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Medical abortion (MA) is recommended by the WHO as a safe and effective pregnancy termination method in the first trimester. From a feminist perspective, it is a non-medicalised, self-managed, emancipating procedure allowing persons seeking abortion to be more in control of their abortion, as opposed to surgical procedures. In European countries where MA is legal, the proportion of MA (relative to surgical abortions) varies greatly. We hypothesised that this ratio may be partly explained by country-level dimensions of gender equality. We assessed the association between MA ratios and gender equality in Europe in correlation and regression analyses, using several country-level gender equality indices. The relevance of other factors, i.e. date of introduction of MA and pregnancy week until which MA is permitted, was also investigated. MA ratios ranged from 24.4% (Italy) to 97.7% (Finland). MA was more frequent relative to surgical abortion in countries with higher levels of gender equality. All gender equality indices were associated with MA ratios (e.g. Global Gender Gap Index corr. coeff: 0.761, p < 0.0001). Specifically, markers of economic and political gender equality seemed to drive the correlations. The pregnancy week until which MA is permitted was associated with both gender equality and MA ratios. Our study suggests that women's participation in the economic and political sphere may have repercussions on the methods offered and used through abortion services. It highlights the link between feminist perspectives, reproductive health policies and practices, and gender equality, especially in terms of access to economic resources and political representation. [ABSTRACT FROM AUTHOR]

Background First- pass effect (FPE), restoring complete or near complete reperfusion (modified Thrombolysis in Cerebral Infarction (mTICI) 2c- 3) in a single pass, is an independent predictor for good functional outcomes in the endovascular treatment of acute ischemic stroke. The economic implications of achieving FPE have not been assessed. Objective To assess the economic impact of achieving complete or near complete reperfusion after the first pass. Methods Post hoc analyses were conducted using ARISE II study data. The target population consisted of patients in whom mTICI 2c--3 was achieved, stratified into two groups: (1) mTICI 2c--3 achieved after the first pass (FPE group) or (2) after multiple passes (non- FPE group). Baseline characteristics, clinical outcomes, and healthcare resource use were compared between groups. Costs from peer- reviewed literature were applied to assess cost consequences from the perspectives of the United States (USA), France, Germany, Italy, Spain, Sweden, and United Kingdom (UK). Results Among patients who achieved mTICI 2c--3 (n=172), FPE was achieved in 53% (n=91). A higher proportion of patients in the FPE group reached good functional outcomes (90- day modified Rankin Scale score 0--2 80.46% vs 61.04%, p<0.01). The patients in the FPE group had a shorter mean length of stay (6.10 vs 9.48 days, p<0.01) and required only a single stent retriever, whereas 35% of patients in the non- FPE group required at least one additional device. Driven by improvement in clinical outcomes, the FPE group had lower procedural/hospitalization- related (24-- 33% reduction) and annual care (11--27% reduction) costs across all countries. Conclusions FPE resulted in improved clinical outcomes, translating into lower healthcare resource use and lower estimated costs. [ABSTRACT FROM AUTHOR]

Objectives. This study aimed to compare performances of China reference and different national references on high blood pressure (HBP). Methods. A cross-sectional study including 695,302 children and adolescents aged 7 to 17 years in Suzhou, China, was conducted to determine the prevalence of HBP based on U.S., international, Europe, and China references in 2016. Results. Different percentiles of height and blood pressure were found among four references. Referring to U.S. reference, the prevalence of HBP was the highest with 26.0%, followed by International reference with 20.0%, Europe reference with 19.5%, and China reference with 19.2%. McNemar tests indicated statistically significant differences between HBP prevalence comparing China reference with the other 3 references (P < 0.001). The area under the curve was 0.947, 0.851, and 0.949 for U.S., international, and Europe reference, respectively. U.S. reference showed the highest sensitivity (98.2%), but the lowest specificity (91.2%), and Europe reference showed the highest kappa value (0.893). Conclusions. The prevalence of HBP varied among these four references, and the appropriate choice of reference would be important to recognize high-risk children and judge the trends of HBP prevalence in the targeted population. [ABSTRACT FROM AUTHOR]

The controversy over Greek deficit statistics highlights three developments, characteristic not only of Greece, but of Europe as a whole: the intended depoliticization of certain issues or domains through the setting up of independent authorities, the transformation of national norms and arrangements that comes with European integration, and the role of transnational epistemic communities. An ongoing statistical dispute between Eurostat and the Greek authorities in the years before 2010, and changes in the governance of Greek statistics from that year onward as the controversy moved to the judicial arena, have revealed conflicting legitimacies and offered a testing ground for a whole series of devices and processes designed to monitor the independence of statistical institutes all over Europe. [ABSTRACT FROM AUTHOR]

We broaden contemporary understandings of the relationship between HR practices that support work-life balance and organizational as well as individual outcomes, through a focus on perceptual discrepancies of entitlement. To theorize this notion, we adopt the self-perception accuracy model and extend it by investigating whether any employee/management discrepancies in perceptions of entitlement mediate the relationship between HR practices supporting work-life balance and outcomes. We use data from 20 European countries and apply a multilevel statistical methodology. Our results did not reveal significant mediation effects, but the perceptions of managers, not of employees, are related to HR practices that support work-life balance. Furthermore, employees tend to have higher expectations of entitlement than does management. Finally, the more aligned management and employee perceptions of entitlement, the higher the positive organizational and individual outcomes over and above contextual idiosyncrasies. Findings denote that, in achieving positive outcomes for employees and organizations, managing perceptions regarding organizational support for work-life balance is more important than actual support practices. © 2015 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

The purpose of the study was to identify trends in research abstracts published in the books of abstracts of the European Congress of Adapted Physical Activity from 2004 to 2012. A documentary analysis of the contents of 459 abstracts was completed. Data were coded based on subcategories used in a previous study by Zhang, deLisle. and Chen (2006) and by Porretta and Sherrill (2005): number of authors, data source, sample size, type of disability, data analyses, type of study, and tocus of study. Descriptive statistics calculated for each subcategory revealed an overall picUire of the state and trends of scientific inquiry in adapted physical activity research in Europe. [ABSTRACT FROM AUTHOR]

Training load (TL) is monitored with the aim of making evidence-based decisions on appropriate loading schemes to reduce injuries and enhance team performance. However, little is known in detail about the variables of load and methods of analysis used in high-level football. Therefore, the aim of this study was to provide information on the practices and practitioners' perceptions of monitoring in professional clubs. Eighty-two high-level football clubs from Europe, the United States, and Australia were invited to answer questions relating to how TL is quantified, how players' responses are monitored, and their perceptions of the effectiveness of monitoring. Forty-one responses were received. All teams used GPS and heart-rate monitors during all training sessions, and 28 used rating of perceived exertion. The top-5-ranking TL variables were acceleration (various thresholds), total distance, distance covered above 5.5 m/s, estimated metabolic power, and heart-rate exertion. Players' responses to training are monitored using questionnaires (68% of clubs) and submaximal exercise protocols (41%). Differences in expected vs actual effectiveness of monitoring were 23% and 20% for injury prevention and performance enhancement, respectively (P < .001 d = 1.0-1.4). Of the perceived barriers to effectiveness, limited human resources scored highest, followed by coach buy-in. The discrepancy between expected and actual effectiveness appears to be due to suboptimal integration with coaches, insufficient human resources, and concerns over the reliability of assessment tools. Future approaches should critically evaluate the usefulness of current monitoring tools and explore methods of reducing the identified barriers to effectiveness. [ABSTRACT FROM AUTHOR]

Do organizational controls facilitate or hinder employees' trust in their organization? We addressed this question through a mixed-methods design using three studies. Based on a literature review and an open-response survey study (Study 1), we developed a theoretical model proposing that organizational control is positively related to employees' trust in their organization, and that this relationship is mediated by procedural fairness and organizational prestige. This mediated model was tested and supported in a quantitative survey of 582 European managers and professional employees from a range of organizations (Study 2). A complementary, qualitative interview-based study (Study 3) confirmed that well-implemented controls facilitate trust in the organization; however, poorly implemented control systems that are inconsistent, overly rigid, or incentivize untrustworthy behavior can undermine trust in the organization. [ABSTRACT FROM AUTHOR]

Recent biomarker innovations hold potential for transforming diagnosis, prognostic modeling, and precision therapeutic targeting of traumatic brain injury (TBI). However, many biomarkers, including brain imaging, genomics, and proteomics, involve vast quantities of high-throughput and high-content data. Management, curation, analysis, and evidence synthesis of these data are not trivial tasks. In this review, we discuss data management concepts and statistical and data sharing strategies when dealing with biomarker data in the context of TBI research. We propose that application of biomarkers involves three distinct steps—discovery, evaluation, and evidence synthesis. First, complex/big data has to be reduced to useful data elements at the stage of biomarker discovery. Second, inferential statistical approaches must be applied to these biomarker data elements for assessment of biomarker clinical utility and validity. Last, synthesis of relevant research is required to support practice guidelines and enable health decisions informed by the highest quality, up-to-date evidence available. We focus our discussion around recent experiences from the International Traumatic Brain Injury Research (InTBIR) initiative, with a specific focus on four major clinical projects (Transforming Research and Clinical Knowledge in TBI, Collaborative European NeuroTrauma Effectiveness Research in TBI, Collaborative Research on Acute Traumatic Brain Injury in Intensive Care Medicine in Europe, and Approaches and Decisions in Acute Pediatric TBI Trial), which are currently enrolling subjects in North America and Europe. We discuss common data elements, data collection efforts, data-sharing opportunities, and challenges, as well as examine the statistical techniques required to realize successful adoption and use of biomarkers in the clinic as a foundation for precision medicine in TBI. [ABSTRACT FROM AUTHOR]

Multiple factors that influence the learning experience of nursing students while they are in clinical training have been identified, such as the clinical learning environment, the supervision provided by supervisors, and the level of cooperation with the nurse teacher. The objective was to examine whether the relationship between the clinical placement duration and overall satisfaction with clinical training is mediated by the supervisory relationship and learning environment. A secondary analysis was conducted using the data from a cross‐sectional study conducted in 17 higher educational institutions in nine European countries with the Clinical Learning Environment, Supervision and Nurse Teacher scale (n = 1903 pre‐registration nursing students). Satisfaction with the supervisor and a good learning environment mediated the relationship between clinical placement duration and overall satisfaction as perceived by the students. Nursing students with longer clinical placement durations were more satisfied with clinical training as a result of both their satisfaction with their supervisor and their perceptions of good learning environment. The optimal duration a nursing student should remain in the different practice settings is approximately 7 weeks. [ABSTRACT FROM AUTHOR]

Background: The average professional soccer team experiences 1 to 2 traumatic leg fractures per season, with unknown effects on player performance. Purpose: To (1) determine the rate and time to return to play (RTP) following leg fracture, (2) investigate the rate of reinjury following RTP, and (3) investigate long-term effects that lower extremity (LE) fracture may have on elite soccer player performance. Study Design: Cohort study; Level of evidence, 3. Methods: Using publicly available records, we identified athletes sustaining a traumatic leg fracture across the 5 major European soccer leagues (English Premier League, Bundesliga, La Liga, Ligue 1, and Serie A) between 2000 and 2016. Athletes with leg fracture (femur, tibia, and/or fibula) were matched 1:2 to controls by demographic characteristics and performance metrics 1 season before the index timepoint. Investigations included the RTP rate, reinjury rate, player characteristics associated with RTP within 2 seasons, long-term player retention, performance metrics during the 4 following seasons, and subgroup analysis by player position. Results: A total of 112 players with LE fracture and 224 controls were identified. Players with LE fractures were absent for a mean of 157 days (range, 24-601 days) and 21 games (range, 2-68 games). The rate of RTP within 1 season was 80%, with 4% experiencing subsequent refracture. Injured players remained active in the league at a higher rate than their uninjured counterparts. As compared with controls, injured athletes played 309 fewer total minutes (P <.05), scored 0.09 more assists per game (P <.01) 1 season after injury, and scored 0.12 more points per game 4 seasons after injury (P <.01). Defenders were most affected by an LE fracture, playing 5.24 fewer games (P <.05), 603 fewer total minutes (P <.01), and recording 0.19 more assists per 90 minutes of play as compared with controls 1 season after injury (P <.001). Attackers and midfielders demonstrated no significant difference in metrics after RTP when compared with controls. Conclusion: Most players sustaining an LE fracture returned to elite soccer at the same level after a significant loss of playing time, with a 4% rate of refracture. Player retention was higher for those sustaining an LE fracture versus uninjured controls. Overall, injured players did not experience a decline in performance after recovery from an LE fracture. [ABSTRACT FROM AUTHOR]

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This study aimed to investigate the occurrence of suicidal ideation and associated factors in older persons with dementia living at home in eight European countries, and its association with quality of life. Furthermore, changes in suicidal ideation over time were investigated. This cohort study (n = 1,223) was part of the European "RightTimePlaceCare" project conducted in 2010–2013. Participating countries were Estonia, Finland, France, Germany, the Netherlands, Spain, Sweden and the United Kingdom. Baseline and follow-up data were analysed using bivariate and multivariate logistic regression. The occurrence of suicidal ideation in the participating countries varied between 6% and 24%. Factors significantly (p < 0.0018) associated with suicidal ideation using bivariate analysis were: nationality, depressive symptoms, delusions, hallucinations, agitation, anxiety, apathy, disinhibition, irritability, night-time behaviour disturbances, anxiolytics and anti-dementia medication. In the multivariate regression analysis, country of origin, moderate stage of the dementia, depressive and delusional symptoms, and anti-dementia medication were significantly associated with suicidal ideation (p < 0.05). Over time, suicidal ideation decreased from severe to mild or became absent in 54% of the persons with dementia. It is essential that professionals identify older persons with dementia and suicidal ideation and depressive and other psychological symptoms in order to give them appropriate treatment and provide relief for their informal caregivers. We emphasize the importance of identifying suicidal ideation, irrespective of depressive symptoms, and specifically of paying attention to persons with moderate dementia. Living with the informal caregiver seems to be associated with staying stable without suicidal ideation. [ABSTRACT FROM AUTHOR]

This paper deals with the future of mining in Europe but in the framework of a global pandemic. We have analysed the various prognosis of global growth trends and the future of mining in Europe, on the basis of the known statistical data of what has happened so far. Several case studies are included, and a proposal of a strong EU reaction to really be successful in the plans designed when the Raw Material Initiative was planned is suggested. The incredible mining potential of the EU as well as its technological leadership is here presented to demonstrate that, if politically supported, these can bring back Europe to the leading role in mining it had in the past. [ABSTRACT FROM AUTHOR]

This study compared the movement demands of players competing in matches from the elite Australian and European rugby league competitions. Methods: Global positioning system devices were used to measure 192 performances of forwards, adjustables, and outside backs during National Rugby League (NRL; n = 88) and European Super League (SL; n = 104) matches. Total and relative distances covered overall and at low (0-3.5 m/s), moderate (3.6-5 m/s), and high (>5 m/s) speeds were measured alongside changes in movement variables across the early, middle, and late phases of the season. Results: The relative distance covered in SL matches (95.8 ± 18.6 m/min) was significantly greater (P < .05) than in NRL matches (90.2 ± 8.3 m/min). Relative low-speed activity (70.3 ± 4.9 m/min vs 75.5 ± 18.9 m/min) and moderate-speed running (12.5 ± 3.3 m m/min vs 14.2 ± 3.8 m/min) were highest (P < .05) in the SL matches, and relative high-speed distance was greater (P < .05) during NRL matches (7.8 ± 2.1 m/min vs 6.1 ± 1.7 m/min). Conclusions: NRL players have better maintenance of high-speed running between the first and second halves of matches and perform less low- and moderate-speed activity, indicating that the NRL provides a higher standard of rugby league competition than the SL. [ABSTRACT FROM AUTHOR]

Hacquetia is entering 20th year and in editorial we are presenting history of journal in this period, statistics of authors diversity, geographical distribution of published papers and bibliometrics. We highlighted fruitfull collaboration with guest editorsc, the most cited articles and presented future goals. [ABSTRACT FROM AUTHOR]

Background: Moral courage is defined as courage to act according to one's own ethical values and principles even at the risk of negative consequences for the individual. In a complex nursing practice, ethical considerations are integral. Moral courage is needed throughout nurses' career. Aim: To analyse graduating nursing students' moral courage and the factors associated with it in six European countries. Research design: A cross-sectional design, using a structured questionnaire, as part of a larger international ProCompNurse study. In the questionnaire, moral courage was assessed with a single question (visual analogue scale 0–100), the questionnaire also covered several background variables. Participants and research context: The sample comprised graduating nursing students (n = 1796) from all participating countries. To get a comprehensive view about graduating nursing students' moral courage, the views of nurse managers (n = 538) and patients (n = 1327) from the same units in which the graduating nursing students practised were also explored, with parallel questionnaires. Ethical considerations: Ethical approvals and research permissions were obtained according to national standards in every country and all participants gave their informed consent. Results: The mean of graduating nursing students' self-assessed moral courage was 77.8 (standard deviation 17.0; on a 0–100 scale), with statistically significant differences between countries. Higher moral courage was associated with many factors, especially the level of professional competence. The managers assessed the graduating nursing students' moral courage lower (66.5; standard deviation 18.4) and the patients slightly higher (80.6; standard deviation 19.4) than the graduating nursing students themselves. Discussion and conclusions: In all countries, the graduating nursing students' moral courage was assessed as rather high, with differences between countries and populations. These differences and associations between moral courage and ethics education require further research. [ABSTRACT FROM AUTHOR]

Background: Child abuse and neglect, or maltreatment, is a serious public health problem, which may cause long-term effects on children's health and wellbeing and expose them to further adulthood vulnerabilities. Studies on child maltreatment performed in Europe are scarce, and the number of participants enrolled relatively small. The aim of this multi-national European pilot study, was to evaluate the level of understanding and perception of the concepts of child abuse and neglect by European paediatricians working in different medical settings, and the attitude toward these forms of maltreatment in their practice. Methods: The study was performed by a cross-sectional, descriptive, online survey, made available online to European paediatricians members of 50 national paediatric, who belonged to four different medical settings: hospital, family care, university centres and private practice. The questionnaire, designed as a multiple choice questions survey, with a single answer option consisted of 22 questions/statements. Frequency analyses were applied. Most of the data were described using univariate analysis and Chi-squared tests were used to compare the respondents and answers and a significance level of p ≤ 0.05 applied. Results: Findings show that European paediatricians consider the training on child maltreatment currently provided by medical school curricula and paediatric residency courses to be largely insufficient and continuing education courses were considered of great importance to cover educational gaps. Physical violence was recognized by paediatricians mostly during occasional visits with a significant correlation between detecting abuse during an occasional visit and being a primary care paediatrician. Results also showed a reluctance by paediatricians to report cases of maltreatment to the competent judicial authorities. Conclusions: Data of this study may provide useful contribution to the current limited knowledge about the familiarity of European paediatricians with child maltreatment and their skills to recognize, manage and contrast abusive childhood experiences in their practice. Finally, they could provide local legislators and health authorities with information useful to further improve public health approaches and rules able to effectively address shared risk and protective factors, which could prevent child abuse and neglect from ever occurring. [ABSTRACT FROM AUTHOR]

The purpose of this study was to determine predictors of the height of coronavirus disease 2019 (COVID-19) daily deaths' peak and time to the peak, to explain their variability across European countries. For 34 European countries, publicly available data were collected on daily numbers of COVID-19 deaths, population size, healthcare capacity, government restrictions and their timing, tourism and change in mobility during the pandemic. Univariate and multivariate generalised linear models using different selection algorithms (forward, backward, stepwise and genetic algorithm) were analysed with height of COVID-19 daily deaths' peak and time to the peak as dependent variables. The proportion of the population living in urban areas, mobility at the day of first reported death and number of infections when borders were closed were assessed as significant predictors of the height of COVID-19 daily deaths' peak. Testing the model with a variety of selection algorithms provided consistent results. Total hospital bed capacity, population size, the number of foreign travellers and the day of border closure were found to be significant predictors of time to COVID-19 daily deaths' peak. Our analysis demonstrated that countries with higher proportions of the population living in urban areas, countries with lower reduction in mobility at the beginning of the pandemic and countries having more infected people when closing borders experienced a higher peak of COVID-19 deaths. Greater bed capacity, bigger population size and later border closure could result in delaying time to reach the deaths' peak, whereas a high number of foreign travellers could accelerate it. [ABSTRACT FROM AUTHOR]

Background: Cryoballoon ablation for the treatment of patients with atrial fibrillation (AF) has been utilized in Europe for >15 years. Objectives: Report patient and procedural characteristics that influence the safety of cryoablation for the treatment of AF. Methods: Patients enrolled in the prospective, multicenter Cryo AF Global Registry were treated at 38 European centers. Freedom from a ≥30s episode of AF/atrial flutter (AFL)/atrial tachycardia (AT) at 12‐months and serious complications were analyzed. Univariate and multivariable models identified baseline patient and procedural characteristics that predicted a procedure‐related complication. Results: Of the 1418 subjects who completed an index procedure, the cohort was 62 ± 11 years of age, 37.7% female, and 72.2% paroxysmal AF (PAF). The mean procedure, left atrial dwell, and fluoroscopy times were 81 ± 34, 54 ± 25, and 14 ± 13 min, respectively. Among the 766 patients with 12‐month follow‐up, freedom from a ≥30 s AF/AFL/AT recurrence was 83.3% (95% CI: 79.8%–86.3%) and 71.6% (95% CI: 64.6%–77.4%) in patients with PAF and persistent AF. The serious procedure‐ and device‐related adverse event rates were 4.7% and 2.0%. No baseline patient characteristic independently predicted a procedure‐related adverse event; however, prolonged procedure duration (OR = 1.01 [95% CI: 1.00–1.01]), use of general anesthesia (OR = 1.71 [95% CI: 1.01–2.92]), and delivery of a cavotricuspid isthmus line (OR = 3.04 [95% CI: 1.01–9.20]) were each independently associated with the occurrence of a serious procedural safety event (all p <.05). Conclusions: Cryoballoon ablation is safe and effective in real‐world use across a broad cohort of patients with AF. [ABSTRACT FROM AUTHOR]

Background There is a mismatch between attitudinal support for tissue donation and its translation into behavioural action (i.e. become registered donor). The legal and motivational context around tissue donation may contribute to better understanding of this mismatch. Methods Data were extracted from the Eurobarometer 82.2 survey (2014). Data included socio-demographic characteristics, motivations underlying attitudes to tissue donation and the legal context within which donation was considered (opt-in and opt-out consent). The sample was partitioned based on contextual information and seemingly unrelated bivariate probit regressions were used to explore the relationship between passive and active support for tissue donation. Results Approximately 56% of 25 879 respondents stated a willingness to donate tissue after death (passive support) and 9.1% reported that they were a registered donor (active support). We found evidence of unobserved heterogeneity between active and passive support across contexts. Our findings suggest that contexts in which altruistic motives can be supported by self-interest may increase the probability of converting passive to active support. Factors associated with increased support for tissue donation included: higher levels of education; good knowledge of the healthcare system; confidence in the safety of tissue donation; readiness to be a tissue recipient and knowing a recipient of donated tissue. Conclusions Our findings demonstrate the value of examining active and passive support for tissue donation together within specific contexts. This more nuanced approach affords clearer insights that may help to guide policy makers confronted with apparently conflicting evidence around strategies intended to promote organ and tissue donation. [ABSTRACT FROM AUTHOR]

Introduction: Over the last decade, Adaptive Surfing, recently designated as Para Surfing was been growing worldwide. This exponential growth led to an increased number and level of competitive athletes. However, despite some knowledge about the fitness levels of elite surfers and the development of Para Surfing, from the author's knowledge, there are limited to none published research examining Para Surfing. This study aimed to measure how Para Surfing athletes' profiles, training habits, and time spent performing in-water surfing and out-of-water training affected these athletes' final scores in the 1° European Para Surfing Championship. Material and methods: Ninety-five per cent of the participants in the 1° European Adaptive Surfing Championship in Viana do Castelo Portugal, fulfilled a questionnaire according to Para Surfing characteristics, habits and training profile. Results: Congenital conditions were reported by more than 57% of females". Participants' final competition scores were significantly influenced by prior Para Surfing experience (p = 0.026). Final competition scores were significantly correlated with average days per month spent surfing (r = 0.436) and prior Para Surfing experience in years (r = 0.578). Females' final scores were significantly correlated with swimming time per month (r = 1.000) and disability duration in years (r = -1.000). Males competition final scores were significantly correlated with prior Para Surfing experience in years (r = 0.753). Conclusions: Competitive European male and female Para Surfing athletes present significant differences in terms of surfing experiences before becoming disabled and years of competition experience. Time spent surfing and previous surfing experience are key factors for achieving better performance in Para Surfing competitions. [ABSTRACT FROM AUTHOR]

Objective: High levels of stress and burnout are known to negatively impact academic success, quality of life, and wellbeing of students. The purpose of this study was to investigate the degrees of stress and burnout levels of students from several European chiropractic colleges. Methods: Stress and burnout were assessed using the Perceived Stress Scale (PSS-10) and the Maslach Burnout Inventory-Student Survey (MBI-SS). Surveys were delivered electronically in November 2017 to chiropractic students from 4 different chiropractic colleges. Data were analyzed using t test and 1-way ANOVA to determine differences between demographic data. Scores in perceived stress and burnout subscales were compared to the general, chiropractic, and medical student populations. Results: Both the MBI-SS and PSS had similar response rates (30%-34%) and demonstrated statistically significant differences between institutions, with C-3 demonstrating the highest levels of exhaustion (p, .001) and the highest levels of perceived stress (p = .012). MBI-SS results show that in the general chiropractic student population, 26.4% presented high emotional exhaustion, 18.2% high cynicism, and 43.8% low academic efficacy. Meanwhile, the PSS score indicated "moderate" levels of stress. Conclusions: European chiropractic students experience higher levels of perceived stress than the general population and they may suffer levels of burnout similar to those of medical students. These results suggest that colleges should monitor stress and burnout levels in their students. This may help to establish student support systems in order to improve students' quality of life and academic performance, as well as help new graduates transition to their professional lives. [ABSTRACT FROM AUTHOR]

Correct identification of textile fibres is an important issue in archaeology because the use of different materials can yield crucial information about the society that produced the textiles. Textiles made of plant and animal fibres can normally be easily distinguished, but to distinguish between different types of plant fibres, in particular different types of bast fibres, is difficult. Some years back it was shown that the features fibre diameter, lumen diameter, dislocation (nodes), and cross markings cannot be used on their own to distinguish between the typical bast fibres used for textiles in ancient Europe: flax, hemp, and nettle. Particularly not when only a few fibres are available for an examination so that statistical analysis is not possible, as is often the case in archaeology. The last two characterization features typically used to distinguish between bast fibres are cross‐section shape and lumen shape. In this paper, we present a study of retted and unretted fibres (in the stem) of flax, nettle, and hemp, and show that also cross‐section shape and lumen shape cannot be used as distinguishing features on their own. [ABSTRACT FROM AUTHOR]

Using the existing collected data from European and African countries, we present a statistical analysis of forecast of the future number of daily deaths and infections up to 10 September 2020. We presented numerous statistical analyses of collected data from both continents using numerous existing statistical theories. Our predictions show the possibility of the second wave of spread in Europe in the worse scenario and an exponential growth in the number of infections in Africa. The projection of statistical analysis leads us to introducing an extended version of the well-blancmange function to further capture the spread with fractal properties. A mathematical model depicting the spread with nine sub-classes is considered, first converted to a stochastic system, where the existence and uniqueness are presented. Then the model is extended to the concept of nonlocal operators; due to nonlinearity, a modified numerical scheme is suggested and used to present numerical simulations. The suggested mathematical model is able to predict two to three waves of the spread in the near future. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To identify whether a Compassionate Mind Model‐based curriculum reduces students' perceived fears of compassion and improves their professional well‐being. Background: Enabling compassion is mandatory within nurse education but evidencing it is challenging. Research suggests that application of the Compassionate Mind Model might reduce students' fears of compassion and also decrease compassion fatigue. This study reports outcomes of a post‐registration curriculum based on that model for training Specialist Community Public Health Nurses (Health Visiting). Design: A quantitative, prospective evaluation of a 12‐month training course for Health Visiting students. Reporting was guided by the STROBE checklist for observational studies. Methods: Fears of compassion scales were applied at course start (time 1), mid‐point (time 2; +6 months) and end (time 3; +12 months) to evaluate fears of compassion of 26 post‐registration student Health Visitors (81% of course cohort) who provided data at all three points. The Professional Quality of Life tool was administered simultaneously to evaluate compassion satisfaction and burnout/secondary traumatic stress (compassion fatigue). Results: Between time 1 and time 3, mean fears of compassion scores decreased by 16.6‐48.5% (repeated measures analysis of variance); mid‐point scores were intermediary. At time 3, compassion satisfaction had increased slightly (+4.1%), negatively correlated with fears of compassion for self (r = −0.602; p =.001; n = 26) and fears of receiving compassion from others (r = −0.568; p =.002; n = 26). Burnout score decreased by 18.7%, correlated positively with fear of compassion for self (r = 0.493; p =.011; n = 26) and fear of receiving compassion from others (r = 0.615; p =.001; n = 26). Secondary traumatic stress score decreased by 16.5% but was not correlated with any fear of compassion. Conclusion: Findings suggest that application of the Compassionate Mind Model might reduce practitioners' fears of compassion linked to a decrease in risk of compassion fatigue. Relevance to clinical practice: The Compassionate Mind Model could provide an effective vehicle to promote compassion and nurse well‐being. [ABSTRACT FROM AUTHOR]

Complex political, economic, natural and social events shaping the migration phenomenon in all Europe and abroad. Besides, globalisation and Europeanization have resulted in a significant increase in migration flows. Thus, migration become a complex and multi-criteria phenomena with different meanings and estimation methods according to different research objectives. These particularities create an additional pressure on policymakers' shoulders who need a better understanding of the variation of time-series database. Although, have been developed several databases and indices, at the time being there are difficulties regarding the measuring and conceptualization of migration, particularly the return migration within and cross-national framework. This paper discusses these challenges and the methodological limits on migration policy indexes for comparative analysis and learning lessons. [ABSTRACT FROM AUTHOR]

The Mediterranean olive triptych –i.e. the conceptual integration of an ecosystem (the olive-grove), a product (olive-oil) and a nutrition/diet scheme (Mediterranean olive-based diet)– is a discernable cultural model in Europe. In this paper, we attempt to explore the potential and limitations of statistical analysis of compositional data –especially ternary plotting techniques– vs. typical representations of Google Trends -based Conservation Culturomics. In that perspective, typical representations of GT -data in published Culturomics literature, e.g. reference term/country/language/time, are considered as descriptors of variation of public interest (2D trend lines, 3D graphics and triangular projections). Ternary plots, i.e. a typical representation of compositional data, conventionally differ significantly from the previous representations, since the primary GT -data are weighted so that ternary sum equals to 1 (or 100%). We present the technique for such a calculation method. The comparison of these representation techniques allows for strongly diverging interpretations. Lower level interpretations show significant differences between (Mediterranean) countries and/or groups-of-countries (Mediterranean vs. non-Mediterranean) where higher ternary compilations do suggest that cultural pattern across Europe actually diverge. The overall conclusion of this research is that GT -based Culturomics should overcome earliest simplistic approaches, such as linear regressions; and, it has to progressively construct a new epistemology where the significance of accumulation of empirical evidence should be strictly connected to scientific paradigm shift. • Mediterranean olive oil triptych is a pan-european flag cultural human-nature system. • Google Trends data are transformed into ternary plots statistical compositional data. • Ternary plotting uncovers inter-countries/intra-system variations of public interest. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to explore the relationship between perceived distributed leadership and job satisfaction among nurses. Leadership is central to improving quality care. Reports following investigations of poor care standards, identified inadequate leadership as a contributory factor and called for a new kind of leadership. One alternative is distributed leadership. Evidence suggests associations between leadership and job satisfaction but, there is a paucity of research examining associations between distributed leadership and job satisfaction: the purpose of this study was to address this gap. Design/methodology/approach: A cross-sectional survey design was used and data collected via questionnaires. Using census sampling, 350 nurses in a hospital in Malta were selected. A response rate of 50% (n = 176) was achieved. Data were analysed using Spearman's correlation coefficient and multiple regression. Ethical approval was obtained from relevant committees/individuals. Findings: Results indicated a moderate application of perceived distributed leadership and application of all components of distributed leadership could be improved. Nurses were neither satisfied nor dissatisfied with their jobs. Correlation analysis showed a positive relationship between distributed leadership and job satisfaction. Multiple regression showed that commitment and participative decision-making were major predictors of job satisfaction while supervision by managers had a negative effect. Practical implications: Improving distributed leadership is a priority in the nursing profession. Originality/value: To the best of the authors' knowledge, this study is the first to show that distributed leadership has a positive effect on job satisfaction among nurses. Supervision, a constituent of distributed leadership, was associated with reduced job satisfaction, therefore reducing this is paramount. [ABSTRACT FROM AUTHOR]

Background Polyphenols are natural compounds with anticarcinogenic properties in cellular and animal models, but epidemiological evidence determining the associations of these compounds with thyroid cancer (TC) is lacking. Objectives The aim of this study was to evaluate the relations between blood concentrations of 36 polyphenols and TC risk in EPIC (the European Prospective Investigation into Cancer and Nutrition). Methods A nested case–control study was conducted on 273 female cases (210 papillary, 45 follicular, and 18 not otherwise specified TC tumors) and 512 strictly matched controls. Blood polyphenol concentrations were analyzed by HPLC coupled to tandem MS after enzymatic hydrolysis. Results Using multivariable-adjusted conditional logistic regression models, caffeic acid (ORlog2: 0.55; 95% CI: 0.33, 0.93) and its dehydrogenated metabolite, 3,4-dihydroxyphenylpropionic acid (ORlog2: 0.84; 95% CI: 0.71, 0.99), were inversely associated with differentiated TC risk. Similar results were observed for papillary TC, but not for follicular TC. Ferulic acid was also inversely associated only with papillary TC (ORlog2: 0.68; 95% CI: 0.51, 0.91). However, none of these relations was significant after Bonferroni correction for multiple testing. No association was observed for any of the remaining polyphenols with total differentiated, papillary, or follicular TC. Conclusions Blood polyphenol concentrations were mostly not associated with differentiated TC risk in women, although our study raises the possibility that high blood concentrations of caffeic, 3,4-dihydroxyphenylpropionic, and ferulic acids may be related to a lower papillary TC risk. [ABSTRACT FROM AUTHOR]

Background: In European Union countries, any disease affecting less than 5 people in 10,000 is considered rare. As expertise is scarce and rare diseases (RD) are complex, RD patients can remain undiagnosed for many years. The period of searching for a diagnosis, called diagnostic delay, sometimes leads to a diagnostic dead end when the patient's disease is impossible to diagnose after undergoing all available investigations. In recent years, extensive efforts have been made to support the implementation of ORPHA nomenclature in health information systems (HIS) so as to allow RD coding. Until recently, the nomenclature only encompassed codes for specific RD. Persons suffering from a suspected RD who could not be diagnosed even after full investigation, could not be coded with ORPHAcodes. The recognition of the RD status is necessary for patients, even if they do not have a precise diagnosis. It can facilitate reimbursement of care, be socially and psychologically empowering, and grant them access to scientific advances., Results: The RD-CODE project aimed at making those patients identifiable in HIS in order to produce crucial epidemiological data. Undiagnosed patients were defined as patients for whom no clinically-known disorder could be confirmed by an expert center after all reasonable efforts to obtain a diagnosis according to the state-of-the-art and diagnostic capabilities available. Three recommendations for the coding of undiagnosed RD patients were produced by a multi-stakeholder panel of experts: 1/ Capture the diagnostic ascertainment for all rare disease cases; 2/ Use the newly created ORPHAcode (ORPHA:616874 "Rare disorder without a determined diagnosis after full investigation"), available in the Orphanet nomenclature: as the code is new, guidelines are essential to ensure its correct and homogeneous use for undiagnosed patients' identification in Europe and beyond; 3/ Use additional descriptors in registries., Conclusions: The recommendations can now be implemented in HIS (electronic health records and/or registries) and could be a game-changer for patients, clinicians and researchers in the field, enabling assessment of the RD population, including undiagnosed patients, adaptation of policy measures including financing for care and research programs, and to improved access of undiagnosed patients to research programs., (© 2024. The Author(s).)

Background Until recently, Irish age-standardized mortality rates (ASMRs) were amongst the highest in the EU-15. This study examines changes in ASMRs in Ireland from 1956 to 2014. Methods Using data from the World Health Organization Mortality Database, we compare ASMRs in Ireland to other EU-15 countries from 1956 to 2014. ASMRS are used to plot the relative ranking of Ireland within the EU-15, and illustrate trends in which Ireland diverged with, and converged to, the EU-15 average. ASMRS are estimated across sex, age groups (15–64 and 65+ years) and cause of death. Results Between 1956 and 1999, ASMRs in Ireland were amongst the highest in the EU-15. ASMRs in Ireland saw slower improvements during this period as compared to other EU-15 countries. However, post-2000, a sharp reduction in Irish ASMRs resulted in an accelerated convergence to the EU-15 average. As a consequence of improvements in ASMRs between 2000 and 2014, there were an estimated 15 300 fewer deaths in 2014. The majority of these averted deaths were due to lower mortality rates for diseases of the circulatory system and respiratory system. Conclusions Rather than converging to the EU-15 average during the latter half of the 20th century, there was a divergence in ASMRs between Ireland and the EU-15. However, in recent years, Ireland experienced accelerated improvements in mortality rates with large reductions in mortality observed for diseases of the circulatory system and respiratory system, especially amongst older people. [ABSTRACT FROM AUTHOR]

Introduction: Audio description (AD) in museums is crucial for making them accessible for people with visual impairments. Nevertheless, there are limited museum-specific AD guidelines currently available. This research examines current varied international practitioner perspectives on museum AD, focusing on imagery, meaning, emotion and degrees of objectivity, and the regional differences (Europe and United States) in AD traditions, in order to better understand how AD can be used to enhance access to museums. Methods: Forty-two museum describers from 12 countries responded to a questionnaire requiring fixed-choice and free-text responses about the purpose and construction of museum AD. Results: Inference tests showed that European describers agreed more strongly than American describers that AD should "explore meaning" (U = 91.00, N 1 = 24, N 2 = 14, p =.03), and "create an emotional experience" (U = 89.50, N 1 = 24, N 2 = 14, p =.03), rating the use of cognitive prompts as more important (U = 85.50, N 1 = 21, N 2 = 14, p =.04). Qualitative data enriched this understanding by exploring participant responses on the themes of mental imagery, objectivity and interpretation and cognitive prompts. This highlighted broader agreement between regions on mental imagery, but more acceptance of interpretation in AD from the European respondents. Discussion: American and European describers' opinions differ regarding the purpose of AD: whether it is about conveying visual information or whether broader interpretations should be incorporated into descriptions for audiences with visual impairments. Implications for practitioners: These findings indicate that further discussion is needed regarding the purpose of museum AD and, in particular, the way in which objectivity is contextualized. They raise questions about AD providing visual information and/or seeking to address a wider museum experience, including the stimulation of curiosity or emotion. [ABSTRACT FROM AUTHOR]

The notion of improvisation has recently emerged in managerial studies as a viable solution to flexibly dealing with unexpected occurrences in work environments. However, past research on team improvisation has overlooked the contingencies that allow teams to effectively improvise. Drawing upon demand-control theory, we investigate how empowering leadership and overload affect the improvisation-performance relationship in the context of 48 work teams. Our results suggest that empowering leadership positively moderates the relationship between improvisation and performance, while overload attenuates the same relationship. Moreover, we found a joint effect of overload and empowering leadership influencing the improvisation-performance link, such that improvisation is most positively related to performance when empowering leadership is high and overload is low. Conversely, we found that empowering leadership is particularly detrimental to the improvisation-performance relationship when team members perceive high degrees of overload. Our findings make important contributions to the extant team literature as well as to the emerging literature on team improvisation. We outline several significant insights for HR managers and team leaders who are responsible for supporting teams that face unexpected events in the work environment. © 2013 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

• Ensemble modeling for 1-min diffuse fraction is discussed. • The raw ensemble is post-processed using ensemble model output statistics (EMOS). • EMOS outperforms the best stand-alone models such as Yang2 and Engerer2. • EMOS is superior to simple model blending in terms of CRPS and ignorance score. Separation models split diffuse and direct components of solar radiation from the global horizontal radiation. At the moment, all separation models only issue predictions that are deterministic (as opposed to probabilistic). Since the best prediction is necessarily probabilistic, a parametric post-processing framework called the ensemble model output statistics (EMOS) is introduced in this paper, to make probabilistic predictions. EMOS takes the diffuse fractions predicted by an ensemble of existing 1-min separation models, and outputs a predictive distribution, with parameters optimized by maximum likelihood estimation. Clearly, the EMOS-based separation modeling goes beyond the current literature, in terms of uncertainty quantification. Eight popular separation models from the literature, with different architectures, are used to demonstrate the predictive power of EMOS. Using 1-min high-quality radiometric data from seven stations in the USA and four stations in Europe, it is found that Y ang2 is the best stand-alone model with an average RMSE of 21.8%, in terms of direct normal irradiance prediction, contrasting the 26.3% of the previously reported best model, namely, E ngerer2. On the other hand, the EMOS post-processed predictions have an average RMSE of 20.8%, which is lower than that of the best stand-alone model. Moreover, EMOS is shown superior to simple model averaging, in terms of continuous ranked probability score and ignorance score. [ABSTRACT FROM AUTHOR]

Objective: As adolescent cancer patients may suffer from infertility following treatment, fertility counselling is essential. Our aim was to explore the current situation in four European countries in terms of (I) education about the risk for infertility, (II) counselling on fertility preservation, (III) patients' knowledge on fertility, (IV) sufficiency of information and (V) uptake of cryopreservation. Methods: In total, 113 patients (13–20 years) at 11 study centres completed a self‐report questionnaire three and six months after cancer diagnosis. Multivariate logistic regression was used to estimate odds ratios (OR) with 95% confidence intervals (CI). Results: As many as 80.2% of participants reported having received education about the risk for infertility prior to treatment, 73.2% recalled counselling on fertility preservation. Only 52.3% stated they felt sufficiently informed to make a decision. Inability to recall counselling on fertility preservation (OR = 0.03, CI: 0.00–0.47) and female gender (OR = 0.11, CI: 0.03–0.48) was associated with lower use of cryopreservation, whereas older age was associated with higher use. Conclusion: Fertility counselling was available to a relatively high proportion of patients, and it did influence the utilisation of cryopreservation. However, many patients did not feel sufficiently informed. Further improvement is needed to enable adolescent cancer patients to make an informed decision on fertility preservation. [ABSTRACT FROM AUTHOR]

The management of air fare discount programmes for residents on island territories in Europe offers rich statistical information that is hardly exploited in the academic world due to the difficulties of access to it. Thanks to a set of data obtained through parliamentary inquiries, a characterisation of the current Spanish model is offered, as well as an approximation to the air mobility patterns of the residents in the overseas regions. The results not only show a very different behaviour depending on the island of residence, but also warn about undesired repercussions of the discount on fares, about a limited social access to the discount in some corridors and islands or about the high concentration of air trips in a reduced number of residents. Based on this, some of the existing alternatives for a reform of the model, aimed at seeking greater social equity in the context of an ecological transition, are outlined. [ABSTRACT FROM AUTHOR]

For some time Europe is under the spell of covid-16. Remember how it started? Statistics dominated the news in de last 4 months: the finger on the pulse! In the beginning the statistics didn't tell us much. Then the statistics warned us - so said the 'experts' - to be careful, but the question was also raised: are these statistics reliable? And what do the data show? The (possible) shortage of proper protection and treatment, while health care professionals had to make choices: who to give a chance to survive? Apparently, Europe was not prepared for a pandemic. Another problem arose: who should decide about measures to beat the pandemic. In most countries, policymakers and experts joined wisely in a taskforce and prepared measures to be taken. In some countries policy-makers thought - wrongly - they know best. International organizations did play an important advisory role, although their advices were not always welcomed. So, various countries really run into problems and had to call for the army. Health care systems in most countries were not prepared or able to deal with the pandemic. These experiences may stimulate to restructure some health care systems and the way they are managed. International organisations could evaluate the experiences. Statistics showed a higher number of death in some countries, but not in all. Some countries did not test the presence of a covid-19 infection and reported 'zero'. We need reliable statistics and complete data, collected accordingly to welldefined criteria, to study the consequences of the pandemic. Opinions and political blindness will not be helpful to learn. The experiences with the pandemic covid-19 may offer many lessons. The question is: are we willing to learn?. [ABSTRACT FROM AUTHOR]

The importance of Multi National Enterprise Groups (MNEs) on the economy is ever-growing and at the same time, it becomes more complex to capture their activities and structures accurately in official national statistics. The establishment of Large Case Units and the introduction of profiling of MNEs are measures to capture the activities of MNEs correctly so that consistency between statistics can be achieved. At international level, the same challenges can be found. In Europe the existence of the European Statistical System and accompanying legal frameworks make it possible to organize European collaboration, resulting in a EuroGroups Register and European profiling and the Early Warning System. The benefit from a Global Group Register (GGR) seems evident: providing unique identification of MNEs and insight in the structure of internationally operating MNEs helps to create valuable information for policymakers on many different economic themes. At a global level, we do not have legal facilities like those in the EU, which makes it important to look for other solutions. An initial GGR has to be built upon publicly available sources and upon sources from commercial data providers. The benefits of establishing a Global Group Register are multiple and work in this area should be encouraged. [ABSTRACT FROM AUTHOR]

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Extensive staff turnover within the statutory social services is a serious problem in Sweden and in other European countries. This study examines which work conditions predict social workers' willingness to stay in their organisation. A web-based questionnaire was used to gather data. The participating social workers responded to two questionnaires over a one-year period. To identify the social workers who wanted to stay and also remained in the organisation, the group 'Stayers' (n  = 1,368) consisted of social workers who reported low intentions to quit at T1. The group 'Leavers' (n  = 1,182) were social workers who had actually resigned at T2. The data were analysed using univariate and multivariate logistic regression analyses. The multivariate analysis shows that the work conditions that predicted staying in the organisation were low degrees of conflicting demands and quantitative demands, high degrees of openness and human resource orientation in the organisation and a high degree of perceived service quality. The results are discussed in relation to public management and managerial responsibility to create sustainable work conditions that facilitate the provision of good social services for citizens. [ABSTRACT FROM AUTHOR]

Purpose: In this study, we aimed to study the correlation between acute and habitual intakes of flavonols, their main food sources and their 24-h urinary concentrations in an European population. Methods: A 24-h dietary recall (24-HDR) and 24-h urine samples were collected on the same day from a convenience subsample of 475 men and women from four countries (France, Italy, Greece and Germany) of the European Prospective Investigation into Cancer and Nutrition (EPIC) study. A standardized 24-HDR software and a country/centre-specific validated dietary questionnaire (DQ) were used to collect acute and habitual dietary data, respectively. The intake of dietary flavonols was estimated using the Phenol-Explorer database. Urinary flavonols (quercetin, isorhamnetin, and kaempferol) were analysed using tandem mass spectrometry with a previous enzymatic hydrolysis. Results: Weak partial Spearman correlations between both dietary acute and habitual intake and urinary concentrations of quercetin (both Rpartial ~ 0.3) and total flavonols (both Rpartial ~ 0.2) were observed. No significant correlations were found for kaempferol and isorhamentin. Regarding flavonol-rich foods, weak correlations were found between urinary concentrations of quercetin and total flavonols and the acute intake of onions and garlics, fruits, tea, and herbal tea (all Rpartial ~ 0.2). For habitual intake, statistically significant correlations were only found between urinary quercetin concentration and herbal tea (Rpartial = 0.345) and between urinary total flavonol concentration and tea, and herbal tea consumption (Rpartial ~ 0.2). Conclusions: Our results suggest that urinary quercetin level can be used as potential concentration biomarkers of both acute and habitual quercetin intake, while urinary concentrations of flavonols are unlikely to be useful biomarkers of individual flavonol-rich foods. [ABSTRACT FROM AUTHOR]

Background: In-hospital cardiac arrest is a major cause of death in European countries, and survival of patients remains low ranging from 20% to 25%. Aims: The purpose of this study was to assess healthcare professionals' knowledge on cardiopulmonary resuscitation among university hospitals in 12 European countries and correlate it with the return of spontaneous circulation rates of their patients after in-hospital cardiac arrest. Methods and results: A total of 570 healthcare professionals from cardiology, anaesthesiology and intensive care medicine departments of European university hospitals in Italy, Poland, Hungary, Belgium, Spain, Slovakia, Germany, Finland, The Netherlands, Switzerland, France and Greece completed a questionnaire. The questionnaire consisted of 12 questions based on epidemiology data and cardiopulmonary resuscitation training and 26 multiple choice questions on cardiopulmonary resuscitation knowledge. Hospitals in Switzerland scored highest on basic life support (P =0.005) while Belgium hospitals scored highest on advanced life support (P <0.001) and total score in cardiopulmonary resuscitation knowledge (P =0.01). The Swiss hospitals scored highest in cardiopulmonary resuscitation training (P <0.001). Correlation between cardiopulmonary resuscitation knowledge and return of spontaneous circulation rates of patients with in-hospital cardiac arrest demonstrated that each additional correct answer on the advanced life support score results in a further increase in return of spontaneous circulation rates (odds ratio 3.94; 95% confidence interval 2.78 to 5.57; P <0.001). Conclusion: Differences in knowledge about resuscitation and course attendance were found between university hospitals in 12 European countries. Education in cardiopulmonary resuscitation is considered to be vital for patients' return of spontaneous circulation rates after in-hospital cardiac arrest. A higher level of knowledge in advanced life support results in higher return of spontaneous circulation rates. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study is to evaluate a novel composite measure of active range of motion (XA) and determine whether this measure correlates with active function. Design: Post hoc analysis of two randomized, placebo-controlled, double-blind studies with open-label extensions exploring changes in active function with abobotulinumtoxinA. Setting: Tertiary rehabilitation centers in Australia, Europe, and the United States. Subjects: Adults with upper (n = 254) or lower (n = 345) limb spastic paresis following stroke or brain trauma. Interventions: AbobotulinumtoxinA (⩽5 treatment cycles) in the upper or lower limb. Main measures: XA was used to calculate a novel composite measure (CXA), defined as the sum of XA against elbow, wrist, and extrinsic finger flexors (upper limb) or soleus and gastrocnemius muscles (lower limb). Active function was assessed by the Modified Frenchay Scale and 10-m comfortable barefoot walking speed in the upper limb and lower limb, respectively. Correlations between CXA and active function at Weeks 4 and 12 of open-label cycles were explored. Results: CXA and active function were moderately correlated in the upper limb (P < 0.0001–0.0004, r = 0.476–0.636) and weakly correlated in the lower limb (P < 0.0001–0.0284, r = 0.186–0.285) at Weeks 4 and 12 of each open-label cycle. Changes in CXA and active function were weakly correlated only in the upper limb (Cycle 2 Week 12, P = 0.0160, r = 0.213; Cycle 3 Week 4, P = 0.0031, r = 0.296). Across cycles, CXA improvements peaked at Week 4, while functional improvements peaked at Week 12. Conclusion: CXA is a valid measure for functional impairments in spastic paresis. CXA improvements following abobotulinumtoxinA injection correlated with and preceded active functional improvements. [ABSTRACT FROM AUTHOR]

With a view to seasonal forecasting of extreme value statistics, we apply the method of Nonstationary extreme value statistics to determine the predictive power of large scale quantities. Regarding winter cold extremes over Europe, we find that the monthly mean daily minimum local temperature - which we call a native co-variate in the present context - has a much larger predictive power than the nonlocal monthly mean Arctic Oscillation index. Our results also prompt that the exploitation of both co-variates is not possible from 70 years-long data sets. [ABSTRACT FROM AUTHOR]

Heart failure (HF) constitutes the growing cardiovascular burden and the major public health issue, but comprehensive statistics on HF epidemiology and related management in Europe are missing. The Heart Failure Association (HFA) Atlas has been initiated in 2016 in order to close this gap, representing the continuity directly rooted in the European Society of Cardiology (ESC) Atlas of Cardiology. The major aim of the HFA Atlas is to establish a contemporary dataset on HF epidemiology, resources and reimbursement policies for HF management, organization of the National Heart Failure Societies (NHFS) and their major activities, including education and HF awareness. These data are gathered in collaboration with the network of NHFS of the ESC member and ESC affiliated countries. The dataset will be continuously improved and advanced based on the experience and enhanced understanding of data collection in the forthcoming years. This will enable revealing trends, disparities and gaps in knowledge on epidemiology and management of HF. Such data are highly needed by the clinicians of different specialties (aside from cardiologists and cardiac surgeons), researchers, healthcare policy makers, as well as HF patients and their caregivers. It will also allow to map the snapshot of realities in HF care, as well as to provide insights for evidence-based health care policy in contemporary management of HF. Such data will support the ESC/HFA efforts to improve HF management ant outcomes through stronger recommendations and calls for action. This will likely influence the allocation of funds for the prevention, treatment, education and research in HF. [ABSTRACT FROM AUTHOR]

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

Purpose: This work aimed to design and validate a novel short food frequency questionnaire (SFFQ) to assess habitual intakes of food items related to non-alcoholic fatty liver disease (NAFLD) in a cohort of European patients. Methods: A 48-item SFFQ was created, with questions from existing FFQs and expert knowledge, emphasizing foods and nutrients implicated in NAFLD pathogenesis. Consenting, fibroscan-diagnosed, NAFLD patients completed the SFFQ during a short interview and were asked to complete a 4-day diet diary (4DDD) at home for return by mail. Nutritional intakes were assessed utilizing the myfood24™ food composition dataset and estimated energy requirements (EER) were calculated using sex-, age- and weight-specific equations. Agreement between the dietary instruments was assessed by Spearman correlations and Bland Altman analysis. Results: Fifty-five patients completed both the SFFQ and the 4DDD within 30 weeks; 42 (76%) were diagnosed with simple steatosis, whereas 13 (24%) had biopsy-proven steatohepatitis; the majority were overweight or obese, with a median (25th; 75th percentile) BMI of 33.2 kg/m2 (29.3; 36.0). Reported energy intakes were well below EER with a median intake of 73% of requirements, suggesting widespread under-reporting. Significant correlations were observed between sugar (r = 0.408, P = 0.002), fat (r = 0.44, P = 0.001), fruits (r = 0.51, P = 0.0001) and vegetables (r = 0.40, P = 0.0024) measurements by the SFFQ and 4DDD. Bland Altman plots with regression analysis demonstrated broad comparability with the 4DDD for intakes of fat (bias − 13.8 g/day) and sugar (bias + 12.9 g/day). Conclusions: A novel SFFQ designed to be minimally burdensome to participants was effective at assessing dietary intakes in NAFLD patients. [ABSTRACT FROM AUTHOR]

Aim: This survey explored caregivers' perceived training needs in 5 European countries (United Kingdom, Greece, Bulgaria, Poland and Italy). Background: Training can enhance the professional capacity of caregivers; however, caregivers' training needs within Europe have not been examined recently. Methods: A survey conducted in 2015 captured data from 550 caregivers using a convenience sampling strategy, through a structured questionnaire and additional open‐ended items and by conducting statistical and content analysis. Results: The results indicated basic nursing skills and specialization, as well as training in psychology‐related skills like time management, emotion regulation, communication and advanced health care systems as the emerging training needs. There were some country differences in specific training need areas. Conclusions: It was concluded that training in basic nursing skills and specialization in nursing specific conditions, in advanced health care systems and in psychology‐related skills could add to the professional capacity of European caregivers employed in health and social care. Implications for nursing management: The findings inform about employed caregivers' training needs in Europe, which may contribute in the provision of quality care and organisational efficiency in health and social care. [ABSTRACT FROM AUTHOR]