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The burden of tuberculosis (TB) in migrant children and young people (CYP) is commonly overlooked, despite the increasing incidence of TB in migrant populations in the European region. This study aimed to examine the distribution and disease characteristics of TB among migrant and native-born CYP through analysis of data from the European Centre for Disease Prevention and Control (ECDC) surveillance system (TESSy). Retrospective database analysis. A retrospective database analysis was conducted on all CYP TB cases (0–17 years) reported to TESSy (1995–2017), exploring distribution, site of TB, and presence of MDR-TB using multivariate analysis in R statistical software. Of the 73,176 CYP TB cases reported in the EU/EFTA (1995–2017), 24.4% (n = 17,879) occurred in migrant CYP and 75.6% (n = 55,297) occurred in native-born CYP. Migrant CYP were more likely (P < 0.001) to have pulmonary TB (OR: 1.90; 95% CI: 1.74–2.09) and unsuccessful treatment outcomes (OR: 2.05; 95% CI: 1.74–2.40) compared to native-born CYP. The proportion of extrapulmonary TB, compared to pulmonary TB across total CYP cases was higher than the existing evidence base. Overall, there were significant differences in the site of TB and treatment outcomes between migrant and native-born CYP. To improve outcomes, TB screening and detection practices should focus on facilitating care in migrant CYP. However, to better understand the implications of these findings on broader TB control, TB among CYP should be addressed more frequently in reports and research. [ABSTRACT FROM AUTHOR]

This study investigates how the effect of employee stock ownership on financial performance may hinge on the diverse cultural and societal contexts of European countries. Based on agency and national culture theories, we hypothesize that the positive relationship between employee stock ownership and return on assets (ROA) is stronger in those nations with lower uncertainty avoidance and higher social trust. Using a multisource, time‐lagged, large‐scale dataset of 1,741 firms from 21 countries in Europe, our multilevel, random coefficient modeling analysis found evidence for these hypotheses, suggesting that uncertainty avoidance and social trust serve as important contextual cues in predicting the linkage between employee stock ownership and financial performance. Our supplemental analysis with distinction between the managerial and nonmanagerial employee stock ownership further indicates managerial employee stock ownership has a direct positive effect on ROA. Although nonmanagerial employee stock ownership had a nonsignificant association with ROA, the relationship was positive and significant when uncertainty avoidance was low and social trust was high. This research contributes to the existing literature by illuminating some of the contextual influences altering the effectiveness of employee stock ownership. Our findings also offer practical suggestions for effectively using employee stock ownership. [ABSTRACT FROM AUTHOR]

Over the last three decades, cancer mortality has shown favourable patterns in Europe. Patterns and trends however have been less favourable for most eastern countries. We computed cancer mortality rates in western (WE) and eastern European (EE) countries using the official mortality database of the World Health Organisation, using joinpoint regression models to identify significant changes in trends over time. Cancer mortality declined by 1–1.4% annually in WE since 1990, to reach an age-standardised rate (world standard) of 125.4/100,000 men and 81.3/100,000 women in 2016. In contrast, EE rates only started to decline around the 2000s in men and remained stable in women, to reach 171.9/100,000 men and 98.2/100,000 women. Lung cancer rates were 30.8/100,000 men and 14/100,000 women in WE versus 47.1/100,000 men and 15.2/100,000 women in EE. In relative terms, the mortality excess in EE increased from 32 to 37% in men and from 15 to 21% in women, compared with WE. The largest percent excesses were for cancers of the upper respiratory tract, stomach, intestines and lung in men and uterus in women. Prostate cancer rates increased in EE to reach 12.7/100,000 in 2016, whereas they decreased to 10.2/100,000 in WE. Compared with rates in 1990, over the period 1991–2016, about 3.9 million cancer deaths were avoided in WE, but no notable improvements was seen in EE. If cancer mortality rates in EE had been those observed in WE, over 55,000 deaths would have been avoided in 2016. Differences in lifestyle patterns, mainly smoking and alcohol, besides different roll-out of improvements in cancer diagnosis and management are the key determinants of the persisting difference in cancer mortality between western and eastern Europe. There is no evidence for the gap to close. • There is a persistent cancer mortality excess in central-eastern versus western Europe. • The gap between eastern and western has increased in relative terms. • Between 1990 and 2016, 3.9 million cancer deaths were avoided in western Europe. • In the same period, no material advancement was observed in eastern Europe. • In 2016, over 55,000 (18%) cancer deaths would have been avoided in eastern Europe by closing the gap. [ABSTRACT FROM AUTHOR]

Background and Aims: While epidemiological studies support a role for heavy, high‐potency cannabis use on first‐episode psychosis, genetic models of causation suggest reverse causal effects of schizophrenia on cannabis use liability. We estimated the genetic relationship between cannabis use disorder (CUD) and schizophrenia (SCZ) and tested whether liability for CUD is causally associated with increased liability to SCZ while adjusting for tobacco smoking. Design This study used summary statistics from published genome‐wide association studies (GWAS). We used genomic structural equation modeling, latent causal variable analysis, and multivariable Mendelian randomization to examine genetic relationships between CUD, cannabis ever‐use, ever‐smoked tobacco regularly, nicotine dependence and SCZ, and to test for a causal relationship between liability to CUD and liability to SCZ. Setting: Genome‐wide association studies were published previously as part of international consortia. Participants: Sample sizes of the GWAS summary statistics used in this study ranged from 161 405 to 357 806 individuals of European ancestry. Measurements Genome‐wide summary statistics for CUD and SCZ were the primary measurements, while summary statistics for cannabis ever‐use, ever‐smoked tobacco regularly and nicotine dependence were included as additional variables in the genomic structural equation models and the multivariable Mendelian randomization analyses. Findings Genetic liability to CUD was significantly associated with SCZ [β = 0.29, 95% confidence interval (CI) = 0.11, 0.46, P = 0.001], even when accounting for cannabis ever‐use, ever‐smoked tobacco regularly and nicotine dependence as simultaneous predictors. We found mixed evidence of a causal relationship, with the latent causal variable analysis finding no evidence of causality (genetic causality proportion = −0.08, 95% CI = −0.40, 0.23, P = 0.87) but the multivariable Mendelian randomization analyses suggesting a significant, risk‐increasing effect of CUD on liability to SCZ (β = 0.10, 95% CI = 0.02, 0.18, P = 0.02), accounting for the additional risk factors (cannabis ever‐use, ever‐smoked tobacco regularly and nicotine dependence). Conclusions: Genetic liability for cannabis use disorder appears to be robustly associated with schizophrenia, above and beyond tobacco smoking and cannabis ever‐use, with mixed evidence to support a causal relationship between cannabis use disorder and schizophrenia. [ABSTRACT FROM AUTHOR]

The process of social, political and economic transformation, which took place in Central and Eastern Europe in the early 90's, has affected many spheres of Europeans' lives, including health-associated issues. These changes also had an impact on mortality rates due to cervical cancer (CC). Therefore, the aim of this study was to analyse CC mortality trends in Europe after 1990. Data on death due to CC, uterine cancers and unspecified uterine cancers, in women aged 20–44, were taken from the WHO Mortality Database. Trends in European countries between 1990 and 2017 were assessed using the Joinpoint Regression Program. Most of the countries experienced a decrease in CC mortality. Although the lowest rates were observed in EU15 Member States, the highest decreases were observed in Central and Eastern Europe. However, there are still differences in mortality in these countries. There are also a few countries like Belarus, Latvia and Ukraine, which experienced an increase in mortality. The range of mortality across Europe in 2017 was between 0.6 and 5.2/100,000 women. It is essential to introduce well-organised screening programmes for early detection of CC with coverage of a correspondingly high percentage of the population, particularly in East-Central Europe, as well as to introduce high-coverage HPV vaccination in all European countries. • Cervical cancer mortality in most of the European countries is decreasing. • The highest decrease in the mortality is observed in Eastern and Southern Europe. • Mortality rates in East-Central Europe are still higher than in Western Europe. • Latvia and Belarus are two European countries with a steady increasing trend. • In Western Europe, epidemiological transition of cervical cancer is completed. [ABSTRACT FROM AUTHOR]

Practice indicators (PI) measure provided care making use of real-world data. This study describes trends and variations in adjuvant treatment of early breast cancer (EBC) using the European Society of Breast Cancer Specialists (EUSOMA) database. The analysis was conducted on anonymous cumulative data registered by 56 certified breast centres, which all entered at least 500 new diagnoses in the database in the 10-year period 2010–2019. Practice trends of radiotherapy, endocrine treatment, chemotherapy, and anti-HER2 therapy were evaluated. The association with age group (<50, 50–69, ≥70) and geographical area of the centre (Northern, Central, Southern Europe; NE, CE, SE) was assessed with the Pearson Chi2 test for independence in contingency tables. In total, 150,150 patients with EBC were selected. Overall, radiotherapy was administered more frequently in NE centres, and conversely, endocrine, chemo-, and anti-HER2 therapy were used more frequently in SE centres (p < 0.001). 46.9% of the pN1 patients received postmastectomy radiotherapy, with significant differences by age and geographical region (p < 0.001). Adjuvant endocrine treatment for endocrine-sensitive carcinoma in situ was administered in 46.1%, with a decreasing trend during the study period (58.5–34.5%; p < 0.001). Anti-HER2 therapy was delivered in 75.6% of all patients with HER2BC T1a/bN0, patients older than 70 received anti-HER2 in 67.6% in SE compared to 31.3% in NE centres. Important variations in EBC management between European certified breast centres have been demonstrated. PI using real-world data can help to monitor, evaluate, and eventually guide and align good clinical practice in the management of breast cancer. • Real-world data on early breast cancer management in Europe are informative. • Postmastectomy radiotherapy for pN1 breast cancer varies noticeably across Europe. • Adjuvant endocrine therapy for in situ breast cancer varies noticeably across Europe. • HER2 therapy is used in 76% of patients with HER2+ breast cancer ≤1 cm and N0. [ABSTRACT FROM AUTHOR]

Objective: Systemic sclerosis (SSc) is a heterogeneous connective tissue disease that is typically subdivided into limited cutaneous SSc (lcSSc) and diffuse cutaneous SSc (dcSSc) depending on the extent of skin involvement. This subclassification may not capture the entire variability of clinical phenotypes. The European Scleroderma Trials and Research (EUSTAR) database includes data on a prospective cohort of SSc patients from 122 European referral centers. This study was undertaken to perform a cluster analysis of EUSTAR data to distinguish and characterize homogeneous phenotypes without any a priori assumptions, and to examine survival among the clusters obtained. Methods: A total of 11,318 patients were registered in the EUSTAR database, and 6,927 were included in the study. Twenty‐four clinical and serologic variables were used for clustering. Results: Clustering analyses provided a first delineation of 2 clusters showing moderate stability. In an exploratory attempt, we further characterized 6 homogeneous groups that differed with regard to their clinical features, autoantibody profile, and mortality. Some groups resembled usual dcSSc or lcSSc prototypes, but others exhibited unique features, such as a majority of lcSSc patients with a high rate of visceral damage and antitopoisomerase antibodies. Prognosis varied among groups and the presence of organ damage markedly impacted survival regardless of cutaneous involvement. Conclusion: Our findings suggest that restricting subsets of SSc patients to only those based on cutaneous involvement may not capture the complete heterogeneity of the disease. Organ damage and antibody profile should be taken into consideration when individuating homogeneous groups of patients with a distinct prognosis. [ABSTRACT FROM AUTHOR]

Aims: We mapped and described university study programmes in the addictions field (USPA) in Europe, according to degrees, professional backgrounds, titles, methods of delivery, duration, entrance requirements, fees, clinical practice requirements and courses offered.Methods: The study consisted of two parts: 1) a general mapping of USPA – utilising online databases of scientific literature, and subsequently the Google search engine and 2) a content analysis of the identified study programmes’ websites according to a set of a priori research questions.Findings:A total of 34 USPA were located at 25 universities in eight different European countries. 43.6% (n = 18) were master’s, 15.4% (n = 6) bachelor’s and 12.8% (n = 4) Ph.D. study programmes. Only the Czech Republic offers education across all three levels. The background of many USPA is built on medical (n = 5), social (n = 5) and psychological (n = 4) foundations. Ten programmes are offered both full-time and part-time, and 62% charge tuition. Half of the programmes have clinical practice as a part of the degree requirement.Conclusions: In recent years, the number of specialised education programmes that aim to prepare a new professional workforce has been growing. The findings provide a basis for discussion and cooperation among programmes and universities. [ABSTRACT FROM PUBLISHER]

Background Oncology represents a major sector in the field of orphan drug development in Europe. The objective was to evaluate whether children and adolescents with cancer benefited from the Orphan Drug Regulation. Methods Data on orphan drug designations (ODDs) and registered orphan drugs from 8th August 2000 to 10th September 2016 were collected from the Community Register of medicinal products for human use. Assessment history, product information and existence of paediatric investigation plans were searched and retrieved from the European Medicine Agency website. Results Over 16 years, 272 of 657 oncology ODDs (41%) concerned a malignant condition occurring both in adults and children. The five most common were acute myeloid leukaemia, high-grade glioma, acute lymphoblastic leukaemia, graft-versus-host disease and soft-tissue sarcomas. 74% of 31 marketing authorisations (MAs) for an indication both in adults and children (26 medicines) had no information for paediatric use in their Summary of Product Characteristics (SmPC) at the time of the first MA. Furthermore, 68% still have no paediatric information in their most recently updated SmPC, at a median of 7 years after. Only 15 ODDs (2%) pertained to a malignancy occurring specifically in children and only two drugs received an MA: Unituxin for high-risk neuroblastoma and Votubia for sub-ependymal giant-cell astrocytoma. Conclusion The Orphan Drug Regulation failed to promote the development of innovative therapies for malignancies occurring in children. Major delays and waivers occurred through the application of the Paediatric Medicines Regulation. The European regulatory environment needs to be improved to accelerate innovation for children and adolescents dying of cancer. [ABSTRACT FROM AUTHOR]

We evaluated the epidemiology of Candida bloodstream infections in the neonatal intensive care unit (NICU) of an Italian university hospital during a 9-year period as a means of quantifying the burden of infection and identifying emerging trends. Clinical data were searched for in the microbiological laboratory database. For comparative purposes, we performed a review of NICU candidemia. Forty-one candidemia cases were reviewed (overall incidence, 3.0 per 100 admissions). Candida parapsilosis sensu stricto (58.5%) and C. albicans (34.1%) were the most common species recovered. A variable drift through years was observed; in 2015, 75% of the cases were caused by non-albicans species. The duration of NICU hospitalization of patients with non-albicans was significantly longer than in those with C. albicans (median days, 10 versus 12). Patients with non-albicans species were more likely to have parenteral nutrition than those with C. albicans (96.3% versus 71.4%). Candida albicans was the dominant species in Europe and America (median, 55% and 60%; resp.); non-albicans species predominate in Asia (75%). Significant geographic variation is evident among cases of candidemia in different parts of the world, recognizing the importance of epidemiological data to facilitate the treatment. [ABSTRACT FROM AUTHOR]

Background: frailty is associated with an increased risk of fragility fractures. Less is known, however, about the association between frailty and bone health. Methods: men aged 40-79 years were recruited from population registers in eight European centres for participation in the European Male Aging Study. Subjects completed a comprehensive assessment which included quantitative ultrasound (QUS) scan of the heel (Hologic-SAHARA) and in two centres, dual-energy bone densitometry (dual-energy x-ray absorptiometry, DXA). Frailty was defined based on an adaptation of Fried's phenotype criteria and a frailty index (FI) was constructed. The association between frailty and the QUS and DXA parameters was determined using linear regression, with adjustments for age, body mass index and centre. Results: in total, 3,231 subjects contributed data to the analysis. Using the Fried categorisation of frailty, pre-frail and frail men had significantly lower speed of sound (SOS), broadband ultrasound attenuation (BUA) and quantitative ultrasound index (QUI) compared to robust men (P < 0.05). Similar results were seen using the FI after categorisation into 'high', 'medium' and 'low' levels of frailty. Using the Fried categorisation, frail men had lower femoral neck bone mineral density (BMD) compared to robust men (P < 0.05), but not lower lumbar spine BMD. Using the FI categorisation, a 'high' level of frailty (FI > 0.35) was associated with lower lumbar spine BMD (P < 0.05) when compared to those with low (FI < 0.2), but not lower femoral neck BMD. When analysed as a continuous variable, higher FI was linked with lower SOS, BUA and QUI (P < 0.05). Conclusions: optimisation of bone health as well as prevention of falls should be considered as strategies to reduce fractures in frail older people. [ABSTRACT FROM AUTHOR]

BACKGROUND AND OBJECTIVE: Stillbirth and in-hospital mortality rates associated with verypreterm births (VPT) vary widely across Europe. International comparisons are complicated by a lack of standardized data collection and differences in definitions, registration, and reporting. This study aims to determine what proportion of the variation in stillbirth and in-hospital VPT mortality rates persists after adjusting for population demographics, case-mix, and timing of death. METHODS: Standardized data collection for a geographically defined prospective cohort of VPTs (22+0-31+6 weeks gestation) across 16 regions in Europe. Crude and adjusted stillbirth and in-hospital mortality rates for VPT infants were calculated by time of death by using multinomial logistic regression models. RESULTS: The stillbirth and in-hospital mortality rate for VPTs was 27.7% (range, 19.9%- 35.9% by region). Adjusting for maternal and pregnancy characteristics had little impact on the variation. The addition of infant characteristics reduced the variation of mortality rates by approximately one-fifth (4.8% to 3.9%). The SD for deaths <12 hours after birth was reduced by one-quarter, but did not change after risk adjustment for deaths ≥12 hours after birth. CONCLUSIONS: In terms of the regional variation in overall VPT mortality, over four-fifths of the variation could not be accounted for by maternal, pregnancy, and infant characteristics. Investigation of the timing of death showed that these characteristics only accounted for a small proportion of the variation in VPT deaths. These findings suggest that there may be an inequity in the quality of care provision and treatment of VPT infants across Europe. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to compare the demographics, injury patterns, and outcomes following major trauma between Alpine skiing, snowboarding, and sledding winter sports. Methods: An international population-based prospective trauma database (TraumaRegister DGU) was analyzed for demographic data, types and severity of injuries [body regions, Injury Severity Score (ISS)], early physiology [Glasgow Coma Scale (GCS), blood pressure, body temperature], rescue modality, surgical care, length of stay, and major complications (shock, multiple organ failure mortality). Participating countries included Germany, Austria, Switzerland, Finland, Slovenia, Belgium, Luxembourg, and The Netherlands. Results: A total of 243 winter sport athletes with major trauma were identified (1993-2012), and subjects were divided into Alpine skiers ( n = 174), snowboarders ( n = 29), and sledders ( n = 40). Athletes were predominantly male and presented hypothermic at emergency room arrival, despite a large proportion of air rescue (77 %). Alpine skiing was associated with higher injury severity (ISS 20.8 ± 14.0, p = 0.010) when compared with snowboarding (ISS 18.7 ± 14.0) and sledding (ISS 13.8 ± 9.5). Snowboarding was associated with the highest pre-hospital intubation rate (40.9 %, p = 0.007), despite comparable GCS values and prevalence of loss of consciousness at scene. The injury patterns were different between the three groups. Skiing was associated with head (47.1 %), chest (40.2 %, p = 0.047), and spinal injuries (40.9 %, p = 0.022). Snowboarding was associated with the highest percentage of upper extremity trauma. Sledders had the highest prevalence of facial and lower extremity trauma. Conclusions: Alpine skiing, snowboarding, and sledding result in different injury patterns and affect various age groups. Our data suggest an increased risk for chest and spinal injuries in Alpine skiers. Due to high-energy injury mechanisms, all three winter sports involve a risk of severe multiple trauma. While all athlete groups required a high rate of emergency surgery procedures, the observed in-hospital mortality from winter sports remains low. [ABSTRACT FROM AUTHOR]

Background/Objectives: Polyphenols are plant secondary metabolites with a large variability in their chemical structure and dietary occurrence that have been associated with some protective effects against several chronic diseases. To date, limited data exist on intake of polyphenols in populations. The current cross-sectional analysis aimed at estimating dietary intakes of all currently known individual polyphenols and total intake per class and subclass, and to identify their main food sources in the European Prospective Investigation into Cancer and Nutrition cohort. Methods: Dietary data at baseline were collected using a standardized 24-h dietary recall software administered to 36,037 adult subjects. Dietary data were linked with Phenol-Explorer, a database with data on 502 individual polyphenols in 452 foods and data on polyphenol losses due to cooking and food processing. Results: Mean total polyphenol intake was the highest in Aarhus-Denmark (1786 mg/day in men and 1626 mg/day in women) and the lowest in Greece (744 mg/day in men and 584 mg/day in women). When dividing the subjects into three regions, the highest intake of total polyphenols was observed in the UK health-conscious group, followed by non-Mediterranean (non-MED) and MED countries. The main polyphenol contributors were phenolic acids (52.5-56.9 %), except in men from MED countries and in the UK health-conscious group where they were flavonoids (49.1-61.7 %). Coffee, tea, and fruits were the most important food sources of total polyphenols. A total of 437 different individual polyphenols were consumed, including 94 consumed at a level >1 mg/day. The most abundant ones were the caffeoylquinic acids and the proanthocyanidin oligomers and polymers. Conclusion: This study describes the large number of dietary individual polyphenols consumed and the high variability of their intakes between European populations, particularly between MED and non-MED countries. [ABSTRACT FROM AUTHOR]

Purpose: The European 'Healthy Lifestyle in Europe by Nutrition in Adolescence' (HELENA) project evaluated two different approaches to harmonize the matching procedures between 24-h recall data and food composition databases. In the first approach, the 24-h recall data were linked to the local/national food composition databases using standardized procedures, while in the second approach, the 24-h recall data were linked to the German BLS database which includes a larger food list. The aim of this paper was to compare the intakes of energy and eight nutrient components calculated via both approaches. Methods: Two non-consecutive 24-h recalls were performed in 1268 adolescents. Energy, carbohydrates, proteins, fat, fiber, water, alcohol, calcium and vitamin C were calculated via the two approaches at individual level. Paired samples t test and Pearson's correlations were used to compare the mean intakes of energy and the eight mentioned nutrients and to investigate the possible associations between the two approaches. Results: Small but significant differences were found between the intakes of energy and the eight food components when comparing both approaches. Very strong and strong correlations (0.70-0.95) were found between both methods for all nutrients. Conclusion: The dietary intakes obtained via the two different linking procedures are highly correlated for energy and the eight nutrients under study. [ABSTRACT FROM AUTHOR]

Objective: This study aims to provide demographic data on the 5.4% of U.S. RNs who are Latino in order to assist nursing educators in planning more effective engagement with the growing U.S. Latino population. Methods: Detailed data from the U.S. Census for the years 1980 to 2010 were used to identify the total U.S. population and the total number of RNs in four standard U.S. Census racial and ethnic groups: non-Latino white (NLW), Latino, African American, and Asian/Pacific Islander. Results: The number of RNs in each racial or ethnic group per 100,000 persons of that same group is reported for all four groups. Spanish-language ability and nativity were derived only for the NLW and Latino groups. Data are reported for the United States as a whole and for the five states with the largest Latino populations: California, Florida, Illinois, New York, and Texas. Of the four racial and ethnic groups, Latinos had the fewest number of RNs per 100,000 population in the period from 1980 to 2010. Compared with NLW RNs, Latino RNs were more likely to speak Spanish and to have been born abroad. State-by-state variations from the national patterns are provided. Conclusions: While major nursing organizations have expressed a desire to increase the diversity of the nursing workforce, the data show that Latinos lag far behind all other racial and ethnic groups in representation among RNs. Nursing education programs and institutions need to improve their efforts to increase the number of Latino nurses relative to the Latino population. [ABSTRACT FROM AUTHOR]

Choline is an important nutrient for humans. Choline intake of the European population was assessed considering the European Food Safety Authority European Comprehensive Food Consumption Database and the United States Department of Agriculture Nutrient Database. Average choline intake ranges were 151–210 mg/d among toddlers (1 to ≤3 years old), 177–304 mg/d among other children (3 to ≤10 years old), 244–373 mg/d among adolescents (10 to ≤18 years old), 291–468 mg/d among adults (18 to ≤65 years old), 284–450 mg/d among elderly people (65 to ≤75 years old) and 269–444 mg/d among very elderly people (≥75 years old). The intakes were higher among males compared with females, mainly due to larger quantities of food consumed per day. In most of the population groups considered, the average choline intake was below the adequate intake (AI) set by the Institute of Medicine in the USA. The main food groups contributing to choline intake were meat, milk, grain, egg and their derived products, composite dishes and fish. The main limitations of this study are related to the absence of choline composition data of foods consumed by the European population and the subsequent assumption made to assess their intake levels. Given the definition of AI, no conclusion on the adequacy of choline intake can be drawn for most European population groups. Such results improve the knowledge on choline intake in Europe that could be further refined by the collection of choline composition data for foods as consumed in Europe. [ABSTRACT FROM AUTHOR]

This article summarizes previous employment histories and studies associations between types of histories and quality of life in older ages. Retrospective information from the Survey of Health, Ageing and Retirement in Europe (SHARE) was used and the occupational situation for each age between 30 and 65 of 4,808 men and 4,907 women aged 65 or older in Europe was considered. Similar histories were regrouped using sequence analyses, and multi-level modelling was applied to study associations with quality of life. To avoid reverse causality, individuals with poor health prior to or during their working life were excluded. Men's employment histories were dominated by long periods of paid employment that ended in retirement (‘regular’ histories). Women's histories were more diverse and also involved domestic work, either preceding regular careers (‘mixed’ histories) or dominating working life (‘home-maker’ histories). The highest quality of life was found among women with mixed histories and among men with regular histories and late retirement. In contrast, retirement between 55 and 60 (but not earlier) and regular histories ending in unemployment or domestic work (for men only) were related to lower quality of life, as well as home-maker histories in the case of women. Findings remain significant after controlling for social position, partnership and parental history, as well as income in older ages. Results point to the importance of continuous employment for health and wellbeing, not only during the working life, but also after labour market exit. [ABSTRACT FROM PUBLISHER]

This study examines the conditions under which welfare state policies contribute to an equalization of the opportunity structure, focusing in particular on Scandinavia. Using data on inter-generational mobility and educational attainment, I find a clear equalizing effect in Scanidnavia that does not obtain elsewhere. The effect, however, is assymetric in the sense that it is almost exclusively a bottom-up equalization. [ABSTRACT FROM AUTHOR]

Purpose Conduct a systematic review of school-based interventions to promote physical activity in preschoolers. Design and Methods A systematic search of literature between 2002 and 2014 in nine electronic databases and reference lists was conducted using the terms physical activity combined with environment, children, or interventions. Results Fourteen articles were identified. Interventions were environmental, cognitive/behavioral, or a combination. Positive interventions involving preschool children included manipulation of the playground with the number of children playing at one time, markings, or equipment, and goal setting and reinforcement. Practice Implications More research is needed to determine interventions to promote physical activity in preschool children. [ABSTRACT FROM AUTHOR]

Self-perceived job insecurity is characterised by a considerable variation across European countries; this is mostly attributed to different labour market conditions and welfare-state institutions. In addition to the previous, often static examination of these determinants, this study asks how labour market dynamics and changes in welfare-state interventions are linked to individuals’ perceptions of job insecurity. It is argued that the changing context represents a set of shared experiences that serves as a frame of reference for the perception of job insecurity. Hence, time series of context indicators provided by Organisation for Economic Co-operation and Development (OECD) and data from the European Social Survey are used to conduct multilevel analyses. The results reveal that job insecurity is dynamic, as it increases in countries facing an economic crisis, such as Greece, but decreases in countries with prosperous development like Poland. Furthermore, the results reveal that the past development of the labour market and changes in welfare-state interventions contribute to the explanation of individuals’ perceptions of job insecurity. The response to these changes differs, however, depending on the dimension of job insecurity and the socio-economic characteristics of the workers. [ABSTRACT FROM AUTHOR]

Dietary interventions with flavan-3-ols have shown beneficial effects on vascular function. The translation of these findings into the context of the health of the general public requires detailed information on habitual dietary intake. However, only limited data are currently available for European populations. Therefore, in the present study, we assessed the habitual intake of flavan-3-ol monomers, proanthocyanidins (PA) and theaflavins in the European Union (EU) and determined their main food sources using the EFSA (European Food Safety Authority) Comprehensive European Food Consumption Database. Data for adults aged 18–64 years were available from fourteen European countries, and intake was determined using the FLAVIOLA Flavanol Food Composition Database, developed for the present study and based on the latest US Department of Agriculture and Phenol-Explorer databases. The mean habitual intake of flavan-3-ol monomers, theaflavins and PA ranged from 181 mg/d (Czech Republic) to 793 mg/d (Ireland). The highest intakes of flavan-3-ol monomers and theaflavins were observed in Ireland (191/505 mg/d) and the lowest intakes in Spain (24/9 mg/d). In contrast, the daily intake of PA was highest in Spain (175 mg/d) and lowest in The Netherlands (96 mg/d). Main sources were tea (62 %), pome fruits (11 %), berries (3 %) and cocoa products (3 %). Tea was the major single contributor to monomer intake (75 %), followed by pome fruits (6 %). Pome fruits were also the main source of PA (28 %). The present study provides important data on the population-based intake of flavanols in the EU and demonstrates that dietary intake amounts for flavan-3-ol monomers, PA and theaflavins vary significantly across European countries. The average habitual intake of flavan-3-ols is considerably below the amounts used in most dietary intervention studies. [ABSTRACT FROM PUBLISHER]

Background Research comparing mortality by socioeconomic status has found that inequalities are not the smallest in the Nordic countries. This is in contrast to expectations given these countries’ policy focus on equity. An alternative way of studying inequality has been little used to compare inequalities across welfare states and may yield a different conclusion. Methods We used average life expectancy lost per death as a measure of total inequality in mortality derived from death rates from the Human Mortality Database for 37 countries in 2006 that we grouped by welfare state type. We constructed a theoretical ‘lowest mortality comparator country’ to study, by age, why countries were not achieving the smallest inequality and the highest life expectancy. We also studied life expectancy as there is an important correlation between it and inequality. Results On average, Nordic countries had the highest life expectancy and smallest inequalities for men but not women. For both men and women, Nordic countries had particularly low younger age mortality contributing to smaller inequality and higher life expectancy. Although older age mortality in the Nordic countries is not the smallest. There was variation within Nordic countries with Sweden, Iceland and Norway having higher life expectancy and smaller inequalities than Denmark and Finland (for men). Conclusions Our analysis suggests that the Nordic countries do have the smallest inequalities in mortality for men and for younger age groups. However, this is not the case for women. Reducing premature mortality among older age groups would increase life expectancy and reduce inequality further in Nordic countries. [ABSTRACT FROM AUTHOR]

Objective The aim was to systematically search the dental literature for pre-clinical models assessing implant integration in locally compromised sites (part 1) and systemically compromised animals (part 2), and to evaluate the quality of reporting of included publications. Methods A Medline search (1966-2011) was performed, complimented by additional hand searching. The quality of reporting of the included publications was evaluated using the 20 items of the ARRIVE (Animals in Research In Vivo Experiments) guidelines. Results One-hundred and seventy-six (part 1; mean ARRIVE score = 15.6 ± 2.4) and 104 (part 2; 16.2 ± 1.9) studies met the inclusion criteria. The overall mean score for all included studies amounted to 15.8 ± 2.2. Housing (38.3%), allocation of animals (37.9%), numbers analysed (50%) and adverse events (51.4%) of the ARRIVE guidelines were the least reported. Statistically significant differences in mean ARRIVE scores were found depending on the publication date ( p < 0.05), with the highest score of 16.7 ± 1.6 for studies published within the last 2 years. Conclusions A large number of studies met the inclusion criteria. The ARRIVE scores revealed heterogeneity and missing information for selected items in more than 50% of the publications. The quality of reporting shifted towards better-reported pre-clinical trials within recent years. [ABSTRACT FROM AUTHOR]

In air traffic management (ATM) knowledge of the impact of human factors on performance is critical to address safety incidents. Previous research has largely focused on the effects of single factors on performance which has resulted in a comprehensive understanding of single factor effects. In current control environments however, the residual threats for incidents often result from the interaction of multiple human factors and the resulting cumulative impact on performance. This research uses a literature review, an analysis of over 400 European aviation incident reports and finally a survey of ATM professionals to assess the need for a multifactorial model of performance. Literature findings suggest that Human Factors approaches are fundamentally single-factor in nature, which is out of step with real ATM working contexts. An incident report analysis, supported by a survey of air traffic experts, suggests that multiple factor incident causation exists. This discrepancy suggests the need for a new approach to looking at how incidents occur, and their factors managed, on a day-to-day basis. The proposed solution is a multifactorial model of human performance. [ABSTRACT FROM AUTHOR]

The article reports on the data and descriptive statistics used for the analysis of the performance of emerging multinationals (EMNEs) in Europe. It says that the study used the Amadeus dataset to track the balance sheets of several EMNEs in European countries. It highlights the key indicators gathered from Amadeus including turnover, number of employees, and value added.

Background: Most abortions occur due to unintended pregnancy. Unintended pregnancies are linked to poor health outcomes. Canada receives immigrants from countries with disparate sexual and reproductive health contexts which may influence abortion rates post-migration. We examined the association between abortion and region of birth and birth order among Canadian immigrants. Methods: We conducted a population-based person-years (PY) cohort study in Ontario, Canada using administrative immigration (1991–2012) and health care data (1991–2013). Associations between induced abortion and an immigrant's region of birth were estimated using poisson regression. Rate ratios were adjusted for age, landing year, education, neighborhood income quintile and refugee status and stratified by birth order within regions. Results: Immigrants born in almost all world regions (N = 846,444) were 2–5 times more likely to have an induced abortion vs. those born in the US/Northern & Western Europe/Australia & New Zealand (0.92 per 100 PY, 95% CI 0.89–0.95). Caribbean (Adjusted Rate Ratio [ARR] = 4.71, 95% CI 4.55–4.87), West/Middle/East African (ARR = 3.38, 95% CI 3.26–3.50) and South American (ARR = 3.20, 95% CI 3.09–3.32) immigrants were most likely to have an abortion. Most immigrants were less likely to have an abortion after vs. prior to their 1st birth, except South Asian immigrants (RR = 1.60, 95% CI 1.54–1.66; RR = 2.23, 95% CI 2.12–2.36 for 2nd and 3rd vs 1st birth, respectively). Secondary analyses included further stratifying regional models by year, age, education, income quintile and refugee status. Conclusions: Induced abortion varies considerably by both region of birth and birth order among immigrants in Ontario. [ABSTRACT FROM AUTHOR]

The article discusses the results of a retrospective analysis of the World Health Organization mortality database to compute age adjusted rates of colorectal cancer mortality, according to the age distribution of the standard European population. Findings reveal a significant decline in colorectal cancer mortality in European countries since 1970 despite persistent differences between men and women and between specific regions in Europe.