Search

There is little evidence on the association between child and adolescent mental health (CAMH) policies and adolescent mental health. This study examined this association using data on indicators of adolescent mental health--aggressive behavior, life satisfaction, and psychosomatic symptoms--in 172,829 eleven- to fifteen-year-olds from 30 European countries in the 2013-2014 Health Behaviour in School-Aged Children (HBSC) study. Individual records were linked to national-level policies for CAMH, controlling for national-level adult violence, adult well-being, and income inequality. Multilevel analyses revealed lower adolescent aggressive behavior in countries with more CAMH policies, even after controlling for other national-level indicators. Adolescent life satisfaction and psychosomatic symptoms were not associated with CAMH policies. Results may inform policy recommendations regarding investments in adolescent mental health.

Soil functioning contributes to the delivery of a vast range of ecosystem goods and services, and ecosystem health is therefore reflected by the capacity of the soil to perform underlying functions. Soil organic carbon (SOC) is a key indicator for soil quality as it is an integral driver of many soil functions and associated ecosystem services. Across the globe, SOC stocks are declining due to expanding agriculture and unsustainable practices. Awareness of the fact that soil is a non‐renewable resource and its functioning important for all life on Earth is increasing, especially among policymakers. As such, goals for the preservation and restoration of SOC are formulated in policies under the European Green Deal. However, the evaluation of these goals at the European level is hampered by a non‐harmonized diversity in national SOC monitoring strategies. While some SOC indicators can be useful for the evaluation of most policy goals (i.e., baseline and potential SOC stocks), additional and contrasting SOC data are often required for the evaluation of the goals formulated by the different EU directives. This study provides an overview of five ongoing SOC monitoring programmes across Europe and discusses how national programmes may be aligned to evaluate goals at the EU level. Five countries with very different soil monitoring programmes were included in a case study to illustrate the potential for harmonization and standardization of SOC assessment. Based on this study, we conclude that SOC monitoring strategies can be harmonized, but not standardized. We further suggest five sampling strategies that have potential for harmonization under the proposed Directive on Soil Monitoring and Resilience. [ABSTRACT FROM AUTHOR]

In a rapidly changing health and care landscape, there is acknowledgement that the organization of care should be integrated with the patient placed at the centre. In reality, care systems are often fragmented, disjointed, and focused on the condition rather than the patient. The Science Committee of the Association of Cardiovascular Nursing and Allied Professions of the European Society of Cardiology recognizes the need for a statement on integrated care to guide health professionals caring for people with cardiovascular disease. This statement outlines the evidence for integrated cardiovascular care, identifies challenges, and offers advice for practice, education, and research. [ABSTRACT FROM AUTHOR]

In Europe, design for the durability of new reinforced concrete structures is currently based on a prescriptive approach. The design, execution (construction) and planned maintenance of a concrete structure have to lead to the intended level of safety and serviceability throughout its entire service life. This requires numeric models based on a sound scientific background of mechanistic understanding as the basis for design and management tools and for the further development of standards and regulations. Designers must understand the basic deterioration mechanisms and the potential types and rates of damage development. For example, different types of corrosion cause very different damage developments, some of which reduce structural safety. We propose that the next generation of service life models should either explicitly include the propagation period or implicitly include it by selecting an accepted probability of depassivation that reflects the type of corrosion and its structural implications. [ABSTRACT FROM AUTHOR]

The recently concluded European Lung Cancer Congress 2022 (ELCC22) showcased some very exciting data, with more than 200 abstracts presented during the meeting. Through this review, we focus on selected clinically relevant abstracts that in our opinion represent significant updates in the current management of non-small cell lung cancer (NSCLC). Here, we summarize the updates in surgical management, adjuvant therapy and therapy for advanced stage NSCLC and put these advances in the context of the current clinical standard of care. [ABSTRACT FROM AUTHOR]

Background: To conduct a comprehensive assessment of the association between aggression and academic performance in compulsory education. Method: We studied aggression and academic performance in over 27,000 individuals from four European twin cohorts participating in the ACTION consortium (Aggression in Children: Unraveling gene‐environment interplay to inform Treatment and InterventiON strategies). Individual level data on aggression at ages 7–16 were assessed by three instruments (Achenbach System of Empirically Based Assessment, Multidimensional Peer Nomination Inventory, Strengths and Difficulties Questionnaire) including parental, teacher and self‐reports. Academic performance was measured with teacher‐rated grade point averages (ages 12–14) or standardized test scores (ages 12–16). Random effect meta‐analytical correlations with academic performance were estimated for parental ratings (in all four cohorts) and self‐ratings (in three cohorts). Results: All between‐family analyses indicated significant negative aggression–academic performance associations with correlations ranging from −.06 to −.33. Results were similar across different ages, instruments and raters and either with teacher‐rated grade point averages or standardized test scores as measures of academic performance. Meta‐analytical r's were −.20 and −.23 for parental and self‐ratings, respectively. In within‐family analyses of all twin pairs, the negative aggression–academic performance associations were statistically significant in 14 out of 17 analyses (r = −.17 for parental‐ and r = −.16 for self‐ratings). Separate analyses in monozygotic (r = −.07 for parental and self‐ratings), same‐sex dizygotic (r's = −.16 and −.17 for parental and self‐ratings) and opposite‐sex dizygotic (r's = −.21 and −.19 for parental and self‐ratings) twin pairs suggested partial confounding by genetic effects. Conclusions: There is a robust negative association between aggression and academic performance in compulsory education. Part of these associations were explained by shared genetic effects, but some evidence of a negative association between aggression and academic performance remained even in within‐family analyses of monozygotic twin pairs. [ABSTRACT FROM AUTHOR]

During the coronavirus 2019 (COVID-19) pandemic, outpatient visits for patients with atrial fibrillation (AF), were converted into teleconsultations. As a response to this, a novel mobile health (mHealth) intervention was developed to support these teleconsultations with AF patients: TeleCheck-AF. This approach incorporates three fundamental components: 1) "Tele": A structured teleconsultation. 2) "Check": An app-based on-demand heart rate and rhythm monitoring infrastructure. 3) "AF": comprehensive AF management. This report highlights the significant importance of coordination of the TeleCheck-AF approach at multiple levels and underlines the importance of streamlining care processes provided by a multidisciplinary team, using an mHealth intervention, during the COVID-19 pandemic. Moreover, this report reflects on how the TeleCheck-AF approach has contributed to strengthening the health system in maintaining management of this prevalent sustained cardiac arrhythmia, whilst keeping patients out of hospital, during the pandemic and beyond. [ABSTRACT FROM AUTHOR]

Purpose: To report the 12-month results of a multicenter, prospective, randomized controlled trial to determine if the ZILVER PTX paclitaxel-eluting stent was noninferior in terms of safety and efficacy compared with surgical bypass. Materials and Methods: This is a study in symptomatic TransAtlantic Inter-Society Consensus (TASC) C and D femoropopliteal lesions comparing endovascular ZILVER PTX stenting vs surgical bypass surgery using a prosthetic graft (ClinicalTrials.gov identifier NCT01952457). Between October 2013 and July 2017, 220 patients (mean age 68.6±10.5 years; 159 men) were enrolled and randomized to the ZILVER PTX treatment group (113, 51.4%) or the bypass treatment group (107, 48.6%). Most of the lesions were occlusions (208, 94.5%); the mean lesion length was 247.1±69.3 mm. The primary outcome measure was primary patency at 12 months, defined as no evidence of binary restenosis or occlusion within the target lesion or bypass graft based on a duplex-derived peak systolic velocity ratio <2.4 and no clinically-driven target lesion revascularization (TLR) in endovascular cases or reintervention to restore flow in the bypass. Results: The estimated 12-month primary patency rate was 74.5% (95% CI 66.3% to 82.7%) for the ZILVER PTX group vs 72.5% (95% CI 63.7% to 81.3%) for the bypass arm (p=0.998). Freedom from TLR at 12 months was 80.9% (95% CI 73.3% to 88.5%) for the ZILVER PTX group vs 76.2% (95% CI 68.0% to 84.4%) for the bypass group (p=0.471). The 30-day complication rate was significantly lower in the ZILVER PTX group (4.4% vs 11.3%, p=0.004). Also, procedure time and hospital stay were significantly shorter in the ZILVER PTX group (p<0.001 for both). Conclusion: With noninferior patency results, a lower complication rate, and shorter procedures and hospital stays, paclitaxel-eluting stenting might become a recommended treatment for long TASC C and D femoropopliteal lesions. [ABSTRACT FROM AUTHOR]

The agri-food and rural development sector in Europe is undergoing digitalization, and therefore becoming increasingly data-dependent. However, limited experience in implementing Findable, Accessible, Interoperable, and Reusable (FAIR) data principles has restricted knowledge sharing and reusability. This study aims to investigate the existing FAIR Data Management practices in the agri-food and rural development sector by assessing the FAIRness of project outputs from recent H2020-funded Multi-Actor Projects (MAPs). We conducted a FAIRness assessment of project outputs using both semi-automatic and manual framework, and we also carried out a comprehensive review of the data sharing practices among selected MAPs. Of the investigated MAPs, <10% have achieved FAIR compliance and applied FAIR data management practices. The measured FAIRness of project products, including journal articles, conference papers, and books, is higher than that of other product types such as videos, audios, and presentations. The study highlights the critical need for standardizing the adoption of FAIR data principles and data management practices across both the agri-food and rural development sector but also across bureaucratic data management throughout Europe more widely. Such a change would facilitate broader utilization and re-use of MAPs outputs and results, enhancing decision-making and agri-food and rural development practices. [Display omitted] • The agri-food and rural development sector in Europe is becoming increasingly data-dependent. • The Open Science and the FAIR Data principles enhance decision-making by promoting FAIRness of agri-food research outputs. • The research community in the agri-food and rural development sector has limited experience in applying these principles. • Assessed FAIRness of project outputs in EU-funded agri-food and rural development MAPs. [ABSTRACT FROM AUTHOR]

Synchronous oligometastatic disease (sOM) has been described as a distinct disease entity; however, there is no consensus on OM definition (OM-d) in non–small-cell lung cancer (NSCLC). A consensus group was formed aiming to agree on a common OM-d that could be used in future clinical trials. A European survey was circulated to generate questions and input for the consensus group meeting. A European Organisation for Research and Treatment of Cancer Lung Cancer Group (LCG)/sOM-d consensus group survey was distributed to LCG, sOM-d consensus group, and several European thoracic oncology societies' members. 444 responses were analysed (radiation oncologist: 55% [n = 242], pulmonologist: 15% [n = 66], medical oncologist: 14% [n = 64]). 361 physicians (81%) aimed to cure sOM NSCLC patients and 82% (n = 362) included the possibility of radical intent treatment in their sOM-d. The maximum number of metastases considered in sOM-d varied: 12% replied 1 metastasis, 42% ≤ 3, and 17% ≥ 5 metastases. 79% (n = 353) stated that number of organs involved was important for sOM-d, and most (80%, n = 355) considered that only ≤3 involved organs (excluding primary) should be included. 317 (72%) included mediastinal lymph node involvement in the sOM-d and 22% (n = 70/317) counted mediastinal lymph node as a metastatic site. Most physicians completed sOM staging with brain magnetic resonance imaging (91%, n = 403) and positron emission tomography/computed tomography (98%, n = 437). Pathology proof of metastatic disease was a requirement to define sOM for 315 (71%) physicians. The preferred primary outcome for sOM clinical trials was overall survival (73%, n = 325). Although consensual answers were obtained, several issues remain unresolved and will require further research to agree on a sOM-d. • The majority aimed to cure sOM NSCLC patients. • The maximum number of metastases considered in sOM-d was 42% ≤ 3 and 17% ≥ 5. • Most considered only ≤3 involved organs (excluding primary). • Few counted mediastinal lymph node as a metastatic site. • The preferred primary outcome for sOM clinical trials was overall survival. [ABSTRACT FROM AUTHOR]

The article focuses on advanced nursing practice across Europe including considered aims to meet the demands of higher patient acuity, patients with complex healthcare needs, and an ageing population living longer with multiple chronic conditions such as cardiovascular disease (CVD).

Multidimensional family therapy (MDFT) is an established treatment program for youth displaying multiproblem behavior. We examined whether MDFT decreased criminal offending among cannabis abusing adolescents, as compared with individual psychotherapy (IP). In a Western European randomized controlled trial comparing MDFT with IP, a sample of 169 adolescents with a cannabis disorder completed self-reports on criminal offending. Half indicated they had committed one or more criminal offenses in the 90 days before the baseline assessment. Follow-up assessments were at 6 and 12 months after randomization. The proportion of adolescents reporting nondelinquency increased during the study period, most so in the MDFT condition. In addition, MDFT lowered the number of violent offenses more than IP. This difference was not seen for property crimes. In cannabis abusing adolescents, MDFT is an effective treatment to prevent and reduce criminal offending. MDFT outperforms IP for violent crimes. [ABSTRACT FROM AUTHOR]

The article presents the discussion on Obstructive sleep apnoea (OSA) being highly prevalent in patients with atrial fibrillation (AF). Topics include describing the potential for a multidisciplinary integrated approach for comprehensively managing OSA and AF; and patient-centred approach focusing on engagement and education of patients with AF allowing the clarification of the role of OSA management as part of AF treatment.

Four regional chemistry transport models were applied to simulate the concentration and composition of particulate matter (PM) in Europe for 2005 with horizontal resolution ~20 km. The modelled concentrations were compared with the measurements of PM chemical composition by the European Monitoring and Evaluation Programme (EMEP) monitoring network. All models systematically underestimated PM10 and PM2.5 by 10-60 %, depending on the model and the season of the year, when the calculated dry PM mass was compared with the measurements. The average water content at laboratory conditions was estimated between 5 and 20% for PM2.5 and between 10 and 25% for PM10. For majority of the PM chemical components, the relative underestimation was smaller than it was for total PM, exceptions being the carbonaceous particles and mineral dust. Some species, such as sea salt and NO- 3, were overpredicted by the models. There were notable differences between the models' predictions of the seasonal variations of PM, mainly attributable to different treatments or omission of some source categories and aerosol processes. Benzo(a)pyrene concentrations were overestimated by all the models over the whole year. The study stresses the importance of improving the models' skill in simulating mineral dust and carbonaceous compounds, necessity for high-quality emissions from wildland fires, as well as the need for an explicit consideration of aerosol water content in model-measurement comparison. [ABSTRACT FROM AUTHOR]

Accurate modelling of mitigation measures for nitrogen deposition and secondary inorganic aerosol (SIA) episodes requires a detailed representation of emission patterns from agriculture. In this study the meteorological influence on the temporal variability of ammonia emissions from livestock housing and application of manure and fertilizer are included in the chemistry transport model LOTOS-EUROS. For manure application, manure transport data from Flanders (Belgium) were used as a proxy to derive the emission variability. Using improved ammonia emission variability strongly improves model performance for ammonia, mainly by a better representation of the spring maximum. The impact on model performance for SIA was negligible as explained by the limited, ammonia rich region in which the emission variability was updated. The contribution of Flemish agriculture to modelled annual mean ammonia and SIA concentrations in Flanders were quantified at respectively 7–8 and 1–2 μg/m 3 . A scenario study was performed to investigate the effects of reducing ammonia emissions from manure application during PM episodes by 75%, yielding a maximum reduction in modelled SIA levels of 1–3 μg/m 3 during episodes. Year-to-year emission variability and a soil module to explicitly model the emission process from manure and fertilizer application are needed to further improve the modelling of the ammonia budget. [ABSTRACT FROM AUTHOR]

As part of an hierarchical, multi-scale, hydromorphological framework for European rivers that has been developed within the REFORM project, a procedure for classifying rivers has been devised. The procedure includes components that categorise river channel morphology, floodplain morphology, flow regime, and groundwater-surface water interactions, and is designed for operational use in the context of river management. Channel morphology is classified at a first level by a basic river typology interpreted using remotely sensed images, and at a second level by an extended river typology that integrates information from field observations. Floodplains are classified by adopting the Nanson and Croke typology with specific reference to the types of floodplain that are most likely to be encountered widely across Europe. Nine flow regime types are identified using a series of hydrological indicators. Finally, where groundwater has a significant influence on river flows, a range of potential groundwater-surface water interactions are identified reflecting the morphological river type and its geological and climatic setting. Within the REFORM project, the river typology has been tested using case studies representative of a wide variety of European catchment conditions. Four case studies are used to illustrate the classification procedure and to discuss its main strengths and limitations. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Social Intervention: Theory & Practice is the property of Universiteit Utrecht and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The article presents a study which evaluates the reliability and feasibility of a set of quality indicators (QIs) in palliative care settings and services across Europe. Among the methods used are descriptive statistics, chi-square analysis, and analysis of variance. It shows that the set of QIs seemed to measure four reliable domains including equipment and continuity of care, personnel training and appraisal, and availability of controlled drugs.

The aim of this article is to present the results of an international study on outreach approaches in the private domain in social work with a focus on moral dilemmas. The reason to start the study was to investigate if a trend in Dutch social work toward outreach approaches can be recognized in other European countries and what can be learned from other outreach practices. First, a definition of outreach approaches in the private domain was discussed. Next, data were collected by interviews with social workers in four different countries, executed by social work students and researchers. Although no evidence was found that outreach approaches in other countries than the Netherlands are increasing, many similarities were found in social workers' interpretation of their outreach work. All the interviewees emphasized that outreach approaches are intended for excluded people who are at risk or a risk and who are not in contact with social services. All workers stress the importance of gaining trust and staying in touch. A dilemma is that workers often find themselves between two fires. They tend to give priority to the relation with the client and accept that this can contradict rules of organizations or society. [ABSTRACT FROM AUTHOR]

A personal narrative is presented which explores the author's experience of travelling with his colleagues to different countries to exchange ideas in the field of bone and joint infections.

At the beginning of the 1960s, it was clear that a vaccine against measles would soon be available. Although measles was (and remains) a killer disease in the developing world, in the United States and Western Europe this was no longer so. Many parents and many medical practitioners considered measles an inevitable stage of a child's development. Debating the desirability of measles immunization, public health experts reasoned differently. In the United States, introduction of the vaccine fit well with Kennedy's and Johnson's administrations' political commitments. European policymakers proceeded cautiously, concerned about the acceptability of existing vaccination programs. In Sweden and the Netherlands, recent experience in controlling polio led researchers to prefer an inactivated virus vaccine. Although in the early 1970s attempts to develop a sufficiently potent inactivated vaccine were abandoned, we have argued that the debates and initiatives of the time during the vaccine's early history merit reflection in today's era of standardization and global markets. [ABSTRACT FROM AUTHOR]

Abstract: Tropospheric ozone contributes to the removal of air pollutants from the atmosphere but is itself a pollutant that is harmful to human health and vegetation. Biogenic isoprene emissions are important ozone precursors, and therefore future changes in land use that change isoprene emissions are likely to affect atmospheric ozone concentrations. Here, we use the chemical transport model LOTOS-EUROS (dedicated to the regional modeling of trace gases in Europe) to study a scenario in which 5% of the crop- and grass-land in Europe is converted into poplar plantations to be used for biofuel production. Although this scenario is rather conservative, our simulations project that isoprene emissions are substantially increased by an average of 45% over the simulated domain. As a consequence, ozone peak values are expected to increase by up to 6%, and ozone indicators for damage to human health and vegetation by up to 25% and 40%, respectively. Finally, we show that after the change in land use NO x emission reductions of 15–20% in Europe would be required to restore the ozone levels to current values. Because biomass production is expected to increase throughout Europe in the coming decades, we conclude that careful consideration of the tree types and regions to be used is required to constrain the concomitant air pollution to a minimum. [Copyright &y& Elsevier]

Non-native species can cause negative impacts when they become invasive. This study entails a comparison of risk classifications for 25 aquatic non-native species using various European risk identification protocols. For 72% of the species assessed, risk classifications were dissimilar between countries. The pair-wise comparison of Freshwater Fish Invasiveness Scoring Kit (FISK) scores of in total 28 fish species from the UK, Flanders (Belgium) and Belarus resulted in a higher correlation for scores of Flanders- Belarus than that of Flanders-UK and Belarus-UK. We conclude that different risk classifications may occur due to differences in (1) national assessment protocols, (2) species-environment matches in various biogeographical regions, and (3) data availability and expert judgement. European standardisation of risk assessment protocols, performance of biogeographical region specific risk classifications and further research on key factors for invasiveness of aquatic ecosystems are recommended. [ABSTRACT FROM AUTHOR]

This article reviews current European legislation concerning allergens and their labelling, in particular in relation to the need to optimise consumer protection and improve the quality of life of food allergic consumers. Adequate communication concerning the presence of (potentially) allergenic ingredients is, for susceptible individuals, essential if intake of these hazardous ingredients is to be avoided. European food labelling legislation requires pre-packaged foodstuffs to be labelled with a list of ingredients, including a reference to allergens. However, some food products and ingredients are excluded from these labelling requirements. These exceptions may represent hazards for food allergic individuals. In order to contribute to a higher level of consumer protection some issues which have potential to improve the existing European legislation have been identified. At the present time, food producers voluntarily use precautionary labelling to warn allergic consumers for the possible unintentional presence of allergens. An embedding of precautionary labelling in European legislation is advocated. To improve the readability of the information, European legislation should include some additional requirements. The information provision should be uniform at least across European Member States. Additional research is required in order to harmonise regulations and consumer preferences for information provision at the international level. [ABSTRACT FROM AUTHOR]

Abstract: A Decision Support System (DSS) has been developed to evaluate the technical and economical feasibility of CO2 storage in the subsurface. The DSS performs a detailed, stochastic analysis of the technical and economical aspects of a CCS project, which consists of any number of CO2 sources and sinks plus the connecting pipeline network. The DSS uses the database of CO2 emission points and storage locations in Europe that has been compiled in the EU Geocapacity project. The system is a combination of an internet application, which visualises the database and allows the user to select sources and sinks and create a pipeline network, and an application to be run on a local computer, which performs a stochastic analysis of the costs of a CO2 capture, transport and storage system. The DSS provides not only an estimate of the total CCS cost, but also an analysis of the elements in the CCS chain (capture, compression, transport and storage), enabling a feasibility analysis on several levels. [Copyright &y& Elsevier]

Abstract: The focus of the GeoCapacity project is GIS mapping of CO2 point sources, infrastructure and geological storage in Europe. The main objective is to assess the European capacity for geological storage of CO2 in deep saline aquifers, oil and gas structures and coal beds. Other priorities are further development of methods for capacity assessment, economic modelling and site selection as well as international cooperation, especially with China. The results of GeoCapacity will include 25 countries and comprises most European sedimentary basins suitable for geological storage of CO2. [Copyright &y& Elsevier]

This article presents the results of a pilot of a cross-national learning process within the context of social work education. The pilot was carried out in the electronic environment by students from four European universities (Hogeschool Utrecht, Sheffield, Tartu and Vilnius). The analysis of the social work case of a disabled person was aimed at developing students' abilities to make sensitive cross-national comparisons, to communicate within a different language and cultural context and to demonstrate understanding between practice and policy in a different country. Students' reflections revealed the relevance of cross-cultural social work case analysis for developing future social workers' professional and personal competencies. The study offered new insights into the social reality of the students' own countries, into social work education and practice, and provided a broader understanding of international social work trends. The evaluation of the piloted e-learning programme indicated the advantages and limitations of long distance, cross-national learning. Straipsnyje pristatomi socialinio darbo studentams skirtos elektroninio mokymosi programos bandymo tarptautiniu lygiu rezultatai. Programos bandyme dalyvavo keturiu Europos aukstuju mokyklu studentai (Sefildo, Tartu, Vilniaus universitetu ir Utrechto Hogeschool). Elektronineje erdveje jiems buvo pateiktas neigalaus asmens problemiskos socialines adaptacijos atvejis, kuri, vadovaujant destytojams, jie turejo sinchroniskai isanalizuoti programoje nurodytomis pakopomis. Mokymo programos tikslas - ugdyti studentu tarpkulturine kompetencija, gebejimus atlikti lyginamaja analize, padeti jiems giliau suprasti rysi tarp skirtingu saliu socialines politikos ir socialinio darbo praktikos. Studentu refleksijos bei atvejo sprendimo proceso analize parode, kad tokia programa yra tinkama ugdyti busimu socialiniu darbuotoju profesine ir asmenine kompetencija tarptautiniu lygiu. Vertindami elektroninio mokymosi programa, studentai konstatavo, kad ji leido jiems naujai pazvelgti i savo saliu socialine situacija, geriau suprasti tarptautinio socialinio darbo tendencijas ir suteike lyginamuju tyrimu patirties. Programos bandymas padejo identifikuoti ir distancinio mokymo trukumus, i kuriuos butina atsizvelgti taikant ja ateityje. In dit artikel worden de resultaten van de pilot van een e-learning programma gepresenteerd waaraan Social Work opleidingen van verschillende Europese universiteiten en hogescholen hebben deelgenomen (Hogeschool Utrecht, Vilnius University, Sheffield Hallam University Sheffield en University of Tartu). Een Nederlandse casus over de begeleiding van de werksituatie van een verstandelijk gehandicapte cliënt vormde het uitgangspunt. Gedurende een periode van 10 weken, maakte van elk land een groep van 4 studenten een analyse en interventieplan. De resultaten van digitaal verstrekte opdrachten werden met elkaar vergeleken. De bedoeling was dat studenten op deze wijze inzicht verwerven in diversiteit van benaderingen binnen Social Work in Europa. Het resultaat van de pilot is dat minstens zoveel overeenkomsten als verschillen in de Social Work praktijk en het onderwijs zichtbaar werden. Internationale trends konden worden onderscheiden. In een evaluatie van het e-learning programma worden de mogelijkheden en beperkingen van grensoverschrijdend afstandsonderwijs besproken. [ABSTRACT FROM AUTHOR]

The article presents summaries of selected legislation and jurisprudence in European courts. They include the judgment of the Court of Justice of the European Communities on the labeling of foodstuffs for general consumption and the judgment of the European Court of Human Rights on a pharmacy's refusal to sell contraceptives to three women.

Editorial. Discusses genetic discrimination, the situation where genetic data is being used to deny a person equal treatment or equal opportunities. Legal and ethical issues concerning a person's hereditary predispositions and susceptibilities; Privacy laws that regulate health or genetic information and avoid the abuse of genetic data in European countries; Difference of genetic discrimination from other forms of discrimination;

Comments on the case "K. and T. v. Finland," filed before the European Court of Human Rights on July 12, 2001. Case background; Application brought by a mother and her cohabitant, the applicant father, both Finnish nationals; Placement of a child in a children's home by the Social Welfare Board's decision; Proceedings before the Commission; Proceedings before the Grand Chamber of the Court.

Presents selected medical legislation and jurisprudence in Europe, compiled as of September 2000. Case of Litwa v. Poland; Case of Bergens Tidene and others v. Norway

In order to assess the relationship between environmental stress and crown condition of forest trees monitored since 1986 in Europe, estimates of stress factors, including temperature stress, drought stress and air pollution stress, were derived with the best data, methods and models currently available. This paper presents information on the methods used to derive such stress factors, and on the overall ranges, the temporal trends, the spatial distribution and the reliability of the calculated stress factors. The temperature stress indices did not show much temporal variation between 1985 to 1995. As expected spatial patterns were north-south orientated, going from colder northern regions to warmer southern regions. The calculated relative transpiration showed a more complex pattern, coinciding to a large extend with patterns of rainfall and temperature. Potential acid deposition decreased between 1986 and 1992, but remained fairly constant after 1992. The strong decrease was mainly the result of the decrease in SOx deposition, and to a small decrease in NOy deposition. Highest levels of the S and N deposition were calculated in Central and Western Europe. Base cation deposition was largest in coastal areas and in southern Europe. This is mainly due to soil dust, Sahara dust and sea salt. Base cation deposition can compensate almost entirely for the potential inputs in the south of Europe, whereas in central Europe it equalled about 25% of the potential acid input. A comparison between site specific modelled deposition and deposition derived from throughfall data showed that the total acid deposition is usually overestimated by the model, whereas the total nitrogen deposition is underestimated, especially at plots with high nitrogen loads. There is, however, a significant correlation between measured and modelled data for all S and N deposition, thus allowing their use in a statistical analyses. [ABSTRACT FROM AUTHOR]

Presents selected legislation and jurispundence concerning medicine in Europe, compiled as of September 1999. Margaret Boyle and Others v. Equal Opportunities Commission; The Queen v. Ministry of Agriculture, Fisheries and Food ex parte British Agrochemicals Association Ltd.; Musial v. Poland.

Discusses legal contests involving medical establishments presided by the European Court of Human Rights. Termination of medical personnel affiliated with a professional association; Refusal of a sick leave application made by a French police officer who suffered a heart attack during a cross-country race; Proceedings before the European Commission on Human Rights and the European Court.

Presents several judgments of cases related to health law in Europe. Facts of the Sodermare et al v. Regione Lombardia case; Basis of the court decision on the case of Franz&eacuten; Contention of the plaintiff on the case of M. S. v. Sweden.

Presents several cases in Europe. Judgments; Basis of the rulings of the Court; Decision of the court.

Presents several judgments related to health law in Europe. Facts of the case of Bizotto v. Greece; Contention of the plaintiff of the case of Z v. Finland; Basis of the court decision.

Highlights the difficulties for monetary union in Europe. Proposed key factors needed for the success of monetary union; Economic criteria for political acceptance of a single currency and a single European central bank; Problems and challenges faced by the European Monetary Union (EMU); Prospect in the event of EMU failure; European financial system in the global environment.

Introduces the articles published in the December 1999 issue of the "European Journal of Health Law." Issues regarding public health law discussed in the issue; Authors who contributed to the issue.

Background: Systemic relapses remain a major problem in locally advanced rectal cancer. Using short-course radiotherapy followed by chemotherapy and delayed surgery, the Rectal cancer And Preoperative Induction therapy followed by Dedicated Operation (RAPIDO) trial aimed to reduce distant metastases without compromising locoregional control.Methods: In this multicentre, open-label, randomised, controlled, phase 3 trial, participants were recruited from 54 centres in the Netherlands, Sweden, Spain, Slovenia, Denmark, Norway, and the USA. Patients were eligible if they were aged 18 years or older, with an Eastern Cooperative Oncology Group (ECOG) performance status of 0-1, had a biopsy-proven, newly diagnosed, primary, locally advanced rectal adenocarcinoma, which was classified as high risk on pelvic MRI (with at least one of the following criteria: clinical tumour [cT] stage cT4a or cT4b, extramural vascular invasion, clinical nodal [cN] stage cN2, involved mesorectal fascia, or enlarged lateral lymph nodes), were mentally and physically fit for chemotherapy, and could be assessed for staging within 5 weeks before randomisation. Eligible participants were randomly assigned (1:1), using a management system with a randomly varying block design (each block size randomly chosen to contain two to four allocations), stratified by centre, ECOG performance status, cT stage, and cN stage, to either the experimental or standard of care group. All investigators remained masked for the primary endpoint until a prespecified number of events was reached. Patients allocated to the experimental treatment group received short-course radiotherapy (5 × 5 Gy over a maximum of 8 days) followed by six cycles of CAPOX chemotherapy (capecitabine 1000 mg/m2 orally twice daily on days 1-14, oxaliplatin 130 mg/m2 intravenously on day 1, and a chemotherapy-free interval between days 15-21) or nine cycles of FOLFOX4 (oxaliplatin 85 mg/m2 intravenously on day 1, leucovorin [folinic acid] 200 mg/m2 intravenously on days 1 and 2, followed by bolus fluorouracil 400 mg/m2 intravenously and fluorouracil 600 mg/m2 intravenously for 22 h on days 1 and 2, and a chemotherapy-free interval between days 3-14) followed by total mesorectal excision. Choice of CAPOX or FOLFOX4 was per physician discretion or hospital policy. Patients allocated to the standard of care group received 28 daily fractions of 1·8 Gy up to 50·4 Gy or 25 fractions of 2·0 Gy up to 50·0 Gy (per physician discretion or hospital policy), with concomitant twice-daily oral capecitabine 825 mg/m2 followed by total mesorectal excision and, if stipulated by hospital policy, adjuvant chemotherapy with eight cycles of CAPOX or 12 cycles of FOLFOX4. The primary endpoint was 3-year disease-related treatment failure, defined as the first occurrence of locoregional failure, distant metastasis, new primary colorectal tumour, or treatment-related death, assessed in the intention-to-treat population. Safety was assessed by intention to treat. This study is registered with the EudraCT, 2010-023957-12, and ClinicalTrials.gov, NCT01558921, and is now complete.Findings: Between June 21, 2011, and June 2, 2016, 920 patients were enrolled and randomly assigned to a treatment, of whom 912 were eligible (462 in the experimental group; 450 in the standard of care group). Median follow-up was 4·6 years (IQR 3·5-5·5). At 3 years after randomisation, the cumulative probability of disease-related treatment failure was 23·7% (95% CI 19·8-27·6) in the experimental group versus 30·4% (26·1-34·6) in the standard of care group (hazard ratio 0·75, 95% CI 0·60-0·95; p=0·019). The most common grade 3 or higher adverse event during preoperative therapy in both groups was diarrhoea (81 [18%] of 460 patients in the experimental group and 41 [9%] of 441 in the standard of care group) and neurological toxicity during adjuvant chemotherapy in the standard of care group (16 [9%] of 187 patients). Serious adverse events occurred in 177 (38%) of 460 participants in the experimental group and, in the standard of care group, in 87 (34%) of 254 patients without adjuvant chemotherapy and in 64 (34%) of 187 with adjuvant chemotherapy. Treatment-related deaths occurred in four participants in the experimental group (one cardiac arrest, one pulmonary embolism, two infectious complications) and in four participants in the standard of care group (one pulmonary embolism, one neutropenic sepsis, one aspiration, one suicide due to severe depression).Interpretation: The observed decreased probability of disease-related treatment failure in the experimental group is probably indicative of the increased efficacy of preoperative chemotherapy as opposed to adjuvant chemotherapy in this setting. Therefore, the experimental treatment can be considered as a new standard of care in high-risk locally advanced rectal cancer.Funding: Dutch Cancer Foundation, Swedish Cancer Society, Spanish Ministry of Economy and Competitiveness, and Spanish Clinical Research Network. [ABSTRACT FROM AUTHOR]

Petroleum refinery effluents (PRE) are wastewaters from industries associated with oil refining. Within Europe, PREs are regulated through local discharge permits and receive substantial treatment before emission. After treatment, PREs can still contain low levels of various pollutants potentially toxic to organisms. Earlier work, including whole-effluent toxicity assessments, has shown that the toxicity of permitted PREs is often limited. However, the extent to which PREs contribute to chemical pollution already present in the receiving environment is unknown. Therefore, our study aimed to assess the contribution of PREs to mixture toxic pressure in the environment, using the multi-substance potentially affected fraction of species (msPAF) as an indicator. Based on measured chemical concentrations, compiled species sensitivity distributions (SSD) and a mechanistic solubility model, msPAF levels were estimated for undiluted effluents at discharge points and diluted effluents downstream in receiving waters. Median msPAF-chronic and msPAF-acute levels of PREs at discharge points were 74% (P50) and 40% (P95), respectively. The calculated msPAF levels were reduced substantially to <5% downstream for most effluents (82%), indicating low to negligible toxicity of PREs in receiving environments beyond the initial mixing zone. Regardless of differences in endpoints and locations, hydrocarbons (mainly total petroleum hydrocarbons) and inorganics (mainly ammonia) explained at least 85% of the mixture toxic pressure. The msPAF levels of PREs were on average 2.5–4.5 orders of magnitude lower than msPAF levels derived from background pollution levels, suggesting that PREs were minor contributors to the toxic pressure in the environment. This study presents a generic methodology for quantifying the potential toxic pressure of PREs in the environment, identifying hotspots where more effective wastewater treatment could be needed. We explicitly discuss the uncertainties for further refinement and development of the method. [Display omitted] • We assessed petroleum refinery effluent (PRE) contribution to chemical pollution. • 82% of PREs posed no significant toxic pressure in receiving environments. • PREs were not major contributors to chemical pollution in the environment. • Toxic pressure was mostly explained by aromatic constituents (C 10 –C 15). [ABSTRACT FROM AUTHOR]

The EU Water Framework Directive and Priority Substance Directive provide a framework to identify substances that potentially pose a risk to surface waters and provide a legal basis whereby member states are required to monitor and comply with environmental quality standards (EQSs) set for those substances. The cost and effort to continuously measure and analyse real world concentrations in all water bodies across Europe are high. Establishing the reliability of environmental exposure models to predict concentrations of priority substances is key, both to fill data gaps left by monitoring campaigns, and to predict the outcomes of actions that might be taken to reduce exposure. In this study, we aimed to validate the ePiE model for the pharmaceutical ibuprofen by comparing predictions made using the best possible consumption data with measured river concentrations. The results demonstrate that the ePiE model makes useful, conservative exposure predictions for ibuprofen, typically within a factor of 3 of mean measured values. This exercise was performed across a number of basins within Europe, representative of varying conditions, including consumption rates, population densities and climates. Incorporating specific information pertaining to the basin or country being assessed, such as custom WWTP removal rates, was found to improve the realism and accuracy of predictions. We found that the extrapolation of consumption data between countries should be kept to a minimum when modelling the exposure of pharmaceuticals, with the per capita consumption of ibuprofen varying by nearly a factor of 10. • The ePiE model makes useful, conservative exposure predictions for ibuprofen. • ePiE can provide a suitable alternative to fill monitoring data gaps. • Using real WWTP removal rates instead of predicted removal improved predictions. • The methods to obtain consumption data can be applied for all post-launch APIs. • The extrapolation of consumption data between countries should be avoided. [ABSTRACT FROM AUTHOR]

Abstract: We evaluated various modeling options for estimating concentrations of PCB-153 in the environment and in biota across Europe, using a nested multimedia fate model coupled with a bioaccumulation model. The most detailed model set up estimates concentrations in air, soil, fresh water sediment and fresh water biota with spatially explicit environmental characteristics and spatially explicit emissions to air and water in the period 1930–2005. Model performance was evaluated with the root mean square error (RMSElog), based on the difference between estimated and measured concentrations. The RMSElog was 5.4 for air, 5.6–6.3 for sediment and biota, and 5.5 for soil in the most detailed model scenario. Generally, model estimations tended to underestimate observed values for all compartments, except air. The decline in observed concentrations was also slightly underestimated by the model for the period where measurements were available (1989–2002). Applying a generic model setup with averaged emissions and averaged environmental characteristics, the RMSElog increased to 21 for air and 49 for sediment. For soil the RMSElog decreased to 3.5. We found that including spatial variation in emissions was most relevant for all compartments, except soil, while including spatial variation in environmental characteristics was less influential. For improving predictions of concentrations in sediment and aquatic biota, including emissions to water was found to be relevant as well. [Copyright &y& Elsevier]

Respecting and protecting personal autonomy requires that autonomy is interpreted in conjunction with the principle of good care in a way consistent with (the aspirations enshrined in) human dignity. This leads to a principled and relational approach towards personal autonomy. This implies an active role of health care providers, as councillors of patients, and a personalised way of obtaining informed consent, to maximally ensure the enjoying personal autonomy.

The United States of America and the European Countries have responded quite differently to the to the human rights of candidate workers as imposed by genetic and predictive health testing. Whereas the United States traditionally relies largely on the non-discrimination principle, the European countries seem to attach more value to the right to privacy and the principle of social justice. A recently published communication of the Commission of the European Communities seems to bridge these two legal traditions.