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Potentially, technology transfer offices (TTOs) can play a significant role in facilitating the successful transfer of technologies and knowledge between universities and industry. Many developing countries are currently developing technology transfer practices within their universities. However, many developing country TTOs operate inefficiently or are ineffective. The sharing of experiences can lead to improvements in this endeavour. Advanced nations can serve as a frame of reference and a basis of policy recommendations for developing countries due to the longevity of their technology transfer activities. The authors issued 234 questionnaires to European university TTOs, of which 54 usable questionnaires were returned. They combine the data from these questionnaires with 19 interviews conducted with university TTO staff from 9 countries in an attempt to create a typology of practices that developing nations could emulate to improve technology transfer in their own contexts. While ultimately a clear typology was not forthcoming, the authors found some relationship between the dominant focus in the mission statement of developed country TTOs, the activities they undertake, their position in the university governance structure and their level of maturity which may usefully inform the development of TTO practices in developing countries.

Immigrant minority (IM) languages have a significant presence in certain European regions. Nonetheless, these languages are not usually included in the school curriculum. This paper aims to analyse the studies published between 2010 and 2020 considering IM languages in multilingual European education contexts. The method included a search of academic papers published in the databases ERIC, Web of Science and Scopus, which yielded 42 studies. The studies were analysed by considering: (1) the demographic characteristics of the countries where the studies were conducted, (2) the sociolinguistic or psycholinguistic focus of the papers in relation to the European country, and (3) the characteristics of the bi-multilingual education programme including IM languages. The results indicate that: (1) the demographic characteristics of the country are not strictly related to the number of studies published, (2) most studies have a sociolinguistic approach even though many studies analyse both sociolinguistic and psycholinguistic factors, and (3) only seven multilingual education programmes including IM languages were described in these papers. We conclude that there is a lack of research focusing on IM languages in educational settings and discuss how addressing these gaps could create opportunities for building equitable multilingual communities in Europe.

Objective To examine the relationship between the numbers of people walking or bicycling and the frequency of collisions between motorists and walkers or bicyclists. The common wisdom holds that the number of collisions varies directly with the amount of walking and bicycling. However, three published analyses of collision rates at specific intersections found a non-linear relationship, such that collisions rates declined with increases in the numbers of people walking or bicycling. Data This paper uses five additional data sets (three population level and two time series) to compare the amount of walking or bicycling and the injuries incurring in collisions with motor vehicles. Results The likelihood that a given person walking or bicycling will be struck by a motorist varies inversely with the amount of walking or bicycling. This pattern is consistent across communities of varying size, from specific intersections to cities and countries, and across time periods. Discussion This result is unexpected. Since it is unlikely that the people walking and bicycling become more cautious if their numbers are larger, it indicates that the behavior of motorists controls the likelihood of collisions with people walking and bicycling. It appears that motorists adjust their behavior in the presence of people walking and bicycling. There is an urgent need for further exploration of the human factors controlling motorist behavior in the presence of people walking and bicycling. Conclusion A motorist is less likely to collide with a person walking and bicycling if more people walk or bicycle. Policies that increase the numbers of people walking and bicycling appear to be an effective route to improving the safety of people walking and bicycling. [ABSTRACT FROM AUTHOR]

Transport is one of the fastest growing sources of emissions of greenhouse gases. Some European countries have adopted comprehensive 'sustainable transport' policies, in which climate change is addressed. This paper looks into how sustainable transport policy frameworks deal with climate change challenges in three countries: the Netherlands, Sweden, and the United Kingdom. In particular, the focus is on the role of follow-up and monitoring systems to keep the policies on track. For the United Kingdom, a critical analysis is made of strengths and weaknesses of the policy monitoring regime. The analysis shows that the monitoring approach, while ambitious, has suffered some deficits that may have weakened the role of the high-level strategies. Current efforts to strengthen the system are discussed. [ABSTRACT FROM AUTHOR]

A child's disability, long-term illness, or mental ill-health is known to affect siblings' health, social life, school engagement, and quality of life. This article addresses a research gap by its focus on young sibling carers and the impact of providing care to a sibling. A cross-national survey study was conducted in 2018–2019 (Italy, the Netherlands, Slovenia, Sweden, Switzerland, the UK) to examine the incidence of adolescent sibling carers, the extent of care they provide, and their self-reported health, well-being, and school situation. The survey was completed by 7146 adolescents, aged 15–17, and 1444 of them provided care to family members with health-related conditions. Out of these, 286 were identified as Sibling Carers and 668 as Parent Carers, while 181 had both sibling(s) and parent(s) with health-related conditions, and thus were identified as Sibling–Parent Carers. Sibling Carers and Sibling–Parent Carers carried out higher levels of caring activities compared to Parent Carers. They reported both positive aspects of caring, such as increased maturity, and negative aspects, such as mental ill-health, impact on schooling and a lack of support. To reduce the negative aspects of a sibling carer role, it is important to recognise them and to implement early preventive measures and formal support. [ABSTRACT FROM AUTHOR]

Background In Europe, more than 15 million people live with heart failure (HF). It imposes an enormous social, organizational and economic burden. As a reaction to impending impact on healthcare provision, different country-specific structures for HF-care have been established. The aim of this report is to provide an overview and compare the HF-care approaches of Germany, Ireland, the Netherlands and the UK, and to open the possibility of learning from each other's experience. Methods A mixed methods approach was implemented that included a literature analysis, interviews and questionnaires with HF-patients and caregivers, and expert interviews with representatives from healthcare, health service research and medical informatics. Results The models of HF-care in all countries analyzed are based on the European Society of Cardiology guidelines for diagnosis and treatment of HF. Even though the HF-models differed in design and implementation in practice, key challenges were similar: (i) unequal distribution of care between urban and rural areas, (ii) long waiting times, (iii) unequal access to and provision of healthcare services, (iv) information and communication gaps and (v) inadequate implementation and financing of digital applications. Conclusion Although promising approaches exist to structure and improve HF-care, across the four countries, implementation was reluctant to embrace novel methods. A lack of financial resources and insufficient digitalization making it difficult to adopt new concepts. Integration of HF-nurses seems to be an effective way of improving current models of HF-care. Digital solutions offer further opportunities to overcome communication and coordination gaps and to strengthen self-management skills. [ABSTRACT FROM AUTHOR]

Public discourses on citizenship, identity and nationality, which link geographical borders and the political boundaries of a community, are infused with tensions and contradictions. This paper illustrates how these tensions are interwoven with multilayered notions of home, belonging, migration, citizenship and individual's ‘longing just to be’, focusing on the Dutch and the British context. The narratives of a number of Dutch and British women, who either immigrated to the respective countries or were born to immigrants, illustrate how the growing rigid integration and assimilative discourses in Europe contradict an individual anchoring in national and local communities. The narratives of women participating in these studies show multilayered angles of belonging presenting an alternative to the increasing strong argument for a fixed notion of positioning and national belonging. The female ‘new’ citizens in our study tell stories of individual choices, social mobility and a sense of multiple belonging in and across different communities. [ABSTRACT FROM PUBLISHER]

This paper has contributed to confirming the link between education and health in developed countries. The analysis is based on 11 European Union countries. We estimate country-specific health functions, where the dependent variable is self-reported health status and the education attainment is one of the main inputs. All eight waves (1994–2001) of the European Community Household Panel are deployed. A random effects ordered probit is estimated in order to control, to a given extent, for unobserved heterogeneity. Explanatory variables are both time invariant (education attainment and gender) and time varying (gross wages, hours of work, age and living alone). Results confirm the positive impact of secondary education on health in most cases and tertiary education in all cases, even after controlling for other inputs in the health function and taking unobserved heterogeneity into account. Secondary education has an impact on health in all countries in the sample except for The Netherlands and UK. The effect does not differ between secondary and tertiary education in France, Ireland and Greece. The correlation between education and health is interpreted in different but complementary ways by diverse approaches and we may not disentangle the precise mechanism that connects health with education from our results. Anyway, it seems clear that better coordination is needed between education and health policies to effectively improve health literacy. Other relevant results from our study are that women register poorer health than men, age contributes to worsening health status and wages contribute positively to health. [ABSTRACT FROM AUTHOR]

The European natural gas market is characterized by declining indigenous resources, particularly in the UK and the Netherlands, and a growing dependence on a small number of large exporters who, as a consequence, see their market power increasing. In this paper we analyze long-run scenarios for the European natural gas markets in a model, NATGAS, that explicitly includes both factors, resource constraints and producers' market power. Finite resources lead to interdependencies of current production decisions and future opportunities. These decisions in turn depend on the potential for large producers to set market prices above marginal costs. We analyze the impact of conditions on the global LNG market on market shares of pipeline gas suppliers, as well as on the speed of depletion of indigenous European resources. We focus on how shadow prices of resource constraints affect substitution patterns in the various scenarios. [ABSTRACT FROM AUTHOR]

Objective. European countries practice a wide range of car driving license renewal procedures. These range from issuing lifelong licenses without subsequent medical checks, to issuing a license to age 70 and for 3- or 5-year periods thereafter based on self-declarations of medical fitness, to requiring medical examinations for renewal, to renewal every 5 years from the age of 45. This paper presents a case study of the different older driver licensing procedures in seven European countries and addresses the association between these procedures and older driver safety. Method. The seven countries studied consist of France, The Netherlands, the United Kingdom, Denmark, Finland, Norway, and Sweden. The first-mentioned three countries have the most relaxed license renewal procedures and least demanding medical examination requirements. Results. There is no evidence that any license renewal procedure or requirement for a medical examination has an effect on the overall road safety of drivers aged 65+, though undoubtedly there are individual drivers who should no longer be driving who might be detected by stringent renewal procedures. Considering the three countries with the most relaxed licensing procedures, The Netherlands and United Kingdom have the lowest fatality rate for car drivers aged 65+, and the rate for France is falling rapidly. Conclusions. There is also evidence that stringent renewal procedures and demanding medical examinations at renewal reduce the level of car driving licenses among older people. France, The Netherlands, and the United Kingdom have the highest level of driving license holding by people aged 65+, which has direct implications for the independent mobility of older people. Reduced mobility also has safety implications: in about half the European countries for which road accident fatality data have been analyzed, people aged 65+ are at greater risk of death as a pedestrian than as a car driver. [ABSTRACT FROM AUTHOR]

The article presents information about the book "Institutions and Regional Labour Markets in Europe." The book contains twelve papers that take an institutional perspective in comparing the performance of European labor markets in different regional socioeconomic settings. The papers discuss the spatial-institutional perspective on the labor market in Europe; general changes in the European labor market; regional and institutional changes in European labor markets; regional labor markets and institutions in Great Britain; institutions and regional labor markets in the Netherlands; institutions and regional return to education in Sweden; institutions and regional labor markets in Spain.

Background: Advance care planning supports patients to reflect on and discuss preferences for future treatment and care. Studies of the impact of advance care planning on healthcare use and healthcare costs are scarce. Aim: To determine the impact on healthcare use and costs of an advance care planning intervention across six European countries. Design: Cluster-randomised trial, registered as ISRCTN63110516, of advance care planning conversations supported by certified facilitators. Setting/participants: Patients with advanced lung or colorectal cancer from 23 hospitals in Belgium, Denmark, Italy, the Netherlands, Slovenia and the UK. Data on healthcare use were collected from hospital medical files during 12 months after inclusion. Results: Patients with a good performance status were underrepresented in the intervention group (p < 0.001). Intervention and control patients spent on average 9 versus 8 days in hospital (p = 0.07) and the average number of X-rays was 1.9 in both groups. Fewer intervention than control patients received systemic cancer treatment; 79% versus 89%, respectively (p < 0.001). Total average costs of hospital care during 12 months follow-up were €32,700 for intervention versus €40,700 for control patients (p = 0.04 with bootstrap analyses). Multivariable multilevel models showed that lower average costs of care in the intervention group related to differences between study groups in country, religion and WHO-status. No effect of the intervention on differences in costs between study groups was observed (p = 0.3). Conclusions: Lower care costs as observed in the intervention group were mainly related to patients' characteristics. A definite impact of the intervention itself could not be established. [ABSTRACT FROM AUTHOR]

Background: The prevalence of obesity has risen in recent decades and reached epidemic proportions worldwide. The proportion of those living with obesity is also increasing in nursing homes. This could impact the nursing care required, equipment and facilities provided, and morbidity in these settings. Limited evidence exists on clinical consequences of obesity in nursing home residents and their care. Objective: Therefore, the aim was to examine the rate and associated factors of obesity (BMI ≥30; class I (BMI 30.0–34.9 kg/m2), class II (BMI 35.0–39.9 kg/m2), and class III (BMI >40.0 kg/m2)) amongst older nursing home residents in European countries. Methods: We analysed data from 21,836 people who reside in nursing homes in Austria, the Netherlands, and the United Kingdom. They participated in the "International Prevalence Measurement of Care Quality", a cross sectional study between 2016 and 2019, where trained nurses interviewed the residents, reviewed care records, and conducted clinical examinations. A tested and standardised questionnaire comprised questions on demographic data, measured BMI, medical diagnosis according to ICD‐10, and care dependency. Descriptive and logistic regression analyses were performed. Results: Obesity rates were highest in Austria (17.1%) and lowest in the UK (13.0%) (p =.006). Residents with obesity were younger and less likely to be care dependent or living with dementia and had more often diabetes mellitus, endocrine, metabolic, and skin diseases compared to residents without obesity (p <.05). Most obese residents had obesity class I. Therefore, two subgroups were built (class I vs. class II + III). Residents with obesity class II + III were more frequently care dependent for mobility, getting dressed and undressed, and personal hygiene compared to residents with class I (p <.05). Conclusions: This study identified several factors that are associated with obesity amongst older nursing home residents in selected European countries. Implications for practice: The division into obesity classes is important for planning targeted care according to the individual needs of nursing home residents. [ABSTRACT FROM AUTHOR]

Background: Psychosis rates are higher among some migrant groups. We hypothesized that psychosis in migrants is associated with cumulative social disadvantage during different phases of migration. Methods: We used data from the EUropean Network of National Schizophrenia Networks studying Gene-Environment Interactions (EU-GEI) case–control study. We defined a set of three indicators of social disadvantage for each phase: pre-migration, migration and post-migration. We examined whether social disadvantage in the pre- and post-migration phases, migration adversities, and mismatch between achievements and expectations differed between first-generation migrants with first-episode psychosis and healthy first-generation migrants, and tested whether this accounted for differences in odds of psychosis in multivariable logistic regression models. Results: In total, 249 cases and 219 controls were assessed. Pre-migration (OR 1.61, 95% CI 1.06–2.44, p = 0.027) and post-migration social disadvantages (OR 1.89, 95% CI 1.02–3.51, p = 0.044), along with expectations/achievements mismatch (OR 1.14, 95% CI 1.03–1.26, p = 0.014) were all significantly associated with psychosis. Migration adversities (OR 1.18, 95% CI 0.672–2.06, p = 0.568) were not significantly related to the outcome. Finally, we found a dose–response effect between the number of adversities across all phases and odds of psychosis (⩾6: OR 14.09, 95% CI 2.06–96.47, p = 0.007). Conclusions: The cumulative effect of social disadvantages before, during and after migration was associated with increased odds of psychosis in migrants, independently of ethnicity or length of stay in the country of arrival. Public health initiatives that address the social disadvantages that many migrants face during the whole migration process and post-migration psychological support may reduce the excess of psychosis in migrants. [ABSTRACT FROM AUTHOR]

Widespread use of the Internet in 21st century society is not risk-free. This paper studies the comorbidity of some problematic uses of Internet with depression in order to assess their correlation. With that aim, a meta-analysis of 19 samples obtained from 13 different studies (n=33,458) was carried out. The subjects of these studies are adolescents between the ages of 12 and 18 years ([mu]=15.68) from different cultures and continents (Europe, Euro-Asia, America and Asia). The effect size obtained from the use of a random-effects model (r=0.3, p<0.000) is significant, moderate and positive, thus confirming the relation between pathologic uses of the Internet and depression. Moreover, meta-regression test results showed that 9% of the variance (R2=0.09) is associated with the male gender, while age and culture are not significant variables. The variability rate of the studies is high (I2=87.085%), as a consequence of heterogeneity rather than publication bias, as Egger's regression test shows (1-tailed p-value=0.25; 2-tailed p-value=0.50, and [sigma]=1.57). Therefore, the need for specific interventions in secondary education dealing with this issue is evident to ensure that it does not extend into adult life.

Student learning outcomes assessment examines whether programs cover the material stated in their learning goals, whether students are learning the material, and the impact on student retention, graduation, post-graduation outcomes, and institutional accreditation, with the aim of providing faculty with data that can be used to help programs evolve or improve. While there is a plethora of research regarding effective methods of assessment used in the United States, little has been written regarding cross-national comparisons of assessment methodologies. This paper examines the current state of assessment in several nations and regions, and draws parallels in practices across countries. A literature search using the term "outcomes assessment" yielded 228 articles, of which, only 35 described practices outside the United States. Generally, searches on the terms "outcomes assessment" and "global" tend to return studies of outcomes assessment of teaching about global issues as it is practiced in the United States, rather than results about outcomes assessment practices used in other countries.

The aim of the present study was to examine parental experiences of homeschooling during the COVID-19 pandemic in families with or without a child with a mental health condition across Europe. The study included 6720 parents recruited through schools, patient organizations and social media platforms (2002 parents with a child with a mental health condition and 4718 without) from seven European countries: the UK (n = 508), Sweden (n = 1436), Spain (n = 1491), Belgium (n = 508), the Netherlands (n = 324), Germany (n = 1662) and Italy (n = 794). Many parents reported negative effects of homeschooling for themselves and their child, and many found homeschooling to be of poor quality, with insufficient support from schools. In most countries, contact with teachers was limited, leaving parents with primary responsibility for managing homeschooling. Parents also reported increased levels of stress, worry, social isolation, and domestic conflict. A small number of parents reported increased parental alcohol/drug use. Some differences were found between countries and some negative experiences were more common in families with a child with a mental health condition. However, differences between countries and between families with and without a mental health condition were generally small, indicating that many parents across countries reported negative experiences. Some parents also reported positive experiences of homeschooling. The adverse effects of homeschooling will likely have a long-term impact and contribute to increased inequalities. Given that school closures may be less effective than other interventions, policymakers need to carefully consider the negative consequences of homeschooling during additional waves of the COVID-19 pandemic and future pandemics. [ABSTRACT FROM AUTHOR]

Many researchers and practitioners consider ethnic segregation in neighbourhoods or schools detrimental to migrants' acculturation in host societies. Empirically, however, segregation is a 'mixed bag' and its effects depend crucially on the investigated acculturation domain (e.g., negative for language skills, positive for well‐being). As most prior studies have focused on a restricted spectrum of acculturation, a comprehensive assessment within one single study is needed to establish comparability across different acculturation domains. Among over 8000 immigrant‐background students from four countries, we investigated the association of classroom segregation, defined as opportunities for contact with natives and other migrants, with a broad spectrum of acculturation (academic, attitude‐related, identity‐related, social, health‐related, and psychological criteria). Some findings were consistent (e.g., academic acculturation), some were contrary to prior research (e.g., social acculturation). In sum, our results shed light on the 'mixed bag' of segregation and contribute to the understanding of a crucial social issue. [ABSTRACT FROM AUTHOR]

This literature review aims to examine the approach given to open science policy in the different studies. The main findings are that the approach given to open science has different aspects: policy framing and its geopolitical aspects are described as an asymmetries replication and epistemic governance tool. The main geopolitical aspects of open science policies described in the literature are the relations between international, regional, and national policies. There are also different components of open science covered in the literature: open data seems much discussed in the works in the English language, while open access is the main component discussed in the Portuguese and Spanish speaking papers. Finally, the relationship between open science policies and the science policy is framed by highlighting the innovation and transparency that open science can bring into it.

Objectives To measure changes in prevalence and predictors of home smoking bans (HSBs) among smokers in four European countries after the implementation of national smoke-free legislation. Design Two waves of the International Tobacco Control Policy Evaluation Project Europe Surveys, which is a prospective panel study. Pre- and post-legislation data were used from Ireland, France, Germany and the Netherlands. Two pre-legislation waves from the UK were used as control. Participants 4634 respondents from the intervention countries and 1080 from the control country completed both baseline and follow-up and were included in the present analyses. Methods Multiple logistic regression models to identify predictors of having or of adopting a total HSB, and Generalised Estimating Equation models to compare patterns of change after implementation of smoke-free legislation to a control country without such legislation. Results Most smokers had at least partial smoking restrictions in their home, but the proportions varied significantly between countries. After implementation of national smoke-free legislation, the proportion of smokers with a total HSB increased significantly in all four countries. Among continuing smokers, the number of cigarettes smoked per day either remained stable or decreased significantly. Multiple logistic regression models indicated that having a young child in the household and supporting smoking bans in bars were important correlates of having a pre-legislation HSB. Prospective predictors of imposing a HSB between survey waves were planning to quit smoking, supporting a total smoking ban in bars and the birth of a child. Generalised Estimating Equation models indicated that the change in total HSB in the intervention countries was greater than that in the control country. Conclusions The findings suggest that smoke-free legislation does not lead to more smoking in smokers' homes. On the contrary, our findings demonstrate that smoke-free legislation may stimulate smokers to establish total smoking bans in their homes. [ABSTRACT FROM AUTHOR]

This paper examines the right to health care. Various expressions of this right may be distinguished. These include both individual rights and social rights which could be based upon international treaties and constitutional rights. They may be found in national health legislation and, in some cases, in jurisprudence. To analyze the consequences of limiting the right to health care, a framework for judicial review has been developed which encompasses these expressions of the right to health care. The framework was used to examine legal and health policy developments in three Western and two Eastern European countries. In Italy and the Netherlands the right to health care is protected constitutionally (but on differing legal bases) while the United Kingdom does not have a written constitution. In contrast, Hungary and Poland have for many years seen the state take responsible for the provision, administration and allocation of health care services and the right to health care was guaranteed theoretically but not in practice because of the lack of (financial) means. However, the Polish Constitution explicitly anticipates possible limitations of the right to health care. What all these countries have in common is a cost containment perspective where the future will bring even tighter limits on what resources patients may consume. Despite differences in legal structure between these countries, where they seem to converge is on the consequences of putting limitations on the right to health care. The courts in Italy, the Netherlands and the UK have formulated conditions drawn from the acceptance that this right has to be judged within the context of limited resources. It may be concluded that finding a compromise between the right to health care and cost containment policies could also be an issue, Eastern European countries will have to face in the future. [ABSTRACT FROM AUTHOR]

The actions that individuals take to proactively craft their jobs are important to help create more meaningful and personally enriching work experiences. But do these proactive behaviors have implications beyond working life? Inspired by the suggestion that individuals aim for a meaningful life we examine whether on days when individuals craft their jobs, they are more likely to craft non-work activities. It also seems likely that characteristics of the home environment moderate these cross-domain relationships. We suggest that crafting crosses domains particularly when individuals gain resources through high autonomy and high workload at home. We partly supported our model through a daily diary study, in which 139 service sector employees from six European countries (Belgium, Denmark, Germany, Netherlands, Spain, UK) reported their experiences twice a day for five consecutive workdays. Home autonomy and home workload strengthened the positive relationship between seeking resources at work and at home. Moreover, home autonomy strengthened the positive association between seeking challenges at work and at home, and the negative relation between reducing demands at work and at home. These findings suggest that the beneficial implications of job crafting transcend life boundaries thereby providing advice for how individuals can experience greater meaning in their lives. [ABSTRACT FROM AUTHOR]

Purpose: As a component of thyroid hormones, adequate iodine intake is essential during pregnancy for fetal neurodevelopment. Across Europe, iodine deficiency is common in pregnancy, but data are lacking on the predictors of iodine status at this life stage. We, therefore, aimed to explore determinants of iodine status during pregnancy in three European populations of differing iodine status. Methods: Data were from 6566 pregnant women from three prospective population-based birth cohorts from the United Kingdom (ALSPAC, n = 2852), Spain (INMA, n = 1460), and The Netherlands (Generation R, n = 2254). Urinary iodine-to-creatinine ratio (UI/Creat, µg/g) was measured in spot-urine samples in pregnancy (≤ 18-weeks gestation). Maternal dietary intake, categorised by food groups (g/day), was estimated from food-frequency questionnaires (FFQs). Multivariable regression models used dietary variables (energy-adjusted) and maternal characteristics as predictors of iodine status. Results: Median UI/Creat in pregnant women of ALSPAC, INMA, and Generation R was 121, 151, and 210 µg/g, respectively. Maternal age was positively associated with UI/Creat in all cohorts (P < 0.001), while UI/Creat varied by ethnicity only in Generation R (P < 0.05). Of the dietary predictors, intake of milk and dairy products (per 100 g/day) was positively associated with UI/Creat in all cohorts [ALSPAC (B = 3.73, P < 0.0001); INMA (B = 6.92, P = 0.002); Generation R (B = 2.34, P = 0.001)]. Cohort-specific dietary determinants positively associated with UI/Creat included fish and shellfish in ALSPAC and INMA, and eggs and cereal/cereal products in Generation R. Conclusions: The cohort-specific dietary determinants probably reflect not only dietary habits but iodine-fortification policies; hence, public-health interventions to improve iodine intake in pregnancy need to be country-specific. [ABSTRACT FROM AUTHOR]

This article puts contemporary debates about the relationship between immigration policy and the welfare state in historical perspective. Relying on new historical data, the article examines the relationship between immigration policy and social policy in Western Europe in the late 19th and early 20th centuries, when the modern welfare state emerged. Germany already had comparably strict immigration policies when the German Empire introduced the world's first national social insurances in the 1880s. Denmark, another early social-policy adopter, also pursued restrictive immigration policies early on. Almost all other countries in Western Europe started out with more liberal immigration policies than Germany's and Denmark's, but then adopted more restrictive immigration policies and more generous social policies concurrently. There are two exceptions, Belgium and Italy, which are discussed in the article. [ABSTRACT FROM AUTHOR]

Abstract: The aim of this article is to shed light on the nexus between occupational pensions (OPs) and the financialization of pensions in Europe. In particular, we address the following questions: Has the recent evolution of OPs contributed to the financialization of pension policy? Is the nexus between OPs and financialization the result of the increased influence of financial markets in the pension field? Or of a more complex interaction of state, market, and social actors? By comparing Italy, the Netherlands and the United Kingdom, we show financialization is a broad process that affects the three countries, but it has followed three different paths. In Italy, financialization is spreading through individual pension schemes rather than OPs. The Dutch collective OPs are still a central part of the pension systems, but are increasingly influenced by the financial markets. In the United Kingdom, employer‐led OPs are in the hands of the financial services industry. This proves that financialization is a powerful trend, but has to deal with domestic socioeconomic institutions (a country's political economies and pensions institutions) that shape actors' strategies and reforms. Financial actors have an increased role in pension politics, but are involved in complex interactions with the state, employers, and trade unions. [ABSTRACT FROM AUTHOR]

Purpose: After regulatory restrictions for terfenadine and astemizole in '90s, only scarce evidence on proarrhythmic potential of antihistamines has been published. We evaluate the risk of ventricular tachyarrhythmia (VA) related to the use of individual antihistamines. Methods: A matched case-control study nested in a cohort of new users of antihistamines was conducted within the EU-funded ARITMO project. Data on 1997-2010 were retrieved from seven healthcare databases: AARHUS (Denmark), GEPARD (Germany), HSD and ERD (Italy), PHARMO and IPCI (Netherlands) and THIN (UK). Cases of VA were selected and up to 100 controls were matched to each case. The odds ratio (OR) of current use for individual antihistamines (AHs) was estimated using conditional logistic regression. Results: For agents largely used to prevent allergic symptoms, such as cetirizine, levocetirizine, loratadine, desloratadine and fexofenadine, we found no VA risk. A statistically significant, increased risk of VA was found only for current use of cyclizine in the pooled analysis (ORadj, 5.3; 3.6-7.6) and in THIN (ORadj, 5.3; 95% CI, 3.7-7.6), for dimetindene in GEPARD (ORadj, 3.9; 1.1-14.7) and for ebastine in GEPARD (ORadj, 3.3; 1.1-10.8) and PHARMO (ORadj, 4.6; 1.3-16.2). Conclusions: The risk of VA associated with a few specific antihistamines could be ascribable to heterogeneity in pattern of use or in receptor binding profile. [ABSTRACT FROM AUTHOR]

The article presents a study on the impact of multimorbidity on the frequency of participation of older people in Europe in social leisure activities. Topics include the use of data from the European Project on Osteoarthritis (EPOSA), the concept of multimorbidity, and the individual and environmental factors that predict social leisure activity participation among the elderly. It also discusses the continuity theory of Robert Atchley.

Background: Strong primary care systems are believed to have an important role in dealing with healthcare challenges. Strengthening primary care systems is therefore a common policy goal for many countries. This study aims to investigate whether the Netherlands, the UK and Germany have strengthened their primary care systems in 2006-2012. Method: For this cross-sectional study, data from the International Health Policy surveys of the Commonwealth Fund in 2006, 2009 and 2012 were used. The surveys represent the experiences and perspectives of primary care physicians with their primary care system. The changes over time were researched in three areas: organization of primary care processes, use of IT in primary care and use of benchmarking and financial incentives for performance improvement. Results: Regarding organization of primary care processes, in all countries the use of supporting personnel in general practice increased, but at the same time practice accessibility decreased. IT services were most advanced in the UK. The UK and the Netherlands showed increased use of performance feedback information. German GPs were least satisfied with how their system works across the 2006-2012 timeframe. Conclusion: All three countries show trends towards stronger primary care systems, although in different areas. Coordination and comprehensive care through the assignment of assisting personnel and use of disease management programs improved in all countries. In the Netherlands and the UK, informational continuity is in part ensured through better IT services. All countries showed increasing difficulties upholding primary care accessibility. [ABSTRACT FROM AUTHOR]

Treatment of metastatic soft tissue sarcoma ( mSTS) commonly includes multiple lines of chemotherapy, until a decline in performance status precludes further treatment. The primary objective of this study was to describe the lifetime healthcare resource utilisation and cost among mSTS patients with favourable response to chemotherapy. SABINE was a multi-centre ( n = 25), multi-country ( n = 9) retrospective chart review study of mSTS patients with favourable response to chemotherapy following 4 cycles. Healthcare resource utilisation was collected from first line until death or end of follow-up. Costs were analysed by health states (defined by treatment line, chemotherapy use and disease progression) and estimated by multiplying the mean weekly cost per health state by the expected number of weeks spent in each health state. Expected per-patient lifetime medical cost was €65 616 (95% CI: €51 454-€85 003); comprised of IV chemotherapy (31.7%), inpatient care (24.8%), concomitant medication (11.0%), oral chemotherapy (8.9%), outpatient visits (8.8%), radiotherapy (6.3%), hospice (4.0%), imaging (3.7%) and laboratory (0.7%). Weekly costs were 280-330% higher during chemotherapy treatment periods than off-chemotherapy, especially after disease progression. Per-patient costs were highest in the USA and lowest in the Netherlands and UK. The economic burden of mSTS is considerable and the amount of resources devoted to its treatment varies across countries. [ABSTRACT FROM AUTHOR]

Objective To examine (1) the impact of pictorial cigarette warning labels on changes in self-reported warning label responses: warning salience, cognitive responses, forgoing cigarettes and avoiding warnings, and (2) whether these changes differed by smokers' educational level. Methods Longitudinal data of smokers from two survey waves of the International Tobacco Control (ITC) Europe Surveys were used. In France and the UK, pictorial warning labels were implemented on the back of cigarette packages between the two survey waves. In Germany and the Netherlands, the text warning labels did not change. Findings Warning salience decreased between the surveys in France (OR=0.81, p=0.046) and showed a non-significant increase in the UK (OR=1.30, p=0.058), cognitive responses increased in the UK (OR=1.34, p<0.001) and decreased in France (OR=0.70, p=0.002), forgoing cigarettes increased in the UK (OR=1.65, p<0.001) and decreased in France (OR=0.83, p=0.047), and avoiding warnings increased in France (OR=2.93, p<0.001) and the UK (OR=2.19, p<0.001). Warning salience and cognitive responses decreased in Germany and the Netherlands, forgoing did not change in these countries and avoidance increased in Germany. In general, these changes in warning label responses did not differ by education. However, in the UK, avoidance increased especially among low (OR=2.25, p=0.001) and moderate educated smokers (OR=3.21, p<0.001). Conclusions The warning labels implemented in France in 2010 and in the UK in 2008 with pictures on one side of the cigarette package did not succeed in increasing warning salience, but did increase avoidance. The labels did not increase educational inequalities among continuing smokers. [ABSTRACT FROM AUTHOR]

Objectives: The aim of the study was to assess the prevalence of oral contraceptive (OC) use, user characteristics and prescribing patterns by accessing health care databases of three European countries. Methods: A retrospective study was performed from 2009 to 2010 in three general practice (GP) databases from the Netherlands, UK and Italy and in one database of linked pharmacy and hospitalisation data in the Netherlands. The presence of selected chronic conditions and diagnoses of diseases associated with OC use were assessed, as were switches, discontinuations and types of OC used during the study period. Results: Among 2.16 million women aged 15 to 49 years, 16.0% were using an OC on 1 January 2010. The prevalence ranged from 19.7% in a Dutch database to 2.6% in the Italian database. During 2009 and 2010, mainly second-generation progestogens were prescribed in the Netherlands (79.4% and 78.3% of users), both second- (57.9%) and third-generation progestogens (43.6%) were prescribed in the UK, and mainly third-generation progestogens in Italy (61.8%). Most switches were to third- or fourth-generation pills. The prevalence of chronic diseases tended to be higher among OC users, and the proportions of women with a history of disease associated with OC use tended to be lower than among non-users. Conclusions: Second-generation OCs were most frequently prescribed in the Netherlands. In the UK, and even more so in Italy, many women used third- or fourth-generation OCs. Preparation switches were mainly to third- or fourth-generation OCs. Among OC users, a somewhat higher prevalence of chronic diseases was observed; however, information bias cannot be ruled out. 摘 要目的本研究的目的在于通过分析三个欧洲国家多个卫生数据库，评估口服避孕药的应用率、应用者的特征及处方类型。 方法本回顾性研究分析了2009年至2010年荷兰、英国与意大利的三个常规实践（GP）数据库，以及荷兰的一个药店连锁数据库与医院数据库。研究评估了某些与口服避孕药相关的慢性情况与疾病诊断，研究期间口服避孕药非连续性应用且种类多样。 结果研究包含216万名女性，年龄分布在15岁至49岁，其中16.0%的女性在2010年1月1日应用口服避孕药。应用率最高为荷兰数据库（19.7%），最低为意大利数据库（2.6%）。在2009年至2010年期间，荷兰女性主要应用第二代避孕药（分别有79.4%与78.3%的女性），英国女性应用第二代（57.9%）与第三代避孕药（43.6%），意大利女性主要应用第三代避孕药（61.8%）。最多的转换是第三代或第四代避孕药。服用口服避孕药的女性慢性病的发生率有升高的趋势，患有与口服避孕药相关病史的女性比例低于非口服避孕药女性。 结论二代口服避孕药是荷兰女性最常用的类型。在英国与大部分意大利女性，三代与四代口服避孕药应用更多。准备转换主要为三代与四代口服避孕药。在口服避孕药应用者中，观察发现慢性病的发生率更高，但不排除信息存在偏倚。 [ABSTRACT FROM PUBLISHER]

Background: The evidence that inspires and fosters communication skills, teaching programmes and clinical recommendations are often based on national studies which assume, implicitly, that patients' preferences towards doctors' communication style are not significantly affected by their cultural background. The cross-cultural validity of national results has been recognized as a potential limitation on how generally applicable they are in a wider context. Using 35 country-specific focus group discussions from four European countries, the aim of the present study is to test whether or not national cultures influence lay people's preferences towards doctors' style of communication.Methods: Lay people preferences on doctor's communication style have been collected in Belgium, the Netherlands, the United Kingdom and Italy. Each centre organized between eight and nine focus groups, where participants (n = 259) were asked to comment on a video of a simulated medical interview. The discussions were audiotaped, transcribed and coded using a common framework (Guliver Coding System) that allowed for the identification of different themes.Results: The frequency distribution of the topics discussed highlights lay people's generally positive views towards most part of doctors interventions. The regression model applied to the Guliver categories highlighted slight national differences and the existence of a cross-cultural appreciation, in particular, of five types of intervention: Doctors attitudes (both Task-Oriented and Affective/Emotional), Summarizing, Structuring and Providing solution.Conclusion: Lay panels valued doctors' communication style in a similar manner in the countries selected. This highlights the existence of a common background, which in the process of internationalization of heath care, might foster the implementation of cross-national teaching programmes and clinical guidelines. [ABSTRACT FROM AUTHOR]

In the policy period following the Lisbon Strategy of 2000, European governments increasingly regard universities, and the research they produce, as key to enhancing economic performance. With this heightened respect for the value of university-based research, comes an impatience to see returns on the public investments made. We analyze how policy is being used to influence the academic research process through the evaluations and funding allocation that accompany public funding. This paper features examples from the European Union and recent policy developments in two nation states to investigate how policy seeks to enhance the non-academic impacts of academic research.

BackgroundSeveral studies have reported weak associations between religious or spiritual belief and psychological health. However, most have been cross-sectional surveys in the USA, limiting inference about generalizability. An international longitudinal study of incidence of major depression gave us the opportunity to investigate this relationship further.MethodData were collected in a prospective cohort study of adult general practice attendees across seven countries. Participants were followed at 6 and 12 months. Spiritual and religious beliefs were assessed using a standardized questionnaire, and DSM-IV diagnosis of major depression was made using the Composite International Diagnostic Interview (CIDI). Logistic regression was used to estimate incidence rates and odds ratios (ORs), after multiple imputation of missing data.ResultsThe analyses included 8318 attendees. Of participants reporting a spiritual understanding of life at baseline, 10.5% had an episode of depression in the following year compared to 10.3% of religious participants and 7.0% of the secular group (p < 0.001). However, the findings varied significantly across countries, with the difference being significant only in the UK, where spiritual participants were nearly three times more likely to experience an episode of depression than the secular group [OR 2.73, 95% confidence interval (CI) 1.59–4.68]. The strength of belief also had an effect, with participants with strong belief having twice the risk of participants with weak belief. There was no evidence of religion acting as a buffer to prevent depression after a serious life event.ConclusionsThese results do not support the notion that religious and spiritual life views enhance psychological well-being. [ABSTRACT FROM PUBLISHER]

Issue congruence between voters and parties can be achieved if voters and parties follow the party mandate model. A central requirement of this model is that parties fulfil their electoral mandate. This article studies collective party mandate fulfilment by comparing parties’ election manifestos with the parliamentary speeches of their politicians in two countries: a typical consensus democracy, the Netherlands, and a typical majoritarian democracy, the United Kingdom. The central question is whether a difference in collective mandate fulfilment exists between these two types of democracy. Contrary to previous findings, this study finds that such a difference does not exist, at least not with regard to the two countries analysed. This can be explained by the way in which the party mandate is conceptualised. The article also analyses the development of party mandate fulfilment over time and finds no evidence for the idea that collective mandate fulfilment is declining. [ABSTRACT FROM PUBLISHER]

Achterberg and colleagues conclude there is in train a significant change toward deprivatization in Europe. In the late 1990s Christians were more pro public religion in countries where they were least numerous and in the Netherlands in particular there had been an increasing difference in attitudes between believers and nonbelievers over 25 years. Examining more recent survey data on British attitudes (1998 and 2008), we find a firm consensus among the nonreligious against religion having a high public profile, while Christians are more likely to object to antireligion sentiment and people belonging to non-Christian religions are more likely to support public religion. Nonreligious people appear to be no more hostile now than in the late 1990s, and where there has been a decrease in sympathy for public religion it is among religious groups. [ABSTRACT FROM AUTHOR]

To estimate the proportion of nurses in Hungary who intend to change their profession or want to migrate abroad; to compare the proportion of nurses who intend to leave nursing in Hungary and in selected European countries; and to describe factors that predict nurses' intent to work in their current job another year. An exploratory research design with subsequent comparison was used, and a cross-sectional mail survey was implemented. Measures of intent to leave, to work another year as well as indicators of push and pull factors were identified and adopted from a literature review. One thousand nurses were randomly selected and mailed a questionnaire. Comparison was made with the results from the NEXT study. For statistical analyses, linear and logistic regression was used to predict nurses' intention to leave and proportional z-test for making comparisons. Nurses ( n = 754) responded the questionnaire. Approximately half of the sample did not consider changing to another health care job or leaving the profession. Compared with Hungary, the proportion of nurses who intended to leave nursing was significantly lower in Belgium and the Netherlands but was greater or the same in the rest of the European countries. Speaking a foreign language was the most significant predictor of working abroad for Hungarian nurses. Number of shifts, satisfaction with flexible scheduling and managerial support were all relevant predictors of working another year as a nurse. Both the intent to leave nursing and migrating abroad were prevalent issues in Hungary. Working conditions and social/managerial support were key factors identified as strong predictors of stay in the same job for another year. Compared with other European countries, Hungary was not in a worse position in the proportion of nurses wanting to leave nursing. All hospital managers and head nurses should be aware of their role in keeping nurses in the clinical practice and avoid staff nurses migration from the Hungarian health care system. [ABSTRACT FROM AUTHOR]

In 2007, the Dutch state secretary for European affairs lamented the narrow focus on the rules of European integration in the public debate, overshadowing the EU’s impact on citizens’ daily lives. This study compares the amount and type of news about the EU in the British, French and Dutch press during the period 1990—2003. A content analysis of Dutch EU coverage for the years 2004 up to 2006 was subsequently undertaken, which saw key events such as the EU enlargement and referenda on the constitution. The results show how Dutch EU news is notable for its domestic viewpoint until 2003. The prominence of EU news in all three countries seems unrelated to the EU’s growing authority. Besides key events regarding the integration process, the EU appears to rely on crises and rows to draw media attention. Everyday politics remain invisible. [ABSTRACT FROM PUBLISHER]

Atypical forms of employment (part-time work, mini-jobs, fixed-term contracts and solo self-employment) have gained in importance overall in recent years in many European countries. They are often part of an irregular career pattern and carry a high risk of unemployment. In a 6-country comparison (Germany, the United Kingdom, the Netherlands, Italy, Denmark and Poland) we consider whether and in what way national social protection laws cover the various forms of non-standard employment and the specific risks these entail. Significant variations were found in coverage standards and practices between countries as well as substantial variability within countries in their responses to different types of non-standard employment. A need for further and improved coordination of both social legislation and tax law is identified. [ABSTRACT FROM AUTHOR]

Economic thought has often regarded business cycles as asymmetric. This study examines the existence of asymmetries over the business cycle in seven European countries: France, Germany, Ireland, Italy, Luxembourg, The Netherlands and the United Kingdom. To analyse this issue, industrial production in these countries from 1957 to 1998 is examined, and quarterly contractions and expansions in this variable are compared. The results obtained with both parametric and non- parametric methods allow the existence of asymmetries in these countries to be questioned. [ABSTRACT FROM AUTHOR]

Ever since the increase at the beginning of the 1980s unemployment in the European Union has remained high. Now, at the end of the 1990s, it is slowly declining but still averages about 10% of the working population. This poor performance is not shared by every European country, however. In particular, much has been made of the relatively good performance of the Netherlands and Great Britain. It is asked whether the Netherlands and Great Britain really have had such an outstanding labour market performance and if so, why is this the case and what lessons can be drawn for other countries. The strategy is to use recent international comparisons to identify the potential determinants of labour market performance and to investigate in detail to what extent these determinants play a role in the specific labour markets of the Netherlands and Great Britain. In the early 1980s standardized unemployment rates in the Netherlands and Great Britain were well above the European Union (EU) average. By the late 1980s unemployment in both countries had fallen to the EU average and was well below.

This article presents a study which examined how attitudes to maternal employment at different stages of child rearing vary across and within eight nations in the European Union: Great Britain, Germany, Austria, the Netherlands, Sweden, Ireland, Italy and Spain, using data from the 1994 International Social Survey Programme. The prevalence of married women in the labor force undermines the traditional gender division of labor, whereby men are responsible for the public sphere of paid work and women are confined to the private sphere of home life. Increasingly women, even those with small children, are in paid employment. Women are now expected to contribute to the family income, but they are also expected to place family needs first. Based on the results of the study, cohort, education and women's labor force participation all have a marked effect on attitudes to maternal employment, with support for mothers working associated with more recent cohorts, higher education and the labor force participation of women or the wives/partners of men. Women's employment status has a stronger effect on the attitudes of men than of women. One unexpected and interesting finding was the dramatic effect that the labor force participation of women has on women's attitudes to maternal employment in the Netherlands. Austria is the only country where endorsement of maternal employment is consistently suppressed by its relatively conservative gender-role attitudes. Meanwhile, Ireland and Spain are very comparable with Germany in having low support of mothers working when the youngest child is of school age.

Green parties achieved a major breakthrough in the 1989 European elections. Who voted green in these elections? This first comprehensive comparative analysis of the green voter in Europe reveals, that, as expected, green voting is more common among the young, well-educated, and middle class, and green voters also tend to be left-wing, post-materialist and concerned about the environment and arms limitation. But these stereotypical attributes of greenness closely apply to the German and Dutch Greens only: green voters in other countries comply far less, if at all, with this socio-demographic profile. The one pervasive predictor is environmental concern, which is dominant in Britain, France, Belgium and Ireland. It is rather less important in Germany and the Netherlands where post-materialism and a left-wing orientation are more prevalent instead. The basis of green voting is thus rather less narrow than previously thought. The sharper delineation of support for the German Greens has contributed to a relatively stable green vote in the past, but the potential for attracting other sectors of the electorate are clearly very limited. Green parties in most other countries appear to be able to attract votes from a wider spectrum of the population but the commitment of these voters is likely to be far more volatile. [ABSTRACT FROM AUTHOR]

Reports on cases involving environmental law in Europe and Great Britain from September 11, 2003 to December 11, 2003. European Commission's claim that the Netherlands failed to fulfil its obligations concerning the protection waters against pollution; Commission's claim that Great Britain failed to adopt the necessary legislative and administrative provisions on the landfill of waste within two years of entry into force.