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Potentially, technology transfer offices (TTOs) can play a significant role in facilitating the successful transfer of technologies and knowledge between universities and industry. Many developing countries are currently developing technology transfer practices within their universities. However, many developing country TTOs operate inefficiently or are ineffective. The sharing of experiences can lead to improvements in this endeavour. Advanced nations can serve as a frame of reference and a basis of policy recommendations for developing countries due to the longevity of their technology transfer activities. The authors issued 234 questionnaires to European university TTOs, of which 54 usable questionnaires were returned. They combine the data from these questionnaires with 19 interviews conducted with university TTO staff from 9 countries in an attempt to create a typology of practices that developing nations could emulate to improve technology transfer in their own contexts. While ultimately a clear typology was not forthcoming, the authors found some relationship between the dominant focus in the mission statement of developed country TTOs, the activities they undertake, their position in the university governance structure and their level of maturity which may usefully inform the development of TTO practices in developing countries.

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

With schools and universities closing across Europe, the COVID-19 lockdown left actors in the field of education battling with the unprecedented challenge of finding a meaningful way to keep the wheels of education turning online. The sudden need for digital solutions across the field of education resulted in the emergence of a variety of digital networks and collaborative online platforms. In this joint article from scholars around Europe, we explore the COVID-19 lockdowns of physical education across the European region, and the different processes of emergency digitalization that followed in their wake. Spanning perspectives from Italy, Germany, Belgium, and the Nordic countries, the article's five cases provide a glimpse of how these processes have at the same time accelerated and consolidated the involvement of various commercial and non-commercial actors in public education infrastructures. By gathering documentation, registering dynamics, and making intimations of the crisis as it unfolded, the aim of the joint paper is to provide an opportunity for considering the implications of these accelerations and consolidations for the heterogeneous futures of European education.

Privacy advocates and hacker activists ('hacktivists') oppose biometric technologies, such as electronic fingerprinting and facial recognition, that are increasingly used to sort and identify people. This paper draws from ethnographic fieldwork among technology experts and hacktivists in Denmark and Germany to explore how these individuals work to resist the encroachment of surveillance technologies in their physical and digital lives. Particular attention is paid to the practices they use to mask their locations, communications, and legal identities, thereby negotiating the border between public and private. This article describes how hacktivists exchange information about data protection and border-crossing to illustrate how encryption and other steps to protect privacy can be understood as moral practices. As opposed to common legal and philosophical definitions that characterise the right to privacy as inherent to the liberal, individual self, I suggest that hacktivists are advancing novel understandings of both identity and privacy as relational. [ABSTRACT FROM AUTHOR]

The number of outlaw bikers is growing globally. Despite this, little research exists on these groups and their alleged violent tendencies. To address this, the current paper uses unique data to examine whether gang violence causes outlaw biker violence. The period examined runs from mid-2008 until early 2012 during which violent clashes occurred between outlaw bikers and street gang members involved in an alleged conflict in Copenhagen, Denmark. A precise description of each individual act of violence would make it possible to identify whether specific acts were carried out in furtherance of the alleged conflict. This would allow one to determine whether outlaw bikers commit violence on behalf of their club. However, such knowledge is unavailable. The paper therefore takes a different approach by examining whether acts of violence committed by the two groups are statistically associated. In other words, it considers whether one or more acts can be described as retaliatory during the observation periods. The sample consists of 640 individuals involved with the Hells Angels Motorcycle Club or with non-biker street gangs–both of which are present in Copenhagen. Statistical models are used to predict 143 violent events committed by 196 outlaw bikers. The results suggest that violence committed by gang members predicts violence committed by outlaw bikers. This indicates that violent acts committed by outlaw bikers are at least partly a form of retaliation carried out on behalf of their club. The paper expands the literature on the kinds of inter-group, micro-level processes that can lead to reciprocal violence by including outlaw bikers in a literature that has previously focused on non-biker street gangs. [ABSTRACT FROM AUTHOR]

The literature on higher education policy points to changes in the dominant discourse over the years. In particular, the ascendance of a discourse marked by concepts of new public management, using language inspired by neoclassical economic theory which characterizes education as a marketplace where students are customers, has led scholars to critically question the foundations of modern higher education policy. This paper uses critical discourse analysis to trace the development of higher education policy discourse in Denmark from the late 1970s until today. The authors find that the discourse has moved from a pluralistic one embracing not only the economic benefits of education, but also emphasizing on democracy, citizenship, and equality, towards a predominantly economic one, focused squarely on notions of globalization and competitiveness in a knowledge society. [ABSTRACT FROM AUTHOR]

Body image issues can affect all domains of sexual functioning. The aim of this study was to examine how, in a sociocultural context where physical and sexual attractiveness is equated with young and slim body ideals, appearance dissatisfaction and importance are related to sexual satisfaction in older adults in four European countries. A cross-sectional survey with probability samples of the population aged 60–75 years was used. Only respondents with a partner were included in this paper, and the countries included Norway (n = 957), Denmark (n = 846), Belgium (n = 612), and Portugal (n = 367). Sexual satisfaction, appearance dissatisfaction, and importance were assessed, and frequency of intercourse/kissing and cuddling, relationship satisfaction, age, and body mass index were all used as control variables. Belgian men scored significantly lower on sexual satisfaction, while there was no difference in sexual satisfaction in women. Appearance dissatisfaction was lower in Scandinavian women and men, and in Belgian men, and appearance salience was lower in Norwegian men and women, and in Portuguese women. Linear regression analysis revealed that, adjusting for confounders, appearance dissatisfaction was significantly related to sexual satisfaction in Scandinavian women and men, as well as in Belgian men. Compared to research on younger adults, appearance evaluation appeared to play an equally important role in sexual satisfaction in older adults in our study. The variation in appearance dissatisfaction in older adults across European countries is a novel finding that needs to be examined further. [ABSTRACT FROM AUTHOR]

This paper contains a sociocultural analysis of school sport experiences of Muslim girls in two countries with different gender policies in physical education (PE) classes: England and Denmark. In Denmark, PE lessons take place in co-educative classes, in England schools are more diverse, with predominantly co-educational but also single-sex and faith schools offering different learning contexts. Two case studies from Denmark and England are used to explore the experiences of migrant Muslim girls in these different settings. A social constructionist approach to gender underpins the interpretation of stakeholders' voices on the inclusion of Muslim girls and the analysis of PE discourses in these countries. Findings illustrate similarities and differences at the interface of cultural diversity, political rhetoric of inclusion and realities of sport experiences for Muslim girls in both countries. Complex influences on PE experiences include gender stereotypes, cultural and religious orientations and practices, as well as actions and expectations of parents, communities and coaches/teachers. The studies provide insights into the ways participants managed their identities as Muslim girls in different sport environments to enable participation and retention of their cultural identities. Highlighted throughout the paper are the ways in which school sport policy and practice, providers and gatekeepers, can include or exclude groups, in this case Muslim girls. Too often coaches and teachers are unaware of crucial facts about their learners, not only in terms of their physical development and capabilities but also in terms of their cultural needs. Mistakes in creating conducive learning environments leave young people to negotiate a way to participate or refrain from participation. [ABSTRACT FROM AUTHOR]

Forty years ago Denmark had very few residents of non-Nordic extraction, but since then a flood of immigrants, refugees and their family members have changed the social dynamic between "native" Danes and "outsiders." Seeking ways to cope with this challenge, Denmark has in the last ten years focused on how best to "integrate" its immigrants. A perusal of Danish research literature reveals that "integration" is an elusive and multi-faceted term; yet it is used in a specific manner by the Danish government. Its stance is that employment equals integration. Once an immigrant or refugee obtains a job, then that individual is "integrated." Semi-structured, in-depth interviews were held in Copenhagen with government officials and in the County of North Jutland with refugees, Danish language instructors, job counselors and volunteer workers to determine the extent to which the Danish government was succeeding with its policies. The focus on economic integration left many social issues unaddressed and even the limited government goal of "economic integration" is not being achieved. Given numerous barriers to the employment of immigrants, the interviewed refugees faced the choice of either remaining in their assigned municipalities and continuing to receive social welfare benefits or moving away from the municipalities in search of employment. Either choice meant a lack of economic assimilation in their assigned placement, essentially discrediting Danish policy. The paper concludes with possible alternative approaches to the integration of refugees and immigrants into Danish society. [ABSTRACT FROM AUTHOR]

This paper proposes a framework to account for innovation similar to the usual accounting framework in production analysis and a measure of innovativity comparable to that of total factor productivity. This innovation accounting framework is illustrated using micro-aggregated firm data from the first Community Innovation Surveys (CIS1) for seven European countries: Belgium, Denmark, Ireland, Germany, the Netherlands, Norway, and Italy for the year 1992. On the basis of estimation of a generalized Tobit model and measuring innovation as the share of total sales due to improved or new products, it compares the propensity to innovate, and the innovation intensity conditional and unconditional on being innovative, across the seven countries and low- and high-tech manufacturing sectors. Even with relatively few explanatory variables, our innovation framework already accounts for sizeable differences in country innovation intensity. It also shows that differences in innovativity across countries can be nonetheless very large. [ABSTRACT FROM AUTHOR]

Although European Union legal frameworks tend to conceive of sex and gender in binary terms, a growing number of countries in Europe and around the world have been increasingly allowing for third gender markers and non-binary possibilities in identity documents, passports, and public registries, of which the X marker in the sex or gender field has become the most common. However, initiatives like the X, which may initially signal trans-friendliness, must be considered alongside heightened border surveillance. As more and more European countries begin to follow this trend of expanding possibilities for registering (non-binary) gender (e.g. Malta, Denmark, Germany, the Netherlands), we look here to some illustrative examples (e.g. Nepal, Canada, Pakistan) that have been at the forefront of non-binary legal recognition to interrogate the complications and conundrums that these developments may provoke in European contexts. [ABSTRACT FROM AUTHOR]

BACKGROUND The objective of this study was to evaluate the importance attributed by consumers in Denmark (DK), Germany (DE) and Spain (ES) and across dietary lifestyles to the characteristics of different types of foods based on alternative proteins. Data were collected through a web‐based survey (15 November to 16 December 2019). A total of 872 completed questionnaires from DK (n = 258), DE (n = 296) and ES (n = 318) were obtained. RESULTS: Four segments according to frequency of animal‐ and plant‐based food consumption were identified: (i) no animal, high plant; (ii) low animal, high plant; (iii) moderate animal and plant; and (iv) high animal, moderate plant. Across all segments, foods based on legumes/pulses as well as plant‐based spreads and products that do not resemble meat in taste and texture were of interest. Segment 4 was more in favour of 'health' as an important factor in new food products, whereas segment 1 was more likely to consider 'animal friendly', 'minimally processed', 'environmentally friendly' and 'produced with minimum CO2 emissions' as key aspects. Furthermore, familiarity was of minor importance across the segments. This could indicate an opening for new, innovative plant‐based alternatives that have their own identity. CONCLUSION: An overall interest exists towards innovative food products based on plant protein, specifically legumes/pulses, among consumers in the three countries and across different dietary lifestyles. © 2021 Society of Chemical Industry. [ABSTRACT FROM AUTHOR]

Small game animals are generally hunted with lead gunshot which often fragments causing elevated lead concentrations in meat and presenting health risks to frequent consumers and vulnerable groups. We reviewed three decades of European data on lead concentrations in the meat of gamebirds, rabbits and hares across countries with various restrictions on lead gunshot use. Mean meat lead concentrations decreased to a low level in Denmark, the only country in the study with a total ban on lead gunshot use. In contrast, elsewhere in Europe meat lead concentrations increased over time, an unexplained and previously undescribed finding. The only regulatory restriction associated with a decrease in meat lead concentrations was the Danish total ban on lead gunshot use. We calculated an arithmetic mean lead concentration in small game meat of 5.205 ppm w.w. (2011–2021) from across Europe. EU and UK regulators are considering banning lead ammunition for all hunting to protect human and wildlife health. The mean value we found for small game meat (2011–2021) was fourteen times higher than that used in a recent EU-wide risk assessment. [ABSTRACT FROM AUTHOR]

The World Health Organization (WHO) reports that routine immunization coverage has declined in Europe. In this article, we present the findings of a Norman Fairclough–inspired critical discourse analysis undertaken to explore how the Danish media came to suggest a possible linkage between the human papillomavirus (HPV) vaccine and serious side effects. The findings of the analysis highlight the social consequences of the controversy over the HPV vaccine, identified within the framework of three perspectives: (1) overall criticism of vaccine efficacy and safety, rooted in an ideological opposition; (2) a growing societal tendency to question the authority of the official health bodies; and (3) the specific controversy over the HPV vaccine. We suggest that the controversy over the HPV vaccine is rooted in an ideological conflict, and the declining acceptance implies that the perception that the vaccine causes serious side effects has gained currency among the general public. [ABSTRACT FROM AUTHOR]

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Background: Despite improvements in treatment for rheumatoid arthritis (RA), psoriatic arthritis (PsA) and spondyloarthritis (axSpA), several key unmet needs remain, such as fatigue. The objective of this study was to describe the severity of fatigue, disease characteristics and socioeconomic factors in people with RA, PsA and axSpA. Methods: The study was designed as a cross-sectional survey collecting patient characteristics such as disease characteristics, socioeconomic factors and fatigue in people with RA, PsA and axSpA in Denmark. Respondents were consecutively recruited for the study over a six-month period in 2018 via routine visits to outpatient rheumatology clinics. Study nurses collected information on diagnosis, current disease-related treatment and disease activity from medical journals. People were invited to complete a questionnaire related to socioeconomic factors and containing the FACIT-Fatigue subscale. Descriptive statistics were analyzed using SAS. Results: We invited 633 people to participate, and 488 (77%) completed the questionnaire. Women constituted 62% of respondents, and the mean age was 53.5 years. Respondents had on average been diagnosed between 11 and 15 years ago. Overall, 79% had no changes to their disease-related treatment during the past year, and the average disease activity as indicated by DAS28 for RA and PsA was 2.48 and 2.36, respectively, and BASDAI for axSpA was 28.40. Fatigue was present in all three diagnoses (mean: 34.31). The mean fatigue score varied from respondents answering that they suffered from no or little fatigue (mean: 45.48) to extreme fatigue (mean: 10.11). Analyses demonstrated that the respondents were not considerably different from nonrespondents, and the study population is considered representative compared with Danish RA and axSpA patients in the Danish National Rheumatology Registry, the DANBIO database. Conclusion: We found that the majority of the study population were fatigued (61%). They had low disease activity and few disease-related treatment changes. [ABSTRACT FROM AUTHOR]

Purpose: Public health policies and actions increasingly acknowledge the climate burden of food consumption. The aim of this study is to describe dietary intakes across four European countries, as baseline for further research towards healthier and environmentally-friendlier diets for Europe. Methods: Individual-level dietary intake data in adults were obtained from nationally-representative surveys from Denmark and France using a 7-day diet record, Italy using a 3-day diet record, and Czech Republic using two replicates of a 24-h recall. Energy-standardised food and nutrient intakes were calculated for each subject from the mean of two randomly selected days. Results: There was clear geographical variability, with a between-country range for mean fruit intake from 118 to 199 g/day, for vegetables from 95 to 239 g/day, for fish from 12 to 45 g/day, for dairy from 129 to 302 g/day, for sweet beverages from 48 to 224 ml/day, and for alcohol from 8 to 15 g/day, with higher intakes in Italy for fruit, vegetables and fish, and in Denmark for dairy, sweet beverages and alcohol. In all countries, intakes were low for legumes (< 20 g/day), and nuts and seeds (< 5 g/day), but high for red and processed meat (> 80 g/day). Within countries, food intakes also varied by socio-economic factors such as age, gender, and educational level, but less pronounced by anthropometric factors such as overweight status. For nutrients, intakes were low for dietary fibre (15.8–19.4 g/day) and vitamin D (2.4–3.0 µg/day) in all countries, for potassium (2288–2938 mg/day) and magnesium (268–285 mg/day) except in Denmark, for vitamin E in Denmark (6.7 mg/day), and for folate in Czech Republic (212 µg/day). Conclusions: There is considerable variation in food and nutrient intakes across Europe, not only between, but also within countries. Individual-level dietary data provide insight into the heterogeneity of dietary habits beyond per capita food supply data, and this is crucial to balancing healthy and environmentally-friendly diets for European citizens. [ABSTRACT FROM AUTHOR]

Monitoring and managing customers’ satisfaction are key features to benefit from today’s competitive environment. In higher education context, only a few studies are available on satisfaction and loyalty of the main customers who are the students, which signifies the need to investigate the field more thoroughly. The aim of this research is to measure the strength of determinants of students’ satisfaction and the importance of antecedents in students’ satisfaction and loyalty in Denmark. Our research model is the modification of European Performance Satisfaction Index (EPSI), which takes the university’s image direct effects on students’ expectations into account from students’ perspective. The structural equation model of student satisfaction and loyalty has been evaluated using partial least square path modelling. Our findings confirm that the EPSI framework is applicable on student satisfaction and loyalty among Danish universities. We show that all the relationships among variables of the research model are significant except the relationship between quality of software and students’ loyalty. Results further verify the significance of antecedents in students’ satisfaction and loyalty at Danish universities; the university image and student satisfaction are the antecedents of student loyalty with a significant direct effect, while perceived value, quality of hardware, quality of software, expectations, and university image are antecedents of student satisfaction. Eventually, our findings may be of an inspiration to maintain and improve students’ experiences during their study at the university. Dedicating resources to identified important factors from students’ perception enable universities to attract more students, make them highly satisfied and loyal. [ABSTRACT FROM AUTHOR]

Background: Congenital toxoplasmosis (CT) causes a substantial disease burden worldwide. The aim of this study was to estimate the disease burden of CT in Denmark, a developed country with free public healthcare and nationwide data available. Methods: Using data primarily from two public health surveillance programmes conducted between 1992 and 2007, we estimated the incidence, occurrence of sequelae, mortality and the burden of disease in terms of disability-adjusted life years (DALYs) of CT in Denmark in 2014. Findings: We estimated that 14 children were born with CT in 2014, of which six will have developed sequelae by the age of 12. CT resulted in a total disease burden of 123 DALYs (95% uncertainty interval [UI], 100–148), of which 78 (95% UI, 64–94) were due to foetal loss and 2 (95% UI, 1–3) were due to neonatal death; the remaining burden was due to moderate to severe life-long sequelae. A comparison of the estimated incidence of CT with the number of reported CT cases in 2008–2014 indicated that for each reported CT case, at least five other CT cases could be expected to have occurred and gone unreported. Interpretation: Early onset, severity, and life-long duration of sequelae have a major effect on the disease burden of CT. Our data suggest that CT is under-diagnosed or under-reported in Denmark. The estimated disease burden and public health impact in Denmark is lower than in other European countries, highlighting the need for country-specific studies. [ABSTRACT FROM AUTHOR]

Background: There is strong research evidence on the importance of health equity and equality for wellbeing in societies. As chronic non-communicable diseases are widespread, the positive impact of physical activity (PA) on health has gained importance. However, PA at the population level is far from optimal. PA depends not only on individual factors, but also on policies for PA in sport, health, transport, education and other sectors, on social and cultural factors, and on the environment. Addressing health inequalities and inequities in PA promotion policies could benefit from policy development processes based on partnership and collaboration between various sectors, researchers, practitioners and policy makers (= cross-sectoral, evidence-informed policy making). The objective of this article is to describe how equity and equality was addressed in PA policies in four EU member states (Denmark, Finland, Romania and England), who were partners in the REPOPA project (www.repopa.eu, EC/FP7/Health Research/GA 281532). Methods: Content analysis of 14 PA policies and 61 interviews were undertaken between 2012 and 2013 with stakeholders involved in developing PA policies in partner countries. Results: Even though specific population subgroups were mentioned in the policy documents analysed, they were not necessarily defined as vulnerable populations nor was there a mention of additional emphasis to support such groups from being marginalised by the policy due to inequity or inequality. There were no clear objectives and activities in the analysed policies suggesting commitment of additional resources in favour of such groups. Addressing equity and equality were often not included in the core aims of the policies analysed; these aspects were mentioned in the background of the policy documents analysed, without being explicitly stated in the aims or activities of the policies. In order to tackle health inequities and inequalities and their consequences on the health status of different population subgroups, a more instrumental approach to health equality and equity in PA promotion policies is needed. Policies should include aims to address health inequalities and inequities as fundamental objectives and also consider opportunities to allocate resources to reduce them for identified groups in this regard: the socially excluded, the remote, and the poor. Conclusions: The inclusion of aspects related to health inequalities and inequities in PA policies needs monitoring, evaluation and transparent accountability if we are to see the best gains in health of socially disadvantaged group. To tackle health inequities and inequalities governance structures need to take into consideration proportionate universalism. Thus, to achieve change in the social determinants of health, policy makers should pay attention to PA and proportionally invest for universal access to PA services. PA promotion advocates should develop a deeper awareness of political and policy structures and require more equity and equality in PA policies from those who they seek to influence, within specific settings for policy making and developing the policy agenda. [ABSTRACT FROM AUTHOR]

Background: Over the past decades, both health inequalities and income inequalities have been increasing in many European countries, but it is unknown whether and how these trends are related. We test the hypothesis that trends in health inequalities and trends in income inequalities are related, i.e. that countries with a stronger increase in income inequalities have also experienced a stronger increase in health inequalities. Methods: We collected trend data on all-cause and cause-specific mortality, as well as on the household income of people aged 35-79, for Belgium, Denmark, England & Wales, France, Slovenia, and Switzerland. We calculated absolute and relative differences in mortality and income between low- and high-educated people for several time points in the 1990s and 2000s. We used fixed-effects panel regression models to see if changes in income inequality predicted changes in mortality inequality. Results: The general trend in income inequality between high- and low-educated people in the six countries is increasing, while the mortality differences between educational groups show diverse trends, with absolute differences mostly decreasing and relative differences increasing in some countries but not in others. We found no association between trends in income inequalities and trends in inequalities in all-cause mortality, and trends in mortality inequalities did not improve when adjusted for rising income inequalities. This result held for absolute as well as for relative inequalities. A cause-specific analysis revealed some association between income inequality and mortality inequality for deaths from external causes, and to some extent also from cardiovascular diseases, but without statistical significance. Conclusions: We find no support for the hypothesis that increasing income inequality explains increasing health inequalities. Possible explanations are that other factors are more important mediators of the effect of education on health, or more simply that income is not an important determinant of mortality in this European context of high-income countries. This study contributes to the discussion on income inequality as entry point to tackle health inequalities. More research is needed to test the common and plausible assumption that increasing income inequality leads to more health inequality, and that one needs to act against the former to avoid the latter. [ABSTRACT FROM AUTHOR]

Tuberculosis (TB) is a well-known occupational hazard. Based on more than two decades (1992–2012) of centralized nationwide genotyping of all Mycobacterium tuberculosis culture-positive TB patients in Denmark, we compared M. tuberculosis genotypes from all cases notified as presumed occupational (N = 130) with M. tuberculosis genotypes from all TB cases present in the country (N = 7,127). From 1992 through 2006, the IS6110 Restriction Fragment Length Polymorphism (RFLP) method was used for genotyping, whereas from 2005 to present, the 24-locus-based Mycobacterial Interspersed Repetitive Unit-Variable Number of Tandem Repeat (MIRU-VNTR) was used. An occupational TB case was classified as clustered if the genotype was 100% identical to at least one other genotype. Subsequently, based on genotype, time period, smear positivity, geography, susceptibility pattern, and any reported epidemiological links between the occupational cases and any potential source cases, the occupational case was categorized as confirmed, likely, possible or unlikely occupationally infected. Among the 130 notified presumed occupational cases, 12 (9.2%) could be classified as confirmed and 46 (35.4%) as unlikely, accounting for nearly half of all cases (44.6%). The remaining 72 cases (55.4%) were categorized as possible. Within this group, 15 cases (11.5%) were assessed to be likely occupational. Our study shows that genotyping can serve as an important tool for disentangle occupational TB in high-income low incidence settings, but still needs to be combined with good epidemiological linkage information. [ABSTRACT FROM AUTHOR]