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Objective: To assess the validity of patient self‐reported oral health measures as used in a large multi‐country survey for populations aged 50+. Background: Information on people's oral health status is important for assessing oral health needs within populations. However, clinical examination is not always possible. Patient self‐reported measures may provide an alternative when time and other resources are scarce. Materials and methods: Using oral health items from the Survey of Health, Ageing and Retirement in Europe (SHARE), self‐reported measures were collected from 186 patients receiving treatment at Heidelberg University Hospital. Self‐reports were compared with subsequent clinical examinations. Analyses were conducted for patients of all age groups and separately for patients aged 50+ (analogous to the SHARE study population). Diagnostic accuracy, agreement and correlation of patient‐reported information were examined using descriptive statistics and Bland‐Altman plots. Results: Patient‐reported presence or absence of a full tooth count was closely related to clinical measurement, both for all age groups (sensitivity: 93%; specificity: 92%) and persons aged 50+ (sensitivity: 100% specificity: 94%). Bland‐Altman plots indicate good agreement between patient‐ and clinical reports of the number of teeth at age 50+ (Concordance Correlation Coefficient = 0.95). Discriminatory power of patient‐reporting was good regarding presence vs absence of artificial teeth, but less robust regarding partial vs full replacement of missing teeth. Conclusion: Patient self‐evaluations provide reasonable estimates of clinical measures and appear sufficiently accurate for examining variations in the number of teeth, including among populations aged 50+. However, patient reports of the extent of replacement of missing teeth may not constitute reliable reflections of clinical conditions. [ABSTRACT FROM AUTHOR]

Objectives Oral diseases are still among the most common chronic diseases globally with substantial detrimental impact especially on elderly people's health and well-being. However, limited evidence exists on international variation in the oral health status of the older population. We aimed to examine international variation in tooth loss and tooth replacement in the general population aged between 50 and 90 years. Methods A cross-sectional analysis of data from the fifth wave of the Survey of Health, Ageing and Retirement in Europe (SHARE) was conducted. The data cover 14 European countries (Austria, Belgium, Czech Republic, Denmark, Estonia, France, Germany, Italy, Luxembourg, the Netherlands, Slovenia, Spain, Sweden, and Switzerland) and Israel, and they were collected during the year 2013. Age-specific percentages of the population having all natural teeth, the age-specific numbers of natural (and artificial) teeth, and the age-specific percentages of full, partial, or no replacement of missing teeth were assessed with stratification by country. It was further evaluated to which extent proposed oral health goals concerning tooth loss at higher ages had been achieved. Results In total, 62 763 individuals were included in the study. Age-standardized mean numbers of natural teeth exhibited substantial variation, ranging from 14.3 (Estonia) to 24.5 (Sweden). The oral health goal of retaining at least 20 teeth at age 80 years was achieved by 25% of the population or less in most countries. A target concerning edentulism (≤15% in population aged 65-74 years) was reached in Sweden, Switzerland, Denmark, France, and Germany. Tooth replacement practices varied especially for a number of up to five missing teeth which were more likely to be replaced in Austria, Germany, Luxembourg, and Switzerland than in Israel, Denmark, Estonia, Spain, and Sweden. Conclusions This study suggests that the age-specific number of natural teeth and the practice of tooth replacement in the over 50s differ substantially among the included countries. The present results may be helpful in the formulation and evaluation of oral health goals in the older population. [ABSTRACT FROM AUTHOR]

Background: National vaccination coverage rates for individuals at increased risk of influenza-related complications represent a useful public health indicator of preparedness. We compared European countries regarding (i) vaccination coverage among high-risk groups and (ii) the likelihood that high-risk individuals reported influenza vaccination compared with those at lower risk. Methods: We used data from the Survey of Health, Ageing and Retirement in Europe (SHARE) collected in 2004–05. Adults aged ≥50 years from 11 countries provided self-reports of an influenza vaccination in the previous year (n = 16 913). We defined four high-risk groups (age ≥65 years, presence of vascular disease, chronic lung disease or diabetes) and calculated vaccination coverage with 95% confidence intervals for each country. Country-specific multivariable logistic regression was used to estimate odds ratios (ORs) for membership in a high-risk group and vaccination. Results: The Netherlands had the highest influenza vaccination coverage in high-risk groups (≥75% in any group) while Greece had the lowest (<27% in any group). Older age was positively associated with report of vaccination in all countries, but the strength of this association varied from an OR of <2 (Germany) to >13 (The Netherlands). The ORs for the chronic disease groups was ≥4 for The Netherlands and were considerably lower (and often not statistically significant) for the other countries. Conclusion: Influenza vaccination coverage among high-risk groups varies considerably between European countries. Our findings highlight potential opportunities for reducing influenza-related complications through support for vaccination programs that target high-risk individuals more effectively. [ABSTRACT FROM AUTHOR]

Screening for colorectal cancer (CRC) by colonoscopy and sigmoidoscopy has been demonstrated to be effective in reducing CRC incidence and mortality, and they are increasingly employed as screening tests and for diagnostic purposes in many countries. We conducted a systematic review to provide up-to-date estimates on the utilization of lower gastrointestinal endoscopy (colonoscopy and sigmoidoscopy) in the general average-risk population in different countries. PubMed and Web of Science were searched for relevant articles published between 1 September 2008 and 31 October 2016. A total of 23 studies from the US and 20 studies from other countries were included in this review. Estimates from the US were highest, continued to increase over the past decade and reached 62% for colonoscopy use within 10years in people aged 50-75years in 2012. Endoscopy use in other countries was substantially lower (12-44% for lifetime colonoscopy use and 13-30% for recent colonoscopy use), except for Germany, where 55% of the screening-eligible population reported colonoscopy utilization within the previous 10years in 2008-2011. Both lifetime and recent endoscopy use increased with age and peaked at approximately 70-75years. Although several European and Asian countries have started to collect endoscopy utilization data through periodic national health surveys, more data are still much needed from non-US countries. With the implementation of CRC screening programs in an increasing number of countries, especially European countries, an increase in endoscopy use and subsequent reduction in CRC incidence and mortality in the years to come might be expected in those countries. [ABSTRACT FROM AUTHOR]

• 28 research institutes have joined in the Policy Evaluation Network (PEN). • PEN studies EU policies on diet, physical activity and sedentary behaviours. • PEN advances knowledge on impact and effective implementation of these policies. • We here describe the rationale and specific goals of PEN, and highlight innovations. Non-communicable diseases (NCDs) are the leading cause of global mortality. As the social and economic costs of NCDs have escalated, action is needed to tackle important causes of many NCD's: low physical activity levels and unhealthy dietary behaviours. As these behaviours are driven by upstream factors, successful policy interventions are required that encourage healthy dietary behaviours, improve physical activity levels and reduce sedentary behaviours of entire populations. However, to date, no systematic research on the implementation and evaluation of policy interventions related to these health behaviours has been conducted across Europe. Consequently, no information on the merit, gaps, worth or utility of cross-European policy interventions is available, and no guidance or recommendations on how to enhance this knowledge across European countries exists. As part of the Joint Programming Initiative "A Healthy Diet for a Healthy Life" (JPI HDHL), 28 research institutes from seven European countries and New Zealand have combined their expertise to form the Policy Evaluation Network (PEN). PEN's aim is to advance tools to identify, evaluate, implement and benchmark policies designed to directly or indirectly target dietary behaviours, physical activity, and sedentary behaviour in Europe, as well as to understand how these policies increase or decrease health inequalities. Using well-defined evaluation principles and methods, PEN will examine the content, implementation and impact of policies addressing dietary behaviour, physical activity levels and sedentary behaviour across Europe. It will realise the first steps in a bespoke health policy monitoring and surveillance system for Europe, and refine our knowledge of appropriate research designs and methods for the quantification of policy impact. It will contribute to our understanding of how to achieve successful transnational policy implementation and monitoring of these policies in different cultural, demographic or socioeconomic settings. PEN will consider equity and diversity aspects to ensure that policy actions are inclusive and culturally sensitive. Finally, based on three policy cases, PEN will illustrate how best to evaluate the implementation and impact of such policies in order to yield healthy diets and activity patterns that result in healthier lives for all European citizens. [ABSTRACT FROM AUTHOR]

Introduction: To quantify the association of self-reported lower gastrointestinal endoscopy use measured in 2004/05 with colorectal cancer (CRC) mortality changes over 2004-2015 in Europe., Methods: An ecological analysis was performed using endoscopy utilization data from the Survey of Health, Aging, and Retirement in 11 European countries in 2004/05 and CRC mortality data from the World Health Organization Mortality Database over 2004-2015. Mortality trends were compared through annual mortality changes from joinpoint regression models. Cross-national variations in mortality trends with respect to endoscopy use were tested for statistical significance by negative binomial regression models., Results: The proportion of respondents who reported having had an endoscopy within 10 years varied widely across countries, from 6.1% to 25.1%. Large disparities in CRC mortality trends were also observed, with annual mortality change ranging from a decline of 3.3% to an increase of 0.9% for men and from a decline of 3.3% to a decline of 0.6% for women. Endoscopy uptake was negatively associated with the magnitude of annual mortality change over 2004-2015 (rate ratio for a 10-year mortality change per 10% higher endoscopy use, 0.88; 95% confidence interval, 0.82-0.94)., Discussion: This analysis provides quantitative evidence on the contributions of endoscopy use to CRC mortality declines in European countries over the past decade. A considerable fraction of protection is likely to be delivered through endoscopic removal of adenomas and sessile serrated lesions. With many European countries having recently implemented CRC screening programs, an increase in endoscopy use and a subsequent reduction in CRC mortality would be expected.

Objectives: Dental diseases are the most common chronic diseases worldwide. Healthy teeth are vital for quality of life, particularly diet and nutrition. However, little information exists to inform health policymakers about potentially long-lasting influences of early-life conditions. The purpose of this study was to investigate the relation between early-life socioeconomic conditions and number of natural teeth at age 50 and above., Methods: Analyses were conducted on cross-sectional data from the Survey of Health, Ageing and Retirement in Europe (SHARE wave 5), which includes information on 41 560 respondents aged 50 years or older from 14 European countries and Israel. Using SHARE life history information, a series of regression models (OLS, Tobit) were estimated to analyse the relationship between socioeconomic conditions in earlier life and the number of teeth at age 50+., Results: Childhood socioeconomic background was associated with the number of natural teeth at age 50 and above, even after controlling for current determinants of oral health. Respondents who had had more than 25 books in their childhood household had a mean 1.4 (95% CI: 1.2-1.5) more teeth than respondents with fewer books. Respondents who reported poor financial conditions during childhood had a mean 0.6 (95% CI: 0.3-0.9) fewer teeth than respondents who reported better financial conditions in childhood., Conclusion: These findings substantiate the association between socioeconomic conditions in the early years of life and tooth retention to older adulthood and highlight the long-lasting relation between childhood living conditions and oral health through the lifecourse., (© 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: The standardisation of the assessment methodology and case definition represents a major precondition for the comparison of study results and the conduction of meta-analyses. International guidelines provide recommendations for the standardisation of falls methodology; however, injurious falls have not been targeted. The aim of the present article was to review systematically the range of case definitions and methods used to measure and report on injurious falls in randomised controlled trials (RCTs) on fall prevention., Methods: An electronic literature search of selected comprehensive databases was performed to identify injurious falls definitions in published trials. Inclusion criteria were: RCTs on falls prevention published in English, study population ≥ 65 years, definition of injurious falls as a study endpoint by using the terms "injuries" and "falls"., Results: The search yielded 2089 articles, 2048 were excluded according to defined inclusion criteria. Forty-one articles were included. The systematic analysis of the methodology applied in RCTs disclosed substantial variations in the definition and methods used to measure and document injurious falls. The limited standardisation hampered comparability of study results. Our results also highlight that studies which used a similar, standardised definition of injurious falls showed comparable outcomes., Conclusions: No standard for defining, measuring, and documenting injurious falls could be identified among published RCTs. A standardised injurious falls definition enhances the comparability of study results as demonstrated by a subgroup of RCTs used a similar definition. Recommendations for standardising the methodology are given in the present review.