 countries varied between 8,158 and 12,828. Translations of the De Jong Gierveld loneliness scale have been tested using reliability and validity tests including a confirmatory factor analysis to test the two-dimensional structure of loneliness. Test outcomes indicated for each of the countries under investigation reliable and valid scales for emotional and social loneliness, respectively. [ABSTRACT FROM AUTHOR]