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Data on educational attainments are often qualitative data where the only information available is the highest level of education of the individual. If these levels of education may be ranked, the information available becomes ordinal. It is then possible to use measures of inequality as well as of overall attainment suggested in recent years (mostly in the field of self-assessed health) for the case where only ordinal information is available. This paper adopts these recent suggestions and proposes new measures of educational inequality and overall educational attainment. Our empirical illustration is based on Eurostat data for the year 2011.

• Familial hypercholesterolemia (FH) is associated with a lifelong elevation in LDL-C. • Atherosclerotic cardiovascular disease (ASCVD) risk in FH is high but heterogeneous. • The prevalence of metabolic syndrome (MetS) in a multinational cohort of FH was 14%. • The presence of MetS was associated with a 2-fold increased risk of incident ASCVD. • The presence of MetS was associated with a 4.9-fold increased risk of mortality. The association between familial hypercholesterolemia (FH) and premature atherosclerotic cardiovascular disease (ASCVD) is well established. Several risk factors other than the cumulative low-density lipoprotein cholesterol (LDL-C) have been shown to modulate the severity of the phenotype in these patients. However, the effect of the metabolic syndrome (MetS) on ASCVD risk in FH remains to be determined. The objective was to study the association between the presence of MetS and the incidence of different ASCVD endpoints and all-cause mortality. This prospective follow up study used data from 5 independent FH cohorts from Europe and North America. We analysed data of 2401 adult heterozygous FH without history of a prior ASCVD event (21,139 person-years of follow-up). Multivariate Cox proportional hazards regression was used to estimate the association between MetS and the incidence of the different endpoints. The prevalence of MetS was 14% in the study population. The presence of MetS was a significant predictor of incident 10-year ASCVD after adjustment for traditional cardiovascular risk factors (HR 2.07, 95% CI 1.34-3.19), as well as of 10-year major adverse cardiovascular event (MACE) (HR 4.59, 95% CI 2.27-9.30), 10-year myocardial infarction (MI) (HR 4.29, 95% CI 1.91-9.63), and 30-year all-cause mortality (HR 4.87, 95% CI 1.99-11.89). Our findings suggests that FH patients with MetS, have an increased cardiovascular risk that is independent from LDL-C and other traditional risk factors. Future studies are required to determine the most appropriate strategy to reduce the cardiovascular burden associated with MetS in this population. [ABSTRACT FROM AUTHOR]

This monograph describes the overall language situation in Luxembourg, a highly multilingual country in Western Europe, from a language policy and planning perspective. The first part discusses the social and historical contexts, including major societal changes and uncertainties about the future, which are bound up with Europeanisation and the accelerated processes of globalisation. It also deconstructs the notions of Luxembourgish as a "minority language" and French as the "language of prestige", and describes a two-pronged language ideology that allows for either monolingual identification with Luxembourgish or trilingual identification with the languages recognised by the language law of 1984 (Luxembourgish/ German/ French). The second part discusses the trilingual school-system, a system in which large numbers of romanophone students are forced to go through a German-language literacy programme. The third part provides an overview of language spread in the areas of the media and literary writing. The fourth part examines language purism and tensions concerning the standardisation of Luxembourgish, as well as the debates about language requirements for citizenship. The discussion shows how language policy scholarship needs to be approached from a multidimensional perspective, that is, by taking into account dynamics on the global, regional and local levels in addition to those at the state level. (Contains 1 figure, 1 table, and 12 notes.)

The problems of higher education in central and eastern Europe are discussed, including the processes of reform and the communist past; the need to both rebuild elites and expand participation; the role of the university between state and market; the relationship between research and teaching; and priorities for cooperation between western and eastern Europe. (DB)

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People with metastatic breast cancer face many challenges and disparities in obtaining optimal cancer care. These challenges are accentuated in underserved patient populations across Europe, who are less likely to receive quality healthcare for reasons including socioeconomic inequalities, educational or cultural status, or geographic location. While there are many local and national initiatives targeted to address these challenges, there remains a need to reduce disparities and improve access to healthcare to improve outcomes, with a focus on multidisciplinary stakeholder engagement. In October 2019, a range of experts in metastatic breast cancer, including healthcare professionals, patient representatives, policymakers and politicians, met to discuss and prioritize the critical needs of underserved patient populations with metastatic breast cancer in Europe. Six key challenges faced by these communities were identified: the need for amplification of the metastatic breast cancer patient voice, better and wider implementation of high-quality guidelines for metastatic breast cancer, more collaboration between stakeholders, tailored support for patients from different cultural and ethnic backgrounds, improved data sharing, and work-related issues. The Expert Panel then conceived and discussed potential actionable goals to address each key challenge. Their conclusions present a set of interrelated approaches to address the different challenges and could serve as the basis for concerted improvement of the lives of patients with metastatic breast cancer in Europe. • A pan-European approach is needed to tackle disparities in metastatic breast cancer treatment. • Multi-stakeholder collaboration may overcome challenges faced by underserved patients. • New interventions integrated with existing initiatives could improve patient care. [ABSTRACT FROM AUTHOR]

From goods and people to finance and data flows, this article documents the changing nature of cross-border flows, with the relative rise of data flows versus traditional trade flows of goods and services in Europe. Within this mix change, we also report a few new important findings. First, using principal component techniques to decompose the mix of cross-border flows, we discover four factors explaining 90% of the mix variation in flows. The largest one correlates positively with all flows and can thus be interpreted as a measure of a country contribution to global flows. The component with the smallest capture of cross-border flows variance exhibits a contrasting set of correlates (positive with traditional trade, but negative with data flows) and can be interpreted as a measure of traditional, outside of digital, cross-border flows. Second, using a dynamic panel of the 28 European countries in the last 25 years, three out of the four principal components correlate with a country output growth, with a positive elasticity of cross-border flows, especially focus on data flows, to output growth. Third, cross-border data flows are the largest contributor to output growth given its large recent increase, within a material contribution of up to 0.5- to 1 point of growth for European countries. [ABSTRACT FROM AUTHOR]

Forest plantation is a widely used silvicultural practice throughout Europe most particularly to renew planted forest stands. The long term impact of forest plantations on soil fertility is a major concern for forest managers and policy makers, in particular in the context of global change because forests endure increased climatic and/or silvicultural and/or nutritional pressure. In the present study we investigated the tree species effects on soil solution chemistry and major elements fluxes, to better understand the impact of tree species on soil processes and fertility. The chemical composition of throughfall and soil solutions were compared between six 35-year-old monospecific stands (Norway spruce, Corsican pine, sessile oak, European beech, Douglas fir and Nordmann fir) and the reference plot (beech and oak coppice with standards) of the common garden experiment at the Breuil-Chenue Experimental site (Burgundy, France). Tree species had a strong effect on the chemistry of throughfall and soil solution, in particular on the relative contribution of nitrate, sulfate and dissolved organic carbon to the anionic charge. Mean concentrations of major elements varied widely between stands. Nitrate concentrations were highest for the Douglas fir and Corsican pine probably due to the tree species effect on nitrification processes. In both stands, the nitrate leaching causes large acidification with high drainage losses of magnesium, calcium and monomeric aluminum. For Norway spruce, sessile oak, European beech and reference plot, sulfate and dissolved organic carbon were the main anionic drivers for solution chemistry and nutrient fluxes. Soil acidification processes were less intense in these stands and aluminum was mainly transported in the soil profile by Al-cheluviation by dissolved organic compounds. The results of this study suggest that tree species strongly influence the chemistry of throughfall and soil solutions and may strongly influence on the short-term (35 years) soil pedogenic processes from weak acidification and crypto-podzolisation to strong soil acidification. [ABSTRACT FROM AUTHOR]

Purpose: We evaluated urinary collecting system invasion as a prognostic parameter of renal cell carcinoma. Materials and Methods: A total of 1,124 patients who underwent nephrectomy for a renal tumor at 5 European centers were included in this retrospective study. Several variables were analyzed including urinary collecting system invasion, age, sex, TNM stage, Fuhrman grade, histological subtype, Eastern Cooperative Oncology Group performance status and cancer specific survival. Results: There were 771 males (68.6%) and 353 females (31.4%) in this study, and median age was 61 years (range 14 to 88). Median tumor size was 6 cm (range 1 to 24). Tumors were organ confined and Fuhrman grade was recorded as 1 or 2 in 67.1% and 62.3% of cases, respectively. Symptoms were present at diagnosis, and Eastern Cooperative Oncology Group performance status was 1 or more in 50.3% and 16.1% of the cases, respectively. Median followup was 43 months (range 1 to 299). At the end of followup 246 patients (21.9%) died of cancer. In 132 cases (11.7%) urinary collecting system invasion was noted. Urinary collecting system invasion was associated with symptoms, TNM stage, Fuhrman grade, tumor size (p <0.001) and Eastern Cooperative Oncology Group performance status (p = 0.003), but not with histological subtype (p = 0.7). On univariate analysis TNM stage, Fuhrman grade, symptoms, Eastern Cooperative Oncology Group performance status, tumor size and urinary collecting system invasion (p = 0.0001) were significant predictors of cancer specific survival. Urinary collecting system invasion was an independent prognostic parameter only in the setting of pT1–T2 tumors. When the urinary collecting system was invaded the 5 and 10-year probabilities of survival were 43% and 41%, respectively. Conclusions: Urinary collecting system invasion appears to be an independent prognostic parameter of organ confined renal cell carcinoma. Our data support the need to integrate this parameter in further TNM revisions. [Copyright &y& Elsevier]

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The author offers information on the principality of Monaco's financial life with focus given to its disciplined budgeting practices, its moderate fiscal policy based on value-added tax (TVA), and its stable position in an international economic environment. Topics include its international banking industry, its financial regulation in compliance with international standards, and its fight against money laundering, the financing of terrorism, and corruption.

In the current content of economic and financial crisis, the attention of citizens in France, as in many other European countries, is focused above all on economic and social questions (purchasing power, employment, housing etc.). This means that environmental considerations are increasingly downplayed, as are energy issues-though to a lesser extent, given their economic impact. However, the questions of future energy prospects and combating climate change are just as pressing now as they have ever been. Some argue that they might even serve as levers to restart economic growth. It is a very good time, then, for Jacques Lesourne to be summarizing the situation on energy and climate that prevails within the EU. How it European policy with regard to energy and global warming organised (the overall architecture, the objectives, the legal instruments etc.)? What are the major events that have occurred in the fast five years that have impacted significantly on these fields? Has European policy borne fruit where energy and the climate are concerned? This article strives to provide answers to all these questions, while stressing the degree to which the increasing number of decisions taken at member-state level without Europe-wide consultation in leading to harmful incoherence and is casting doubt on the EU's capacity to remain a leader in the world-wide struggle against global warming. And this leads to other questions which are crucial for the future, regarding the best way of organizing this European energy policy at the national, EU or international level, while not tailing to pay attention to the main parties concerned: namely, European consumers. [ABSTRACT FROM AUTHOR]

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Abstract: The ESPON 2006 scenario project generated three integrated roll-forward scenarios (A roll-forward scenario is a scenario in which the hypotheses define the parameters at the start of the covered time period and the scenario then explores the unfolding of events based on theses hypotheses. This is opposed to a roll-backward scenario in which the situation at the end of the time period is defined and the scenario then explores the path to reach this situation.). In the trend scenario renewed efforts are made for the Lisbon strategy, demanding extra investments in R&D and education. Regional policy will also be continued with vigour. In the Competition Scenario bold decisions are made regarding Europe''s continued prosperity. The Lisbon strategy takes precedence over institutional reform and other sectoral policies. In the Cohesion Scenario Europe is confronted with the challenge of fully integrating the various regions in Europe. The budgets for Regional Policy and Rural Development Policy are enhanced and targeted to the most needy regions. The scenarios are described as stories about the future, supported by model calculations and visualised by various maps. They concentrate on urban and rural development and on territorial developments in different parts of Europe, like North-West Europe, the Alpine Space and Central and Eastern Europe. In addition, a proactive, roll-back scenario explores the possibilities to combine competitiveness, cohesion and sustainability. A message, derived from the scenarios, is that independent of the explored policy options the European territory will be confronted with large challenges like a (rapid) decline of fossil energy resources and increasing impacts of climate change. The scenarios appear particularly helpful in the context of the current paradigm shift in European regional policy from a policy for balance to a policy for aggregate growth. [Copyright &y& Elsevier]

Abstract: A significant change in trends regarding energy prices (in particular oil) has taken place in 2003 at the beginning of the Iraq War. It has revealed a very strong tension between oil prices on the one hand and the relationship between global oil supply and demand on the other. The strong growth rates of emerging economies up to 2008 have generated a very sharp increase in oil prices. The temporary economic recession of 2008–2009 has resulted in turn into a significant decrease of oil prices, down to a level which remained, however, twice as high as that of early 2003. With the economy recovering from the recession, it is highly probable that energy prices will continue to increase and that Europe will be confronted with high energy prices in the coming decades. Against this general background, two scenarios have been elaborated which differ mainly by the time of occurrence of oil peaking. 1 [1] Oil peaking (or Peak Oil) is a term for the time when the rate of global oil production reaches its final maximum, changing from the past upwards trends to the inevitable future declining trends. Oil peaking means an abrupt disruption of the balance between oil supply and demand and therefore a sharp increase of oil price. The differences between the scenario hypotheses are therefore differences of context in relation to exogenous factors. Policies are also considered in the scenarios, but they are not at the forefront and their impact is considered as limited in relation to that of exogenous factors. The first scenario “Europe in a context of high energy price” assumes that the process of oil peaking will not take place before 2030, but that oil price increase will nevertheless be sustained and substantial until then. Numerous adjustments will have to be made in the economy and their territorial impacts will be significant (less polycentricity, more compact cities, decline of the importance of road and air transport). The second scenario “Europe after oil production peaking” assumes that oil production will peak around the mid-2010s (followed by gas production peaking around 2025), despite significant investments to increase production. In a context of steadily growing oil and gas demand, Europe will be confronted with serious economic difficulties. The territorial impacts will be different from those suggested by the first scenario, with stronger pressure put on rural areas and a loss of attractiveness of large cities related to increasing unemployment and social tensions. In both scenarios, the countries of central and eastern Europe will be more severely hit by the new energy context. The scenarios were elaborated in 2005 and slightly reviewed in 2009 in order to take account of the impacts of the economic recession in Europe and of the growing concerns about climate change. [Copyright &y& Elsevier]

In the 1990s, an intensive standardization effort in the field of industrial acoustics took place within the International Organization for Standardization (ISO) with the objective to cover the entire field of occupational noise, from sound sources (machinery) to noise exposure of workers. This lead to the drafting of three groups of key International Standards (ISO) which were adopted word for word as European standards (EN ISO) closely linked to European regulation: • Group 1 on noise sources: the ISO 11688 series (2 standards) on the design of low-noise machinery, the ISO 3740 (8 standards), ISO 9614 (3 standards) and ISO 11200 (6 standards) series on the measurement of noise emission from machinery, ISO 4871 on noise declaration and a large number of noise test codes for machinery families; • Group 2 on technical means to reduce noise along its propagation path: a series of 8 ISO standards dealing with the design of technical means to reduce noise at the workplace (i.e. enclosures, cabins for the personnel, screens, silencers) and the measurement of their noise control performance; • Group 3 on workplace noise: the ISO 11690 series (3 standards) on the design of low-noise workplaces, ISO 14257 on the characterization of the acoustical performance of rooms (sound decay curves) and ISO 9612 on the measurement of occupational noise exposure. As a whole, these standards back the strategy for occupational noise control that is recognized worldwide but not necessarily implemented. Starting from the fact that designing low-noise machinery will ultimately reduce the noise levels to which workers are exposed around the world, this strategy is based on the market forces acting between the main parties involved i.e. machinery designers, machinery users, national and regional authorities and occupational health and safety experts with the technical assistance of noise consultants. [ABSTRACT FROM AUTHOR]

The article looks at companies and markets viable for providing high definition television (HDTV) services in Europe. In Germany, the digital switchover is a main factor in resolving capacity issues in the telecommunication market. Meanwhile, Spain has the advantage of a relatively homogenous HD-compatible system, which can be compared to the one implemented in France. France has become the dominant player when considering the HD segment on the terrestrial front. The country is also trying to cope with the rise of Internet protocol television (IPTV).

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The article focuses on the regulatory challenge faced by the fibre to home and hybrid fibre coaxial technologies in Europe. It provides an overview of the successes and failures of the technology starting with mobile services which developed under regulation from the early 1990s. In 1998, regulation had a more impact on telephone services via carrier selection rather than on the services' development. This imposed tariffs rebalancing between subscription and traffic. Meanwhile, penetration and innovation of Broadband access was accelerated by unbundling penetration which was imposed by 2000 European regulation. At present time, the challenge involves the development of very high speed services on fibre access networks.

Digital convergence is quickly leading to various telecommunications and media sourcing triple play services of voice, television and internet. This article describes the extent to which bundling strategies have been recently deployed by access providers, and their impact on competition in Western Europe. Generally speaking, we observe that the "business sorting" effect of bundling is larger than that of "business stealing" for triple-play in Western Europe. The sorting effect does not however compensate for the extra competition arising from the full convergence of access provision. [ABSTRACT FROM AUTHOR]

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Comments on the diversity in the urban life of Europe. Implications associated with the definition of urbanity with reference to the European urban life; Facts associated with different types of densifications of a European city; Basis behind the invention of an urban city in Europe with approvals from the sociological and political consequences of the region.

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On the basis of the interconnection of national networks of clinical research centres (CRCs) and clinical trials units (CTUs), the European Clinical Research Infrastructures Network (ECRIN) programme aims to develop an infrastructure allowing for bottom-up harmonisation of the support and training for, and practice of, clinical research, and to provide public sponsors for biotechnology small and medium-sized companies (SMEs) with support for translational research and multicentre clinical studies in Europe. This will be achieved through an application to the next FP6 ‘Integrated Infrastructure Initiatives’ call. However, prior work is required to improve the reciprocal knowledge of partners in the ECRIN consortium and, as a first step, country-specific workshops will be organised by national networks in order to address the organisation of CRC/CTUs and national networks, and their interaction with the national environment of clinical research; this will enable in-depth discussion addressing the bottlenecks hampering transnational studies. Keywords: clinical research centres, European network Résumé Le programme ECRIN vise à développer un réseau européen de centres de recherche clinique au travers de l’appel d’offres « Infrastructures » du 6ème PCRD (Programme Cadre de Recherche et Développement de la Communauté Européenne). Actuellement il associe six réseaux nationaux de centres de recherche clinique ou de centres d’essais cliniques (réseau des KKS allemand, Institut Mario Negri italien, réseau de centres d’essais cliniques danois, réseau des centres d’essais cliniques français, le réseau italien du CIRM [Consortium Italien pour la Recherche Médicale] et le réseau français des CIC Inserm [Centres d’Investigation Clinique]). Sous l’impulsion de ce projet, d’autres réseaux nationaux sont en voie de constitution (Suède, Espagne) afin de se connecter au réseau, et des contacts ont été pris dans d’autres pays européens. L’objectif est d’une part de promouvoir des activités de réseau afin de tendre vers une application des directives européennes et une meilleure harmonisation de la formation, des pratiques et des supports de la recherche clinique, et d’autre part de faciliter l’accès transnational en proposant un certain nombre de services « à la carte » aux investigateurs, publics mais aussi industriels. Le champ d’application privilégié en sera d’une part le domaine des maladies rares et des médicaments orphelins, la recherche physiopathologique, mais aussi le développement de thérapies innovantes issues du domaine des biotechnologies permettant aux PME (petites et moyennes entreprises) européennes un accès facilité aux essais cliniques. En amont du développement de cette infrastructure, un projet préparatoire permettra une connaissance réciproque approfondie des réseaux nationaux et des particularités de leur environnement. Mots clés : centres de recherche clinique, réseau européen Texte reçu le 6 mai 2003 ; accepté le 10 décembre 2003 [ABSTRACT FROM AUTHOR]

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Discusses the need to develop a competitive European economy. Information on the project "Constitution for Europe," which aims at a durable development founded on a balanced economic growth; Reference to the responsibility of the governments of various countries in Europe to devote all the attention necessary to the progress of young people in the business sector; Need of working together for the development of a new European pact for youth.

Fisheries research organisations are described as large entities. Inthe European Union, Iceland, Israel and Norway, one or two main fisheries research institutes have been identified. In this detailed examination, research programmes in fisheries is presented in various technological fields. Theoretical knowledge of Evolutionary economics isused to understand the functioning of fisheries research in these 17countries. Concepts of technological trajectories, path-dependancy, technological lock-in are valuable. Six main technological trajectories synthetize the foundations of research in fisheries amongst European Union, Iceland, Israel and Norway. It deals with fishery biology, fishing gear technology, aquaculture, ecology, quality (of habitat and fish), and socioeconomics. For example, most of research institutesare concerned with the trajectory of fishery biology. In others cases, specificities exist in a few countries as socioeconomics. [ABSTRACT FROM AUTHOR]

Objective: Understanding preferences of patients with rheumatoid arthritis (RA) can facilitate tailored patient-centric care. This study elicited trade-offs that patients with RA were willing to make during treatment selection., Methods: Patients with RA completed an online discrete choice experiment, consisting of a series of choices between hypothetical treatments. Treatment attributes were selected based on literature review and qualitative patient interviews. Eligible patients were ≥18 years old, diagnosed with RA, receiving systemic disease-modifying antirheumatic drug therapy, and residents of Europe or USA. Male patients were oversampled for subgroup analyses. Data were analysed using a correlated mixed logit model., Results: Of 2090 participants, 42% were female; mean age was 45.2 years (range 18-83). Estimated effects were significant for all attributes (p<0.001) but varied between patients. Average relative attribute importance scores revealed different priorities (p<0.001) between males and females. While reducing pain and negative effect on semen parameters was most important to males, females were most concerned by risk of blood clots and serious infections. No single attribute explained treatment preferences by more than 30%. Preferences were also affected by patients' age: patients aged 18-44 years placed less importance on frequency and mode of treatment administration (p<0.05) than older age groups. Patients were willing to accept higher risk of serious infections and blood clots in exchange for improvements in pain, daily activities or administration convenience. However, acceptable trade-offs varied between patients (p<0.05)., Conclusion: Treatment preferences of patients with RA were individual-specific, but driven by benefits and risks, with no single attribute dominating the decision-making., Competing Interests: Competing interests: RA, consultancy fees from AbbVie, Amgen, Biogen, Bristol Myers Squibb, Celltrion, Gilead, Janssen, Lilly, Medac, MSD, Mylan, Novartis, Pfizer, Roche, Sandoz, Sanofi-Genzyme, UCB, VIATRIS. JCNG, consultancy fees from Lilly, Janssen, Amgen, GSK, AbbVie, Galápagos, MSD; speakers fees from MSD, Pfizer, BMS, AbbVie, UCB Pharma, Janssen, Lilly, Faes Farma, Roche, Celgene, Sanofi, Nordic Pharma, Gebro, Novartis, Biogen, Amgen, Sandoz. PJ, grants support from Pfizer and Roche; speakers fees from Eli Lilly; support for meeting attendance from Galapagos. CM, consultancy fees from BMS, AbbVie, Gilead; speakers fees from BMS, AbbVie, Eli Lilly, Pfizer, Boehringer, Galapagos, Sanofi, Roche. RM, grant support from Novartis; consultancy fees from Ferring; speakers fees from Amgen and Galapagos. HR, speakers fees from Gilead Science, Merck Sharp; Pfizer Cooperation Austria, Janssen. HEV, grants from Galapagos, Boehringer Ingelheim; speakers fees from Galapagos, AbbVie, Boehringer Ingelheim, Novartis, Pfizer, UCB, Janssen. SH, employee of Evidera Inc, which is part of Thermo Fisher Scientific's Clinical Research Group; Evidera received payment for conducting the work outlined in this manuscript; SH is a minority stockholder of Thermo Fisher Scientific, as part of his employment with Evidera. CW, employee of Evidera Inc, which is part of Thermo Fisher Scientific's Clinical Research Group; Evidera received payment for conducting the work outlined in this manuscript. NK, employee of Evidera Inc, which is part of Thermo Fisher Scientific's Clinical Research Group; Evidera received payment for conducting the work outlined in this manuscript; NK is a minority stockholder of Thermo Fisher Scientific, as part of his employment with Evidera. KVB, employee and shareholder of Galapagos NV., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)