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Background: Health and social care systems face difficulties in managing multimorbidity, disease burden and complex needs in long‐term conditions such as Parkinson's disease. Objective: This study aimed to develop a European understanding of how health and social care professionals can collaborate with stakeholders from different organizations and sectors to enhance the management of Parkinson's disease in a community setting by identifying the existing gaps in this process and how people with Parkinson's disease and their family carers could benefit from these partnerships. Methods: A mixed‐methods sequential study was conducted in Denmark, Norway, Spain and the United Kingdom. The findings from the qualitative phase are presented. Individual semistructured interviews were analysed using Braun's and Clarke's thematic analysis. A meta‐ethnography approach was used to analyse and synthesize cross‐national findings. Results: A total of 41 healthcare professionals and 39 stakeholders from different disciplines and sectors were interviewed in the four countries. The participants acknowledged a lack of awareness of available resources and poor communication between the different support systems in the management of Parkinson's disease. To promote multiagency collaborations, the participants highlighted the need to organize services along the Parkinson's disease journey, patient involvement and strategic involvement of carers in organizing resources and Parkinson's disease care pathways. According to the participants, the benefits from multiagency partnerships could lead to an enhanced continuity of care and specialized knowledge, mobilization of resources in the community, personalized support and improved access to services. Conclusions: Policymakers are called upon to create formal structures that facilitate multisectoral collaborations to promote an integrated system of care for the management of Parkinson's disease in the community. To address this challenge, we propose five strategies showing how organizations can work together to optimize the use of resources and enhance the management of Parkinson's disease throughout the illness trajectory. Patient or Public Contribution: Patient and Public Involvement groups made up of stakeholders, healthcare professionals, patients with Parkinson's disease and family carers participated in the design of the study, the development of the interview guides and the validation of the findings. [ABSTRACT FROM AUTHOR]

Background: Catalonia (in the north east of the Iberian Peninsula) is among the most prospected territories in Europe, from the ethnobotanical point of view. The aim of the present paper is to undertake a global analysis in the area considered, including plants, plant life forms, and ethnobotanical data within a physiographic and geographic framework. Methods: Data from 21 ethnobotanical prospection areas in Catalonia were collected, analyzed, and compared, with the focus on plant life forms and geographic divisions. Results: A total of 824 taxa constitute the Catalan ethnoflora, and 316 of them are shared by the six physiographic zones recognized in Catalonia. When three major geographic areas are considered (Pyrenean, inland, and littoral), 394 taxa have been reported in only one out of the three areas. Concerning life forms, phanerophytes and chamaephytes together, i.e., those taxa present all through the year, are the most cited (37.12%). Conclusions: This first study constitutes a new approach to ethnobotanical data analysis. The results show the particular importance of plants with a large distribution area and plants with available biomass throughout the year. Apart from this, other kind of plants, e.g., those present in only one territory, are of interest for its originality and sometimes for the local significance. [ABSTRACT FROM AUTHOR]

Aim: To assess the relationship between low-to-moderate–intensity physical activity (LMPA) in 2011 and chronic diseases in 2011 and 2013 among older European adults. Methods: Participants (16,157 men and 21,260 women) from 13 European countries were interviewed about the presence of chronic conditions and LMPA. The association between LMPA and number of chronic diseases was assessed using logistic regression models. Results: Most of the older adults participated in LMPA more than once a week (81.9%), 8.4% participated once a week, and 9.3% did not participate. The prevalence of chronic diseases was significantly lower among those who reported engaging in LMPA. The LMPA in 2011 was related with lower odds of having several chronic diseases in 2013. Conclusion: Engaging in LMPA is associated with reduced risk for chronic diseases in older European men and women. Even the practice of LMPA once a week seems to be enough to diminish the risk of having chronic diseases. [ABSTRACT FROM AUTHOR]

Aim: Nurse leaders influence workplace culture; however, little is known about ethnic cultural influences on nurse leader development. This research aims to identify personal strategies promoting effective leadership by nurse leaders from European small island countries. Design: Descriptive qualitative study. Methods: In 2017, nineteen semi‐structured interviews with nurse leaders from England, Greece, Republic of Ireland and Malta explored leadership journeys, strategies employed to support their growth and development, and how cultural identity played a role. Transcripts were analysed using reflexive thematic analysis. Results: Four main themes and 12 subthemes captured the strategies and approaches of the nurse leaders: (1) Influences, (2) Communication, (3) Process and (4) Relationships. These findings reflect and validate the five transformational leadership practices of the Exemplary Leadership Model. While cultural island identity was discussed, there was a shared cultural identity within the role of "nurse leader" that spanned all islands. Patient or Public Contributions: Nineteen nurse leaders contributed to this study. [ABSTRACT FROM AUTHOR]

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

A growing proportion of immigrants enter Canada on temporary resident permits to study or work, or they enter as asylum seekers—all with limited rights or access to permanent residence. As a result, transnational family separation is a growing phenomenon among immigrants who are unable to migrate as a family or who face barriers to family reunification. Using a systems-centered intersectional lens, the authors examine pathways to transnational family separation among immigrant women who arrived in Canada with precarious immigration status. Analysis draws from qualitative interviews with 35 immigrant women living in different regions of Ontario, Canada. Through examining intersecting social systems and processes, the authors analyze how transnational family separation is constituted through embedded gendered, racial, and class processes in Canada's immigration system and labor market, which normalize family separation as a common experience for racialized immigrants in Canada. Given the harms associated with prolonged family separation, the authors urge the social work profession to advocate for immigration policies that prioritize family reunification and uphold the rights of migrants to maintain family unity. [ABSTRACT FROM AUTHOR]

Background Active mobility and public transport increase physical activity (PA) levels. With varying intensity and effectiveness, European cities implement Sustainable Urban Mobility Plans (SUMPs) to spur transport-related PA. Therefore, we aim to examine drivers and barriers to SUMP implementation and assess its influence on PA across European cities. Methods We screened policy reports to gain insights into SUMP implementation in one Danish, two German and two Polish cities. Further, we conducted semi-structured interviews with SUMP stakeholders in these cities to explore their experiences with SUMP implementation. Thematic analysis of interview transcripts was applied to identify similarities and differences across cities. To assess the effect of SUMP implementation on PA, we searched for data on indicators of transport-related PA. Results All investigated cities are committed to sustainable mobility. Nonetheless, complex institutional structures, the dominant role of motorized traffic as well as complex regional and local policy integration hamper SUMP implementation. Danish, German and Polish cities face different contexts in terms of financing, national guidelines and the prominence of sustainability as a policy objective. Each city adopts unique indicators for monitoring the effects of SUMPs on transport-related PA. The variety of indicators and limited data availability impede a comparative evaluation across cities. Constrained by this restriction, we identified motorization rate, modal split and public transport ridership as suitable indicators. Conclusions Local idiosyncrasies need to be accounted for when assessing the implementation of SUMPs. Nonetheless, consistent indicators and data transparency are essential for comparing the effectiveness of SUMPs and their impact on PA. [ABSTRACT FROM AUTHOR]

Summary: Background: Living in single parent and blended families or as an only child—compared to living in two‐parent biological families or with siblings, respectively—is associated with a higher body mass index (BMI) in cross‐sectional studies. However, longitudinal research addressing the children's BMI in this context is scarce. Further, little is known about the association between family structure and metabolic health. Objectives: This study aimed at investigating the association between both aspects of family structure with BMI and a metabolic score (MetS). Methods: Cross‐sectional data from 7804 children participating in the European multi‐center I.Family study (2013/2014) and longitudinal data from 5621 children who also participated previously in the IDEFICS study (2007–2010) were used. Family structure was assessed by a detailed interview. BMI z‐score and the MetS were based on measured anthropometry, blood pressure, high‐density lipoprotein, blood glucose, and triglycerides. Linear regressions were performed to model associations between family structure with BMI and MetS. Results: Children from single‐parent families had higher BMI z‐scores in the cross‐sectional (β = 0.09, 95% confidence interval [CI]: 0.001 to 0.18) and longitudinal analyses compared to those from two‐parent families. Cross‐sectionally, the number of siblings was associated with lower BMI z‐scores (β = −0.07, 95% CI: −0.10 to −0.03) and lower MetS (β = −0.14, 95% CI: −0.26 to −0.01). Longitudinally, only children between baseline and follow‐up had higher BMI z‐scores at follow‐up (β = 0.07, 95% CI: 0.01 to 0.14) compared to stable siblings. Conclusion: Obesity prevention measures should focus on single‐parent households and families with an only child. [ABSTRACT FROM AUTHOR]

Aims. Alcohol use disorders (AUDs) are prevalent in Europe but occurrence in primary care and the proportion of treated cases are understudied. This study reports prevalence of AUDs and their treatment in European primary health care settings and compares them with general population estimates.Procedure. We sampled 358 general practitioners (GPs, refusal rate: 56.4%) across six European countries (Germany, Hungary, Italy, Latvia, Poland, and Spain) who assessed 13,003 patients including providing AUD diagnoses. A subsample of 8,476 patients (refusal rate: 17.8%) was interviewed subsequently, assessing DSM-IV AUD diagnoses via the Composite International Diagnostic Interview. Final AUD diagnoses combined GP and patient interview information.Findings. Past year AUDs were prevalent with 11.8% (95% CI: 11.2–12.5%) across all regions, which is 1.6 times the European general population AUD estimate. Of those diagnosed with AUDs, 17.7% (95% CI: 15.4–20.0%) received professional help. Compared to general population estimates, AUDs and their treatment were more prevalent in primary care settings in most countries, with disproportionally high AUD rates in Italy and Spain and unexpectedly low AUD rates in Hungary.Conclusions. We found higher prevalence and treatment rates of AUDs in primary health care compared to general population surveys, with large variability between the observed countries. [ABSTRACT FROM AUTHOR]

Parental engagement in parenting programs is essential for good outcomes but can be challenging for many families. In low- and middle-income countries, where resources are limited and there are fewer support services, there is little research examining the factors that influence engagement. This mixed-methods study explored factors associated with parent engagement, as well as barriers and supports, in a pilot evaluation of a parenting program with 140 parents in North Macedonia, Republic of Moldova, and Romania. The relationship between various quantitative types of engagement (e.g., premature drop-out, participation) and a range of demographic, personal, and implementation factors were examined. Qualitative parent interviews explored barriers and supports to program engagement. Implementation variables (e.g., phone calls with parents, program fidelity and text messages sent to parents) were consistently positively associated with different types of engagement after controlling for other factors. Parents of boys, being a victim of intimate partner violence, more children in the household and better parental well-being were positively associated with premature drop-out whilst having a child enrolled in school was positively associated with participation. Barriers included logistical factors such as timing and lack of childcare facilities. Factors that increased engagement included facilitator skills/support, weekly text messages and phone calls and engagement strategies such as transport and childcare. The results emphasise the importance of implementation factors in increasing parent engagement in parenting programs and will help to inform the next phase of the project as well as other family-support initiatives in the three countries. The trial is registered on ClinicalTrials.gov (ID: NCT03552250). Highlights: A mixed-methods approach was used to examine parent engagement in a parenting program in Southeastern Europe. The most consistent associated factors across the types of engagement were implementation factors. Results will inform later phases of the project and support implementation of parenting programs in Southeastern Europe. [ABSTRACT FROM AUTHOR]

Aim To examine whether in Europe perceptions of 'alcoholism' differ in a discrete manner according to geographical area. Method Secondary analysis of a data set from a European project carried out in 2013–2014 among 1767 patients treated in alcohol addiction units of nine countries/regions across Europe. The experience of all 11 DSM-4 criteria used for diagnosing 'alcohol dependence' and 'alcohol abuse' were assessed in patient interviews. The analysis was performed through Multiple Correspondence Analysis. Results The symptoms of 'alcohol dependence' and 'alcohol abuse', posited by DSM-IV, were distributed according to three discrete geographical patterns: a macro-area mainly centered on drinking beer and spirit, a culture traditionally oriented toward wine and a mixed intermediate alcoholic beverage situation. Conclusion These patterns of perception seem to parallel the diverse drinking cultures of Europe. [ABSTRACT FROM AUTHOR]

The objectives of this study were to: (1) determine the impact of COVID-19 on the operations within the 9 sections of the European Council on Chiropractic Education (ECCE) 'Standards'; (2) identify specific rapid changes to the programs; and (3) identify positive changes that will continue post-pandemic. This was a mixed methods audit and thematic analysis of data from interviews conducted via a cloud-based video conferencing tool with program leaders of the ECCE accredited institutions. A validated questionnaire designed around ECCE's "Standards" was used, consisting of 3 sections: (1) Severity of the COVID-19 impact on each ECCE Standard section; (2) Description of program changes made for each section; (3) Identification of positive changes continuing post-pandemic. Descriptive statistics were calculated for Part 1 and compared for significant differences via the Kruskal-Wallis test. Verbal responses to Parts 2 and 3 were evaluated independently by 3 researchers using a modified "thematic analysis" approach. Final thematic categories and themes were agreed upon by the researchers. There was a 100% response rate. Outpatient teaching clinics were most severely affected, followed by teaching chiropractic technique courses. Curricular structure and duration and program management were least affected (p =.033). Four thematic categories were identified: Extreme Stress, Courses Most Severely Affected, Integrity of Examinations and Assessments, and Positive Changes That Will Continue. Final-year students were most negatively impacted due to restricted opportunities in outpatient clinics. Integrity of examinations was also a problem. Positive, innovative teaching materials and methods were quickly developed and should continue. [ABSTRACT FROM AUTHOR]

This qualitative study explored the experiences of transracial Korean adoptee returnees who were born in Korea, separated from their biological families, raised in the United States and three European countries by White families, and given an Anglicized or Germanic name at the time of their adoption. This study focused on participants' journeys of reclaiming their Korean birth names and the various influences that factored into this decision. Data were collected from in-depth, semi-structured interviews (in-person or via Skype) and coded using grounded-theory methods that integrated a constructivist-interpretivist and critical epistemological paradigm. Participants (N = 12) were transracial Korean adoptees with ages ranging from 22 to 42 years (M = 32.67 years) who were between 0 and 88 months (M = 22.33 months) at the time of adoption, all of whom had returned to Korea. Results from the interviews revealed 11 axial categories and 2 overarching selective categories related to the name reclamation process: (a) name reclamation was part of a larger identity development process; (b) factors that prevented or slowed the name reclamation process. Limitations and future areas of research are discussed. [ABSTRACT FROM AUTHOR]

Our study aimed to enhance understanding of memory decline (MD) in old age by evaluating longitudinal effects of personal and national contributing factors. We used data collected by the Survey of Health, Ageing and Retirement in Europe (SHARE) from 12 European countries and Israel. Our sample included 11,930 retirees aged 50+, interviewed at baseline and four years later. MD was evaluated by the change in the number of recalled words from first to second interview. Except for gender, all of our explanatory variables had a significant unique effect on MD – age, education, type of occupation, European geographical region, early retirement, time elapsed from retirement, reason for retirement, active lifestyle, re-employment, health/function status, depressive symptoms, and decline in physical and mental health – over the four years of the study. Our findings indicate that MD can be postponed by national policies such as those which prolong years of education and participation in the workforce, and by social interventions directed to promote active lifestyles in late life, especially in Mediterranean and Eastern European nations. [ABSTRACT FROM AUTHOR]

Loneliness is a subjective experience escalating worldwide and affecting older adults. Digital solutions can play a major role in addressing loneliness, although its use has been facing resistance due to scarce involvement of older adults in its design. MOAI LABS is an ongoing European project that adopts a co-design process to develop digital solutions to address loneliness in older adults. This study reports the experience of loneliness shared by a group of eight community-dwelling older Portuguese adults (aged 64 to 86 years old), who are "experts by experience" (who feel alone). Findings were obtained from two co-creation sessions that were audio-recorded, and transcribed. The data analysis was performed involving the research team and the "experts by experience." Three themes emerged: 1) loneliness as a detrimental "state of the soul"; 2) loneliness reinforced by features of the aging process; and 3) loneliness builds more loneliness. MOAI LABS co-design process of digital solutions will embrace these experiences and involve frontline gerontological social workers who have experience with older adults' loneliness. [ABSTRACT FROM AUTHOR]

Aims: To explore caregivers' needs and problems in three European countries and associate the clusters of caregivers' needs with their sociodemographic characteristics. Design: A qualitative focused mixed methods design was used. Methods: In total, 52 caregivers of heart failure (HF) people were interviewed in three European countries between March 2017 and December 2018. Transcripts were analysed using the seven‐phase method of the exploratory multidimensional analysis according to Fraire with Reinert lexical classes findings were organized in dendrograms. Mayring's content analysis was also performed. Results: Three clusters of caregivers were identified: spouses, adult children and non‐family members. Caregivers not only provide HF patients with vital unpaid support for their physical and emotional needs, but they are continually trying to cope with their social isolation and deteriorating health. Conclusions: Informal caregiving emerged as a complex process influenced by various sociodemographic factors. Gender, relationship type and economic status are the important factors to be considered planning to develop approaches to address the needs of caregivers serving people with heart failure. Impact A comprehensive understanding of the nature of informal caregiving of individuals with heart failure, the complexity of the real‐world sociodemographic and cultural factors is warranted. The use of the EMDA method gave us the possibility of processing large masses of qualitative data through rapid, complex calculations. In detail, AATD allowed us to study in deep the significant fuzziness of what caregivers expressed and to analyse the content of the entire interviews and to produce global knowledge by using multi‐dimensional statistical methods to grasp the fundamental sense of the interviews, beyond the simple words. Three clusters were identified in the samples, including spouses, adult children and non‐family members. This study demonstrated that some sociodemographic characteristics could lead to everyday needs. Therefore, these demographic characteristics should be considered in developing targeted interventions. The research was conducted in Europe, but the technique shown can be replicated everywhere. The findings not only impact nursing but can be extended to all those stakeholders who concur with a public health educational mission. Patient or Public Contribution: Carers were involved in this study after the discharge of their loved ones or at the time of the outpatient visit. They were involved after they had been observed in their dynamics of involvement in caring of the familiars or friends with heart failure. [ABSTRACT FROM AUTHOR]

Aim: International health authorities suggest that individuals aged 65 years and above and people with underlying comorbidities such as hypertension, chronic lung disease, cardiovascular disease, cancer, diabetes, and obesity are at increased risk of severe Coronavirus Disease 2019 (COVID-19); however, the prevalence of risk factors is unknown in many countries. Therefore, we aimed to describe the distribution of these risk factors across Europe. Subject and methods: Prevalence of risk factors for severe COVID-19 was identified based on interviews from 73,274 Europeans aged 50+ participating in the Survey of Health, Ageing and Retirement in Europe (SHARE) in 2017. Burden of disease was estimated using population data from Eurostat. Results: A total of 75.3% of the study population (corresponding to approx. 60 million European men and 71 million women) had at least one risk factor for severe COVID-19, 45.9% (approx. 36 million men and 43 million women) had at least two factors, and 21.2% (approx. 17 million men and 20 million women) had at least three risk factors. The prevalence of underlying medical conditions ranged from 4.5% for cancer to 41.4% for hypertension, and the region-specific prevalence of having at least three risk factors ranged from 18.9% in Northern Europe to 24.6% in Eastern Europe. Conclusions: Information about the prevalence of risk factors might help authorities to identify the most vulnerable subpopulations with multiple risk factors of severe COVID-19 and thus to decide appropriate strategies to mitigate the pandemic. [ABSTRACT FROM AUTHOR]

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

The involvement of social workers in policy-making processes is grounded in a professional requirement for promoting social justice, however, it is inherently a political activity related to the socio-political context in which it occurs. What does this political involvement mean when it comes to minority social workers in multicultural societies, who are expected to act as policy actors in policy arenas designed by the majority group in society? This article is based on the assumption that minority social workers, whose number is on the rise in various European countries, need opportunities and motivations in a socio-political context in order to act as policy actors in cross-cultural political situations. Using insights from the literature on the political participation of ethnic minorities and knowledge in the field of public policy, we present a theoretical Minority Policy Practice model (MPP) to examine different factors that may affect the involvement of minority social workers in policy practice. These new theoretical understandings are expected to serve as a basis for advancing training programmes and designing policy procedures to increase the involvement of minority social workers as policy actors in multicultural countries. [ABSTRACT FROM AUTHOR]

Abstract: This paper reports on in-depth research, using a grounded theory approach, to examine the ways in which very old people perceive healthy ageing in the context of living alone at home within urban settings in five European countries. This qualitative study was part of a cross-national project entitled ENABLE-AGE which examined the relationship between home and healthy ageing. Interviews explored the notion of healthy ageing, the meaning and importance of home, conceptualisations of independence and autonomy and links between healthy ageing and home. Data analysis identified five ways in which older people constructed healthy ageing: home and keeping active; managing lifestyles, health and illness; balancing social life; and balancing material and financial circumstances. Older people reflected on their everyday lives at home in terms of being engaged in purposeful, meaningful action and evaluated healthy ageing in relation to the symbolic and practical affordances of the home, contextualised within constructions of their national context. The research suggests that older people perceive healthy ageing as an active achievement, created through individual, personal effort and supported through social ties despite the health, financial and social decline associated with growing older. The physicality and spatiality of home provided the context for establishing and evaluating the notion of healthy ageing, whilst the experienced relationship between home, life history and identity created a meaningful space within which healthy ageing was negotiated. [Copyright &y& Elsevier]

Comparative European data using Second Generation Surveillance System (SGSS) are scarce among gay, bisexual and other men who have sex with men. This study evaluated the implementation of Sialon II, a bio-behavioural HIV research combined with targeted HIV prevention in 13 European cities conducted in collaboration with community partners. A mixed-methods process evaluation assessed the project's coverage, outputs, quality, challenges and opportunities for improvement. Data collected through structured questionnaire from 71 data collectors from community-based organisations and semi-structured interviews with 17 managers of participating gay venues were analysed. Overall implementation was successful, achieving 4901 valid behavioural questionnaires and obtaining 4716 biological samples. Challenges in conducting bio-behavioural research in gay venues related to strict research protocols and unfavourable characteristics of venues. Formative research, collaboration with community gay venues, and offering HIV prevention emerged as facilitators. Community researchers' training was crucial for fidelity to research protocols, increased trust amongst communities and enabled data collectors to effectively address practical problems in the field. Scientifically sound SGSS with community participation is feasible and allows for including 'hard-to-reach' populations. Prevention benefits include awareness raising, capacity building and sexual health promotion in gay venues. The findings are beneficial for epidemiological research among other HIV key populations. [ABSTRACT FROM AUTHOR]

The article analyses the motivations for participating in collaborative digital platforms in Europe. From the duality of roles approach, the motivations of European obtainers and providers are studied, with special emphasis on the role played by occupational status. For that purpose, a pan-European sample of 14,050 citizens from 28 countries is investigated and a quantitative data analysis is applied through a system of structural equations. Regarding overall motivations, the research has identified that economic and usefulness motivations predict the obtaining of goods and services through collaborative platforms. In the case of provision, utility motivations are complemented by other pro-social predictors, such as the possibility of non-monetary exchanges. In addition, the occupational status of the individuals significantly determines their key motivations. Self-employed individuals are essentially motivated by price and novelty in explaining when they consider becoming obtainers. In contrast, managers are more motivated by convenience. In addition, self-employed individuals will be more likely to provide resources on collaborative platforms for non-monetary exchange reasons. Managerial implications of these results are also discussed. [ABSTRACT FROM AUTHOR]

Perinatal mental illness is associated with considerable maternal and infant morbidity and mortality. However, there are currently no specific guidelines on the standards and structure of postgraduate perinatal psychiatric training in Europe. We describe the characteristics of available and desired specialist perinatal psychiatry training from the perspective of European psychiatrists in training. An online survey was conducted among 34 national psychiatric trainee association representatives of the European Federation of Psychiatric Trainees (EFPT). Participants from the countries in which perinatal psychiatry training was available were invited to participate in in-depth follow-up interviews. Six countries out of 34 (18%) reported that specialist training in perinatal mental health was available (Finland, France, Germany, Ireland, Malta, and the UK). The nature of available training varied in duration, the supervision and assessment model employed, and the training scheme context. Of the 28 countries where specialist perinatal psychiatry training was unavailable, the majority of national representatives (22 countries, 76%) wanted specialist perinatal psychiatry training to be included in their national training curricula. There is a gap between the expected skills and the available training for psychiatrists to meet the mental healthcare needs of women in the perinatal period. Given the prevalence and impact of perinatal mental illness and the expressed desires of trainees themselves for specialist training, this finding should prompt urgent action. [ABSTRACT FROM AUTHOR]

Despite norms and regulations on accessibility, people with disabilities continue to face many problems in the built environment and it happens, in particular, in historic places and buildings. These, so numerous in Italian and European old cities, are not accessed only as tourist and/or cultural attractions but they are often accessed as public places, workspaces and study places in which accessibility should be ensured. This article is based on a qualitative research carried out in Trento, an old Italian city, in which people with disabilities and representatives of public and private organisations working in the area of urban or building construction and maintenance were interviewed. The findings show, in particular, that norms and regulations on conservation often prevail on those on accessibility, even when they could coexist and, at the same time, improve universal accessibility in historical built environments. In Italy, Europe and elsewhere, standards should be applied to ensure equal rights to people with disabilities in all aspects of life, including access to the built environment. Local, national and international governments and institutions assign great importance to the conservation of historic city centres and buildings. This study found that there is only a partial - and often inconsistent - implementation of the laws on accessibility in historic built environments, as priority is given to the protection of such environments. Precedence given to the conservation of historic built environments causes many accessibility issues, thus limiting the possibility of people with disabilities to move around independently and carry out everyday life activities. The study suggests that art-historical values and accessibility can go hand in hand, in particular if people with disabilities are included in decision-making processes and can have their say through participatory planning. [ABSTRACT FROM AUTHOR]

Data about the regulatory approaches to donor human milk (DHM) in European countries are lacking. The aim of this study is to describe the various regulations of DHM within European countries, to assess its legislative context and its impact in relation to donor milk banking. We performed a cross‐sectional survey using a semistructured online questionnaire addressing 29 national European milk‐banking representatives from June 2020 to February 2021. Representatives of 26 national DHM services participated in this study. The legal classification and regulatory status of DHM were defined in 9 out of 26 areas of jurisdiction (35%) as either food product (n = 6), product of human origin according to a blood, tissue, cell regulation (n = 2), or medicinal product (n = 1). In the remainder, DHM remains unclassified. Most legislations did not provide a comprehensive framework concerning DHM and costs to cover milk bank operations were rarely reimbursed. In general, the lack of national legislative governance and the actual legislative regulations in place do not support the use of DHM in European countries. National medical guidelines for the use of DHM have been issued in only 11 countries. The current number and distribution of milk banks (n = 239) within participating countries may not provide an equitable access to DHM for eligible infants. These findings could guide stakeholders aiming to establish a regulatory framework for DHM. Key messages: There is a lack of a legislative framework concerning the use of donor human milk in the majority of European countries.Available national legislative frameworks differed widely with gaps in the regulation of safety and quality of donor human milk, protection of donors and recipients, and cost recovery.Despite clearly demonstrated benefits and unequivocal recommendations for the use of donor human milk there is a lack of national guidance in many European countries. [ABSTRACT FROM AUTHOR]

Abstract: People who have been in out-of-home care as children are at high risk of social exclusion as adults. Longitudinal research suggests that this is closely linked to their low level of educational attainment. Yet in the past the education of children in care has attracted little research interest. In particular, almost nothing is known about the education of these young people beyond the stage of compulsory schooling. This paper draws on evidence from a European Union funded project, Young People in Public Care: Pathways to Education in Europe (YiPPEE) which aimed to find out how more care leavers could be encouraged to stay in school longer and enabled to access further and higher education. The research was carried out over three years by a consortium of five countries: England, Denmark, Sweden, Spain and Hungary. Four principal methods were used: a state-of-the-art literature and policy review, secondary analysis of published and unpublished statistics, surveys of responsible public bodies in social care and education, including interviews with professionals and managers, and biographical narrative interviews with a sample of 170 young people aged 18–24. Individual country studies were consolidated at each stage into comparative reports. 1 [1] All reports can be accessed on the project website: http://tcru.ioe.ac.uk/yippee. Principal results: In all the five European countries studied, remaining in formal education at least to age 18 or 19 has become the norm. However, this is not true for children in care and the gap in attainment is widening. Despite major differences in care and education systems between the five countries, the experiences of young people in transition from care to independence were found to be remarkably similar. Almost all had experienced many disruptions in their earlier education, both in their birth families and often also after entering care. Beyond 16 the picture was one of cumulative delay, with few young people able to follow the conventional pathway through school to college or university. Professionals identified as a major structural problem the historical split between care and education. Low expectations and lack of interest in education by social workers and carers, limited horizons and inadequate financial and personal support were the other main obstacles. Facilitating factors for educational achievement were strong personal motivation, having a close supportive adult, stability in care and school placements, satisfactory accommodation and financial help. Conclusions: If children and youth in out-of-home care are to enjoy equal opportunities with their peers a much stronger focus is needed in all countries on their formal and informal education throughout their time in care and beyond. With low level educational qualifications or none, they are severely disadvantaged in the labour market, especially at a time of high youth unemployment. In addition, their lack of family support and weak social networks put them at great risk of social exclusion in adulthood. Targeted measures to promote social mobility via participation in higher levels of education should be an explicit aim of welfare authorities. [Copyright &y& Elsevier]

Migrants comprise a growing proportion of European populations. Although many are healthy, those who do need healthcare often face barriers and the care they receive may be inappropriate to their needs. This paper summarises good practices identified in a review of health services for migrants in Europe. Governments should ensure that migrants are entitled to health services, that the services are appropriate to their needs and that data systems are in place to monitor utilisation and detect inequities. Health services should adopt a 'whole organisation approach', in which cultural competence is viewed as much as a task for organisations as for individuals. Health workers should take steps to overcome language, social and cultural barriers to care. In each case, existing examples of good practice are provided. At a time when support is growing in some countries for political parties pursuing anti-immigrant agendas and governments in all countries are pursuing austerity policies, there is a greater need than ever for the public health community to ensure that migrants have access to services that are effective and responsive to their needs. [ABSTRACT FROM AUTHOR]

Abstract: The prevalence of diabetes is growing in many countries. Prescription oral medications have been developed to treat the disease since the 1950s. More recently, a group of diabetes drugs, known as the glitazones, have been developed and introduced on to North American and European markets since the late 1990s. When first introduced, the glitazones were widely regarded as ‘innovative’ pharmaceuticals and have remained on the American and EU markets, among others, throughout the 2000s. Yet, enormous uncertainties about their therapeutic value have remained since they came on the market a decade ago. This paper investigates how socio-political systems of drug development and regulation generate such pharmaceutical uncertainty consequent upon the limited informational value that diabetes drug trials provide about the health risks and benefits of such medications when used in clinical practice. Drawing on documentary research and fieldwork interviews, the first in-depth analysis of regulation of ‘innovative’ pharmaceuticals in both the US and supranational EU is presented. It is argued that these pharmaceutical uncertainties can be explained by reference to four key factors: regulatory paradigms using surrogate markers for drug efficacy; drug approval standards in policy and legislation; ideological expectations of innovation within regulatory agencies; and pharmaceutical industry shaping of drug evaluation. [Copyright &y& Elsevier]

Abstract: The paper makes uses of cognitive mappings developed from personal interviews with a number of European airline executives to examine the differences in managerial attitudes of low-cost and transitional carriers. In particular it explores the extent to which there is a convergence of views regarding the ways various airline models will develop in the future. [Copyright &y& Elsevier]

The paper discusses the traditional ritual, medicinal and insect repellent use of Dysphania schraderiana in Poland, a plant with little ethnobotanical and phytochemical data. Our research suggests that its properties should be further studied comparing it with the related D. botrys and D. ambrosioides. D. schraderiana is an aromatic and medicinal annual herb related to D. ambrosioides and D. botrys and practically absent from historical accounts of plant uses in Europe. The aim of this work is to characterise the current use of D. schraderiana in south east Poland on the background of historical Dysphania species use in Europe. The data on D. schraderiana was collected in 2020, based on interviews with 42 people in rural areas of south-eastern Poland where the species is used today. A range of textual sources were searched including old medicinal herbals, pharmaceutical handbooks, ethnobotanical publications and culinary databases regarding all the uses of Dysphania species in Europe. In the study area D. schraderiana occurs in the whole spectrum of cultivation stages – from being intentionally cultivated to completely wild. The plant is used mainly as an apotropaic and insect repellent, blessed during Catholic church holidays (mainly Assumption Day), and sometimes used as incense in churches (and blessed on Epiphany Day). D. schraderiana rarely occurs in European historical sources, except sometimes classed as a false, inferior form of D. botrys , which has been known for centuries as a moth repellent and treatment for respiratory illness. We hypothesise that the plant was not easily distinguished from D. botrys and their uses strongly overlapped. For some unknown reason the use of D. botrys died out, whereas a relatively large semi-feral population of D. schraderiana exists in south-eastern Poland where it has remained a culturally important plant. D. schraderiana is a rare case of a non-native plant traditionally used within an area of Europe but previously nearly overlooked in European ethnobotanical literature. Historical uses of Dysphania spp. in other areas of Poland and former Poland (now western Ukraine) suggest that the genus was used more widely in regions beyond the one studied. However, a very compact distribution of use suggests that D. schraderiana may have been brought to SE Poland from a single source outside the study area. Its common name, and use as a holy incense plant, is associated it with the well-known biblical tree resin obtained from Commiphora myrrha (Nees) Engl. [Display omitted] [ABSTRACT FROM AUTHOR]

Abstract: The paper explores the merit of the willingness-to-pay (WTP) method as a way to elicit public preferences regarding health care priorities. The aim is to test the extent to which the implicit ranking inferred from the ordinal differences in WTP-values corresponds with respondents’ explicit ranking of the same programmes. This issue of convergent validity is explored by face-to-face interviewing of population samples in six European countries—in total 1240 respondents. The most consistent result is the inconsistency of WTP and explicit ranking in all six countries. The convergent validity of WTP is low, particularly among those who did not state different WTP-values on the three programmes being considered. [Copyright &y& Elsevier]

Suicide is one of the leading causes of death in adolescents and help-seeking behaviour for suicidal behaviour is low. School-based screenings can identify adolescents at risk for suicidal behaviour and might have the potential to facilitate service use and reduce suicidal behaviour. The aim of this study was to assess associations of a two-stage school-based screening with service use and suicidality in adolescents (aged 15 ± 0.9 years) from 11 European countries after one year. Students participating in the 'Saving and Empowering Young Lives in Europe' (SEYLE) study completed a self-report questionnaire including items on suicidal behaviour. Those screening positive for current suicidality (first screening stage) were invited to an interview with a mental health professional (second stage) who referred them for treatment, if necessary. At 12-month follow-up, students completed the same self-report questionnaire including questions on service use within the past year. Of the N = 12,395 SEYLE participants, 516 (4.2%) screened positive for current suicidality and were invited to the interview. Of these, 362 completed the 12-month follow-up with 136 (37.6%) self-selecting to attend the interview (screening completers). The majority of both screening completers (81.9%) and non-completers (91.6%) had not received professional treatment within one year, with completers being slightly more likely to receive it (χ2(1) = 8.948, V = 0.157, p ≤ 0.01). Screening completion was associated with higher service use (OR 2.695, se 1.017, p ≤ 0.01) and lower suicidality at follow-up (OR 0.505, se 0.114, p ≤ 0.01) after controlling for potential confounders. This school-based screening offered limited evidence for the improvement of service use for suicidality. Similar future programmes might improve interview attendance rate and address adolescents' barriers to care. [ABSTRACT FROM AUTHOR]

The aim of this study was to identify factors that influence the perceived stigma of two assistive devices for visual impairment, namely the white cane and smart glasses. Face-to-face semi-structured interviews with eight European students were conducted to probe their experiences and knowledge related to disability, assistive technology, visual impairment, as well as handheld and wearable devices. Close relationships with disabled people seems to have a positive influence on participants perceptions about stigma, disability, and assistive technology. Academic background seems to not have any influence. The aesthetics of assistive devices was observed as an important factor that influences the adoption or abandonment of the device. Device without negative symbolism but with modern aesthetics (smart glasses) were positively accepted by the participants than the device with traditional aesthetics and symbolisms of visual impairment (white cane). Designers should, therefore, consider aesthetics in addition to functionality in order to avoid the perceived stigma, thereby reducing the chances of device abandonment. Understanding the factors that influence the perceived stigma associated with assistive technology can help designers and developers to reduce assistive technology abandonment and perceived stigma. Designers need to consider both functionality and aesthetics. While functionality is crucial for the users' adaptation, aesthetics is important for the users' positive perceptions. [ABSTRACT FROM AUTHOR]

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

Measurement errors due to failure to obtain the required data from the selected sample (non-response errors) are a matter of great methodological concern to current survey researchers. The author assumes that respondents' attitude to the questionnaire is largely determined by social conditions and maintains that in order to minimise this error (and achieve a satisfactory response rate) these conditions should be taken into account in the course of survey design, during the preparatory stage (interviewer selection and training: when specifying the timeline and number of contacts with individual respondents). implementation stage (interviewer monitoring) and control stage (back-checks). Although there are many ways to enhance response rates, the paper focuses on response-maximisation techniques applied in the European Social Survey that achieved a response rate of more than 70%. [ABSTRACT FROM AUTHOR]

Studies show that older migrants have poorer health than native populations in Western Europe. To date, little systematic research has explored the differences between men and women within older populations with migration backgrounds. This article examines gender-specific aspects and mediating mechanisms of self-reported health among older migrants from Turkey. Using a mixed method approach, data and results from a quantitative survey and a qualitative study conducted in Berlin, Germany, are analysed and integrated at the interpretive level. Standardised face-to-face interviews were carried out with the help of a network approach with 194 older migrants from Turkey (93 women, 101 men, mean age: 68). Potential mediators showing significant gender differences are included in a parallel multiple mediation analysis. The documentary method is used to analyse 11 semi-structured narrative interviews with first-generation labour migrants from Turkey. Women reported significantly worse subjective health than men (c = 0.443, bCI [0.165–0.736]), conveyed through greater functional limitations (ab = 0.183, bCI [0.056–0.321]) and emotional loneliness (ab = 0.057, bCI [0.008–0.128]). Respondents to the qualitative study perceived that women age earlier and have poorer health due to the burden of performing a greater variety of social roles. Higher levels of emotional loneliness among women could be caused by their experiences of negatively assessed partnerships. Our results show that as a group, older female migrants have an elevated health vulnerability. A broader scientific foundation regarding gender differences in the health of older migrants and their causes is needed to promote gender-sensitive prevention and care for this group. [ABSTRACT FROM AUTHOR]

To explore how cancer could be diagnosed in a more timely way. Grounded theory analysis of primary care physicians' free text survey responses to: 'How do you think the speed of diagnosis of cancer in primary care could be improved?'. Secondary analysis of primary care physician interviews, survey responses, literature. Primary care in 20 European Örenäs Research Group countries. Primary care physicians: 1352 survey respondents (2013-2016), 20 Spanish and 7 Swedish interviewees (2015–2019). Conceptual explanation of how to improve timeliness of cancer diagnosis. Pluralistic task shifting is a grounded theory of a composite strategy. It includes task sharing – among nurses, physicians, nurse assistants, secretaries, and patients – and changing tasks with cancer screening when appropriate or cancer fast-tracks to accelerate cancer case finding. A pluralistic dialogue culture of comprehensive collaboration and task redistribution is required for effective pluralistic task shifting. Pluralistic task shifting relies on cognitive task shifting, which includes learning more about slow analytic reasoning and fast automatic thinking initiated by pattern recognition; and digital task shifting, which by use of eHealth and telemedicine bridges time and place and improves power symmetry between patients, caregivers, and clinicians. Financial task shifting that involves cost tracking followed by reallocation of funds is necessary for the restructuring and retraining required for successful pluralistic task shifting. A timely diagnosis reduces expensive investigations and waiting times. Also, late-stage cancers are costlier to treat than early-stage cancers. Timing is central to cancer diagnosis: not too early to avoid overdiagnosis, and never too late. We present pluralistic task shifting as a conceptual summary of strategies needed to optimise the timeliness of cancer diagnosis. Cancer diagnosis is under-researched in primary care, especially theoretically. Thus, inspired by classic grounded theory, we analysed and conceptualised the field: Pluralistic task shifting is a conceptual explanation of how the timeliness of cancer diagnosis could be improved, with data derived mostly from primary care physicians. This includes task sharing and changing tasks including screening and cancer fast-tracks to accelerate cancer case finding, and requires cognitive task shifting emphasising learning, and digital task shifting involving the use of eHealth and telemedicine. Financial task shifting with cost tracking and reallocation of funds is eventually necessary for successful pluralistic task shifting to happen. [ABSTRACT FROM AUTHOR]

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

This article focuses on the book "Technology Management and Public Policy in the European Union," edited by William Cannell and Ben Dankbarr. This book contains seven papers based on a study conducting interviews with top managers in over 250 enterprises in nine European countries, explore firm-level competencies underlying technology management in European firms and consider the policy instruments that can be used to promote them. Ben Dankbarr provides an over-view of the patterns of technology management found in European firms.

This article contributes to the study of the demand side of welfare politics by investigating gender differences in social investment preferences systematically. Building on the different functions of social investment policies in creating, preserving, or mobilizing skills, we argue that women do not support social investment policies generally more strongly than men. Rather, women demand, in particular, policies to preserve their skills during career interruptions and help to mobilize their skills on the labour market. In a second analytical step, we examine women's policy priorities if skill preservation and mobilization come at the expense of social compensation. We test our arguments for eight Western European countries with data from the INVEDUC survey. The confirmation of our arguments challenges a core assumption of the literatures on the social investment turn and women's political realignment. We discuss the implication of our findings in the conclusion. [ABSTRACT FROM AUTHOR]

Increasing caregiving needs for family members has created pressure on prime-age workers. Combined with the ageing population, the demand for care related to illness and disability by relatives mean more of the workforce may have to consider caring needs (Bauer and Sousa-Poza, 2015). 'Informal caregivers' provide care generally without payment (Yoo et al., 2004). In contrast to formal care, informal caregivers usually have a close relationship with the recipient: for example, siblings and adult children. Informal caregiving is considered a desirable option to meet support needs from several perspectives; these caregivers may be preferred by recipients relative to formal arrangements especially during severe acute illnesses. Caregivers may also feel a personal sense of responsibility to look after loved ones rather than defer to strangers (Fine, 2012) though this may depend on the individual's needs and the available alternatives. Although men are starting to play an important role due to shifting social gender roles, the vast majority of informal caregivers are women who increasingly attempt to juggle caring with labour force participation (Carmichael et al., 2008). [ABSTRACT FROM AUTHOR]

Background: Recognized disparities in quality of end‐of‐life care exist. Our aim was to assess the quality of care for patients dying from cancer, as perceived by bereaved relatives, within hospitals in seven European and South American countries. Materials and Methods: A postbereavement survey was conducted by post, interview, or via tablet in Argentina, Brazil, Uruguay, U.K., Germany, Norway, and Poland. Next of kin to cancer patients were asked to complete the international version of the Care Of the Dying Evaluation (i‐CODE) questionnaire 6–8 weeks postbereavement. Primary outcomes were (a) how frequently the deceased patient was treated with dignity and respect, and (b) how well the family member was supported in the patient's last days of life. Results: Of 1,683 potential participants, 914 i‐CODE questionnaires were completed (response rate, 54%). Approximately 94% reported the doctors treated their family member with dignity and respect "always" or "most of the time"; similar responses were given about nursing staff (94%). Additionally, 89% of participants reported they were adequately supported; this was more likely if the patient died on a specialist palliative care unit (odds ratio, 6.3; 95% confidence interval, 2.3–17.8). Although 87% of participants were told their relative was likely to die, only 63% were informed about what to expect during the dying phase. Conclusion: This is the first study assessing quality of care for dying cancer patients from the bereaved relatives' perspective across several countries on two continents. Our findings suggest many elements of good care were practiced but improvement in communication with relatives of imminently dying patients is needed. (ClinicalTrials.gov Identifier: NCT03566732). Implications for Practice: Previous studies have shown that bereaved relatives' views represent a valid way to assess care for dying patients in the last days of their life. The Care Of the Dying Evaluation questionnaire is a suitable tool for quality improvement work to help determine areas where care is perceived well and areas where care is perceived as lacking. Health care professionals need to sustain high quality communication into the last phase of the cancer trajectory. In particular, discussions about what to expect when someone is dying and the provision of hydration in the last days of life represent key areas for improvement. Disparities exist in the quality of end‐of‐life care. This article assesses the quality of care for dying cancer patients, as perceived by bereaved relatives, within hospitals in seven European and South American countries. [ABSTRACT FROM AUTHOR]

Objective: Analyse the relationship between different levels of physical activity (PA) and depression symptoms in a representative sample of European older adults. Methods: Data on PA, depression symptoms and sociodemographic variables from 64688 (28015 men) older adults participating in SHARE wave 6 was collected through a face-to-face interview. The EURO-D 12-item scale was administered for depression symptoms. Participants reported the frequency they engaged in moderate-intensity PA (MPA) and vigorous-intensity PA (VPA). Results: Men and women engaging in MPA and VPA once or more than once a week had less depression symptoms than those who engage less than once a week. MPA and VPA once or more than once a week were inversely associated with the depression symptoms score. Furthermore, engaging in MPA and VPA decreased the odds of depression (cut-off point of ≥4 depression symptoms) compared to engaging in PA less than once a week. Conclusions: Policies for promoting mental health should include PA for the prevention or treatment of depression symptoms. PA presents physical and psychological benefits and can be used as an overall health-promoting strategy, facing numerous problems at a time. [ABSTRACT FROM AUTHOR]

The interplay between professionals and clients has been examined in a number of settings and the impact of laymen on professional behavior is well-known to the sociologists. In this research report these insights are applied to police-citizen interaction in an effort to explain the dynamics of discretionary decisions by police officers and the role such discretion plays in their quest to attain higher professional stature. Specific attention will be paid to variations in the willingness of policemen to develop and utilize informers or "stool pigeons." This article examines information secured in tape-recorded personal interviews conducted during the winter of 1971 by the author in two European police departments. Discretionary decisions to arrest or not, or to press serious or minor charges, become one part of the negotiation between policemen and citizens, making it possible for the police to carve out a work style balancing professional rules and codes while also making sufficient concessions to client controls necessary to operate in the streets.

Background: Lifting The Burden (LTB) and European Headache Federation (EHF) have developed a set of headache service quality indicators, successfully tested in specialist headache centres. Their intended application includes all levels of care. Here we assess their implementation in primary care. Methods: We included 28 primary-care clinics in Germany (4), Turkey (4), Latvia (5) and Portugal (15). To implement the indicators, we interviewed 111 doctors, 92 nurses and medical assistants, 70 secretaries, 27 service managers and 493 patients, using the questionnaires developed by LTB and EHF. In addition, we evaluated 675 patients' records. Enquiries were in nine domains: diagnosis, individualized management, referral pathways, patient education and reassurance, convenience and comfort, patient satisfaction, equity and efficiency of headache care, outcome assessment and safety. Results: The principal finding was that Implementation proved feasible and practical in primary care. In the process, we identified significant quality deficits. Almost everywhere, histories of headache, especially temporal profiles, were captured and/or assessed inaccurately. A substantial proportion (20%) of patients received non-specific ICD codes such as R51 ("headache") rather than specific headache diagnoses. Headache-related disability and quality of life were not part of routine clinical enquiry. Headache diaries and calendars were not in use. Waiting times were long (e.g., about 60 min in Germany). Nevertheless, most patients (> 85%) expressed satisfaction with their care. Almost all the participating clinics provided equitable and easy access to treatment, and follow-up for most headache patients, without unnecessary barriers. Conclusions: The study demonstrated that headache service quality indicators can be used in primary care, proving both practical and fit for purpose. It also uncovered quality deficits leading to suboptimal treatment, often due to a lack of knowledge among the general practitioners. There were failures of process also. These findings signal the need for additional training in headache diagnosis and management in primary care, where most headache patients are necessarily treated. More generally, they underline the importance of headache service quality evaluation in primary care, not only to identify-quality failings but also to guide improvements. This study also demonstrated that patients' satisfaction is not, on its own, a good indicator of service quality. [ABSTRACT FROM AUTHOR]

Background: Severe acute respiratory syndrome coronavirus-2 is a formidable virus, responsible for coronavirus disease 2019 and endowed with marked neurotropism. The damage it causes to the nervous system is manifold. The main neurological manifestation is anosmia. Olfactory damage is often transient, but there are no data reflecting an observational period of several months. Objective: This study evaluated the trend of anosmia in patients affected by coronavirus disease 2019 in the eight months following diagnosis. Methods: Fifty-five subjects who presented with symptoms suggestive of coronavirus disease 2019 and who developed anosmia, between the end of February and the beginning of March 2020, were investigated. The patients were interviewed after eight months to determine functional recovery and assess the degree of recovery. Results: Ninety-one per cent of the population reported olfactory recovery and, of these, 53 per cent had total recovery after eight months. Females and younger age groups seem slightly advantaged in functional recovery. The elderly population appears to have excellent prospects for full functional recovery. Conclusion: Anosmia represents a frequent neurological manifestation during coronavirus disease 2019. Fortunately, it is transient in most cases, and only a small percentage of patients affected by it report long-term functional deficits. [ABSTRACT FROM AUTHOR]

Timely access to care services is crucial to support people with dementia and their family carers to live well. Carers of people with dementia (N = 390), recruited from eight countries, completed semi-structured interviews about their experiences of either accessing or not using formal care services over a 12-month period in the Access to Timely Formal Care (Actifcare) study. Participant responses were summarised using content analysis, categorised into clusters and frequencies were calculated. Less than half of the participants (42.3%) reported service use. Of those using services, 72.8 per cent reported timely access and of those not using services 67.2 per cent were satisfied with this situation. However, substantial minorities either reported access at the wrong time (27.2%), or feeling dissatisfied or mixed feelings about not accessing services (32.8%). Reasons for not using services included use not necessary yet, the carer provided support or refusal. Reasons given for using services included changes in the condition of the person with dementia, the service's ability to meet individual needs, not coping or the opportunity to access services arose. Facilitators and barriers to service use included whether participants experienced supportive professionals, the speed of the process, whether the general practitioner was helpful, participant's own proactive attitude and the quality of information received. To achieve timely support, simplified pathways to use of formal care services are needed. [ABSTRACT FROM AUTHOR]

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

This article describes the experience of two years of working with migrants residing in the city of Glasgow, Scotland. Three different groups, with participants from Asia, Africa, Latin America and Europe, students, migrants and asylum seekers, converged in three different spaces and frameworks. A total of 51 participants, six men and 41 women between 20 and 50 years of age, took part in spontaneous movement workshops to promote their health, body awareness and well-being, the strengthening of affective bonds and creativity. The impact of the sessions was assessed through an anonymous survey, a semi-structured interview and a facilitator's diary of the sessions. The settings of the three groups were not identical and, thus, did not allow for a comparison between them. However, the results showed that the sessions helped participants to increase their sense of well-being and confidence, facilitate their integration process and strengthen their bonds with other participants. [ABSTRACT FROM AUTHOR]